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ContinueCARE Hospital at Hendrick Medical Center

Community Health Needs Assessment and Implementation PlanJune 2019

TableofContentsSection 1: Community Health Needs Assessment ................................................................................................................................................... 2

Executive Summary ......................................................................................................................................................................................................... 3

Process and Methodology ............................................................................................................................................................................................... 7

Hospital Biography ........................................................................................................................................................................................................ 12

Study Area ..................................................................................................................................................................................................................... 17

Demographic Overview ................................................................................................................................................................................................. 19

Health Status Overview ................................................................................................................................................................................................. 28

Phone Interview Findings .............................................................................................................................................................................................. 69

Local Community Health Reports ................................................................................................................................................................................. 81

Input Regarding the Hospital’s Previous CHNA ............................................................................................................................................................ 84

Evaluation of Hospital’s Impact ..................................................................................................................................................................................... 86

Previous Prioritized Needs ............................................................................................................................................................................................ 97

2019 Preliminary Health Needs .................................................................................................................................................................................... 99

Prioritization ................................................................................................................................................................................................................ 101

Priorities That Will Not Be Addressed ......................................................................................................................................................................... 106

Resources in the Community ...................................................................................................................................................................................... 108

Information Gaps ........................................................................................................................................................................................................ 127

About CHC ContinueCARE ........................................................................................................................................................................................... 129

Appendix ..................................................................................................................................................................................................................... 131

Summary of Data Sources ................................................................................................................................................................................... 132 Data References .................................................................................................................................................................................................. 135 HPSA and MUA/P Information ............................................................................................................................................................................ 137 Interviewee Information ..................................................................................................................................................................................... 146

Section 2: Implementation Plan ...........................................................................................................................................................................148

Section 3: Feedback, Comments and Paper Copies ..............................................................................................................................................157

Input Regarding the Hospital’s Current CHNA ............................................................................................................................................................ 158

ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment and Implementation Plan CHC ContinueCARE

June 2019 Page 1

Section 1:Community Health Needs Assessment


June 2019 Page 2

Executive Summary

A review of the CHNA process and rationales for the identified health needs


June 2019 Page 3

Executive Summary A comprehensive, six‐step community health needs assessment (“CHNA”) was conducted for ContinueCARE Hospital at Hendrick Medical Center (CCHHMC) by CHC ContinueCARE. This CHNA utilizes relevant health data and stakeholder input to identify the significant community health needs in Taylor County, Texas.

The CHNA Team, consisting of leadership from CCHHMC, met with staff from CHC ContinueCARE on November 13, 2018 to review the research findings and prioritize the community health needs. Five significant community health needs were identified by assessing the prevalence of the issues identified from the health data findings combined with the frequency and severity of mentions in community input.

The CHNA Team participated in a roundtable discussion to rank the community health needs based on three characteristics: size and prevalence of the issue, effectiveness of interventions and the hospital’s capacity to address the need. Once this prioritization process was complete, the hospital leadership discussed the results and decided to address three of the prioritized needs in various capacities through a hospital specific implementation plan.

The final list of prioritized needs is listed below:1. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles2. Access to Affordable Care and Reducing Health Disparities Among Specific Populations 3. Access to Primary Care Services and Providers4. Access to Specialty Care Services and Providers5. Access to Mental and Behavioral Health Care Services and Providers

This implementation plan addresses three of the five needs. "Access to Primary Care Services and Providers" and "Access to Mental and Behavioral Health Care Services and Providers" are not addressed largely due to the fact that they are not core business functions of the hospital and the limited capacity of the hospital to address these need. Therefore, hospital leadership has developed the following implementation plan to identify specific activities and services which directly address the remaining three priorities. The objectives were identified by studying the prioritized health needs, within the context of the hospital’s overall strategic plan and the availability of finite resources. The plan includes a rationale for each priority, followed by objectives, specific implementation activities, responsible leaders, annual updates and progress, and key results (as appropriate).

The CCHHMC Board reviewed and adopted the 2019 Community Health Needs Assessment and Implementation Plan on February 11, 2019.


June 2019 Page 4

Priority #1: Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions andUnhealthy Lifestyles

Data suggests that higher rates of specific mortality causes and unhealthy behaviors warrants a need for increased preventive education and services to improve the health of the community. Heart disease and cancer are the two leading causes of death in Taylor County and the state. Taylor County has higher mortality rates than Texas for diseases of heart; malignant neoplasms; chronic lower respiratory diseases; accidents (unintentional injuries); cerebrovascular diseases; Alzheimer’s disease; diabetes mellitus; chronic liver disease and cirrhosis; intentional self‐harm (suicide); septicemia; prostate cancer; colon and rectum cancer; and lung and bronchus cancer.

Taylor County has a higher rate of communicable diseases such as chlamydia than the state, as well as higher prevalence rates of chronic conditions and unhealthy lifestyle behaviors such as obesity, asthma and tobacco use than the state. With regards to maternal and child health, specifically, Taylor County has higher percentages of mothers smoking during pregnancy, low birth weight births, and teen births than the state. Data also suggests that residents may not be seeking necessary preventive care services, such as sigmoidoscopies and colonoscopies.

Several interviewees noted that there is a need for health education in the community regarding chronic conditions and unhealthy lifestyle behaviors, including obesity, high blood pressure, diabetes, and cardiovascular disease. Childhood obesity was specifically mentioned as a growing problem within the community. It was also emphasized that there is a lack of understanding of the disease process and importance of prevention of chronic conditions among the population, and one interviewee stated: “There is a lack of knowledge in how to navigate the preventative care landscape; they do not see the value in going for preventative care, and that is true even for people with insurance.”

Interviewees also mentioned that there is limited funding available for prevention programs and healthy lifestyle resources, specifically for the low income and uninsured populations in the community. One interviewee stated: “The need to encourage people to diet and exercise…[this] is a community that has challenges with obesity and some of that stems from an economic factor. People are not buying foods for a healthy lifestyle and they are not economically able to support eating right…that leads to an increase in diabetes and cardiovascular disease and a whole bunch of other things.”Priority #2: Access to Affordable Care and Reducing Health Disparities Among Specific Populations

Taylor County has several geographic‐ and population‐based Health Professional Shortage Area designations and census tract‐based Medically Underserved Area/Population designations, as defined by the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA).

Interviewees discussed affordability and cost barriers as concerns that disproportionately affect Medicare, Medicaid and un/underinsured populations in the community. There were several comments raising concern that many providers in the area are no longer accepting Medicare patients and that there is limited access to healthcare services throughout the continuum of care for Medicaid and uninsured patients, which may lead to inappropriate use of the Emergency Room and/or the outmigration of such residents seeking more affordable services outside of Taylor County. One interviewee stated: “[For the uninsured patient], if you need a breast MRI you will be sent to Forth Worth or Lubbock because it is cheaper there.…these patients can’t afford to go out of town.”

It was mentioned that there is a general concern surrounding healthcare funding and the ability of residents to afford healthcare. One interviewee stated: “...there needs to be better career or economic mobility for folks so they can move themselves and their families off of indigent care.”


June 2019 Page 5

Priority #2: Access to Affordable Care and Reducing Health Disparities Among Specific Populations (continued)When asked about which specific groups are at risk for inadequate care, interviewees spoke about pediatric, youth, homeless, low income/working

poor, elderly, non‐English speaking, and veteran populations as being disproportionately challenged by barriers to accessing healthcare services in Taylor County.

With regards to the pediatric population, interviewees mentioned limited access to local counselors, specifically for autism diagnoses; childhood obesity rates; and limited access to local pediatric sub‐specialists as challenges for this particular population. For youth residents, interviewees mentioned higher teen pregnancy rates, issues with recreational drug use, high rates of sexually transmitted infections, and a large homeless population as challenges for the youth community in Taylor County.

When speaking about the homeless population in Taylor County, interviewees raised concern surrounding the lack of local mental health services for such residents. With regards to the low income/working poor population, interviewees mentioned barriers in seeking local, affordable preventive care. For elderly residents, interviewees mentioned issues with providers changing practices and no longer accepting Medicare patients, transportation barriers in accessing healthcare services and follow‐up care, a need for assistance in navigating the healthcare landscape, and an emphasis on the continued focus to address the needs of the large aging population.

With regards to non‐English speaking residents, interviewees noted language barriers and higher teen pregnancy rates within the Hispanic population. Lastly, when discussing challenges for Veteran residents, interviewees noted a lack of local mental health services and difficulty in accessing the VA clinic. Priority #3: Access to Specialty Care Services and Providers

Many interviewees noted the number of patients leaving Taylor County for specific specialty care services such as Oncology, Orthopedics, ENT, and OB/GYN. It was mentioned that local specialty care options are unaffordable for low income and uninsured residents, and one interviewee stated: “We have an issue with [women] who are pregnant and do not have anywhere to go because they do not have any Medicaid...the private doctors will not take them until they have Medicaid.”

Interviewees also mentioned limited GI coverage in the area, as well as limited access to Dermatology and Pediatric sub‐specialty care. A fewinterviewees maintain a perception that there is a need for more specialists who are able to handle high‐risk patients so that those patients do not have to leave the community for care. One interviewee stated: “There are not enough doctors who specialize in high risk patients.”


June 2019 Page 6

A detailed description of the process used to conduct this CHNA, the collaboration between hospital staff and CHC ContinueCARE, and the methods of data collection and analysis

Process and Methodology


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CHNA ProcessBackground & Objectives

• This CHNA is designed in accordance with CHNA requirements identified in the Patient Protection and Affordable Care Act and further addressed in the Internal Revenue Service final regulations released on December 29, 2014.

• The objectives of the CHNA are to:‒ Meet federal government and regulatory requirements‒ Research and report on the demographics and health status of the study area, including a review of state and local data

‒ Gather input, data and opinions from persons who represent the broad interest of the community

‒ Analyze the quantitative and qualitative data gathered and communicate results via a final comprehensive report on the needs of the communities served by CCH at HMC

‒ Prioritize the needs of the community served by the hospital‒ Create an implementation plan that addresses the prioritized needs for the hospital


June 2019 Page 8

CHNA ProcessScope of Report

• The CHNA components include:‒ A description of the process and methods used to conduct this CHNA, including a summary of data sources used

in this report ‒ A biography of CCH at HMC‒ A description of the hospital’s defined study area‒ Definition and analysis of the communities served, including both a demographic and a health data analysis‒ Findings from phone interviews that collected input from people who represent a broad interest in the

community, including:• State, local, tribal or regional governmental public health department (or equivalent department or

agency) with knowledge, information or expertise relevant to the health needs of the community;• Members of a medically underserved, low‐income or minority populations in the community, or

individuals or organizations serving or representing the interests of such populations‒ A description of the progress and/or completion of community benefit activities documented in the previous

implementation plan ‒ The prioritized community needs and separate implementation plan, which intend to address the community

needs identified‒ Documentation and rationalization of priorities not addressed by the implementation plan‒ A description of additional health services and resources available in the community‒ A list of information gaps that impact the hospital’s ability to assess the health needs of the community served


June 2019 Page 9

CHNA ProcessMethodology

CCH at HMC worked with CHC ContinueCARE in the development of its CHNA. CCH at HMC provided essential data and resources necessary to initiate and complete the process, including the definition of the hospital’s study area and the identification of key community stakeholders to be interviewed. CHC ContinueCARE conducted the following research:

• A demographic analysis of the study area, utilizing demographic data from the IBM Watson Health Market Expert tool• A study of the most recent health data available• Conducted one‐on‐one interviews with individuals who have special knowledge of the communities, and analyzed results• Facilitated the prioritization process during the CHNA Team meeting on November 13, 2018. CHNA Team included:

– Billy Blasingame, Chief Executive Officer– Meri Combs, Chief Nursing Officer– Andrew Adamski, Director of Community Relations– Crystal Stepp, Community Liaison– Mindy Holster, Registered Respiratory Therapist – Trisha Kane, Human Resources Coordinator

The methodology for each component of this study is summarized below. In certain cases methodology is elaborated in the body of the report.

• CCH at HMC Biography–Background information about CCH at HMC, including the mission, vision, values, and hospital services was provided by the hospital or taken from its website

• Study Area Definition–The study area for CCH at HMC is based on hospital inpatient discharge data from FY 2018 and discussions with hospital staff

• Demographics of the Study Area–Population demographics include population change by race, ethnicity, age, median household income, unemployment and economicstatistics in the study area–Demographic data sources include, but are not limited to, the IBM Watson Health Market Expert tool, Community Commons, the Annie E. Casey Foundation Kids Count Data Center, the U.S. Census Bureau and the United States Bureau of Labor Statistics


June 2019 Page 10

CHNA ProcessMethodology (continued)

• Health Data Collection Process–A variety of sources, which are all listed in the references section of this report, were utilized in the health data collection process–Health data sources include, but are not limited to, the Centers for Disease Control and Prevention (CDC) WONDER Tool, the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, Community Commons, the Texas Department of Health and Human Services, the Texas Cancer Registry, Small Area Health Insurance Estimates (SAHIE), and the U.S. Census Bureau

• Interview Methodology–CCH at HMC provided CHC ContinueCARE with a list of persons with special knowledge of public health in Taylor County, including public health representatives, not‐for‐profit organization professionals, charities and other individuals who focus specifically on underrepresented groups–From that list, seven in depth interviews were conducted using a structured interview guide–Extensive notes were taken during each interview and then quantified based on responses, communities and populations (minority, elderly, un/underinsured, etc.) served, and priorities identified by respondents. Qualitative data from the interviews was also analyzed and reported.

• Evaluation of Hospital’s Impact–A description of the progress and/or completion of community benefit activities documented in the previous implementation plan –CCH at HMC provided CHC ContinueCARE with a report of community benefit activity progress since the previous community health needs assessment

• Prioritization Strategy–Three significant needs were determined by assessing the prevalence of the issues identified in the health data findings, combined with the frequency and severity of mentions in the interviews–Three factors were used to rank those needs during the CHNA Team meeting on November 13, 2018–See the prioritization section for a more detailed description of the prioritization methodology


June 2019 Page 11

A brief description of the hospital and its services

Hospital Biography


June 2019 Page 12

ContinueCARE Hospital at Hendrick Medical CenterAbout the Hospital

ContinueCARE Hospital at Hendrick Medical Center is a 19‐bed Long Term Acute Care Hospital (LTACH) located on the 7th floor of the Jones Building at Hendrick Medical Center. We enjoy the best of both worlds by having a relationship with a large 364‐bed acute‐care hospital yet maintaining our small hospital atmosphere. Our employees are a dedicated team who work together to deliver the best possible care for our patients. Since we have a longer length of stay, our staff has the opportunity to get to know patients and families. We believe spending quality time makes a difference. And we want to make a difference.

As a “hospital‐within‐a‐hospital,” we are a separate yet fully licensed acute‐care hospital with the ability to provide intensive and complex medical treatment. Our specialty programs are specifically designed to meet the needs of long‐term, acute‐care patients.

Source: ContinueCARE Hospital at Hendrick Medical Center, “Home,” https://continuecare.org/hendrick/; information accessed January 13, 2019.


June 2019 Page 13

ContinueCARE Hospital at Hendrick Medical CenterMission, Vision & Values

Our MissionTo provide high quality, cost‐effective healthcare for the residents of the Big Country who require post‐acute services in an LTACH environment.

Our VisionWe are dedicated to providing care through excellence, compassion and respect.

Our Patient and Customer Service Standards• C – Compassion• C – Care• A – Accountable • R – Respect• E – Empathy

Source: ContinueCARE Hospital at Hendrick Medical Center, “About Us,” https://continuecare.org/hendrick/; information accessed January 13, 2019.


June 2019 Page 14

ContinueCARE Hospital at Hendrick Medical CenterServices

A Long Term Acute Care Hospital (LTACH) serves the needs of patients with medically complex conditions, especially those suffering from multisystem complications and needing extended recovery times – a hospital stay that is often 25 days or more. A patient is usually admitted after a short‐term, acute‐care hospital stay. After care in an LTACH, many patients are then able to transition from the LTACH to acute rehab, skilled nursing or go home. Hospice care is also a post‐acute treatment option for patients with a terminal disease who have a life expectancy of six months or less.As an LTACH, ContinueCARE Hospital at Hendrick Medical Center develops a continuum of care between the acute and long term phases of a patient’s illness.Our innovative and distinctive physician‐driven approach allows us to bring new meaning to the “hospital‐within‐a‐hospital” model. As a separate, fully licensed and staffed hospital, we are able to provide intensive and complex medical treatment to patients requiring longer lengths of stay for acute‐care.We have specialty programs designed to meet the needs of long term, acutely ill patients with conditions including ventilator dependence, respiratory failure, chronic pulmonary problems, complex and severe wounds, and infections requiring long term antibiotic therapy. LTACH facilities also provide physical, occupational, speech and nutritional therapies, as well as pain management.Patients and families are invited to attend our weekly interdisciplinary team conference where patient goals are reviewed each week. Patients and families may also request to meet with the team at a more convenient time.

Source: ContinueCARE Hospital at Hendrick Medical Center, “What is an LTACH?,” http://continuecare.org/Taylor/; information accessed September 19, 2017.


June 2019 Page 15

ContinueCARE Hospital at Hendrick Medical CenterThe ContinueCARE Difference

ContinueCARE Hospital at Hendrick Medical Center is a community‐based not‐for‐profit organization dedicated to serving the needs of our community. We understand finances can hinder your ability to receive the care you or your loved ones require. That is why we offer financial assistance to patients who have an economic need and meet the qualifications of our financial assistance policy. If you need financial assistance, we encourage you to complete an application to see if you qualify.

Please visit https://continuecare.org/hendrick/about/ to download the Financial Assistance Policy, Plain Language Summary and Financial Application and Instructions.

Source: ContinueCARE Hospital at Hendrick Medical Center, “Home,” http://continuecare.org/Taylor/; information accessed September 19, 2017.


June 2019 Page 16

The hospital’s defined service area

Study Area


June 2019 Page 17

ContinueCARE Hospital at Hendrick Medical CenterFY 2018 Patient Origin Map

Taylor County comprises 40.2% of FY 2018 Inpatient Discharges

Indicates the hospital

ContinueCARE Hospital at Hendrick Medical CenterPatient Origin Data: July 2017 ‐ June 2018

County State FY 2018 Discharges

% of Total

Cumulative % of Total

Taylor County TX 80 40.2% 40.2%All Others 119 59.8% 100.0%Total 199 100%

Source: Hospital inpatient discharge data; July 2017 – June 2018.


June 2019 Page 18

A demographic analysis of the community served by ContinueCARE Hospital at Hendrick Medical Center

Demographic Overview


June 2019 Page 19

Demographic StatusOverall Population Growth

4.6%

7.1%

Taylor County Texas

Projected 5‐Year Population Growth 2018‐2023

Overall Population Growth

Geographic Location 2010 2018 2023 2018‐2023 Change

2018‐2023 % Change

Taylor County 131,506 138,165 144,491 6,326 4.6%Texas 25,145,561 28,531,603 30,558,741 2,027,138 7.1%

Source: Truven Health Analytics, Market Expert; data accessed October 17, 2018.


June 2019 Page 20

Demographic StatusPopulation by Race/Ethnicity

White Non‐Hispanic63.2%

Black7.0%

Hispanic24.8%

Asian2.2%

American Indian0.4%

All Others2.3%

Taylor County

White Non‐Hispanic41.8%

Black11.8%

Hispanic39.4%

Asian4.9%

American Indian0.3%

All Others1.7%

Texas Taylor County

Race/Ethnicity 2010 2018 2023 2018‐2023 Change

2018‐2023 % Change

White Non‐Hispanic 88,121 87,299 87,732 433 0.5%Black 9,122 9,729 10,271 542 5.6%Hispanic 29,074 34,334 38,461 4,127 12.0%Asian 2,083 3,046 3,765 719 23.6%American Indian 532 580 621 41 7.1%All Others 2,574 3,177 3,641 464 14.6%Total 131,506 138,165 144,491 6,326 4.6%

Texas

Race/Ethnicity 2010 2018 2023 2018‐2023 Change

2018‐2023 % Change

White Non‐Hispanic 11,397,34511,937,219 12,074,136 136,917 1.1%Black 2,886,825 3,366,121 3,670,767 304,646 9.1%Hispanic 9,460,921 11,236,221 12,416,008 1,179,787 10.5%Asian 966,346 1,404,827 1,705,355 300,528 21.4%American Indian 80,586 93,839 102,061 8,222 8.8%All Others 353,538 493,376 590,414 97,038 19.7%Total 25,145,56128,531,603 30,558,741 2,027,138 7.1%

0.5% 5.6% 12.0%23.6%

7.1%14.6%

1.1%9.1% 10.5%

21.4%8.8%

19.7%

White Non‐Hispanic Black Hispanic Asian American Indian All Others

Race/Ethnicity Projected 5‐Year Growth2018‐2023

Taylor County Texas



June 2019 Page 21

Demographic StatusPopulation by Age Group

<1825.0%

18‐4439.5%

45‐6421.0%

65+14.5%

Taylor County

<1825.9%

18‐4437.6%

45‐6423.9%

65+12.6%

Texas Taylor County

Age Cohort 2018 2023 2018‐2023 Change

2018‐2023 % Change

<18 34,561 36,740 2,179 6.3%18‐44 54,515 56,684 2,169 4.0%45‐64 29,058 28,699 ‐359 ‐1.2%65+ 20,031 22,368 2,337 11.7%Total 138,165 144,491 6,326 4.6%

Texas

Age Cohort 2018 2023 2018‐2023 Change

2018‐2023 % Change

<18 7,386,638 7,667,446 280,808 3.8%18‐44 10,715,955 11,223,420 507,465 4.7%45‐64 6,826,784 7,249,066 422,282 6.2%65+ 3,602,226 4,418,809 816,583 22.7%Total 28,531,603 30,558,741 2,027,138 7.1%

6.3% 4.0%

‐1.2%

11.7%

3.8% 4.7% 6.2%

22.7%

<18 18‐44 45‐64 65+

Age Projected 5‐Year Growth2018‐2023

Taylor County Texas



June 2019 Page 22

Demographic StatusMedian Age

• The median age in Taylor County and the state is expected to increase over the next five years (2018‐2023).

• Taylor County (32.8 years) has a younger median age than Texas (39.2 years) (2018).

33.238.9

32.839.2

33.739.5

Taylor County Texas

Median Age2010 2018 2023



June 2019 Page 23

Demographic StatusMedian Household Income & Unemployment Rates

• The median household income in Taylor County and the state is expected to increase over the next five years (2018‐2023).

• Taylor County ($50,789) has a consistent median household income with Texas ($51,492) (2018).

• Unemployment rates in Taylor County slightly decreased between 2015 and 2017, while rates in the state remained relatively steady.

• In 2017, Taylor County (3.5%) had a lower unemployment rate than the state (4.3%).

Source: Truven Health Analytics, Market Expert; data accessed October 17, 2018.Source: Bureau of Labor Statistics, Local Area Unemployment Statistics, rates shown are a percentage of the labor force; data accessed October 17, 2018.

$50,789 $51,492$55,975 $54,995

Taylor County Texas

Median Household Income2018 2023

3.7% 4.4%3.7% 4.6%3.5% 4.3%

Taylor County Texas

Unemployment Rates2015 2016 2017


June 2019 Page 24

Source: Truven Health Analytics, Market Expert; data accessed October 17, 2018.Source: The Annie E. Casey Foundation, Kids Count Data Center, http://datacenter.kidscount.org/; data accessed October 17, 2018.Children Living Below Poverty Definition: Estimated percentage of related children under age 18 living in families with incomes less than the federal poverty threshold.Note: the 2018 Federal Poverty Guidelines define a household size of 4 as living below 100% of the federal poverty level if the household income is less than $25,100, and less than 200% of the federal poverty level if the household income is less than $50,200. Please see the appendix for the full 2018 Federal Poverty Guidelines.

Demographic StatusFamilies and Children Living in Poverty

• Taylor County (11.2%) has a lower percentage of families living below poverty as compared to the state (12.8%) (2018).

• Between 2014 and 2016, the percent of children (<18 years) living below poverty in Taylor County and the state decreased.

• Taylor County (20.7%) has a lower percentage of children (<18 years) living below poverty than Texas (22.4%) (2016).

11.2% 12.8%

Taylor County Texas

Families Below Poverty2018

Taylor County Texas

21.7% 24.5%21.7% 22.9%20.7% 22.4%

Taylor County Texas

Children in PovertyPercent, Children (<18 years)

2014‐2016

2014 2015 2016


June 2019 Page 25

Demographic StatusEducational Attainment

• Taylor County (23.4%) has a lower percentage of residents with a bachelor or advanced degree than the state (28.1%) (2018).


23.4%28.1%

Taylor County Texas

Education Bachelor / Advanced Degree2018

Taylor County Texas


June 2019 Page 26

Demographic StatusChildren in the Study Area

• The percent of public school students that are eligible for free/reduced price lunch in Taylor County (54.6%) is lower than the state rate (58.9%) and slightly higher than the national (52.6%) rate (2015‐2016).

• In 2015‐2016, the percent of students receiving their high school diploma within four years in Taylor County (91.5%) was slightly higher than the state (90.5%) and national (86.1%) rates.

Note: A green dial indicates that the county has a better rate than the state, and a red dial indicates that the county

has a worse rate than the state.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Definition: receiving a high school diploma within four years.


June 2019 Page 27

An analysis of available health data pertaining to the community served by ContinueCARE Hospital at Hendrick Medical Center

Health Status Overview


June 2019 Page 28

Health StatusData Methodology

• The following information outlines specific health data:– Mortality, chronic diseases and conditions, health behaviors, natality, mental health and healthcare access

• Data Sources include, but are not limited to:– Texas Department of State Health Services– Texas Cancer Registry– Small Area Health Insurance Estimates (SAHIE)– Community Commons– The Behavioral Risk Factor Surveillance System (BRFSS)

• The Behavioral Risk Factor Surveillance System (BRFSS) is the world’s largest, on‐going telephone health survey system, tracking health conditions and risk behaviors in the United States yearly since 1984. Currently, information is collected monthly in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam.

• It is a state‐based system of health surveys that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. For many states, the BRFSS is the only available source of timely, accurate data on health‐related behaviors.

• States use BRFSS data to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. Many states also use BRFSS data to support health‐related legislative efforts.

– The Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute– United States Census Bureau

• Data Levels: Nationwide, state, health service region, BRFSS customized area, and county level data


June 2019 Page 29

Source: Texas Department of State Health Services, Center for Health Statistics; http://www.dshs.state.tx.us/chs/vstat/annrpts.shtm; data accessed August 21, 2018.

Health StatusCounty and Health Service Region Map

County Name

Health Service Region

Taylor 2/3


June 2019 Page 30

Source: Community Commons, Mapping Tool, www.communitycommons.org; data accessed October 29, 2018.

Health StatusBRFSS Study Area Map


June 2019 Page 31

Source: County Health Rankings & Roadmaps; www.countyhealthrankings.org; data accessed October 16, 2018.Note: Please see the appendix for full methodology.

Health StatusCounty Health Rankings

• The County Health Rankings rank 242 counties in Texas (1 being the best, 242 being the worst).

• Various factors go into these rankings. For example:

Health Behaviors:• Adult smoking• Adult obesity• Physical inactivity• Teen births

Clinical Care:• Uninsured• Primary care physicians• Preventable hospital stays

Note: Green represents the best ranking for the county, and red represents the worst ranking.

2018 County Health Rankings

Taylor County

Health Outcomes 154LENGTH OF LIFE 154

QUALITY OF LIFE 145

Health Factors 117HEALTH BEHAVIORS 225

CLINICAL CARE 19

SOCIAL & ECONOMIC FACTORS 97

PHYSICAL ENVIRONMENT 114


June 2019 Page 32

Health StatusMortality – Top 10 Causes of Death

Rank Taylor County Texas

1 Diseases of heart (I00‐I09,I11,I13,I20‐I51)

Diseases of heart (I00‐I09,I11,I13,I20‐I51)

2 Malignant neoplasms (C00‐C97)

Malignant neoplasms (C00‐C97)

3 Chronic lower respiratory diseases (J40‐J47)

Cerebrovascular diseases (I60‐I69)

4 Accidents (unintentional injuries) (V01‐X59,Y85‐Y86)

Chronic lower respiratory diseases (J40‐J47)

5 Cerebrovascular diseases (I60‐I69)

Accidents (unintentional injuries) (V01‐X59,Y85‐Y86)

6 Alzheimer's disease (G30)

Alzheimer's disease (G30)

7 Diabetes mellitus (E10‐E14)

Diabetes mellitus (E10‐E14)

8 Chronic liver disease and cirrhosis (K70,K73‐K74)

Septicemia (A40‐A41)

9 Intentional self‐harm (suicide) (*U03,X60‐X84,Y87.0)

Nephritis, nephrotic syndrome and nephrosis (N00‐N07,N17‐N19,N25‐N27)

10 Septicemia (A40‐A41)

Chronic liver disease and cirrhosis (K70,K73‐K74)

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, http://wonder.cdc.gov/ucd‐icd10.html; data accessed October 26, 2018.Note: Age Adjustment Uses 2000 Standard Population. Rates calculated with small numbers are unreliable and should be used cautiously.


June 2019 Page 33

Health StatusMortality – State/County Comparison

Green indicates that the county’s rate is lower than the state’s rate for that disease category.

Red indicates that the county’s rate is higher than the state’s rate for that disease category.

Disease Taylor County

Texas

Diseases of heart (I00‐I09,I11,I13,I20‐I51) 208.4 170.2Malignant neoplasms (C00‐C97) 166.6 153.4Chronic lower respiratory diseases (J40‐J47) 49.8 41.2Accidents (unintentional injuries) (V01‐X59,Y85‐Y86) 47.3 37.6Cerebrovascular diseases (I60‐I69) 47.1 41.7Alzheimer's disease (G30) 44.2 31.2Diabetes mellitus (E10‐E14) 26.9 21.2Chronic l iver disease and cirrhosis (K70,K73‐K74) 24.3 13.3Intentional self‐harm (suicide) (*U03,X60‐X84,Y87.0) 20.5 12.2Septicemia (A40‐A41) 19.5 16.4



June 2019 Page 34

Health StatusMortality – Overall

• Overall mortality rates in Taylor County remained higher than the state rate between 2012 and 2016.

• Overall mortality rates in Taylor County increased between 2012 and 2016, while rates in the state slightly decreased.

• In 2014‐2016, the overall mortality rate in Taylor County (889.7 per 100,000) was higher than the state (740.2 per 100,000).

876.4

750.0

884.3

747.2

889.7

740.2

0

100

200

300

400

500

600

700

800

900

1,000

Taylor County Texas

Overall MortalityAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS

AGE‐ADJUSTED DEATH RATE

DEATHS


DEATHS


DEATHS


Taylor County 3,806 876.4 3,877 884.3 3,947 889.7 6,508 889.2

Texas 537,282 750.0 552,749 747.2 565,532 740.2 918,902 744.9Source: Centers for Disease Control and Prevention, National Center for Health Statistics, http://wonder.cdc.gov/ucd‐icd10.html; data accessed October 26, 2018.Note: Age Adjustment Uses 2000 Standard Population. Rates calculated with small numbers are unreliable and should be used cautiously.


June 2019 Page 35

Health StatusMortality – Diseases of Heart

• Heart disease is the leading cause of death in both Taylor County and the state (2012‐2016).

• Heart disease mortality rates in Taylor County increased between 2012 and 2016, while rates in the state remained steady.

• In 2014‐2016, the heart disease mortality rate in Taylor County (223.2 per 100,000) was higher than the state (169.7 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 840 190.7 910 204.8 1,006 223.2 1,547 208.4

Texas 120,743 170.6 124,980 170.8 128,549 169.7 207,813 170.2

190.7170.6

204.8

170.8

223.2

169.7

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Diseases of HeartAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 36

Health StatusMortality – Malignant Neoplasms (Cancer)

• Cancer is the second leading cause of death in both Taylor County and the state (2012‐2016).

• Cancer mortality rates in Taylor County and the state decreased between 2012 and 2016.

• In 2014‐2016, the cancer mortality rate in Taylor County (163.0 per 100,000) was higher than the state (150.1 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 730 167.6 718 163.9 728 163.0 1,225 166.6

Texas 115,401 156.6 116,380 152.9 118,163 150.1 194,717 153.4

167.6 156.6163.9 152.9163.0150.1

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Malignant Neoplasms (Cancer)Age‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 37

123.3 111.7

18.7 20.1

Taylor County Texas

Female BreastAge‐adjusted Incidence and Mortality Rates per 100,000

2011‐2015

Incidence Mortality

92.4 95.4

22.7 18.1

Taylor County Texas

ProstateAge‐adjusted Incidence and Mortality Rates per 100,000

2011‐2015

Incidence Mortality

57.3 53.141.5 38.8

Taylor County Texas

Colon and RectumAge‐adjusted Incidence and Mortality Rates per 100,000

2011‐2015

Incidence Mortality

41.7 38.1

16.6 14.4

Taylor County Texas

Lung and BronchusAge‐adjusted Incidence and Mortality Rates per 100,000

2011‐2015

Incidence Mortality

Health StatusMortality – Cancer Incidence & Mortality by Type

Source: Texas Central Cancer Registry, 2011‐2015 Cancer Incidence and Mortality Rates by County for Selected Sites, http://www.cancer‐rates.info/tx/; data accessed October 17, 2018.Note: Age Adjustment Uses 2000 Standard Million Population. All rates per 100,000. A minimum of 156cases are required to calculate a stable age‐adjusted rates. Rates calculated with small numbers are unreliable and should be used cautiously.


June 2019 Page 38

Health StatusMortality – Chronic Lower Respiratory Diseases

• Chronic lower respiratory diseases (CLRD) are the third leading cause of death in Taylor County, and the fourth leading cause of death in the state (2012‐2016).

• CLRD mortality rates in Taylor County remained steady between 2012 and 2016, while rates in the state slightly decreased.

• In 2014‐2016, the CLRD mortality rate in Taylor County (48.3 per 100,000) was higher than the state (40.4 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 215 48.9 208 47.0 217 48.3 369 49.8

Texas 28,992 41.8 29,699 41.4 30,006 40.4 49,330 41.2

48.9 41.847.0 41.448.3 40.4

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Chronic Lower Respiratory DiseasesAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 39

Health StatusMortality – Accidents

• Fatal accidents are the fourth leading cause of death in Taylor County, and the fifth leading cause of death in the state (2012‐2016).

• Accident mortality rates in Taylor County increased between 2012 and 2016, while rates in the state remained steady.

• In 2014‐2016, the accident mortality rate in Taylor County (52.0 per 100,000) was higher than the state (37.8 per 100,000).

• In 2014‐2016, the leading cause of fatal accidents in Taylor County was due to motor vehicle accidents.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, http://wonder.cdc.gov/ucd‐icd10.html; data accessed September 13, 2018. Note: Age Adjustment Uses 2000 Standard Population. "‐" indicates that the numerator is too small for rate calculation. Rates calculated with small numbers are unreliable and should be used cautiously. Accident mortality rates include: motor vehicle crashes, other land transport accidents, water transport accidents, air and space transport accidents, falls, accidental shootings, drownings, fire and smoke exposures, poisonings, suffocations, and all other unintentional injuries.

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 173 42.3 181 45.0 210 52.0 319 47.3

Texas 28,431 37.2 29,094 37.2 30,235 37.8 48,943 37.6

42.3 37.245.0 37.252.0

37.8

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AccidentsAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016


June 2019 Page 40

Health StatusMortality – Cerebrovascular Diseases

• Cerebrovascular diseases are the fifth leading cause of death in Taylor County and the third leading cause of death in the state (2014‐2016).

• Cerebrovascular disease mortality rates in Taylor County decreased between 2012 and 2016, while rates in the state rate slightly increased.

• In 2014‐2016, the cerebrovascular disease mortality rate in Taylor County (41.3 per 100,000) was consistent with the state (42.1 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 226 51.5 206 46.5 188 41.3 351 47.1

Texas 28,486 41.2 29,666 41.5 31,056 42.1 49,644 41.7

51.5 41.246.5 41.541.3 42.1

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Cerebrovascular DiseasesAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 41

Health StatusMortality – Alzheimer’s Disease

• Alzheimer’s disease is the sixth leading cause of death in Taylor County and the state (2012‐2016).

• Alzheimer’s disease mortality rates in Taylor County and the state increased between 2012 and 2016.

• In 2014‐2016, the Alzheimer’s disease mortality rate in Taylor County (46.9 per 100,000) was higher than the state (35.4 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 187 40.7 209 44.8 224 46.9 346 44.2

Texas 17,240 26.4 20,968 31.0 24,810 35.4 35,278 31.2

40.726.4

44.831.0

46.9 35.4

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Alzheimer's DiseaseAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 42

Health StatusMortality – Diabetes Mellitus

• Diabetes mellitus is the seventh leading cause of death in Taylor County and the state (2012‐2016).

• Diabetes mortality rates in Taylor County and the state decreased between 2012 and 2016.

• In 2014‐2016, the diabetes mortality rate in Taylor County (23.3 per 100,000) was slightly higher than the state (20.9 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 125 29.1 119 28.1 99 23.3 191 26.9

Texas 15,757 21.6 16,142 21.4 16,339 20.9 26,748 21.2

29.1 21.628.1 21.423.3 20.9

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Diabetes MellitusAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 43

Health StatusMortality – Chronic Liver Disease and Cirrhosis

• Chronic liver disease and cirrhosis is the eighth leading cause of death in Taylor County, and the tenth leading cause of death in the state (2012‐2016).

• Chronic liver disease and cirrhosis mortality rates in Taylor County and the state slightly increased between 2012 and 2016.

• In 2014‐2016, the chronic liver disease and cirrhosis mortality rate in Taylor County (25.6 per 100,000) was higher than the state (13.6 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 82 21.3 88 23.0 97 25.6 154 24.3

Texas 10,392 13.1 10,936 13.4 11,404 13.6 18,116 13.3

21.3 13.123.0 13.425.6

13.6

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Chronic Liver Disease and CirrhosisAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 44

Health StatusMortality – Intentional Self‐Harm (Suicide)

• Intentional self‐harm (suicide) is the ninth leading cause of death in Taylor County, and is not one of the leading causes of death in the state (2012‐2016).

• Suicide mortality rates in Taylor County fluctuated between 2012 and 2016, while rates in the state rate slightly increased.

• In 2014‐2016, the suicide mortality rate in Taylor County (19.9 per 100,000) was higher than the state (12.4 per 100,000).

LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 73 19.4 61 15.5 74 19.9 127 20.5

Texas 9,350 11.9 9,716 12.1 10,145 12.4 16,241 12.2

19.4 11.915.5 12.119.9 12.4

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Intentional Self‐Harm (Suicide)Age‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016



June 2019 Page 45

Health StatusMortality – Septicemia

• Septicemia is the tenth leading cause of death in Taylor County, and the eighth leading cause of death in the state (2012‐2016).

• Septicemia mortality rates in Taylor County and the state remained relatively steady between 2012 and 2016.

• In 2014‐2016, the septicemia mortality rate in Taylor County (19.6 per 100,000) was slightly higher than the state (16.7 per 100,000).


LOCATION

2012‐2014 2013‐2015 2014‐2016 2012‐2016

DEATHS


DEATHS


DEATHS


DEATHS


Taylor County 88 20.6 97 22.1 87 19.6 143 19.5

Texas 11,630 16.3 12,394 16.8 12,732 16.7 20,241 16.4

20.6 16.322.1 16.819.6 16.7

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SepticemiaAge‐adjusted Death Rates per 100,000

2012‐2016

2012‐2014

2013‐2015

2014‐2016


June 2019 Page 46

Health StatusCommunicable Diseases – Chlamydia, Gonorrhea & HIV

• In 2014, Taylor County (518.2 per 100,000) had a higher chlamydia incidence rate than the state (495.6 per 100,000) and the nation (456.1 per 100,000).

• In 2014, Taylor County (116.3 per 100,000) had a lower gonorrhea infection rate than the state (133.6 per 100,000) and the nation (110.7 per 100,000).

• In 2013, Taylor County (155.2 per 100,000) had a lower HIV prevalence rate than the state (345.8 per 100,000) and the nation (353.2 per 100,000).

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.

Note: A green dial indicates that the county has a better rate than the state, and a red dial indicates that the county has a

worse rate than the state.


June 2019 Page 47

Health StatusChronic Conditions – Diabetes

• In 2013, the percent of adults (age 20+) ever diagnosed with diabetes by a doctor in Taylor County (8.8%) was slightly lower than the state (9.2%) and national (9.2%) rates.

• In 2015, the percentage of Medicare Beneficiaries with diabetes in Taylor County (26.3%) was lower than the state (28.2%) and consistent with the national rate (26.6%).

• In 2016, the CCH at HMC 20‐County Region (19.3%) had a higher percent of adults (age 18+) who had ever been diagnosed with diabetes than Health Service Region (HSR) 2/3 (10.1%) and the state (11.2%).

• Between 2015 and 2017, diabetes prevalence rates in adults (age 18+) in HSR 2/3 and the state remained relatively steady.

Note: A green dial indicates that the county has a better rate than the state, and a red dial indicates that the

county has a worse rate than the state.Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Has a doctor, nurse, or other health professional ever told you that you have diabetes? Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

9.1% 10.2% 11.4%19.3% 10.1% 11.2%‐ 11.0% 11.9%

Taylor Co. 20‐County Region HSR 2/3 Texas

DiabetesPercentage, (Adults age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that have ever been diagnosed with diabetes in the CCH at HMC 20‐County Region could not be calculated in 2017 due to a sample size less than 50 and/or a relative standard error greater than 30.0%.


June 2019 Page 48

Health StatusChronic Conditions – Obesity

• In 2013, the percentage of adults (age 20+) who self‐reported that they have a Body Mass Index (BMI) greater than 30.0 (obese) in Taylor County (30.9%) was higher than the state rate (27.9%) and national rate (27.5%).

• In 2017, the CCH at HMC 20‐County Region (39.6%) had a higher percent of obese adults (age 18+) than HSR 2/3 (31.6%) and the state (33.0%).

• Between 2015 and 2017, obesity prevalence rates in adults (age 18+) in the CCH at HMC 20‐County Region, HSR 2/3 and the state overall increased.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: BMI is (weight in lbs. divided by (height in inches squared)) times 703. Recommended BMI is 18.5 to 24.9 Overweight is 25.0 to 29.9 Obese is => 30.0.Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.


county has a worse rate than the state.

35.3% 30.5% 32.4%38.6% 32.5% 33.6%39.6% 31.6% 33.0%

CCH at HMC 20‐CountyRegion

HSR 2/3 Texas

ObesityPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017


June 2019 Page 49

Health StatusChronic Conditions – Arthritis

• In 2017, the percentage of adults (age 18+) that reported ever being told by a doctor, nurse or other health professional that they had some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia in HSR 2/3 (19.6%) was the second lowest as compared to all other health service regions and the state (21.4%).

• In 2017, the CCH at HMC 20‐County Region (24.0%) had a higher percent of adults (age 18+) ever diagnosed with arthritis than HSR 2/3 (19.6%) and the state (21.4%).

• Between 2015‐2017, arthritis prevalence rates in the CCH at HMC 20‐County region fluctuated, while rates in HSR 2/3 and the state remained relatively steady.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Has a doctor, nurse, or other health professional ever told you that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

29.8%20.8% 20.0%

34.7%21.5% 21.6%24.0% 19.6% 21.4%


HSR 2/3 Texas

ArthritisPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017

21.4% 19.6%26.9% 23.7% 21.7% 21.2% 18.2% 19.7% 21.4%

HSR 1 HSR 2/3 HSR 4/5N HSR 6/5S HSR 7 HSR 8 HSR 9/10 HSR 11 Texas

ArthritisPercentage, Adults (age 18+)

2017


June 2019 Page 50

Health StatusChronic Conditions – Asthma

• The percentage of adults (age 18+) who self‐reported that they have ever been told by a doctor, nurse, or other health professional that they had asthma in Taylor County (11.9%) is consistent with the state rate (11.6%) and lower than the national rate (13.4%) (2011‐2012).

• In 2016, the prevalence rate of adults (age 18+) ever diagnosed with asthma by a doctor, nurse or other health professional in the CCH at HMC 20‐County Region (14.8%) was slightly higher than HSR 2/3 (13.7%) and the state (12.5%).

• Between 2015 and 2017, asthma prevalence rates in HSR 2/3 and the state remained relatively steady.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Has a doctor, nurse, or other health professional ever told you that you had asthma?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.



20.0% 11.5% 12.0%14.8% 13.7% 12.5%‐

13.3% 11.8%


HSR 2/3 Texas

AsthmaPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that have ever been diagnosed with asthma in the CCH at HMC 20‐County Region could not be calculated in 2017 due to a sample size less than 50 and/or a relative standard error greater than 30.0%.


June 2019 Page 51

Health StatusHealth Behaviors – Physical Inactivity

• The percentage of adults (age 20+) who self‐reported no leisure time for physical activity outside of work in Taylor County (22.2%) is consistent with the state rate (22.9%) and the national rate (21.8%) (2013).

• In 2016, the number per 100,000 population of recreation and fitness facilities in Taylor County (11.4) was higher than the state (9.3) and consistent with the national rate (11.0).

• In 2017, the percent of adults (age 18+) that reported no leisure time physical activity in the past month in the CCH at HMC 20‐County Region (41.4%) was higher than the rate in HSR 2/3 (31.4%) and the state (32.1%).

• Between 2015 and 2017, physical inactivity rates in the CCH at HMC 20‐County Region, HSR 2/3, and the state overall increased.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Recreation and Fitness Facility Definition: establishments primarily engaged in operating fitness and recreational sports facilities featuring exercise and other active physical fitness conditioning or recreational sports activities, such as swimming, skating, or racquet sportsSource: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Physical Activity Definition: During the past month, did you participate in any physical activities or exercises such as running, golf, gardening or walking for exercise?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.



38.5%28.1% 29.5%32.6%

23.7% 25.2%41.4%

31.4% 32.1%

CCH at HMC 20‐County Region HSR 2/3 Texas

Physical InactivityPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017


June 2019 Page 52

Health StatusHealth Behaviors – Binge Drinking

• In 2017, the percent of adults (age 18+) who were at risk of binge drinking in HSR 2/3 (16.6%) was consistent with all other health service regions and the state (17.8%).

• In 2017, the binge drinking prevalence rate in the CCH at HMC 20‐County Region (24.5%) was higher than HSR 2/3 (16.6%) and the state (17.8%).

• Between 2015 and 2017, binge drinking prevalence rates in HSR 2/3 remained relatively stable while rates in the state overall increased.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: During the past 30 days, what is the largest number of drinks you had on any occasion? Respondents are classified as “at risk” for binge drinking if males reported consuming 5 or more and females reported consuming 4 or more alcoholic beverages at one time. Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

13.1% 16.6% 11.4%18.0% 21.1% 18.7% 20.7% 18.3% 17.8%


Binge DrinkingPercentage At Risk, Adults (age 18+)

2017

17.6% 16.5% 15.9%‐

17.1% 17.9%24.5% 16.6% 17.8%


HSR 2/3 Texas

Binge DrinkingPercentage At Risk, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that are at risk of binge drinking in the CCH at HMC 20‐County Region could not be calculated in 2016 due to a sample size less than 50 and/or a

relative standard error greater than 30.0%.


June 2019 Page 53

Health StatusHealth Behaviors – Smoking

• The percentage of adults (age 18+) who self‐reported currently smoking cigarettes some days or every day in Taylor County (21.2%) is higher than the state rate (16.5%) and slightly higher than the national rate (18.1%) (2006‐2012).

• In 2016, the percentage of adults (age 18+) that reported smoking every day in the CCH at HMC 20‐County Region (30.7%) was higher than HSR 2/3 (22.5%) and the state (22.7%).

• Between 2015 and 2017, the percentage of everyday smokers in HSR 2/3 and the state fluctuated.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Frequency of Smoking Definition: Do you now smoke cigarettes every day, some days, or not at all? (Respondents that reported smoking ‘Every Day’ are included in this chart)Note: smoking refers to cigarettes, and does not include electronic cigarettes (e‐cigarettes, NJOY, Bluetip), herbal cigarettes, cigars, cigarillos, little cigars, pipes, bidis, kreteks, water pipes (hookahs), marijuana, chewing tobacco, snuff, or snus.Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.



40.2%25.7% 25.9%30.7% 22.5% 22.7%

‐

27.1% 26.2%


HSR 2/3 Texas

Smoking Frequency ‐ Every DayPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that are currently smoking every day in the CCH at HMC 20‐County Region could not be calculated in 2017 due to a sample

size less than 50 and/or a relative standard error greater than 30.0%.


June 2019 Page 54

Health StatusHealth Behaviors – E‐Cigarette Use

• The percentage of adults (age 18+) who self‐reported ever using an e‐cigarette in HSR 2/3 (20.0%) is consistent with all other health service regions and the state (20.8%) (2017).

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Have you ever used an e‐cigarette or other electronic vaping product, even just one time, in your entire life?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

18.3% 20.0%29.0%

19.3% 23.4% 23.3% 19.5% 20.5% 20.8%


E‐Cigarette Use ‐ EverPercentage, Adults (age 18+)

2017


June 2019 Page 55

Health StatusNatality – Maternal and Child Health Indicators

Source: Texas Department of State Health Services, Texas Health Data, Birth Outcomes report filtered for Taylor County, TX; http://healthdata.dshs.texas.gov/VitalStatistics/Birth; data accessed September 26, 2018. Note: percentages are crude rates based on number of specific indicator‐related cases divided by total births. Rates are not calculated if number of cases are too low for statistical reliability.

1.7%4.7%

Taylor County Texas

No Prenatal CarePercent of All Births

2015

9.7%

3.6%

Taylor County Texas

Smoking During PregnancyPercent of All Births

2015

9.2% 8.2%

Taylor County Texas

Low Birth Weight (<2,500g)Percent of All Births

2015

9.8%8.2%

Taylor County Texas

Teen Births (age 0‐19)Percent of All Births

2015


June 2019 Page 56

Health StatusMental Health – Depressive Disorders

• The percentage of the Medicare fee‐for‐service population with depression in Taylor County (19.6%) is higher than the state rate (17.0%) and the national rate (16.7%) (2015).

• In 2017, the percent of adults (age 18+) ever diagnosed with a depressive disorder in the CCH at HMC 20‐County Region (23.1%) was higher than HSR 2/3 (15.9%) and the state (16.7%).

• Between 2015 and 2017, depression prevalence rates in the CCH at HMC 20‐County Region, HSR 2/3 and the state fluctuated.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Has a doctor, nurse, or other health professional ever told you that you have a depressive disorder including depression, major depression, dysthymia, or minor depression?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.



21.3% 16.7% 16.1%10.9% 12.5% 12.5%23.1% 15.9% 16.7%


HSR 2/3 Texas

Depressive DisordersPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017


June 2019 Page 57

Health StatusMental Health – 14+ Days of Poor Mental Health

• In 2017, HSR 2/3 (10.4%) had the second lowest rate of adults (age 18+) that reported experiencing 14 or more days of poor mental health as compared to all other health service regions and the state (11.8%).

• In 2015, the CCH at HMC 20‐County Region (12.4%) had a higher percent of adults (age 18+) that reported experiencing 14 or more days of poor mental health than HSR 2/3 (8.4%) and the state (10.0%).

• Between 2015 and 2017, the percent of adults (age 18+) that reported experiencing 14 or more days of poor mental health in HSR 2/3 and the state steadily increased.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Days mental health not good ‐ 14 daysNote: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

15.4% 10.4% 9.7% 12.1% 12.3% 13.6% 11.5% 12.2% 11.8%

HSR 1 HSR 2/3 HSR 4/5NHSR 6/5S HSR 7 HSR 8 HSR 9/10 HSR 11 Texas

Days of Poor Mental Health ‐ 14+Percentage, Adults (age 18+)

2017

12.4% 8.4% 10.0%‐

8.6% 10.6%‐

10.4% 11.8%


HSR 2/3 Texas

Days of Poor Mental Health ‐ 14+Percentage, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that reported experiencing 14+ days of poor mental health in the CCH at HMC 20‐County Region could not be calculated in 2016 or 2017 due to a

sample size less than 50 and/or a relative standard error greater than 30.0%.


June 2019 Page 58

Health StatusPreventative Care ‐ Mammography

• The percentage of female Medicare enrollees (age 67‐69) who have received one or more mammograms in the past two years in Taylor County (59.1%) is slightly higher than the state rate (57.9%) and slightly lower than the national rate (63.1%) (2014).

• In 2016, the percent of female adults (age 40+) in HSR 2/3 (65.8%) that reported receiving a mammogram in the past 2 years was consistent with all other health service regions and the state (66.4%).

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Females 40 years and older who had a mammogram within the past 2 yearsNote: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

Note: a green dial indicates that the county has a better rate than the state, and a red dial indicates that the county has a worse rate than the state.

68.9% 65.8% 63.2% 67.2% 70.6% 68.8% 65.6% 63.3% 66.4%


Mammogram in Past 2 YearsPercentage, Female Adults (age 40+)

2016


June 2019 Page 59

Health StatusPreventative Care – Sigmoidoscopy & Colonoscopy

• The percent of adults (age 50+) who self‐reported that they have ever had a sigmoidoscopy or colonoscopy in Taylor County (53.9%) is lower than the state rate (57.3%) and the national rate (61.3%) (2006‐2012).

• In 2016, the percent of adults (age 50‐75) that reported not receiving a colonoscopy in the past 10 years in HSR 2/3 (40.6%) was the second lowest as compared to all other health service regions and the state (43.9%).

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Males and females 50‐75 years who have not had a colonoscopy in the past 10 years ‐ Used to calculate CRCREC.Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

Note: a green dial indicates that the county has a better rate than the state, and a red dial indicates that the county has a worse rate than the state.

42.1% 40.6% 41.2% 47.7%35.2%

43.0%52.3% 51.7%

43.9%


No Colonoscopy in Past 10 YearsPercentage, Adults (age 50‐75)

2016


June 2019 Page 60

Health StatusPreventative Care – Influenza Vaccination (18‐64 Years)

• In 2017, the percent of adults (age 18‐64) in HSR 2/3 (67.4%) that did not receive a flu shot in the past year was consistent with all other health service regions and the state (68.2%).

• In 2017, the CCH at HMC 20‐County Region (74.7%) had a higher percentage of adults (age 18‐64) that did not receive a flu shot than HSR 2/3 (67.4%) and the state (68.2%).

• Between 2015 and 2017, the percent of adults (age 18‐64) that did not receive a flu shot in the CCH at HMC 20‐County Region, HSR 2/3 and the state increased.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: During the past 12 months, have you had either a seasonal flu shot or a seasonal flu vaccine that was sprayed in your nose? *ADULTS AGE 18‐64 YEARS*Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

64.3% 67.4%74.0%

66.8% 64.6%72.3% 69.4% 73.0% 68.2%


No Flu Shot in the Past YearPercentage, Adults (age 18‐64)

2017

59.9% 59.3% 61.7%71.6%

62.0% 66.9%74.7%

67.4% 68.2%


HSR 2/3 Texas

No Flu Shot in the Past YearPercentage, Adults (age 18‐64)

2015‐2017

2015 2016 2017


June 2019 Page 61

Health StatusPreventative Care – Influenza Vaccination (65+ Years)

• In 2017, the percent of adults (age 18‐64) in HSR 2/3 (45.0%) that did not receive a flu shot in the past year was the third highest as compared to all other health service regions and the state (40.6%).

• In 2015, the CCH at HMC 20‐County Region (25.6%) had a lower percentage of adults (age 18‐64) that did not receive a flu shot than HSR 2/3 (32.6%) and the state (33.8%).

• Between 2015 and 2017, the percent of adults (age 18‐64) that did not receive a flu shot in HSR 2/3 and the state increased.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: During the past 12 months, have you had either a seasonal flu shot or a seasonal flu vaccine that was sprayed in your nose? *ADULTS AGE 18‐64 YEARS*Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

‐

45.0% 50.0%38.0% 40.8%

29.9%

51.1%36.3% 40.6%


No Flu Shot in the Past YearPercentage, Adults (age 65+)

2017

Note: the percentage of adults (age 65+) that did not receive a flu shot in the past year in HSR 1 could not be calculated in 2017 due to a sample size less than 50 and/or a relative standard error greater than 30.0%.

Note: the percentage of adults (age 65+) that did not receive a flu shot in the past year in the CCH at HMC 20‐County Region could not be calculated in 2016 and 2017 due to a sample size less than 50

and/or a relative standard error greater than 30.0%.

25.6% 32.6% 33.8%

‐

43.1% 42.7%

‐

45.0% 40.6%


HSR 2/3 Texas

No Flu Shot in the Past YearPercentage, Adults (age 65+)

2015‐2017

2015 2016 2017


June 2019 Page 62

Health StatusPreventative Care – Pneumococcal Vaccination (65+ Years)

• In 2017, the percentage of older adults (age 65+) who self‐reported they have never received a pneumonia vaccine in HSR 2/3 (23.1%) is the second lowest as compared to all other health service regions and the state (25.8%).

• In 2015, the percent of adults (age 65+) that reported that they have never received a pneumonia shot in the CCH at HMC 20‐County Region (13.8%) was lower than HSR 2/3 (27.7%) and the state (29.1%).

• Between 2015 and 2017, the percent of adults (age 65+) that had never received a pneumonia shot in HSR 2/3 and the state overall decreased.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Have you ever had a pneumonia shot? *ADULTS AGE 65+ YEARS*Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

‐

23.1% 26.6% 29.7% 25.5% 22.7%

‐

28.6% 25.8%


No Pneumonia ShotPercentage, Adults (age 65+)

2017

Note: the percentage of adults (age 65+) that have never received a pneumonia shot in HSR 1 and HSR 9/10 could not be calculated in 2017 due to a sample size less than 50 and/or a relative standard error greater

than 30.0%.

Note: the percentage of adults (age 65+) that have never received a pneumonia shot in the CCH at HMC 20‐County Region could not be calculated in 2016 and 2017 due to a sample size less than 50

and/or a relative standard error greater than 30.0%.

13.8%27.7% 29.1%

‐

30.4% 28.7%

‐

23.1% 25.8%


HSR 2/3 Texas

No Pneumonia ShotPercentage, Adults (age 65+)

2015‐2017

2015 2016 2017


June 2019 Page 63

Source: United States Census Bureau, Small Area Health Insurance Estimates filtered for Taylor County, TX, https://www.census.gov/data‐tools/demo/sahie/#/; data accessed September 24, 2018.

Health StatusHealth Care Access ‐ Uninsured

• As of 2016, Taylor County (19.9%) has a lower rate of uninsured adults (age 18‐64) as compared to the state (22.6%).

• Taylor County and the state experienced consistent declines in the percentage of uninsured adults (age 18‐64) between 2014 and 2016 (2.8% and 3.2%, respectively).

22.7%25.8%

19.5%

23.3%19.9%

22.6%

2.8% 3.2%

Taylor County Texas

UninsuredPercent, Adults (age 18‐64)

2014‐2016

2014 2015 2016 2014‐2016 % Change


June 2019 Page 64

Health StatusHealth Care Access – Medical Cost Barrier

• In 2017, the percent of adults (age 18+) that reported experiencing a medical cost barrier in the past 12 months in HSR 2/3 (17.0%) was the second lowest as compared to all other health service regions and the state (19.6%).

• In 2016, the percent of adults (age 18+) that reported experiencing a medical cost barrier in the past 12 months in the CCH at HMC 20‐County Region (18.7%) was higher than HSR 2/3 (15.6%) and the state (17.9%).

• Between 2015 and 2017, the percent of adults (age 18+) that needed medical care but could not receive it due to cost increased in HSR 2/3, and decreased in the state.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Was there a time in the past 12 months when you needed to see a doctor but could not because of the cost?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

22.1% 17.0%24.1% 21.9%

14.0%19.9% 19.8%

25.3%19.6%


Medical Cost BarrierPercentage, Adults (age 18+)

2017

17.9% 16.2%33.3%

18.7% 15.6% 17.9%

‐17.0% 19.6%


HSR 2/3 Texas

Medical Cost BarrierPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that experienced a medical cost barrier in the CCH at HMC 20‐County Region could not be calculated in 2017 due to a sample size less than 50 and/or a relative

standard error greater than 30.0%.


June 2019 Page 65

Health StatusHealth Care Access – Personal Doctor

• In 2017, HSR 2/3 (28.1%) had a consistent percent of adults (age 18+) that had no personal doctor as compared to most other health service regions and the state (32.2%).

• In 2016, the CCH at HMC 20‐County Region (32.2%) had a higher percent of adults (age 18+) that had no personal doctor than HSR 2/3 (28.6%) and the state (31.1%).

• Between 2015 and 2017, the percent of adults (age 18+) in HSR 2/3 decreased, while rates in the state remained steady.

Source: Texas Behavioral Risk Factor Surveillance System, Center for Health Statistics, Texas Department of State Health Services; data accessed September 10, 2018.Definition: Do you have one person you think of as your personal doctor or health care provider?Note: “‐” indicates a rate could not be calculated. Rates for sample sizes less than 50 or that yield a relative standard error greater than 30.0% are unreliable and will not be provided.

29.3% 28.1% 29.6% 31.1% 28.4%34.9%

46.7%36.8% 32.2%


No Personal DoctorPercentage, Adults (age 18+)

2017

24.6% 31.1% 33.3%32.2% 28.6% 31.1%

‐

28.1% 32.2%


HSR 2/3 Texas

No Personal DoctorPercentage, Adults (age 18+)

2015‐2017

2015 2016 2017

Note: the percentage of adults (age 18+) that do not have a personal doctor in the CCH at HMC 20‐County Region could not be calculated in 2017 due to a sample size less than 50 and/or a relative

standard error greater than 30.0%.


June 2019 Page 66

Health StatusHealth Care Access – Provider Access

• The number of primary care providers per 100,000 population in Taylor County (69.6 per 100,000) is consistent with the state rate (68.7 per 100,000) and lower than the national rate (87.8 per 100,000) (2014).

• The number of dentists per 100,000 population in Taylor County (74.2 per 100,000) is higher than the state rate (54.1 per 100,000) and the national rate (65.6 per 100,000) (2015).

• The rate of the population to the number of mental health providers in Taylor County (140.5 per 100,000) is higher than the state (102.3 per 100,000) and lower than the national rate (202.8 per 100,000) (2018).

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Definition: Doctors classified as "primary care physicians" by the AMA include: General Family Medicine MDs and DOs, General Practice MDs and DOs, General Internal Medicine MDs and General Pediatrics MDs. Physicians age 75 and over and physicians practicing sub‐specialties within the listed specialties are excluded.Definition: All dentists ‐ qualified as having a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), who are licensed by the state to practice dentistry and who are practicing within the scope of that license.Definition: Psychiatrists, psychologists, clinical social workers, and counselors that specialize in mental health care.




June 2019 Page 67

Cost of health care may delay or inhibit patients from seeking preventative care.

In 2012‐2016, the percentage of the population with insurance enrolled in Medicaid (or other means‐tested public health insurance) in Taylor County (21.6%) was consistent with the state (21.5%) and national rates (21.6%).

Lack of accessible and available primary care resources for patients to access may lead to increased preventable hospitalizations.

In 2014, the rate of preventable hospital events in Taylor County (41.0 per 1,000 Medicare Enrollees) was lower than that of the state (54.3 per 1,000 Medicare Enrollees) and the nation (49.9 per 1,000 Medicare Enrollees).

Lack of transportation is frequently noted as a potential barrier to accessing and receiving care.

Between 2012 and 2016, 5.4% of households in Taylor County had no motor vehicle, as compared to 5.6% in Texas and 9.0% in the nation.

Source: Community Commons, Health Indicator Report: logged in and filtered for Taylor County, TX, www.communitycommons.org; data accessed October 29, 2018.Definition: Ambulatory Care Sensitive (ACS) conditions include pneumonia, dehydration, asthma, diabetes, and other conditions which could have been prevented if adequate primary care resources were available and accessed by those patients.

Health StatusHealth Care Access – Common Barriers to Care




June 2019 Page 68

A review of the community input collected from persons with expert knowledge of public health in the community served by ContinueCARE Hospital at Hendrick Medical Center

Phone Interview Findings


June 2019 Page 69

Overview

• Conducted 7 interviews with the two groups outlined in Internal Revenue Service Final Regulations issued December 29, 2014

• Discussed the health needs of the community, access issues, barriers and issues related to specific populations

• Gathered background information on each interviewee

Source: ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment Interviews Conducted by CHC ContinueCARE, August 15, 2018– August 30, 2018.


June 2019 Page 70

Interviewee Information

Katie Alford: President/CEO, Community Foundation of Abilene

Dr. Cathy Ashby: President & CEO, Abilene United Way

Brian Bessent: Vice President, Hendrick Health System

Annette Lerma: Interim Health Services Director, Taylor County Health Department

Crystal Martin: Program Manager, West Central Texas Council of Governments ‐ Area

Agency on Aging

Dr. Peter Norton: Medical Director, Taylor County Health Department

Doug Peters: President & CEO, Abilene Chamber of Commerce



June 2019 Page 71

Interviewee Characteristics

•Work for a state, local, tribal or regional governmental public health department (or equivalent department or agency) with knowledge, information or expertise relevant to the health needs of the community

28.6%

•Member of a medically underserved, low‐income or minority populations in the community, or individuals or organizations serving or representing the interests of such populations

71.4%



June 2019 Page 72

Community Need Summary• Interviewees discussed the following as the most significant health

issues:— Access to Primary Care— Access to Mental Health Services — Access to Dental Services— Access to Specialty Services— Insurance Coverage & Affordability of Care— Community Education & Preventative Care



June 2019 Page 73

Access to Primary Care• Issues:

Limited availability of Primary Care Providers Limited local providers who take Medicare/

Medicaid Difficulty finding PCPs taking new patients Aging practices Changing practices of PCPs in the area and

moving to concierge‐style medicine New providers leaving after a few years Transportation barriers, particularly for the

elderly and low income population Limited number of bilingual providers

• Needs: Attract native residents in the medical field

to return home Appropriate succession planning for

potential retirements Providers that accept all insurance types Continued efforts to provide translators in

the clinic setting

“There are no primary care physicians available in Abilene.”

“The biggest barrier we see is Medicare doctors not accepting Medicare.”

“Access to doctors who are accepting new Medicare patients [is an issue]...”

“We have done a lot of recruiting for Primary Care physicians…but we have seen more of the established practices in town changing their practices ‐some are no longer accepting patients, some are no longer accepting

Medicaid patients. We have seen a larger amount [of providers] in the past year to 24 months who have stopped seeing patients in the hospital.”

“We have some aging doctors who will be passing on their practice in the next several years.”

“We’ve seen more [PCPs] go to a concierge style of medicine or limiting what type of practices they have.”

“We are seeing concierge medicine, [and] they don’t bill certain insurances.”

“Our only issue [with primary care access] is transportation. We have a clinic for those without insurance and they don't have reliable

transportation to get there.”

“To have primary care physicians who can speak multiple languages would be great…I am not sure we are meeting all our language issues.”



June 2019 Page 74

Access to Mental Health Services• Issues:

Lack of mental and/or behavioral health facilities, resources and services

Limited options for low income, uninsured and veteran populations

Lack of primary prevention tactics for residents requiring mental and/or behavioral health services

Mental health providers leaving the community after a short time

Patients traveling outside the community for psych evaluations, specifically the pediatric population for an autism diagnosis

Increasing prevalence of mental ailments for youth including substance abuse (alcohol, recreational drugs)

• Needs: Increased access to local mental and behavioral services,

specifically for un/underinsured, veterans and youth residents

Attract native resident in the mental and behavioral health field to return home

Increased emphasis on need for primary prevention for mental/behavioral health

“...we don't have access to counseling services…[including services for] serious mental health needs that may need medication or a hospital setting. We don't have anything preventative because we don't have

enough mental health counselors.”

“Mental health is urgent and it isn’t going away.”

“We have no indigent mental health. Anyone that has been incarcerated and does not qualify for a bed in Abilene has to be transported

elsewhere.”

“We have a critical shortage of [mental health] options for people.”

“If we can address the mental health of children while they are young, [we] can probably prevent things that are going on in adults.”

“We can’t track down [mental health] professionals that would stay here long term to provide the care the community needs.”

“We have one facility, the Betty Hardwick Center, and it is state funded…there is a huge waiting list.”

“Autism diagnosis and autism services…I hear parents saying they have to go out of town for a diagnosis.”

“Our biggest unmet needs in Taylor County are services related to mental health, services related to drug addiction, and services related to

autism.”Source: ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment Interviews Conducted by CHC ContinueCARE, August 15, 2018– August 30, 2018.


June 2019 Page 75

Access to Dental Services• Issues:

Limited number of dentists in the community accepting Medicaid/Medicare

Aging practices/providers who accept un/underinsured patients

Long wait times for indigent dental services Lack of affordable dental care, routine and

specialty Limited preventative dental services for the

un/underinsured population• Needs:

Increased access to and availability of local dental care providers that accept Medicaid, Medicare, and uninsured

Appropriate succession planning for potential retirements

Emphasis on the needs of underserved residents, low income and uninsured

“…we are not limited in numbers [for dental services]. I think it is going to come down to those who have payer sources.”

“We could do better [with dental services]. Those who are economically and socially disadvantaged don’t have the same

access.”

“There is one place in town that offers dental care for [the indigent population] and his wait list is 3 months…he is basically just doing

extractions because he does not have time for any sort of preventative care. Our biggest concern is that the dentist is way past

retirement and they cannot find a replacement.”

“There are patients who have funding, but they can’t afford it…others might have insurance but it still [is expensive] to access it and some folks may be better without insurance because they can’t afford the

copays.”

“[Dental services] are not adequate…there are facilities, but they are expensive. Medicare does not pay for it…we have funding on the AAA

side to help with help maintenance, but it is for one year.”

“It is not just that dentures are expensive, but they have to be replaced so often and that is a big issue that we see.”



June 2019 Page 76

Access to Specialty Services• Issues:

Patients leaving the area for specialty care services such as Oncology, Orthopedics, ENT, Ob/GYN (Medicaid)

Affordability of specialty care for low income/uninsured population

Limited GI coverage Limited access to dermatology care,

pediatric specialists Perceived need for more specialists

providing care for high risk patients• Needs:

Increased access to and availability of local specialty providers that accept Medicaid, uninsured

Improved coverage within Oncology, Orthopedics, ENT, Ob/GYN specialists

Promote local specialty care services within the community to keep patients at home for specialized care

“Patients are referred out [for] GYN/ONC to Lubbock, Forth Worth...”

“...specialists have a hard time in Abilene because people [are] going outside [of the county] for second opinions.”

“When people need a specialist a lot people go to Dallas.”

“We have an issue with [women] who are pregnant and do not have anywhere to go because they do not have any Medicaid...the private doctors

will not take them until they have Medicaid.”

“Our biggest area of improvement is GI. We do not have full coverage for call.”

“We have also struggled with child healthcare specialists. We have worked with Ft. Worth…that age group for specialists can be a struggle.”

“...we are well established with all of the specialty providers with the exception of Dermatology.”

“There are not enough doctors who specialize in high risk patients.”

“I have several friends who have been diagnosed with cancer and they are traveling to the Metroplex to get care because they do not have anyone here

who can help them adequately.”

“[Cancer patients] are traveling to the Metroplex to get care because they do not have anyone here who can help them.”



June 2019 Page 77

Insurance Coverage & Affordability of Care• Issues:

Lack of affordable preventative services for Medicare, Medicaid and un/underinsured populations

Several providers no longer accepting Medicare patients

Limited access to healthcare services throughout the continuum of care for Medicaid and uninsured patients

Overuse of ER for non‐emergent issues Outmigration of patients seeking more affordable

services General concern for healthcare funding

• Needs: Greater number of local preventative and primary

care options for all payer types Emphasis on the needs of low income and elderly

residents Continued education regarding when to use the

Emergency Room vs. a Primary Care Provider Opportunities for economic mobility

“Insurance is just not affordable. It continues to be more expensive.”

“There are patients who have funding, but they can’t afford [healthcare]…some folks may be better without insurance because

they can’t afford the copays.”

“We have no indigent care. That is the glaring need right now.”

“With the elderly population, there are still many that struggle financially despite having Medicare.”

“We do have all the levels of post‐acute care at Hendrick, but Medicaid does not cover those services.”

“We have a lot of wrong utilization of patients coming into service points of the hospital when they could have been taken care of in a preventative care setting…Most of that is due to people not having

insurance.”

“[For the uninsured patient], if you need a breast MRI you will be sent to Forth Worth or Lubbock because it is cheaper there.…these patients

can’t afford to go out of town.”

“...there needs to be better career or economic mobility for folks so they can move themselves and their families off of indigent care.”



June 2019 Page 78

Community Education & Preventative Care• Issues:

Lack of understanding of the disease process and importance of prevention of chronic conditions among the population

Chronic conditions and poor lifestyle behaviors (obesity, high blood pressure, diabetes, cardiovascular disease)

Growing problem of childhood obesity Limited funding for prevention programs and

healthy lifestyle resources for low income and uninsured population

• Needs: Greater number of local preventative and primary

care options for all payer types Emphasis on the needs of low income residents Focus on childhood obesity prevention programs

“There is a lack of knowledge in how to navigate the preventative care landscape; they do not see the value in going for preventative care, and

that is true even for people with insurance.”

“We have one of the higher rates of obesity compared to the rest of the state, and so of course all the co‐morbidities that go with that ‐

hypertension, cardiovascular disease ‐ those are the things that contribute the most burden.”

“The need to encourage people to diet and exercise…[this] is a community that has challenges with obesity and some of that stems from an economic factor. People are not buying foods for a healthy lifestyle and they are not economically able to support eating right…that leads to an increase in

diabetes and cardiovascular disease and a whole bunch of other things.”

“Many of those patients we see have diabetes, COPD, high cholesterol…we probably need to do more from a preventative standpoint.”

“We could do a better job with childhood obesity…there are not enough resources for childhood obesity.”

“The health system has a fitness center…The poorer population lack those resources the most. Those who have the means are fine.”

“Those at the lower end of the socioeconomic scale are going to use the Emergency Room inappropriately when they don't have access to public

health resources.”Source: ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment Interviews Conducted by CHC ContinueCARE, August 15, 2018– August 30, 2018.


June 2019 Page 79

Populations Most At Risk

• Pediatric– Limited access to local counselors,

specifically for autism diagnoses– Childhood obesity– Limited access to pediatric sub‐specialists

• Youth– High teen pregnancy rates – Recreational drug use– High rate of sexually transmitted infections– Large population of homeless youth/

children • Homeless

– Lack of local mental health services• Low Income / Working Poor

– Barriers for local, affordable preventative care

• Elderly– Providers changing practices and no longer

accepting Medicare– Transportation to access healthcare services

and follow‐up care– Assistance in navigating the healthcare

landscape– Continued focus to address the needs of the

large aging population• Non‐English Speaking

– Language barriers – High teen pregnancy (Hispanic)

• Veterans– Lack of mental health services – Difficulty accessing the VA clinic

When asked about which specific groups are at risk for inadequate care, interviewees spoke about:



June 2019 Page 80

A description of the community health assessments completed by the local health departments and other organizations within CCH at HMC’s defined study area

Local Community Health Reports


June 2019 Page 81

Abilene Regional Council2017 Regional Needs Assessment

• The Regional Needs Assessment (RNA) is a document created by the Prevention Resource Center (PRC) in Region 2 along with Evaluators from PRCs across the State of Texas and supported by the Texas Health and Human Services Commission (HHSC). The PRC Region 2 serves 30 counties in Northwest Texas.

• This assessment was designed to aid PRC’s, HHSC, and community stakeholders in long‐term strategic prevention planning based on most current information relative to the unique needs of the diverse communities in the State of Texas. This document presents a summary of statistics relevant to risk and protective factors associated with drug use, as well as consumption patterns and consequences data, at the same time it offers insight related to gaps in services and data availability challenges.

• A team of regional evaluators procured national, state, regional, and local data through partnerships of collaboration with diverse agencies in sectors such as law enforcement, public health, and education, among others. Secondary qualitative data collection also was conducted, in the form of surveys, focus groups, and interviews with key informants. The information obtained through these partnerships has been analyzed and synthesized in the form of this Regional Needs Assessment. PRC 2 recognizes those collaborators who contributed to the creation of this RNA.

• The RNA by is hoped to be a useful reference for our region. Once completed on July 31, 2017 the PRC staff began to promote and share information in this document to state, regional, county and city stakeholders across our area. In every community meeting attended, PRC staff will share county reports or data reported in this document. We look forward to not only sharing the information but building on existing partnerships and initiating new partnerships in order to fully evaluate the communities across our coverage area.

Source: Abilene Regional Council, 2017 Regional Needs Assessment, https://abilene.communityos.org/cms/system/files/Region2NeedsAssessment2017.pdf; information accessed January 13, 2019.


June 2019 Page 82

Abilene Regional Council2017 Regional Needs Assessment (continued)

• Key Findings: Demographics: Region2 is generally made up of middle‐aged to older adults. Approximately 59% of our

population are ages 30‐85+. Ethnicity is dominated by Anglos however there is a growing Hispanic and “Other Races” in our area. Our overall population has steadily increased over the past six years.

Socioeconomics: The average medium income reports lower than the state. Although we have low unemployment rate with many residents employed, our region reports to have a high percentage of single‐parent households, children in poverty, and households with public assistance and food stamps.

Consumption: Methamphetamines, marijuana, tranquilizers and synthetic narcotics are the most seized substances taken off the streets by law enforcement in our reported area from 2014‐2016. Alcohol and marijuana are the most consumed substances among high school and college aged students within our region. There is also a high rate of prescriptions being issued to residents of our area.

Consequences: Child abuse, suicide, teen births, chronic disease, drug and alcohol poisoning deaths, drug related court cases and incarcerations exceed the state rates and/or are increasing over time. Most individuals seeking treatment are in need of services related to amphetamine use, alcohol or opioid misuse.

Protective Factors: Our area is fortunate to have hundreds of non‐profits and social service agency’s within our counties. Many of these services provide basic needs such as food, water, clothes; others provide treatment for mental health, the mental disabled, psychiatric treatment; others provide counseling inpatient/outpatient services; intervention services include drug and alcohol referrals and counseling, peer recovery coaching, pregnancy intervention for new and expecting mothers at‐risk, and the numerous coalitions and community groups all willing to assist client or community members in needs. Region 2 has an atmosphere of a small town in which people truly do care in assisting one another. We are a community that truly cares.

Source: Abilene Regional Council, 2017 Regional Needs Assessment, https://abilene.communityos.org/cms/system/files/Region2NeedsAssessment2017.pdf; information accessed January 13, 2019.


June 2019 Page 83

A review of the community input provided on the hospital’s previous CHNA and Implementation Plan

Input Regarding the Hospital’s Previous CHNA


June 2019 Page 84

Consideration of Previous Input• IRS Final Regulations require a hospital facility to consider

written comments received on the hospital facility’s most recently conducted CHNA and most recently adopted Implementation Strategy in the CHNA process.

• The hospital made every effort to solicit feedback from the community by providing a feedback mechanism on the hospital’s website. However, at the time of this publication, written feedback has not been received on the hospital’s most recently conducted CHNA and Implementation Strategy.

• To provide input on this CHNA please see details at the end of this report or respond directly to the hospital online at the site of this download.


June 2019 Page 85

An evaluation of the hospital’s impact regarding initiatives detailed in the hospital’s previous Implementation Plan

Evaluation of Hospital’s Impact


June 2019 Page 86

Evaluation of Hospital’s Impact• IRS Final Regulations require a hospital facility to

conduct an evaluation of the impact of any actionsthat were taken, since the hospital facility finishedconducting its immediately preceding CHNA, toaddress the significant health needs identified in thehospital’s prior CHNA.

• This section includes activities completed based on the 2017 to 2019 Implementation Plan.


June 2019 Page 87

ContinueCARE Hospital at Hendrick Medical CenterFY 2017 - FY 2019 Implementation Plan

A comprehensive, six-step community health needs assessment (“CHNA”) was conducted for ContinueCARE Hospital at Hendrick Medical Center (CCHHMC) by CHC ContinueCARE. This CHNA utilizes relevant health data and stakeholder input to identify the significant community health needs in Taylor County. The CHNA Team, consisting of leadership from CCHHMC, met with staff from CHC ContinueCARE on April 12, 2016 to review the research findings and prioritize the community health needs. Three significant community health needs were identified by assessing the prevalence of the issues identified from the health data findings combined with the frequency and severity of mentions in community input. The CHNA Team participated in a roundtable discussion to rank the community health needs based on three characteristics: size and prevalence of the issue, effectiveness of interventions and the hospital’s capacity to address the need. Once this prioritization process was complete, the hospital leadership discussed the results and decided to address the first two prioritized needs in various capacities through a hospital specific implementation plan.

The final list of prioritized needs is listed below: 1. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles 2. Access to Affordable Care and Reducing Health Disparities Among Specific Populations 3. Access to Mental and Behavioral Health Care Services

This implementation plan addresses the top two of the three needs. "Access to Mental and Behavioral Health Care Services" is not addressed largely due to the fact that it is not a core business function of the hospital and the limited capacity of the hospital to address this need. Hospital leadership has developed the following implementation plan to identify specific activities and services which directly address the top two priorities. The objectives were identified by studying the prioritized health needs, within the context of the hospital’s overall strategic plan and the availability of finite resources. The plan includes a rationale for each priority, followed by objectives, specific implementation activities, responsible leaders, annual updates and progress, and key results (as appropriate).

The CCHHMC Board reviewed and adopted the 2016 Community Health Needs Assessment and Implementation Plan on May 9, 2016.


June 2019 Page 88

ProgressKey Results

(As Appropriate)Progress

Key Results (As Appropriate)

ProgressKey Results

(As Appropriate)

Ongoing Oct. 2016- Eastland

CCHMC did not participate in FY18 but will ensure they

receive the promotion emails on the event next year

to consider attending.

N/A OngoingBreckenridge Health

Fair - October 27, 2018

Priority #1: Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles

Rationale:-In 2013, Taylor County (841.9 per 100,000) had a significantly higher overall mortality rate than the state (749.2 per 100,000). -Heart disease and cancer are the first and second leading causes of death in the study area and Texas (2013 rate).-Taylor County has higher age-adjusted death rates than Texas in the following disease categories: cancer, cerebrovascular diseases, Alzheimer's disease, chronic lower respiratory diseases, diabetes mellitus, accidents, septicemia, chronic liver disease and cirrhosis, and influenza and pneumonia (2013 rate).-In comparison to peer counties, Taylor County (156.0 per 100,000) ranked within the top of the middle two quartiles for heart disease deaths per 100,000. Heart disease death rates in Taylor County were also higher than the U.S. median (126.7 per 100,000) and the Healthy People 2020 Target (103.4 per 100,000). -In 2013, Taylor County's cancer mortality rate (163.2 per 100,000) that was higher than the state rate (156.1 per 100,000).-Combined 2008-2012 age-adjusted incidence rates per 100,000 show that Taylor County had higher incidence rates of Colon and Rectum Cancer (44.2 per 100,000), Female Breast Cancer (122.3 per 100,000), and Lung and Bronchus Cancer (60.3 per 100,000) as compared to the state (40.2 per 100,000; 113.1 per 100,000; and 58.1 per 100,000, respectively). -Taylor County ranked within the middle two quartiles (117.7 per 100,000) for female breast cancer incidence rates per 100,000 (2006-2010). -Cerebrovascular disease is the 3rd leading cause of death in the Taylor County, and 4th leading cause of death in Texas. Between 2011 and 2013, Taylor County maintained higher cerebrovascular disease mortality rates than the state, with a much higher rate in 2013 (53.0 per 100,000 compared to 40.1 per 100,000).-In comparison to peer counties, Taylor County (61.2 per 100,000) ranked within the least favorable quartile for stroke deaths per 100,000. Stroke death rates in Taylor County were also higher than the U.S. median (46.0 per 100,000) and the Healthy People 2020 Target (34.8 per 100,000). -Alzheimer’s Disease is the 4th leading cause of death in Taylor County, and the 6th leading cause of death in Texas. In 2013, Taylor County had a much higher Alzheimer’s Disease mortality rate than the state (43.8 per 100,000 compared to 24.4 per 100,000). -In comparison to peer counties, Taylor County (36.4 per 100,000) ranked within the top of the middle two quartiles for Alzheimer’s disease deaths per 100,000. Alzheimer’s disease death rates in Taylor County were also higher than the U.S. median (27.3 per 100,000).-In comparison to peer counties, Taylor County (48.8 per 100,000) ranked within the middle two quartiles for chronic lower respiratory disease (CLRD) deaths per 100,000. CLRD death rates in Taylor County were also slightly lower than the U.S. median (49.6 per 100,000). -Diabetes Mellitus mortality rates in Taylor County (34.9 per 100,000) remain higher than the state (21.6 per 100,000) (2013).-In comparison to peer counties, Taylor County (30.5 per 100,000) ranked within the top of the middle two quartiles for diabetes deaths per 100,000. Diabetes death rates in Taylor County were also higher than the U.S. median (24.7 per 100,000). -Fatal accidents in Taylor County (33.1 per 100,000) are just slightly lower than the state (36.8 per 100,000) (2013). Motor vehicle accidents and accidental poisonings were the leading causes of fatal accidents in 2013 for Taylor county.-Septicemia mortality rates in both Taylor County and Texas increased between 2011 and 2013, but Taylor County experienced a more significant increase. In 2013, septicemia mortality rates (22.3 per 100,000) in the county were higher than the state (16.4 per 100,000). -In 2012, Taylor County (9.5%) had a slightly higher percent of adults (age 20+) that were diagnosed with diabetes than the state (9.2%) and national rates (9.1%).-Between 2012 and 2014, diabetes prevalence rates in adults (age 18+) in both Health Service Region (HSR) 2/3 and the state slightly increased. -In comparison to peer counties, Taylor County (9.3%) ranked within the two middle quartiles for adult diabetes prevalence. Diabetes prevalence rates in Taylor County were also slightly higher than the U.S. median (8.1%). -In 2012, Taylor County had a higher percentage of its population that was considered obese (31.4%) than the state (28.2%) and national rates (27.1%). -In comparison to peer counties, Taylor County (33.1%) ranked within the least favorable quartile for adult obesity prevalence. Adult obesity prevalence rates in Taylor County also ranked above the U.S. median (30.4%). -In 2014, HSR 2/3 (21.2%) had a higher prevalence rate of arthritis as compared to the majority of other regions and the state (19.4%). Between 2012 and 2014, the percent of adults (age 18+) who reported having been diagnosed with arthritis in HSR 2/3 remained relatively steady, while rates in the state declined.-In 2014, HSR 2/3 (11.7%) had a higher rate of diagnosed asthma than the state (11.1%), but a lower rate than the majority of other regions. Between 2012 and 2014, the percent of adults (age 18+) who have been diagnosed with asthma in both HSR 2/3 and the state slightly increased.-In 2014, HSR 2/3 (10.4%) had a higher prevalence rate of current, everyday smokers than the majority of other regions and the state (8.7%). -In comparison to peer counties, Taylor County (21.2%) ranked within the bottom of the middle two quartiles for the prevalence of adult smoking. Taylor also fell below the U.S. median (21.7%), but ranked above the Healthy People 2020 Target (12.0%). -Between 2006 and 2012, the percentage of adults (age 50+) who self-reported that they have ever had a sigmoidoscopy or colonoscopy in Taylor County (53.9%) was higher than the state (57.3%) and national rate (61.3%).-In 2012, the rate of preventable hospital events in Taylor County (46.9 per 1,000 Medicare Enrollees) was much lower than that of the state (62.9 per 1,000) and the nation (59.2 per 1,000).-Many interviewees discussed the prevalence of chronic conditions and the lack of focus on preventive care as concerns in the community. Specific conditions that were mentioned include cancer, heart disease, diabetes, and obesity. One interviewee stated: "...I think there is probably just a lack of education about the importance of preventative care."

Objective:Increase healthy lifestyle education and prevention resources at the hospital and in the community

FY 2019FY 2018FY 2017Action Steps

1.A. CCHHMC will continue to participate in health fairs within surrounding counties 2-3 times per year.


June 2019 Page 89

ProgressKey Results



ProgressKey Results

(As Appropriate)


Ongoing

1. Jan. 2017-included rural

facilities back in market.

2. Mar. 2017- New CEO joined

marketing and education

endeavors.

Ongoing

Open house in December 2017 -

included case managers,

physicians, social workers, some vendors, some

education. Brought in a couple of

educators, such as a Wound Vac and Respiratory Device educator. Did tours and refreshments,

etc.

Ongoing

CCHHMC will continue to educate referral resources on the role of the

LTACH and potential

collaboration efforts as opportunities

arise.

Ongoing

1. 7/19/16- Openhouse for CN &

NM's2. Visitingphysicians

offices.3. Nurse

ambassador program.

4. Education cardsfor CM's on new

rule. 5. Mar. 2017- New

CEO joined marketing and

educationendeavors.

Ongoing Inservices with larger hospitals Ongoing

CCHHMC regularly hosts lunch and learn events for

case managers and physicians to

educate them on LTACH criteria.

Ongoing

1. Critical CareModules developed

and completed.2. CCRN/PCCN

Certification prep. 3. Collaboration withHMC for critical care

education.

Ongoing Ongoing

Ongoing

1. June 2016:Weight

Watchers meeting. 2. July 27, 2016:

Biometric screening.3. Monthly wellness

emails.

Ongoing Biometric screening in Fall 2017

**LANGUAGE UPDATED FY19**

Biometric screening in Fall 2018

Ongoing Ongoing Ongoing

1.D. CCHHMC provides education to staff to expand the patients that they serve, including telemetry and critical care training to meet the needs of higher acuity patients.

1.B. CCHHMC will continue to conduct outreach to referral resources in order to educate them about the role of the Long Term Acute Care Hospital (LTACH), and how they can work together to promote a healthier community.

1.C. CCHHMC provides education to physicians and case managers from their host and other Short Term Acute Care Hospitals regarding LTACH criteria.

1.E. CCHHMC will engage in a variety of employee wellness initiatives, including a health plan that is prevention driven. Initiatives include the promotion of employee and family wellness via Asset Health (formerly Accountable Health), offering need specific special programs, CHIP (Coronary Health Improvement Plan), smoking cessation opportunities, diabetes management (via UMR - Employee Medical Plan), weight management, providing and highlighting healthy food options in the hospital cafeteria, promoting fitness opportunities, providing mental health education via the Employee Assistance Program (EAP), and continuing the tobacco-free new hire policy.

1.F. CCHHMC will continue to incentivize employees to maintain healthy lifestyles on their health plans through offering a reduction on a portion of their premiums if employees meet certain criteria.



Biometric screening July 27, 2016


June 2019 Page 90

ProgressKey Results



ProgressKey Results

(As Appropriate)


Ongoing Referrals made PRN Ongoing

Diabetic nurse that can come do

counseling and a counseling group

that we refer patients to as a

service that Hendrick provides.

**ACTIVITY REMOVED FY19 - DO NOT REMOVE FOR TRACKING

PURPOSES**

N/A

Ongoing Referrals made PRN Ongoing Referrals made

PRN Ongoing Referrals made PRN

REMOVED FY17 **DO NOT

REMOVE FOR CHNA TRACKING

PURPOSES**

N/A N/A N/A N/A N/A

Ongoing

Feb. 24, 2017: Case Manager

volunteered during event.

Ongoing




Ongoing




OngoingReferrals made asappropriate per pt

choice. Ongoing

Referrals made asappropriate per pt

choice. Ongoing

Referrals made asappropriate per pt

choice.

Ongoing

1. June 29, 2016: Active

Shooter/HostageSituation w/Host2. Aug. 13, 2016: Actual fire event

occurred in Host hospital. CCH staff participated in

response. 3. Sep. 22, 2016: met with Host for Nov drill/training

prep.4. Nov 8 & 17, 2016:

Active Shooter training

drill. 5. Feb 7, 2017: met

withHost for future

ActiveShooter training/drill

prep.

Ongoing

CPR classes provided as needed.

Participate in emergency

response events by the host.

All staff receive BLS training quarterly. Available to teach

out in the community as well.

**LANGUAGE UPDATED IN

FY19**

Ongoing

CPR classes provided as needed.

Participate in emergency

response events by the host.

All staff receive BLS training quarterly. Available to teach

out in the community as well.

1.G. CCHHMC will support Hendrick Medical Center with the Diabetes Education and Support Center, making patients and families aware of resources. The center offers inpatient diabetes survival skills education, outpatient education by individual appointment, diabetes self-management education classes, diabetes workshops and community presentations on diabetes and related topics.

1.L. CCHHMC engages in community disaster preparedness events with the host as they arise.

1.H. CCHHMC will support Hendrick Medical Center with the Hendrick Center for Rehabilitation, making patients and families aware of resources. Services include: physical therapy, sports medicine, occupational therapy and hand clinic, speech therapy, Lymphedema therapy, vestibular rehab, aquatics and inpatient hospital.

1.I. CCHHMC will support Hendrick Medical Center with the Hendrick Cancer Center, making patients and families aware of resources. Services include: clinical research trials, health screenings, infusion clinics, medical oncology, on-site pharmacy, outreach clinics, palliative care and radiation oncology.

1.J. CCHHMC will support Hendrick Medical Center with "A Day to Take Heart," making patients and families aware of resources. "A Day to Take Heart" is an annual event for heart health education that offers free cardiac screenings, including blood pressure, cholesterol, BMI, diabetes, and carotid artery assessment. The first 100 participants receive an ECG.

1.K. CCHHMC supports the Hendrick Medical Center skilled nursing facility, home health agency, and hospice program.


June 2019 Page 91

ProgressKey Results



ProgressKey Results

(As Appropriate)


Ongoing

Oct. 15, 2016: CCHsponsorship for

2016Ball.

*Declined toparticipate in 2017

Ongoing





FY19**

Ongoing




Ongoing

Jan 1, 2017: Discharge

follow-up phone calls

initiated.

Ongoing

CCHHMC is evaluating the follow-

up discharge protocol and will implement such calls during the

defined time frames that are appropriate


FY19**

Ongoing

CCHHMC conducts follow-up discharge phone calls 24-48

hours after a patient is discharged to

their home.

Ongoing Upon request Ongoing Upon request Ongoing Upon request



PURPOSES**

N/A N/A N/A N/A N/A


Ongoing Ongoing

Ongoing

Tracheostomy Care and Management

education provided to The Oaks at

Radford Hills on Nov. 16, 2017

Ongoing

CCHHMC will continue to be

available to provide education upon

request.

Ongoing



PURPOSES**

N/A N/A N/A

Ongoing

Walking Interdisciplinary

Team Conferences held weekly in

patient rooms with patient and/or family

Ongoing




Ongoing




1.M. CCHHMC participates in the Cattle Baron's Ball community event that focuses on promoting the prevention of and education for cancer-related diagnoses.

1.R. CCHHMC is available to provide education on ventilator and trachea care to skilled nursing facilities by request.

1.Q. CCHHMC has affiliation agreements with Texas State Technical College, Abilene Christian University, Texas Tech, Cisco, and Patty Hanks for clinical rotations within nursing and respiratory areas.

1.S. CCHHMC actively participates in the Abilene Strengthening Working Families Collaborative. The purpose of the group is to review current labor market data and identify workforce needs and strategies for improvement.

1.P. Staff from CCHHMC serve on the Board of Directors for the Cancer Services Network.

1.N. CCHHMC follows up with patients during discharge and provides patients' other physicians with a copy of his/her discharge summaries as requested in order to increase collaboration across the continuum of care. In addition, patients' other physicians receive regular updates on their patient's health during their stay at the LTACH.

1.O. CCHHMC is available to speak at any community events, provide information, or participate in other educational opportunities by request.

1.T. CCHHMC educates patients and families about LTACHs and what services can be provided in conjunction with community resources through speaking at local events, providing educational brochures, and interacting with families in the facility.


June 2019 Page 92

ProgressKey Results



ProgressKey Results

(As Appropriate)


- - - -

**ACTIVITY ADDED FY2019**

Ongoing

CCHHMC attends morning ICU rounds at HMC daily, and also attends ICU

rounds a few times a week at Shannon

Medical Center.

- - - -


Ongoing

- - - -


Ongoing

Participate on a quarterly basis

- - - -


Ongoing




1.W. CCHHMC will continue to participate in the quarterly Critical Care Collaborative, the quarterly Nursing Home Consortium and Joint Council with Host Leadership to discuss referral and admission patterns, barriers and concerns, as well as successes.

1.X. CCHHMC will continue to host interdisciplinary team meetings on a weekly basis that include all necessary persons in discussions regarding individual patient care for a more comprehensive, patient-centered approach. CCHHMC staff encourage family members to attend as well in order to fully understand the needs of the patient.

1.U. CCHHMC staff will continue to attend morning ICU rounds with the host to identify and educate on what would meet LTACH criteria.

1.V. CCHHMC will continue to train all clinical staff on BLS and ACLS for all RN and RT staff.


June 2019 Page 93

ProgressKey Results



ProgressKey Results

(As Appropriate)


Ongoing PRN Ongoing PRN Ongoing PRN

Ongoing

Dec. 2016: participated

in food bank.Will participate in

2017

Ongoing

CCHHMC participated in a toiletry drive in

FY18.


Ongoing

CCHHMC will continue to

participate in drive events as

opporutities arise, and is exploring participating in

upcoming school supply and food

drives in the community.

Ongoing

Dec. 2016: participated

in food bank. Collected 72

pounds of food to donate.

CCHHMC did not participate in a food drive during FY18.

N/A

**ACTIVITY REMOVED FY19 - DO NOT REMOVE FOR TRACKING

PURPOSES**

See 2.C.

See 2.C.

Ongoing Monthly basis Ongoing

Monthly basis; 2 employees

volunteer at Meals on Wheels Mondays

for 2 hrs.

Ongoing


Monthly basis; 2 employees

volunteer at Meals on Wheels Mondays

for 2 hrs.

Rationale:-Both Taylor County ($49,908) and Texas ($51,603) have lower median household incomes than the United States ($53,028). -Taylor County (22.6%) has a lower rate of residents with Bachelor’s or advanced degrees than the state (26.6%) and the nation (28.9%). -Both Taylor County (13.1%) and Texas (14.0%) have higher rates of poverty than the United States (11.7%). -In 2013, over one-fourth (26.4%) of children live in households in Taylor County that had difficulty meeting their basic food needs, as compared to 27.4% in the state. -In 2012, the percent of female Medicare enrollees (age 67-69) in Taylor County (61.6%) that received one or more mammograms in the past two years was slightly higher than the state (58.9%) and national (63.0%) rates.-Between 2013 and 2015, the percent of uninsured adults (age 18-64) decreased in both Taylor County and the state. Taylor County (16.0%) and Texas (16.0%) both remained above the national rate (11.0%) in 2015. -In 2014, HSR 2/3 (16.8%) had the second lowest rate of adults that reported experiencing a medical cost barrier in the past 12 months, as compared to all other regions and the state (17.6%). -In comparison to peer counties, Taylor County (21.6%) ranked within the middle two quartiles for the prevalence of persons under age 65 that are uninsured, and also ranked above the U.S. median (17.7%).-In comparison to peer counties, Taylor County (21.2%) ranked within the least favorable quartile for the percent of adults that needed to see a doctor within the past 12 months, but could not because of cost. Cost barriers to care rates in Taylor County were also above the U.S. median (15.6%) and the Healthy People 2020 Target (9.0%). -Between 2010 and 2014, over one-fifth (21.8%) of the insured population in Taylor County was receiving Medicaid, which is very slightly below the state (22.1%) and slightly above the national rate (20.8%). -Between 2010 and 2014, 5.7% of households had no motor vehicle, as compared to 5.9% of Texas. -Interviewees discussed the high prevalence of uninsured residents in the community. One interviewee cited access to health care as one of the three biggest needs, remarking that the underserved and indigent populations are a specific concern. The cost of health care and the ability to pay for insurance was also cited as one of the three biggest needs. It was noted that some physicians are currently not accepting Medicaid or Medicare.-Many interviewees noted that the limited access to health care services for these populations culminates in inappropriate Emergency Room use. Interviewees cited many reasons for inappropriate Emergency Room use, including cost, lack of insurance, and lack of education. One interviewee stated: "I think there is a gap between people who have insurance, but their deductible is so high that they don’t go [to the doctor]."-Interviewees discussed that services for elderly and minority populations are concerns in the community. For elderly patients, the cost of prescription medication and the limited number of physicians who accept Medicare is a significant problem. Interviewees discussed that the Hispanic, African American, and refugee populations were also the most underserved groups in the community. Objective:Participate in initiatives and create opportunities to increase access to affordable care and reduce health disparities among specific populations

Priority #2: Access to Affordable Care and Reducing Health Disparities Among Specific Populations

FY 2017Action Steps

2.A. CCHHMC will continue to support Pathways at Hendrick Medical Center, which serves patients with a serious, chronic or life-limiting illness or injury but are not necessarily terminally or irreversibly ill. Services are provided regardless of ability to pay.

FY 2018 FY 2019

2.B. CCHHMC provides health education and prevention resources in multiple languages, as well as a translator phone and resources for the hearing impaired, on an as needed basis.

2.E. CCHHMC staff participate in volunteering at local nonprofit organizations, such as the Junior League and the local Meals on Wheels organizations, to assist in serving the underserved population in the area.

2.C. CCHHMC will continue to host and/or participate in drive events (i.e., toiletry, food) in conjunction with local organizations as needed to benefit the community.

2.D. CCHHMC will begin hosting a food drive for the local food bank in order to address the higher rates of child food insecurity in the area.


June 2019 Page 94

ProgressKey Results



ProgressKey Results

(As Appropriate)

FY 2017Action Steps

FY 2018 FY 2019

Ongoing

Volunteered 10 plus hours over holiday

season. April - volunteering for "Painting with a Twist" fund raiser

and Blues Festival.

ACTIVITY REMOVED FY18

**DO NOT REMOVE FOR

TRACKING PURPOSES**

N/A N/A N/A

Ongoing Attends monthly meetings

ACTIVITY REMOVED FY18

**DO NOT REMOVE FOR

TRACKING PURPOSES**

N/A N/A N/A

Ongoing Support on an as needed basis. Ongoing Support on an as

needed basis. Ongoing Support on an as needed basis.

- - - - Ongoing **ACTIVITY ADDED FY2019**




Ongoing PRN Ongoing PRN Ongoing PRN

2.F. CCHHMC actively participates in Salvation Army's programs, i.e. Angel Tree Project, Holiday Meals and Fund Raisers. Addresses needs of underprivileged children and families, along with homeless.

2.M. CCHHMC provides case management services and referrals that relate to mental or behavioral health conditions on an as needed basis.

2.G. CCHHMC actively participates in Salvation Army's Advisory Board.

2.H. CCHHMC will continue to support Hendrick Medical Center in the aggressive recruiting underway for primary care physicians. Hendrick Provider Network is well established to recruit physicians and meet the needs of the community.

2.I. CCHHMC will continue to provide services to eligible uninsured and underinsured individuals as outlined in their charity care policy, which is available to every patient on admission. This allows patients and/or families to know the details of how they may qualify for reduction or elimination of any balance owed by them for services we provide.

2.J. CCHHMC will continue to offer financial assistance and payment plan education to patients who have an economic need and meet the qualifications of the financial assistance policy. If financial assistance is needed, CCHHMC encourages patients to complete an application to see if they qualify.

2.K. CCHHMC will continue to actively assist the Host in the recruitment of Intensive and Pulmonary physicians.

2.L. CCHHMC will continue its strong referral relationship with surrounding acute care facilities to provide specialty services to patients requiring that level of care from the LTACH.


June 2019 Page 95

ProgressKey Results



ProgressKey Results

(As Appropriate)

Ongoing

Feb. 15, 2017- Griefcounselor on-siteafter employee

passed.

Ongoing Ongoing

- - ADDED FY18 Support on an as needed basis. Ongoing Support on an as

needed basis.

- - ADDED FY18Participated in

Asthma Camp on August 2, 2018.

Ongoing

Participate in upcoming 5k

events.

CCHHMC will continue to

participate in Asthma Camp.

- - - - ADDED FY19Donated supplies

and financial support

Additional Community Benefit ActivitiesPlease use the space below to describe any additional community benefit activities that have been implemented and are not described in the previous priorities.

FY 2017

A.A. CCHHMC will continue to offer the Employee Assistance Program (EAP) through Beacon Health Options to help employees navigate various life challenges.

Action Steps

A.D. CCHHMC provides financial and volunteer support to the Coder's Association local events.

FY 2018 FY 2019

A.C. CCHHMC will explore providing support through financial and/or volunteer resources to the host for their Flashback 5K event benefitting Children's Miracle Network and Hendrick Children's Hospital, as well as for their Asthma Camp that serves children in the community with respiratory related diseases.

A.B. CCHHMC provides financial and volunteer support to a Daddy/Daughter dance in Brownwood.


June 2019 Page 96

A list of common health needs that were identified by evaluating demographic data, health data, and responses from interviewees in previous CHNA reports

Previous Prioritized Needs


June 2019 Page 97

Previous Prioritized Needs2013 Prioritized Needs

1. Lack of Primary Care Physicians2. Lack of Health Education3. Chronic Disease Management

2016 Prioritized Needs1. Prevention, Education and Services to

Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles

2. Access to Affordable Care and Reducing Health Disparities Among Specific Populations


June 2019 Page 98

A list of common health needs that were identified by evaluating demographic data, health data, and responses from interviewees

2019 Preliminary Health Needs


June 2019 Page 99

2019 Preliminary Health Needs• Access to Affordable Care and Reducing Health Disparities

Among Specific Populations • Access to Mental and Behavioral Health Care Services and

Providers• Access to Primary Care Services and Providers• Access to Specialty Care Services and Providers • Prevention, Education and Services to Address High

Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles


June 2019 Page 100

A description of the process the hospital used to prioritize the identified health needs, as well as a final list of needs that the hospital will seek to address

Prioritization


June 2019 Page 101

The Prioritization Process• On November 13, 2018 leadership from CCH at HMC met with CHC

ContinueCARE to review findings and prioritize the community’s health needs. Attendees from the hospital included:– Billy Blasingame, Chief Executive Officer– Meri Combs, Chief Nursing Officer– Andrew Adamski, Director of Community Relations– Crystal Stepp, Community Liaison– Mindy Holster, Registered Respiratory Therapist – Trisha Kane, Human Resources Coordinator

• Leadership ranked the health needs based on three factors:– Size and Prevalence of Issue– Effectiveness of Interventions– Hospital’s Capacity

• See the following page for a more detailed description of the prioritization process.


June 2019 Page 102

The Prioritization ProcessThe CHNA Team utilized the following factors to evaluate and prioritize the significant health needs.

1. Size and Prevalence of the Issuea. How many people does this affect?b. How does the prevalence of this issue in our communities compare with its prevalence in

other counties or the state?c. How serious are the consequences? (urgency; severity; economic loss)

2. Effectiveness of Interventionsa. How likely is it that actions taken will make a difference?b. How likely is it that actions will improve quality of life?c. How likely is it that progress can be made in both the short term and the long term?d. How likely is it that the community will experience reduction of long-term health cost?

3. ContinueCARE Hospital at Hendrick Medical Center Capacitya. Are people at ContinueCARE Hospital at Hendrick Medical Center likely to support actions

around this issue? (ready)b. Will it be necessary to change behaviors and attitudes in relation to this issue? (willing)c. Are the necessary resources and leadership available to us now? (able)


June 2019 Page 103

Health Needs Ranking• Hospital leadership participated in a roundtable discussion to

rank the health needs in order of importance, resulting in the following order:

1. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles


3. Access to Primary Care Services and Providers4. Access to Specialty Care Services and Providers5. Access to Mental and Behavioral Health Care Services and Providers


June 2019 Page 104

Final Priorities• Hospital leadership decided to address three of the five ranked

health needs. The final health priorities that the hospital will address through its Implementation Plan are:

1. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles


3. Access to Specialty Care Services and Providers


June 2019 Page 105

A description of the rationale behind why the hospital chose not to address any particular priority

Priorities That Will Not Be Addressed


June 2019 Page 106

Priorities that will not be Addressed• CCH at HMC decided not to specifically address “Access to Primary Care

Services and Providers” and “Access to Mental and Behavioral Health Services and Providers.”

• Based on CCH at HMC’s status as a long term acute care facility, the hospital has focused its capabilities on addressing the needs of this particular market. Therefore, “Access to Primary Care Services and Providers” and “Access to Mental and Behavioral Health Services and Providers” are not directly addressed in the hospital’s implementation plan.

• While CCH at HMC acknowledges that these are significant needs in the community and will work with local community organizations to see how the facility can assist in these areas, the identified priorities will not be addressed by the hospital since they are not core business functions of the hospital and the leadership team felt that resources and efforts would be better spent addressing the remaining three prioritized needs.


June 2019 Page 107

An extensive list of resources that are available in the community to address the identified health needs

Resources in the Community


June 2019 Page 108

Resources in the Community• In addition to the services provided by CCH at HMC, other

charity care services and health resources available in Taylor County are included in this section.


June 2019 Page 109

Type Company City County Address Zip Code Area Code Phone Number Fax Number

Adoptions A Abagail's Silver Spoon AdoptionsAdoptions AdoptionHelp, Inc.Adoptions Adoption AccessAdoptions Centers for Children & Families Midland 1004 N. Big Spring 432 570-1084Adoptions Christian Homes of Abilene Abilene Taylor 1202 Estates Dr. 79602 325 677-2205Adoptions Gladney Center for AdoptionAdoptions Methodist Mission HomeAL Chisholm House Abilene Taylor 1450 E.N. 10th 79601 325 670-0961 677-7126AL Choices Residential AL & Respite Care Abilene Taylor 325 676-7667AL Covenant Place Abilene Abilene Taylor 3234 Buffalo Gap Rd. 79605 325 793-1144 793-1422AL Disability Resources Abilene Taylor 3602 N. Clack St. 79601 325 677-6815AL Highland Assisted Living MHMR Abilene Taylor 2310 S. 7th 79605 325 675-5100AL ICS (Intergrated Community Services) Grp Home Abilene Taylor 325 672-5702 673-4702AL Royal Estates Abilene Taylor 6565 Central Park Blvd. 79606 325 480-2432AL Southern Meadows Abilene Taylor 2234 Robertson Dr. 79606 325 690-6141

AL Wisteria Place AL Center Abilene Taylor 3202 S. Willis St. 79605 325 692-6145 695-2629

AL Redstone Park AL Brownwood Brown 2410 Song Bird Circle 76801 325 643-9056AL Rolling Oaks Personal Care Early Brown 5151 Jenkins Spring Rd. 76801 325 646-4771AL The Woodlands Also Alzheimers locked down unit Eastland Eastland 125 Inspiration Blvd. 76448 254 629-1001 629-1025AL Memory Lane Haskell Haskell 1302 N. 1st 79521 940 864-2727 864-2850AL Almost Home Merkel Taylor 809 Locust 79536 325 928-4119 928-1154AL Heritage House on the Brazos Rotan Fisher 776 State Hwy 70 N 79546 325 735-1501 735-1502

La Esperanza Clinic San Angelo Tom Green 2029 W. Beauregard 325 658-5339 AL Mytlewood Estates San Angelo Tom Green 2695 Valley View Blvd. 79604 325 947-7194AL Sagebrush Living Center MHMR Stamford Jones 1101 Columbia 79553 325 773-2791 773-2448AL Hoyt House Sweetwater Nolan 1700 Hoyt St. 79556 325 235-5655AL Winters Assisted Living Winters Runnels 616 E. Truett 79567 325 754-5083 754-4570IL Christian Village Abilene Taylor 633 E.N. 19th 79601 325 673-1917 673-1554IL Covenant Place Abilene Abilene Taylor 3234 Buffalo Gap Rd. 79605 325 793-1144 793-1422IL Royal Estates Abilene Taylor 6565 Central Park Blvd. 79606 325 480-2432IL Mesa Springs Retirement Village Abilene Taylor 7171 Buffalo Gap Rd. 79606 325 690-1400IL Wesley Court Abilene Taylor 2617 Antilley 79606 325 437-1184 437-1185

IL Wisteria Place Retirement Center Abilene Taylor 3202 S. Willis 79605 325 692-6145 698-2716

IL University Place Abilene Taylor 1250 E.N. 10th 79601 325 676-9946 676-5012IL Wesley Court Abilene Taylor 2617 Antilley Rd. 79606 325 437-1184IL The Windsor Abilene Taylor 401 Pine St. 79601 325 677-0824IL Wisteria Place Abilene Taylor 3917 Wisteria Way 79605 325 695-3232 695-3245DME American Cancer Society Abilene Taylor 325 692-6446DME Apria Healthcare Abilene Taylor 3250 S. Treadway 325 677-2405 677-2436DME Cancer Services Abilene Chapter Abilene Taylor 325 691-1519 691-9920DME Choice Medical No CPM's HMO Blue Abilene Taylor 17 Windmill Circle 79605 325 677-2250 677-2124DME Christian Service Center charity Abilene Taylor 901 Mesquite 79601 325 673-7531DME Craig Martin CPM's Abilene Taylor 800 544-2330 x8016 #2#DME Conva Quip Industries bariatrics Abilene Taylor 4834 Derrick Dr. 79601 325 677-4177 677-7217DME Express Med. No CPM's or liability HMO Blue Abilene Taylor 3122 N. 1st 79603 325 672-3030 672-2030DME Hendrick Medical Supply CPM's Abilene Taylor 1318 N. 8th 79601 325 673-3711 673-4639 or

Taylor County Community Resource List


June 2019 Page 110



DME HillRom Scott Hamlin, Rep Abilene Taylor 817 875-3224 297-7405DME Leddy Brace Braces Only! Abilene Taylor 932 N. Treadway 79601 325 673-5281 673-5282

DME Lincare, Inc. HMO Blue,Tricare,United,Aetna,Cigna/No FirstCare Abilene Taylor 182 S. Willis 79603 325 672-7030 672-0944

DME Owen Total Care Medical Supply Tricare, HMO Blue Abilene Taylor 2133 S. 20th St. 79605 325 690-9200 691-0845DME Pain Management & Rehab Instruments Abilene Taylor 1317 N. 8th 79601 325 370-8709 672-9869DME Rhema Medical Equip. VA contracts Abilene Taylor 3226 S. Clack St. 79606 325 692-7059 698-8235DME Travis Medical Abilene Taylor 4793 Crawford 79605 325 793-3546 793-3548

Keel Drug Ballinger 325 365-3505 365-5376DME Family Medical Big Spring Howard 912 E 4th St. 79720 432 263-6652 264-6290DME VA Transfer Coordinator VA approvals Big Spring Howard 79720 432 263-7361 ext 7212DME Breathe Easy Breckenridge Stephens 801 E. Walker 76424 254 559-8691 559-9200DME Choice Medical No CPM's HMO Blue Brownwood Brown 101 S. Park, Ste. D 76801 325 641-9411 641-9512DME Travis Medical Brownwood Brown 118 A S. Park Dr. 76801 325 646-3290 643-3295DME Oxypro Cisco Eastland 707 Conrad Hilton 76437 866 442-2275 254-442-2282DME MultiPlex Corsicana 3205 A W. 2nd Ave. 903 872-3611 872-3465DME Express Med. No CPM's or liability HMO Blue DeLeon Comanche 1000 S. Texas Ste. B 76444 254 893-4330 893-4332DME Allegro Mobility Eastland Eastland 209 S. Lamar 76448 1-877-291-7350 254-629-0998DME Express Med. No CPM's or liability HMO Blue Eastland Eastland 1405 E. Main St. Ste. 160 76448 254 629-2225 629-2343DME Hendrick Medical Supply Eastland Eastland 969 E. Main 76448 254 629-8338 629-1332DME Med Care Graham Young 76450 940 549-9797 549-1359DME Professional Medical No CPM's Tricare/BCBS Kerrville 723 B Hill Country 830 896-9191 896-9190DME Professional Medical No CPM's Tricare/BCBS Killeen 1300 W Stan Schlueter Loop 300 254 680-4309 680-4932DME Professional Medical No CPM's Tricare/BCBS New Comal 386 A Landa St. 830 608-9577 608-9799

DME Lincare, Inc HMO Blue,Tricare,United,Aetna,Cigna No FirstCare Odessa 2525 N. Grandview Ave. 432 366-8771 366-8226

DME Fisher County Hospital Rotan Fisher 774 State Hwy 70 N. 79546 325 735-2256 735-3070DME American Homepatient San Angelo Tom Green 3353 Knickerbocker 76903 325 942-6432 658-4867

Medway Medical San Angelo 325 223-0231 223-1237DME Oxypro San Angelo Tom Green 3196 Executive Dr. 76903 325 486-1252 653-1869DME Professional Medical No CPM's Tricare/BCBS San Angelo Tom Green 737 Knickerbocker 76903 325 653-1077 658-7035

DME Texas Oxy Care CPM's/Vents BCBS Tricare Aetna Healthsmart San Angelo Tom Green 305 Main St. 76903 325 655-5756 658-3993

DME Professional Medical No CPM's Tricare/BCBS Seguin Guadalupe 120 S. State HWY 46 78155 830 303-8100 303-8101DME Seymour Medical Seymour Baylor 110 W. Reiman 76380 940 889-6060 889-6050DME Barbee Medical Snyder Scurry 5109 College Ave. 79549 325 573-3399 573-6699DME Hendrick Medical Supply Sweetwater Nolan 105 Arizona 79556 325 235-8500 235-8527DME McGlothlin Medical Supply Sweetwater Nolan 1107 E Broadway Ave. 79556 325 235-9001 235-9005DME The Medicine Place Sweetwater Nolan 1410 Lamar 79556 325 235-4366 236-6800

DME Texas Oxy Care CPM's/Vents BCBS Tricare Aetna Healthsmart Winters Runnels 110 N. Main 79567 325 754-5393 754-3043

DME Professional Medical No CPM's Tricare/BCBS Temple Bell 76504 254 773-4309

HH Abilene HH - all BCBS,all major ins.,in network with Tricare,Healthsmart,Aetna Abilene Taylor 265 S. Leggett, Ste. 1 79605 325 672-9454 673-3851

HH Accolade Home Health Abilene Taylor 806 237-2145 866-364-5266HH Angels Care Home Health - No Medicaid Abilene Taylor 3102 S. Clack 79605 325 690-0063 690-0640HH Beyond Faith Homecare & Rehab Abilene Taylor 500 Chestnut Ste. 1509 325 437-7019 437-7020


June 2019 Page 111



HH Big Country Healthcare Services - Medicaid, Medicare, some private ins. Abilene Taylor 3444 N. 1st 79603 325 675-0559 675-0591

HH Caprock HH - case by case pvt.ins., Medicare,Medicaid Abilene Taylor 500 Chestnut Ste. 1000 79603 325 672-2264 672-1771

HH Encompass HH - case by case pvt.,No BCBS,some medicare replacements (Covers Haskell) Abilene Taylor 1 Village Dr. Ste. 200 79605 325 695-3888 695-5044

HH Generations HH - only Medicare,very few pvt.pay pts. Abilene Taylor 1290 S. Willis, Ste. 209 79605 325 690-5913 690-1890

HH Girling Health Care - Medicare,CareImp(w/auth),minimal medicaid,Humana Abilene Taylor 209 S.Danville,Suite 107 79605 325 676-2668 692-0043

HH Hendrick Housecalls Pedi Tricare,Healthsmart Abilene Taylor 1393 Ambler 79601 325 670-2490 677-5643HH Integracare - Medicare, Medicaid(case by case) Abilene Taylor 1665 Antilley Rd Ste 100 79601 325 691-9947 698-6657HH Interim Home Health - Not in Network with FirstCare Abilene Taylor 4400 Buffalo Gap Ste. 2500 79605 325 677-2047 677-9150

HH Jordan Health (Chartwell) - no ins, Medicaid, contract with DADS/CBA/PHC/FamilyCare Abilene Taylor 4150 Southwest Dr, Ste. 250 79605 325 692-4403 677-2530

HH Kinder Hearts HH - Medicare, Medicaid, NO Care Improvement Abilene Taylor 842 Mockingbird 79601 325 672-6135 437-4018

Nurses Unlimited Abilene Taylor 3303 N. 3rd Ste. A 888 859-0640 673-4059

HH Primary Nurse Care - Medicare, BCBS, HMO Medicare Plans Abilene Taylor 3747 W. Lake Rd. 79601 325 677-2903 677-2530

HH Renew HH - medicare, BCBS, some out-of-network, some Medicaid(certain cases) Abilene Taylor 5189 Texas Ave. 79605 325 692-9100 692-9102

HH Southwest Home Health Care - Medicare Only Abilene Taylor 402 Cypress, Ste. 601 79601 325 672-7800 672-7842HH The House that Kerry Built - Tricare, BCBS, Medicaid Abilene Taylor 751 Hickory 79601 325 672-6061 672-5023HH Integracare PHC/CBA No BCBS Albany Shackelford 124 Hill St. 76430 325 762-2854 762-3746HH Interim Home Health PHC Tricare Amarillo Potter 1901 Medi-Park Ste. 1058 806 467-1156 467-1168HH Anson General Hosp Home Health PHC/CBA Anson Jones 1201 Ave. J 79501 325 823-4110 823-3086HH Ballinger Home Health Ballinger Runnels 112 S. 7th 76821 325 365-3889 365-5685HH Accolade Home Health Big Spring Howard 79720 432 264-1164 432-264-1304HH Caring Hearts Home Health Big Spring Howard 1900 Scurry 79720 432 714-4510 714-4511HH Encompass HH. No United Hlthcare, BCBS or Aetna Big Spring Howard 1900 Gregg St. Ste. C 79720 432 264-0044 264-0855HH Brady Healthcare No BCBS Brady McCullough 1700 S. Bridge 76825 325 597-3994 597-0325HH Medway Home Health Care Brady McCullough 1501 S. Bridge 76825 325 597-3107 597-3109HH Integracare PHC/CBA No BCBS Breckenridge Stephens 1906 W. Walker St. 76424 254 559-8780 559-8903HH Renew Home Health Breckenridge Stephens 514 W. Walker 76424 254 559-9582 559-9427HH CMS Health Care BCBS/VA Brownwood Brown 1102 Early Blvd 76801 325 643-4900 646-8605HH Brady Healthcare BHCS No BCBS Brownwood Brown 3657 Hwy 377 South 76801 325 643-4999 643-5538HH Encompass HH. No United Hlthcare, BCBS or Aetna Brownwood Brown 104 S. Broadway St. 76801 325 646-5565 641-2399HH Girling Health Care. PHC/CBA, No BCBS wcomp Brownwood Brown 118 D S. Park 76801 325 643-5525 254-629-8698HH Integracare PHC/CBA No BCBS Brownwood Brown 107 S. Park Dr. Ste. C 76801 325 646-2717 646-2721HH Renew Home Health Burleson Johnson 517 SW Wilshire Blvd. 76028 866 841-3044 720-6748HH Childress Regional Medical HH Childress Childress Highway 83 N. 79201 940 937-6371 937-9626HH Integracare PHC/CBA No BCBS Cisco Eastland 1300 Conrad Hilton Ave. 76437 254 442-2418 442-2482HH Tristar Home Health Cisco Eastland 1106 W. 6th 76437 254 442-4996 442-2002HH CMS Health Care BCBS/VA Coleman Coleman 118 W.Pecan St., Ste. 409 76834 325 625-2186 625-3397HH Encompass HH. No United Hlthcare, BCBS or Aetna Coleman Coleman 300 Commercial 76834 325 625-5558 625-1563HH Integracare PHC/CBA No BCBS Colorado City Mitchell 271 Walnut 79512 325 728-2657 728-3527HH Comanche Community Health Care PHC/CBA Comanche Comanche 108 W. Oak 76442 325 356-2509 356-3716HH Stephens Healthcare Comanche Comanche 76442 325 356-7501 254-965-7040HH Interim Home Health PHC Tricare Crosbyton 218 W. Aspen 806 675-1516


June 2019 Page 112



HH Guardian Healthcare Dallas Dallas 7610 N. Stemmons Fwy Ste. 540 214 678-9500 678-0900HH Medway Home Health DeLeon Comanche 117 North Texas St. 76444 254 893-5990 893-5992HH Brady Healthcare No BCBS Early Brown 950 Early Blvd. 76802 325 643-4999 643-5538HH Encompass HH, No United Hlthcare, BCBS or Aetna Early Brown 104 S. Broadway St. 76802 325 6465565 641-2399HH Guardian - Velita Smith Home Health Early Brown 919 Early Blvd., Ste. 2D 76801 325 646-2999 643-8172HH Encompass HH. No United Hlthcare, BCBS or Aetna Eastland Eastland 300 W Main St. 76448 254 629-8200 629-8220HH Girling Health Care. PHC/CBA No BCBS wcomp Eastland Eastland 405 E. Commerce 76448 254 629-1268 629-8698HH Guardian Healthcare Eastland Eastland 981 E. Main 76448 254 631-0009 631-0020HH Guardian Healthcare Ft. Worth Tarrant 1401 Ballinger Ste. 100 817 882-8200 882-8789HH Coryell Home Health Gatesville Coryell 402 W. Maine 76528 254 865-9233 865-8605HH Beyond Faith Homecare & Rehab Graham Young 604 Oak St., #102 76450 940 521-0300 521-0323HH Graham Regional Home Health No BCBS Graham Young 523 Elm St. 76450 940 549-2672 549-3978HH Integracare PHC/CBA No BCBS Graham Young 457 Oak 76450 940 549-6999 549-6296HH Young County Home Health Graham Young 700 Elm St. 76450 940 549-4039 549-9814HH Lee Healthcare Hamilton Hamilton 114 E. Main 76531 254 386-8971 386-5044HH Stamford Hospital Home Health Firstcare Hamlin Jones 1601 Columbia 79520 325 773-4718 773-5576HH Haskell Home Health No NHIC Haskell Haskell 417 S. 1st 79521 940 864-5074 864-6163HH Accolade Home Health Jayton Kent 347 N. Main 79528 806 237-2145 237-2147HH Knox City Hospital Home Health Firstcare Knox City Knox 701 S. 5th 79529 940 657-3013 657-5377HH Integracare Home Health BCBS No Aetna Lubbock Lubbock 1312 Texas Ave. 79401 806 788-5566 788-5571HH Encompass Midland 4610 N. Garfield Rd. Ste. B-20 432 570-8899 432-570-5669HH Interim Home Health PHC Tricare Midland 1031 Andrews Hwy Ste. 200 79705 432 550-7593 618-0307HH St. Joseph's Home Health includes Scurry Co Midland 24 Smith Rd., Ste. 500 79705 432 684-5858 684-4423HH Integracare PHC/CBA No BCBS Mineral Wells Palo Pinto 937 FM 1821 N. Ste. A 76067 940 325-5255 325-5258HH Interim Home Health PHC Tricare Muleshoe 110 E. Ave C 79347 806 272-5549 272-5540HH Integracare PHC/CBA No BCBS Olney 101 N. Ave C 76374 940 564-4696 564-4695HH Interim Home Health PHC Tricare Pampa 2217 Perryton Parkway 806 665-1445 688-0186HH Interim Home Health PHC Tricare Plainview Hale 2620 Yonkers 806 288-0220HH Interim Home Health PHC Tricare Rotan Fisher 210 W. Sammybaugh 79546 325 735-2687 735-3718HH Encompass HH. No United Hlthcare, BCBS or Aetna San Angelo Tom Green 136 E. Twohig Ave. 76903 325 486-0400 486-0403HH Girling Health Care PHC/CBA No BCBS wcomp San Angelo Tom Green 3180 Exectuve Dr. 76904 325 949-1108 944-8712HH Interim Home Health PHC Tricare San Angelo Tom Green 3402 Green Meadow Ste. B 76904 325 223-1957 223-5140HH Medway Home Health San Angelo Tom Green 3123 Executive 76904 325 944-8181 944-8552HH Nurses Unlimited PHC San Angelo Tom Green 3131 Executive 76904 325 653-2409 655-3525HH Integracare Pedi/PHC Healthsmart San Angelo Tom Green 133 W. Concho Ste. 102 76904 325 944-3063 949-0937HH Shannon Home Health San Angelo Tom Green 2030 Pulliam Ste. 6 76903 325 659-7497 657-7480HH Guardian - Velita Smith Home Health San Saba San Saba 301 E. Wallace 76877 325 372-3196 372-5829

HH Integracare/Home Health of Rual Texas. PHC/CBA; No BCBS Seymour Baylor 108 E. Morris 76380 940 888-3744 888-2609

HH Seymour Hospital Home Health Seymour Baylor 201 Stadium Dr. 76380 940 889-3755 889-2715HH Cogdell Memorial Hosp HH Snyder Scurry 5301 Trinity Blvd. Ste. F 79549 325 574-7340 573-1882HH Integracare Home Health BCBS No Aetna Snyder Scurry 1822 26th St. 79549 325 574-1896 574-1871HH Stamford Hosp Home Health Firstcare and BCBS Stamford Jones 1601 Columbia St. 76553 325 773-4718 773-5576HH Girling Healthcare Services Stephenville Erath 2301A W.S. Loop 76401 254 965-9666 965-8817HH Stephens Home Health Stephenville Erath 711 N. Gram 76401 254 965-6629 965-7040HH Encompass HH. No United Hlthcare, BCBS or Aetna Sweetwater Nolan 900 E. 15th St. 79556 325 235-0888 235-4803HH Rolling Plains Home Health PHC/CBA Sweetwater Nolan 1008 Lamar 79556 325 235-2030 235-0613HH Integracare PHC/CBA No BCBS Tahoka Lubbock 1511 Conway 79373 806 561-1115 561-1122


June 2019 Page 113



HH TLC Home Health Throckmorton Throckmorton 709 N. Minter 76383 940 849-0888 849-0705HH Guardian Healthcare Waxahachie Ellis 300 1st St. 75165 972 937-1560 937-1600HH North Runnels Home Health Winters Runnels 106 N. Main 79567 325 754-4141 754-4337HH Beyond Faith Homecare & Rehab 325 437-7019 437-7020

Hospice Hendrick Hospice Care Abilene Taylor 1682 Hickory 79601 325 677-8516 675-5031

Hospice Hospice of the Big Country Abilene Taylor 4601 Hartford 79605 325 793-5450 793-5459Hospice Integracare Hospice Abilene Taylor 1665 Antilley Rd Ste 100 79605 325 691-9947 521-9722Hospice Solaris Healthcare Hospice Abilene Taylor 1290 S. Willis Ste. 107 79605 888 376-5274 940-521-9722Hospice Hospice of Ballinger Ballinger Runnels 112 S. 7th 76821 325 365-2375 365-5484Hospice Integracare Hospice Bedford 1305 Airport Ste. 401 76021 817 354-7200 354-7206Hospice Solaris Healthcare Hospice Bowie Montague 800 Hwy 59 N, Ste. B 76230 940 872-8080 940-521-9722Hospice Lighthouse Home Health Hospice Brownwood Brown 107 D South Park Dr. 76801 325 643-5718 643-6249Hospice Solaris Healthcare Hospice Brownwood Brown 413 Center Ave. 76801 325 641-1630 646-8127Hospice Comanche Co. Med. Center Hospice Care Comanche Comanche 108 W. Oak 76801 325 356-2966 356-3716Hospice Solaris Healthcare Hospice Decator Wise 1502 S FM 51, Ste. D 76234 940 627-1011 627-3160Hospice Solaris Healthcare Hospice Denton Denton 100 N 1-35 E bldg 201 76210 940 382-7600 566-0564Hospice Lighthouse Home Health Hospice Eastland Eastland 107 E. Southpark 76448 254 629-8017 629-8012Hospice Solaris Healthcare Hospice Graham Young 509 Elm St. 76450 940 521-0922 521-9722Hospice Integracare Hospice Lubbock Lubbock 1312 Texas Ave. 79401 806 472-6900 788-5571Hospice Intergracare Hospice Mineral Wells Palo Pinto 937 FM 1821 N. Ste. A 76067 940 468-4225 325-5258Hospice Solaris Healthcare Hospice Mineral Wells Palo Pinto 101 Holly Hill Rd. 76067 940 325-0059 325-5000Hospice Intergracare Hospice Snyder Scurry 1822 26th St. 79549 325 574-1896 574-1871Hospice Solaris Healthcare Hospice Southlake Tarrant 1725 E Southlake Blvd Ste 120 76092 817 488-4555 488-4544Hospice Solaris Healthcare Hospice Springtown Parker 417 E. Hwy 199, Ste. 2 76082 817 523-5604 523-7947Hospital Abilene Regional Medical Center Abilene Taylor 6250 Hwy 83-84 79606 325 428-1000Hospital Abilene State School Infirmary Abilene Taylor 2501 Maple St. 79602 325 692-4053Hospital Acadia Abilene Behavioral Health Psych Abilene Taylor 4225 Woods Pl. 79602 325 698-6600Hospital Hendrick Medical Center Abilene Taylor 1900 Pine St. 79601 325 670-2000Hospital Reliant Rehabilitation Hospital Abilene Taylor 6401 Directors Parkway 79606 325 691-1600 691-1621Hospital Shackelford Co. Hospital no swing beds Albany Shackelford 840 Gregg St. 76430 325 762-3313 762-2342Hospital Anson General Hospital Anson Jones 101 Ave. J 79501 325 823-3231 823-2574Hospital Kindred Hospital Arlington Tarrant 1000 N. Cooper 76011 817 548-3400Hospital Stonewall Memorial Hospital Aspermont Stonewall 821 N. Broadway 79502 940 989-3551 989-3395Hospital Ballinger Memorial Hospital Ballinger Runnels 608 Ave. B 76821 325 365-2531 365-2662Hospital Big Spring State Hospital Big Spring Howard 1901 N Hwy 87 79720 432 268-7221Hospital Scenic Mountain Medical Center Big Spring Howard 1601 W. 11th Place 79720 432 263-1211 263-0151Hospital Heart of Texas Memorial Hospital Brady McCullough 2008 Nine Rd. 76825 325 597-2901 597-2280

Hospital Stephens Memorial Hospital Breckenridge Stephens 200 S. Geneva 76424 254 559-2241 559-9000

Hospital Brownwood Regional Medical Center Brownwood Brown 1501 Burnet Dr. 76801 325 646-8541 646-5459

Hospital Childress Regional Medical Center Childress Childress 1001 US Hwy 83 N 79201 940 937-9100 937-9133Hospital Coleman County Medical Center Coleman Coleman 310 S. Pecos 76834 325 625-2135 625-3203Hospital Mitchell County Hospital Colorado City Mitchell 997 W I 20 79512 325 728-3431 728-8974Hospital Comanche County Medical Center Comanche Comanche 10201 Hwy 16 N. 76442 325 356-5241 356-3716Hospital Baylor University Medical Center Dallas Dallas 3500 Gaston Ave 75246 214 820-0111


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Hospital Childrens Medical Center Dallas Dallas 1935 Medical District Dr. 75235 214 456-7000Hospital Presbyterian Hospital Dallas Dallas 8200 Walnut Hill Lane 214 345-6789Hospital UT Southwestern Medical Center Dallas Dallas 5323 Harry Hines Blvd. 214 648-3111Hospital Zale Lipshey Dallas Dallas 5151 Harry Hines Blvd. 214 645-5555Hospital DeLeon Hospital no swing beds DeLeon Comanche 407 S. Texas 76444 254 893-2011 893-3017

Hospital Eastland Memorial Hospital no swing beds Eastland Eastland 304 S. Daugherty Ave. 76448 254 629-2601 629-8929

Hospital Baylor All Saints Medical No SNF Ft. Worth Tarrant 1400 8th Ave. 76104 817 926-2544Hospital Baylor Medical Center SW Ft. Worth Tarrant 7100 Oakmont Blvd. 76132 817 346-5700Hospital Cook Children's Medical Center Ft. Worth Tarrant 801 7th Ave. 76104 682 885-4000Hospital Harris Methodist Hospital LTAC Ft. Worth Tarrant 1301 Pennsylvana 817 250-2000Hospital Harris Methodist Hospital SW Ft. Worth Tarrant 6100 Harris Parkway 817 433-5000Hospital John Peter Smith Health Network Ft. Worth Tarrant 1500 S. Main St. 76104 817 927-3431Hospital Kindred Hospital Ft. Worth Tarrant 815 8th Ave. 76104 817 332-4812 332-8843Hospital John Sealy Hospital Galveston 409 772-1011Hospital Shriners Burn Center Galveston 815 Market St. 409 770-6600Hospital UT Medical Branch Galveston 800 962-3648Hospital Graham Regional Medical Center Graham Young 1301 Montgomery Rd. 76450 940 549-3400 549-3978Hospital Baylor Regional Medical Center No SNF Grapevine Tarrant 1650 W. College St. 76051 817 481-1588Hospital Hamlin Memorial Hospital Hamlin Jones 1 North Ave. N 79520 325 576-3646 576-2922Hospital Haskell Memorial Hospital Haskell Haskell 1417 N 1st St. 79521 940 864-2621 864-3713Hospital Ben Taub Hospital Houston Harris 1504 Taub Loop 77030 713 873-2000Hospital Methodist Hospital Houston Harris 6565 Fannin St. 713 790-3311Hospital St. Luke's Episcopal Houston Harris 6720 Bertner Ave. 832 335-1000Hospital Texas Childrens Hospital Houston Harris 6621 Fannin 832 824-1000 800-364-5437Hospital Harris Methodist Hospital Hurst/ Tarrant 817 685-4000Hospital Knox City County Hospital Knox City Knox 701 SE 5th 79529 940 657-3535 657-5521Hospital Covenant Medical Center Lubbock Lubbock 3615 19th St. 79410 806 725-0000Hospital Covenant Children's Medical Center Lubbock Lubbock 4015 22nd 79410 806 725-0000Hospital University Medical Center Lubbock Lubbock 602 Indiana Ave. 79541 806 775-8221Hospital Midland Memorial Hospital Midland 79705 800 833-2916Hospital Medical Center Hospital Odessa Ector 500 W. 4th St 79761 432 640-4000Hospital Odessa Regional Medical Center Odessa Ector 520 E. 6th St. 432 582-8000Hospital Fisher County Hospital Rotan Fisher 774 US Hwy. 70 North 79546 325 735-2256 735-3070Hospital San Angelo Community Medical Center San Angelo Tom Green 3501 Knickerbocker Rd. 76905 325 949-9511Hospital Concho Valley San Angelo Tom Green 76905 325 869-5911Hospital River Crest Hospital San Angelo Tom Green 1636 Hunters Glen 76901 325 949-5722Hospital Shannon Medical Center San Angelo Tom Green 120 E Harris Ave. 76905 325 653-6741 658-8295Hospital Shannon Behavioral Health Svcs San Angelo Tom Green 2018 Pulliam 76905 325 659-7260 659-7263Hospital West Texas Medical Assoc. San Angelo Tom Green 3555 Knickerbocker 76905 325 949-9555Hospital West Texas Rehab Hospital San Angelo Tom Green 3001 S. Jackson 76905 325 223-6300 223-6408Hospital Seymour Hospital Seymour Baylor 200 Stadium Dr. 76380 940 889-5572 889-3337Hospital Cogdell Memorial Hospital Snyder Scurry 1700 Cogdell Blvd. 79549 325 573-6374 574-7389

Hospital Stamford Memorial Hospital Stamford Jones 1601 Columbia 79553 325 773-2725 773-3781

Hospital Harris Methodist Hospital in Erath County Stephenville Erath 965 N Graham St. 76401 254 965-1500 965-1573

Hospital Rolling Plains Memorial Hospital Sweetwater Nolan 200 E. Arizona Ave. 79556 325 235-1701 235-4252


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Hospital Scott & White Temple Bell 2401 S. 31st St. 76504 254 724-2111Hospital Throckmorton County Mem. Hospital Throckmorton Throckmorton 802 N. Minter Ave. 76483 940 849-2151 849-7141Hospital North Runnels Hospital Winters Runnels 7821 Hwy 153 East 79567 325 754-4553 754-3022VA VA Hotline - Department of Veterans Affairs 325 674-1328VA Clinic VA Clinic Abilene Taylor 79602 325 695-3252 695-3414

VA Social Worker, Maria Rivera Abilene Taylor 800 472-1365 x2126VA Clinic VA Clinic Brownwood Brown 76801 325 641-0568VA Hospital Albuquerque New Mexico 505 265-1711VA Hospital Big Spring Jane Witt, ex. 7834 Big Spring Howard 300 Veterans Blvd. 79720 432 263-7361VA Hospital Dallas Dallas Dallas 4500 S. Lancaster Rd. 75216 214 742-8387VA Hospital Houston Houston Harris 713 791-1414VA Hospital Huntsville Huntsville 800 448-2456VA Hospital San Antonio San Antonio Bexar 7400 Merton Minter 210 617-5300VA Hospital Temple Temple Bell 1901 Veteran Memorial Dr. 76054 254 778-4811VA Hospital Waco Waco McLennan 76704 254 752-6581VA Hospital Waco Regional Waco McLennan 76704 254 772-3060

SMRS One Call Kelly Armstrong, Nurse Liason 325 437-7677 437-5921NH Abilene Nursing & Rehab Center SNF/no VA Abilene Taylor 2630 Old Anson Rd. 79603 325 673-5101 673-0568

NH Care Inn of Abilene SNF/no VA vacs-yes Abilene Taylor 4934 S. 7th 79605 325 692-2172 692-4238

NH Coronado Nursing Center SNF vacs-yes Abilene Taylor 1751 N. 15th 79603 325 675-5123 672-6947NH Mesa Springs Abilene Taylor 7171 Buffalo Gap Rd. 79606 325 692-8080 437-5921

NH Northern Oaks Nursing & Rehab SNF vacs-yes Abilene Taylor 2722 Old Anson Rd. 79603 325 676-1677 1-877-366-1677

NH The Oaks at Radford Hills Nursing & Rehab SNF Abilene Taylor 725 Medical Dr. 79601 325 672-3236 677-1033

NH Wesley Court SNF/Pvt Pay Abilene Taylor 2617 Antilley Rd. 79606 325 437-1184 437-0885

NH Windcrest Healthcare Center SNF Abilene Taylor 6050 Hospital Dr. 79606 325 692-1533 698-1208

NH Wisteria Place Nursing & Rehab Center SNF Abilene Taylor 3202 S. Willis St. 79605 325 692-6145 695-2629

NH Valley View Care Center SNF Anson Jones 101 Liberty Ln. 79501 325 823-2141 823-3077NH Gibson Care Center Aspermont Stonewall 931 N. Broadway 79502 940 989-3526 989-3606NH Homestead Nursing & Rehab Baird Callahan 224 E. 6th 79504 325 854-1429 854-2030NH Ballinger Healthcare & Rehab Ballinger Runnels 2001 6th St. 76821 325 365-5766 365-8651NH Central Texas Nursing and Rehab Ballinger Runnels 1800 N. Broadway 76821 325 365-2538 365-2530NH Bangs Nursing Home Bangs Brown 1105 Fitzerald 76823 325 752-6321 752-6883NH Twilight Nursing Home Bangs Brown 504 Southwest 76823 325 752-6322 752-6923NH Cedar Crest Care Center Breckenridge Stephens 1901 W. Elliott 76424 254 559-3303 559-3310NH Villa Haven Health & Rehab/Vendor#4773 Breckenridge Stephens 300 S. Jackson 76424 254 559-3386 559-7259NH Brownwood Nursing & Rehab/Vendor#4881 Brownwood Brown 101 Miller Dr. 76802 325 643-9555 643-9519NH Brownwood Skilled Nursing Brownwood Brown 2700 Memorial Park Dr. 76801 325 643-9801 646-9359NH Care Nursing Center Brownwood Brown 200 CR 616 76802 325 646-5521 643-2790NH Cross Country Health Care Center Brownwood Brown 1514 Indian Creek Rd. 76801 325 646-6529 646-4521NH Oak Ridge Manor Brownwood Brown 2501 Morris Sheppard Dr 76801 325 643-2746 646-3702NH Songbird Lodge Brownwood Brown 2500 Songbird Circle 76801 325 646-4750 643-5250NH Homestead Nursing & Rehab Cisco Eastland 1404 Front St. 76437 254 442-4202 442-1174


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NH Clyde Health Care Center Clyde Callahan 806 Stephens St. 79510 325 893-4288 893-2568NH Coleman Health Care Center/Vendor#4564 Coleman Coleman 2713 Commercial Ave. 76834 325 625-4105 625-3114NH Holiday Hills Nursing Center *no IVS* Coleman Coleman 245 State Hwy 153 W. 76834 325 625-4157 625-5306NH Kristi Lee Manor Colorado City Mitchell 1941 Chestnut 79512 325 728-5247 728-5006NH Valley Fair Lodge No SNF Colorado City Mitchell 1541 Chestnut 79512 325 728-2634 728-3281NH Western Hills Comanche Comanche 400 Old Sydney 76442 325 356-2571 356-2716NH DeLeon Nursing & Rehab DeLeon Comanche 809 E. Navarro 76444 254 893-2075 893-5595NH Golden Age Manor Dublin 704 E. Dobkins 254 445-3379 445-2468NH Valley View Health Care Center Eastland Eastland 700 S. Ostrom 76448 254 629-1779 629-0943

NH Concho Health & Rehabilitation Center rehab, PT, OT Eden TX 613 Eaker St. 76837 325 869-5531 869-5152

NH Gilmer Care Center SNF vents Gilmer 703 N. Titus St. 75644 903 843-5529 680-2175NH Homestead Nursing & Rehab Gorman Eastland 600 W. Roosevelt 76454 254 734-2202 734-2220NH Graham Oaks Care Center 24 bed venilator unit Graham Young 1325 1st St. 76450 940 549-8787 549-6565NH Grand Prairie Health Care Grand Priarie Dallas 820 Small St 972 262-1351 642-0567NH Home Place Manor Hamlin Jones 425 SW Ave. F 79520 325 576-3643 576-3913NH Haskell Health Care Haskell Haskell 1504 N. 1st 79521 940 864-3556 864-8040NH Kent Nursing Home Jayton Kent 1443 N. Maine 79528 806 237-3036 237-2090NH Brazos Valley Care Home Knox City Knox 605 S. Ave. F 79529 940 658-3543 658-5068

NH Southern Specialty Rehab & Nursing vents, trachs, hospice Lubbock 4320 W. 19th Str. 79407 806 795-1774 795-4652

NH Merkel Nursing Center Merkel Taylor 1704 N. 1st 79536 325 928-5673 928-3011NH Mineral Wells Nursing and Rehab Mineral Wells Palo Pinto 316 S.W. 25th Ave. 76067 940 325-1358 325-5802NH Resort Lodge Mineral Wells Palo Pinto 401 N.W. 4th 76067 940 325-3744 328-1463NH Munday Nursing Center Munday Knox 421 W. F St. 76371 940 422-4541 422-5244NH Ranger Care Center Ranger Eastland 460 W. Main St. 76470 254 647-3111 647-5183NH Rising Star Nursing Center Rising Star Eastland 411 S. Miller 76471 254 643-2681 643-1723NH Baptist Memorials Geriatric Center San Angelo Tom Green 902 N. Main 76903 325 655-7391 653-1413NH Cedar Manor San Angelo Tom Green 1915 Greenwood 76901 325 942-0677 942-1331NH Trisun Care Meadow Creek Nursing Center San Angelo Tom Green 4343 Oak Grove Blvd. 76904 325 942-4000 949-3598NH Park Plaza Nursing Center San Angelo Tom Green 2210 Howard 76901 325 944-0561 944-0562NH Regency Home San Angelo Tom Green 3745 Summer Crest Dr. 79601 325 947-8776 947-7237NH Abor Terrece San Angelo Tom Green 609 Rio Concho 76903 325 653-1266 655-6938NH Touchstone Communities San Antonio Bexar 1020 NE Loop 410 78209 210 828-5686 824-4669

Seymour Rehab & Healthcare Seymour 1110 Westview Dr. 76380 980 889-3???Silver Springs 325 701-9975 704-1805

NH Snyder Health Care Center Snyder Scurry 5311 Big Springs Hwy 79549 325 573-6332 573-6334NH Snyder Oaks Care Center Snyder Scurry 210 East 37th St. 79549 325 573-9377 573-8080NH Community Care Center SNF Stamford Jones 1003 Columbia 79553 325 773-3671 773-5751NH Castle View Nursing & Rehab Stephenville Erath 2309 W. Washington 76401 254 968-4191 968-0862NH Senior Care Center of Stephenville Stephenville Erath 2601 N.W. Loop 76401 254 968-4649 968-5535NH Mulberry Manor Stephenville Erath 1670 W. Lingleville Rd. 76401 254 968-2158 968-7679NH Stephenville Nursing Home Stephenville Erath 2311 W. Washington 76401 254 968-3313 968-6890NH Sterling City Nursing Home Sterling City Sterling 309 5th St. 76951 325 378-2134 378-4006

NH Nolan Nursing & Rehab Sweetwater Nolan 705 N. Lamar 79556 325 235-5417 235-4519


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NH Sweetwater Healthcare Center Sweetwater Nolan 1600 Josephine 79556 325 236-6653 236-6834

NH Throckmorton County Nursing Home Throckmorton Throckmorton 1000 N. Mentor 76483 940 849-2861 HBO x4183 / x4139f

NH Winters Senior Citizen Nursing Home Winters Runnels 506 Van Ness 79567 325 754-4567 754-4634

NH Courtyard Gardens-Special Bariatric need/behavprob Witchita Falls Wichita 1501 7th Str. 76301 940 322-0741

Eastland Dialysis 254 629-3600 629-8907

OP / DIAL Fresenius Medical Services Denver, CO ALL NEWLY DIAGNOSED ERSD GO THRU HERE 1ST 877 792-8805 806-792-8808

OP / DIAL Dialysis Center North Side Abilene Taylor 1802 Pine St. 79601 325 672-3243 673-6443OP / DIAL Dialysis Center South Side Abilene Taylor 2009 Hospital Place 79606 325 793-2594 793-2225OP / DIAL West Texas Dialysis Center Big Spring Howard 501 Birdwell Ln., Ste. 10 79720 432 267-2903 267-1756OP / DIAL AccessCare Brownfield Dialysis Brownfield 710 E. Felt St. 79316 806 637-6373 637-6371OP / DIAL Brownwood Renal Care Dialysis Brownwood Brown 118 A S. Park Dr. 76801 325 646-9510 643-5376OP / DIAL AccessCare Colorado City Dialysis Colorado City Mitchell 1546 Chestnut St. 79512 325 728-8348 728-9228OP / DIAL AccessCare Dumas Dialysis Dumas 107 Binkley Ave. 79029 325OP / DIAL AccessCare Fort Stockton Dialysis Fort Stockton 387 W. I 10 79375 432 336-4859 336-4894OP / DIAL AccessCare Muleshoe Dialysis Muleshoe 1100 W. Ave. J 79347 806 272-3122 272-4946OP / DIAL Angelo Kidney Connection San Angelo Tom Green 2901 Sherwood Way Ste. 100 76901 325 617-2496 617-2497OP / HBO Abilene Regional Abilene Taylor 6250 Hwy 83-84 79606 325 428-2800 690-4663

OP / HBO Hendrick Medical Center Abilene Taylor 1900 Pine St. 79601 325 Cent Sched x4270

HBO x4183 / x4139f

OP / HBO West Texas Wound Care Clinic Abilene Taylor 2501 S. Willis, Ste. D 79605 325 793-1104 793-1112OP / HBO Brownwood HBO & Wound Care Center Brownwood Brown 123 S. Park 325 649-3640 649-3646OP / IV ABX Abilene Diagnositc Center Abilene Taylor 325 670-4575 670-6376

OP / IV ABX Hendrick Medical Center Infusion Clinci Abilene Taylor 1900 Pine St. 79601 325 Cent Sched x4270

Infusion Clinic x2596 / x2517f

OP / IV ABX Dr. Hirsch Abilene Taylor 2000 Pine St. 79601 325 673-0100OP / IV ABX Harmony House Infusion Clinic Graham Young 1309 Brazos 76450 940 549-2223 549-5411OP / PT Abilene Physical Therapy & Sports Rehab Clinic Abilene Taylor 4127 S. Danville Dr. 79605 325 695-6011 695-4947OP / PT Action Sports Medicine & PT Abilene Taylor 1717 Pine St. 79601 325 676-5633 676-8831OP / PT Hendrick Center for Rehab Abilene Taylor 1934 Hickory St. 79601 325 670-6000 670-7790OP / PT Human Performance & Rehab Services Abilene Taylor 3802 Buffalo Gap Rd. 79605 325 695-4244 691-0582OP / PT Rebound Sports & Physical Therapy Abilene Taylor 1720 S. Clack St. 79605 325 691-0093 691-0062OP / PT Southwest Therapy Abilene Taylor One Village Dr., Ste. 260 79606 325 437-5884 437-5901OP / PT Spine Abilene Physical Therapy / Abilene Diagnostic Abilene Taylor 1888 Antilley Rd. 79606 325 795-1888OP / PT Texas Sport & Spine Abilene Taylor 4545 Hartford St. 79605 325 698-4545 698-4547OP / PT The Oaks at Radford Hills Nursing & Rehab Abilene Taylor 725 Medical Dr. 79601 325 672-3236OP / PT West Texas Rehabilitation Center Abilene Taylor 4601 Hartford 79605 325 793-3400 793-3534OP / PT Stonewall Memorial Hospital Aspermont Stonewall 821 N. Broadway 79502 940 989-3551 989-3395OP / PT Bangs Physical Therapy Center Bangs Brown 807 E. Hall St. 76823 325 752-6819 752-6906OP / PT Stephens Memorial Rehab Center Breckenridge Stephens 202 S. Hartford 76424 254 559-1864 559-1831OP / PT Action PT Brownwood Brown 919 Early Blvd. Ste 1A 76801 325 646-9900 646-9100OP / PT Brownwood Reg. Rehab & Fitness Brownwood Brown 76801 325 646-0600 641-2557OP / PT Coleman Co. Med Center Cardiac Rehab & Physical Ther Coleman Coleman 310 S. Pecos 76834 325 625-2135 x303 625-5730


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OP / PT Mitchell County Hospital Colorado City Mitchell 1543 Chestnut 79512 325 728-3431 728-2210OP / PT Comanche PT Comanche Comanche 103 W. Oak 76442 325 356-5394 356-3716OP / PT DeLeon Wellness Center DeLeon Comanche 407 S. Texas 76444 254 893-2015 893-2014OP / PT Eastland Memorial Hospital Eastland Eastland 304 S. Daugherty 76448 254 629-2601 631-0819OP / PT Hill Country Physical Therapy Goldwaithe 1503 W. Front St. 325 648-2350 648-2587OP / PT Graham Regional Medical Center Graham Young 523 Elm St. 76450 940 549-3400 521-5151OP / PT Haskell Memorial Hospital Haskell Haskell 1 N. Ave N 79521 940 864-8511 864-8512OP / PT West Texas Rehabilitation Center Ozona 908 1st St. 325 392-9872OP / PT Fisher County Hospital Rotan Fisher 774 Hwy 70 N. 79546 325 735-3434 735-3396OP / PT West Texas Rehabilitation Center San Angelo Tom Green 3001 S. Jackson 76901 325 223-6300 2236447OP / PT Cogdell Memorial Hospital Snyder Scurry 79549 325 574-7259 574-1423OP / PT Stamford Hospital Stamford Jones 1601 Columbia St. 79553 325 773-2725 773-3781OP / PT Stephenville Sports & Rehab Stephenville Erath 2269 N.W Loop 76401 254 965-2723 965-7394OP / PT Rolling Plains Hospital Sweetwater Nolan 200 E. Arizona 79556 325 235-1701 x278 236-6042OP / WC Abilene Regional Abilene Taylor 6250 Hwy 83-84 79606 325 428-2800 428-2819

OP / WC Hendrick Medical Center Abilene Taylor 1900 Pine St. 79601 325 Cent Sched x4270

Wound Care x4369 / x4139f

OP / WC West Texas Wound Care Clinic Abilene Taylor 2501 S. Willis, Ste. D 79605 325 692-0267 793-1112OP / WC Brownwood Wound Care and HBO Clinic Brownwood Brown 123 S. Park 325 649-3640 646-3646OP Wound KCI - Lisa Richey Inpatients

OP Wound Vac KCI - Kerri Mitchell, PT, CWS Clinical

Consultant 1304 S. Midland Dr. 79703 432 978-5548 325-691-0046

Pharmacy Owen Pharmacy Abilene Taylor 2125 S. 20th 79605 325 691-9000 691-0845

Pharmacy Professional Pharmacy Abilene Taylor 79601 325 670-4545 670-2896

Pharmacy Central Line Infusion Amarillo Potter 1301 S. Coulter, Suite 201 79106 806 352-1212 356-9457Pharmacy Paragon Infusion Care BCBS Cigna Aetna Tricare Dallas/Ft Tarrant 17111 Preston Rd, Suite 160 75248 866 972-5888 866-491-5888Pharmacy Central Line Infusion Dallas Dallas 75207 866 479-7377Pharmacy Coram Specialty Infusions Dallas Dallas 444 Oak Lawn, Ste. 545 75207 214 902-3600 902-3601

Pharmacy Paragon Infusion Care BCBS Cigna Aetna Tricare Houston Harris 6721 Portwest Ste. 100 77054 866 918-0201 866-491-5888

Pharmacy Alpha Infusions Marble Falls Burnet 407 Main St. Ste. 3 78654 800 693-4143 830-693-3440Pharmacy MedWay Infusion Services San Angelo Tom Green 3125 Executive Dr. 76904 325 944-0300 944-0355

Pharmacy Walgreens Home Care Infusion Therapy Works with Girling HH 888 492-5442 336-1203

Air Transport Air-Evac 63 Abilene Taylor located @ HMC dispatch 800 247-3822 non-emergAir Transport Air-Evac 52 Brownwood Brown located @ Brownwood Reg Med dispatch 800 247-3822 non-emergAir Transport AIRBORNE 800 247-3010 866-247-3029Air Transport Angel Flight West 888 426-2643Air Transport Angel MedFlight 877 264-3570Air Transport Care Flight Ft. Worth Tarrant 800 442-6260Air Transport Critical Care MedFlight 800 426-6557Air Transport Federal Air Ambulance St. Louis, 5 Kingsbury Place 63112 800 821-0541 314-367-2101

Air Transport Grace Flight America 888 500-0433

Air Transport Global Air Response Areawide 800 631-6565


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Air Transport Lifeguard Aeromed Inc Areawide 800 248-5433

Air Transport Air Methods / Native Air 800 242-6199

Air Transport Teddy Bear Air Ft. Worth Tarrant 800 543-4878

Ambulance MetroCare Abilene Taylor 325 692-9367 690-0625Ambulance Abilene Ambulance Network Abilene Taylor 325 268-0604 866-337-5419Ambulance Shackleford County EMS / Procare EMS Albany Shackelford 840 Gregg St. 325 762-3313 762-2342Ambulance Anson General Hospital EMS Anson Jones 101 Ave. J 325 823-3931 823-3931Ambulance Stonewall County EMS Aspermont Stonewall 940 989-3649Ambulance Ballinger Mem. Hosp. Distr. EMS Ballinger Runnels 325 365-2537 365-2662Ambulance Blackwell EMS Blackwell Nolan 325 282-2323Ambulance Stephens County EMS Breckenridge Stephens 254 559-2241 559-2242Ambulance Guardian EMS Dispatch # 866 458-6111 979-733-0205Ambulance Citizens EMS (Clyde) Clyde Callahan 815 S. 2nd St. 325 893-5754 893-4127Ambulance Capital Ambulance Lampasas 866 373-2873 512-556-0072Ambulance Coleman County Medical Center EMS Coleman Coleman 315 W. Elm 325 625-2135 x227 625-5730Ambulance Comanche County Med. Center EMS Comanche Comanche 10201 Hwy. 16 N 254 879-4995 356-5241Ambulance Mitchell County EMS Colorado City Mitchell 997 W. I-20 325 728-3483Ambulance Cross Plains Ambulance Cross Plains Callahan 254 725-6661 725-4350Ambulance Dallas Care Flight (ground) Dallas Dallas Co. 800 442-6342 972-522-6266Ambulance DeLeon EMS DeLeon Comanche 254 893-2011 879-4995

Ambulance Heart of Texas EMS Early Coleman 1102 Early Blvd. 76802 325 641-0111 325-641-2542

Ambulance Eastland Mem. Hosp. EMS Eastland Eastland 254 629-2601 629-3212Ambulance Erath County EMS Erath 254 965-3318Ambulance Hamlin EMS Hamlin Jones 325 576-3646 576-3635

Ambulance Haskell County EMS Haskell Haskell or call Haskell Hosp 940-864-2621 940 864-3945 864-2575

Ambulance Kent County EMS Kent 806 237-3801

Ambulance Knox County EMS Knox City Knox or call Knox Co. Hosp 940-657-3555 940 657-1313 422-4929

Ambulance Lubbock Aide EMS Lubbock Lubbock 806 792-2168 799-5060Ambulance Merkel EMS Merkel Taylor 325 928-4766 928-1642Ambulance Mitchell County EMS Mitchell 325 728-3431Ambulance Knox County EMS Munday Knox 701 S. 5th 940 422-4929Ambulance Ranger EMS Ranger Eastland 254 647-1505 647-3398Ambulance Fisher County Hospital EMS (Rotan) Rotan Fisher 774 State Hwy. 70 N 325 735-2256Ambulance N. Runnels Hospital EMS Runnels 325 754-4553 754-5097Ambulance Scurry County EMS Snyder Scurry 3902 College Ave. dispatch 325 573-1911 non-emergAmbulance Stamford EMS Stamford Jones 301 Hamilton E. 325 773-2333 773-2333

Ambulance Stephenville EMS Stephenville Erath 356 N. Belknap 254 918-1273 or 918-1274

Ambulance Sweetwater Fire Dept/Ambulance Service Sweetwater Nolan 325 235-4304 235-1507Ambulance Throckmorton County EMS Throckmorton Throckmorton 940 849-2151 849-7141Ambulance South Taylor County EMS Tuscola Taylor 649 Kent St. 325 554-9222 554-9722


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Ambulance Vernon Ambulance Vernon Wilbarger 325 552-2584 552-2293Ambulance North Runnels EMS Winters Runnels 7821 State Hwy. 153 325 754-4553 754-5097Other Citi-Link Abilene Taylor 325 676-6402Other City and Rural Ride (CARR) 800 710-CARROther Double Mountain Coach Aspermont Aspermont Stonewall 800 722-0137 940-988-4380Other Handi Van Abilene Tayhor 325 676-6402Other Medicaid Transportation PAN #800-540-0694 877 633-8747


June 2019 Page 121

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Stormwater Services (325) 437-4937

Street Lighting (325) 676-6489

Street Services (325) 676-6045

Traf�c Signals (325) 676-6066

Traf�c Signs (325) 676-6065

TRANSPORTATION SERVICES PHONE EMAIL

Airport (325) 676-6367

CityLink (325) 676-6287

WATER UTILITIES PHONE EMAIL

Water & Sewer Repair (325) 676-6000

Water Billing & Service (325) 676-6405

Water Quality (Laboratory) (325) 676-6043

By Mail

City of Abilene PO Box 60 Abilene, Texas 79604


June 2019 Page 124





tel:3256766053


tel:3254374937


tel:3256766489


tel:3256766045


tel:3256766066


tel:3256766065





tel:3256766367


tel:3256766287





tel:3256766000


tel:3256766405


tel:3256766043


June 2019 Page 125


June 2019 Page 126

A description of any information gaps in the demographic or health data collected for this study

Information Gaps


June 2019 Page 127

Information Gaps• While the following information gaps exist in the health data section

of this report, please note that every effort was made to compensate for these gaps in the interviews conducted by CHC ContinueCARE.‒ This assessment seeks to address the community’s health needs by

evaluating the most current data available. However, published data inevitably lags behind due to publication and analysis logistics.

‒ The most significant information gap exists within this assessment’s ability to capture various county‐level health data indicators, such as arthritis, binge drinking, e‐cigarette use, days of poor mental health (14+), influenza and pneumonia immunizations, cost barrier to care, and not having a personal doctor. Data for these indicators is reported at the specifically‐created BRFSS level.


June 2019 Page 128

A description of CHC ContinueCARE, which is the organization that collaborated with the hospital to conduct this assessment

About CHC ContinueCARE


June 2019 Page 129

About CHC ContinueCARE• CHC ContinueCARE is the long‐term acute care branch of Community

Hospital Corporation (CHC).• Community Hospital Corporation owns, manages and consults with

hospitals through three distinct organizations – CHC Hospitals, CHC Consulting and CHC ContinueCare, which share a common purpose of preserving and protecting community hospitals.

• Based in Plano, Texas, CHC provides the resources and experience community hospitals need to improve quality outcomes, patient satisfaction and financial performance. For more information about CHC, please visit the website at: www.communityhospitalcorp.com


June 2019 Page 130

– Summary of Data Sources– Data References– HPSA and MUA/P Information– Interviewee Information

Appendix


June 2019 Page 131

Summary of Data Sources


June 2019 Page 132

Summary of Data Sources• Demographics

‒ This study utilized demographic data from IBM Watson Health Analytics Market Expert tool.‒ The United States Bureau of Labor Statistics, Local Area Unemployment Statistics provides unemployment statistics by county and state;

http://www.bls.gov/lau/#tables. ‒ This study also used health data collected by Community Commons, a site which is managed by the Institute for People Place and Possibility,

the Center for Applied Research and Environmental Systems, and Community Initiatives. Data can be accessed at http://www.communitycommons.org/.

‒ The Annie E. Casey Foundation is a private charitable organization, dedicated to helping build better futures for disadvantaged children in the United States. One of their initiatives is the Kids Count Data Center, which provides access to hundreds of measures of child well‐being by county and state; http://datacenter.kidscount.org/.

‒ The United States Bureau of Labor Statistics, Local Area Unemployment Statistics provides unemployment statistics by county and state; http://www.bls.gov/lau/#tables.

• Health Data‒ The County Health Rankings are made available by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health

Institute. The Rankings measure the health of nearly all counties in the nation and rank them within states. The Rankings are compiled using county‐level measures from a variety of national and state data sources. These measures are standardized and combined using scientifically‐informed weights. The Rankings are based on a model of population health that emphasizes the many factors that, if improved, can help make communities healthier places to live, learn, work and play. Building on the work of America's Health Rankings, the University of Wisconsin Population Health Institute has used this model to rank the health of Wisconsin’s counties every year since 2003; http://www.countyhealthrankings.org/.

‒ The Centers for Disease Control and Prevention National Center for Health Statistics WONDER Tool provides access to public health statistics and community health data including, but not limited to, mortality, chronic conditions, and communicable diseases; http://wonder.cdc.gov/ucd‐icd10.html.

‒ This study utilizes Health Service Region level data from the Behavioral Risk Factor Surveillance System (BRFSS), provided by the Texas Department of Health and Human Services; https://www.dshs.texas.gov/chs/brfss/.

‒ This study also used health data collected by Community Commons, a site which is managed by the Institute for People Place and Possibility, the Center for Applied Research and Environmental Systems, and Community Initiatives. Data can be accessed at http://www.communitycommons.org/.


June 2019 Page 133

Summary of Data Sources• Health Data (continued)

‒ The U.S. Census Bureau’s Small Area Health Insurance Estimates program produces the only source of data for single‐year estimates of health insurance coverage status for all counties in the U.S. by selected economic and demographic characteristics. Data can be accessed at https://www.census.gov/data‐tools/demo/sahie/index.html.

‒ The U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA) provides Medically Underserved Area / Population and Health Professional Shortage Area scores, and can be accessed at: https://datawarehouse.hrsa.gov/tools/analyzers.aspx.

• Phone Interviews‒ CHC ContinueCARE conducted interviews on behalf CCH at HMC from August 15, 2018– August 30, 2018.‒ Interviews were conducted and summarized by Ashleigh Patel, Senior Planning Analyst.


June 2019 Page 134

Data References


June 2019 Page 135


June 2019 Page 136

HPSA and MUA/P Information


June 2019 Page 137

Medically Underserved Areas / PopulationsBackground

• Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs) are areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population.

• MUAs have a shortage of primary care services for residents within a geographic area such as:• A whole county• A group of neighboring counties• A group or urban census tracts• A group of county or civil divisions

• MUPs are specific sub‐groups of people living in a defined geographic area with a shortage of primary care services. These groups may face economic, cultural, or linguistic barriers to health care. Examples include, but are not limited to:• Homeless• Low income• Medicaid eligible• Native American• Migrant farmworkers

Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, http://www.hrsa.gov/; data accessed January 9, 2019.


June 2019 Page 138

Medically Underserved Areas / PopulationsBackground (continued)

• The Index of Medical Underservice (IMU) is applied to data on a service area to obtain a score for the area. IMU is calculated based on four criteria:1. Population to provider ratio2. Percent of the population below the federal poverty level3. Percent of the population over age 654. Infant mortality rate

• The IMU scale is from 1 to 100, where 0 represents ‘completely underserved’ and 100 represents ‘best served’ or ‘least underserved.’

• Each service area or population group found to have an IMU of 62.0 or less qualifies for designation as a Medically Underserved Area or Medically Underserved Population.



June 2019 Page 139

Medically Underserved Areas / PopulationsTaylor County

• Taylor County‒ Service Area Name: Taylor Service Area

‒ MUA/P Source ID Number: 03482‒ Designation Type: Medically Underserved Area‒ Index of Medical Underservice Score: 53.7‒ Status: Designated‒ Rural Status: Non‐Rural‒ Designation Date: 05/11/1994‒ Update Date: 05/11/1994


• CT 0102.00• CT 0104.00

• CT 0108.00• CT 0110.00

• CT 0117.00• CT 0119.00


June 2019 Page 140

Medically Underserved Areas / PopulationsTaylor County

• Taylor County‒ Service Area Name: Taylor Service Area

‒ MUA/P Source ID Number: 03483‒ Designation Type: Medically Underserved Area‒ Index of Medical Underservice Score: 60.3‒ Status: Designated‒ Rural Status: Partially Rural‒ Designation Date: 05/11/1994‒ Update Date: 05/11/1994


• CT 0135.00 • CT 0136.00


June 2019 Page 141

Health Professional Shortage AreasBackground

• Health Professional Shortage Areas (HPSAs) are designations that indicate health care provider shortages in:‒ Primary care‒ Dental health‒ Mental health

• These shortages may be geographic‐, population‐, or facility‐based:‒ Geographic Area: A shortage of providers for the entire population within a defined geographic area.‒ Population Groups: A shortage of providers for a specific population group(s) within a defined geographic

area (e.g., low income, migrant farmworkers, and other groups)‒ Facilities:

Other Facility (OFAC) Correctional Facility State Mental Hospitals Automatic Facility HPSAs (FQHCs, FQHC Look‐A‐Likes, Indian Health Facilities, HIS and Tribal

Hospitals, Dual‐funded Community Health Centers/Tribal Clinics, CMS‐Certified Rural Health Clinics (RHCs) that meet National Health Service Corps (NHSC) site requirements)



June 2019 Page 142

Health Professional Shortage AreasBackground

• HRSA reviews these applications to determine if they meet the eligibility criteria for designation. The main eligibility criterion is that the proposed designation meets a threshold ratio for population to providers.

• Once designated, HRSA scores HPSAs on a scale of 0‐25 for primary care and mental health, and 0‐26 for dental health, with higher scores indicating greater need.



June 2019 Page 143

Taylor CountyTaylor County

• County Name: Taylor County• HPSA Name: Taylor County• Designation Type: Geographic HPSA• Status: Designated• Rural Status: Partially Rural


– HPSA Discipline Class:Mental Health

o HPSA ID: 748441o HPSA Score: 12o HPSA Designation Last

Update Date: 12/28/2017


June 2019 Page 144

Taylor CountyLow Income ‐ Taylor County

• County Name: Taylor County• HPSA Name: Low Income – Taylor County• Designation Type: Low Income Population HPSA• Status: Designated• Rural Status: Partially Rural


– HPSA Discipline Class: Primary Care

o HPSA ID: 1481280137o HPSA Score: 15o HPSA Designation Last

Update Date: 08/01/2018


June 2019 Page 145

Interviewee Information


June 2019 Page 146

A B

Katie Alford President/CEO Community Foundation of Abilene 8/14/2018 Taylor County Ashleigh Patel x General PublicCathy Asbhy President/CEO Abilene United Way 8/23/2018 Taylor County Ashleigh Patel x General PublicBrian Bessent Vice President Hendrick Health System 8/9/2018 Taylor County Ashleigh Patel x General PublicAnnette Lerma Interim Health Services Director Taylor County Health Department 8/30/2018 Taylor County Ashleigh Patel x General PublicCrystal Martin Program Manager West Texas Council of Gov/Area Agency on Aging 8/15/2018 Taylor County Ashleigh Patel x Seniors, Aging

Peter Norton, MD Medical Director Taylor County Health Department 8/15/2018 Taylor County Ashleigh Patel x General PublicDoug Peters President/CEO Abilene Chamber of Commerce 8/15/2018 Taylor County Ashleigh Patel x General Public

Source: ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment Interviews Conducted by CHC ContinueCARE, August 15, 2018 – August 31, 2018.

B: Member of a medically underserved, low‐income, and minority populations in the community, or individuals or organizations serving or representing the interests of such populations

A: Work for a State, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community

ContinueCARE Hospital at Hendrick Medical Center Community Health Needs Assessment Interviewee InformationIRS

CategoryName OrganizationInterview

DateTitle

County Served

Interviewer Population Served


June 2019 Page 147

Section 2:Implementation Plan


June 2019 Page 148

ContinueCARE Hospital at Hendrick Medical CenterFY 2020 - FY 2022 Implementation Plan

A comprehensive, six-step community health needs assessment (“CHNA”) was conducted for ContinueCARE Hospital at Hendrick Medical Center (CCHHMC) by CHC ContinueCARE. This CHNA utilizes relevant health data and stakeholder input to identify the significant community health needs in Taylor County.

The CHNA Team, consisting of leadership from CCHHMC, met with staff from CHC ContinueCARE on November 13, 2018 to review the research findings and prioritize the community health needs. Five significant community health needs were identified by assessing the prevalence of the issues identified from the health data findings combined with the frequency and severity of mentions in community input.

The CHNA Team participated in a roundtable discussion to rank the community health needs based on three characteristics: size and prevalence of the issue, effectiveness of interventions and the hospital’s capacity to address the need. Once this prioritization process was complete, the hospital leadership discussed the results and decided to address three of the prioritized needs in various capacities through a hospital specific implementation plan.

The final list of prioritized needs is listed below:1. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles2. Access to Affordable Care and Reducing Health Disparities Among Specific Populations3. Access to Primary Care Services and Providers4. Access to Specialty Care Services and Providers5. Access to Mental and Behavioral Health Care Services and Providers

This implementation plan addresses three of the five needs. "Access to Primary Care Services and Providers" and "Access to Mental and Behavioral Health Care Services and Providers" are not addressed largely due to the fact that they are not core business functions of the hospital and the limited capacity of the hospital to address these need. Therefore, hospital leadership has developed the following implementation plan to identify specific activities and services which directly address the remaining three priorities. The objectives were identified by studying the prioritized health needs, within the context of the hospital’s overall strategic plan and the availability of finite resources. The plan includes a rationale for each priority, followed by objectives, specific implementation activities, responsible leaders, annual updates and progress, and key results (as appropriate).

The CCHHMC Board reviewed and adopted the 2019 Community Health Needs Assessment and Implementation Plan on February 11, 2019.


June 2019 Page 149

ProgressKey Results



ProgressKey Results

(As Appropriate)

Priority #1: Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles

Objective:Increase healthy lifestyle education and prevention resources at the hospital and in the community

Rationale: Data suggests that higher rates of specific mortality causes and unhealthy behaviors warrants a need for increased preventive education and services to improve the health of the community. Heart disease and cancer are the two leading causes of death in Taylor County and the state. Taylor County has higher mortality rates than Texas for diseases of heart; malignant neoplasms; chronic lower respiratory diseases; accidents (unintentional injuries); cerebrovascular diseases; Alzheimer’s disease; diabetes mellitus; chronic liver disease and cirrhosis; intentional self-harm (suicide); septicemia; prostate cancer; colon and rectum cancer; and lung and bronchus cancer. Taylor County has a higher rate of communicable diseases such as chlamydia than the state, as well as higher prevalence rates of chronic conditions and unhealthy lifestyle behaviors such as obesity, asthma and tobacco use than the state. With regards to maternal and child health, specifically, Taylor County has higher percentages of mothers smoking during pregnancy, low birth weight births, and teen births than the state. Data also suggests that residents may not be seeking necessary preventive care services, such as sigmoidoscopies and colonoscopies. Several interviewees noted that there is a need for health education in the community regarding chronic conditions and unhealthy lifestyle behaviors, including obesity, high blood pressure, diabetes, and cardiovascular disease. Childhood obesity was specifically mentioned as a growing problem within the community. It was also emphasized that there is a lack of understanding of the disease process and importance of prevention of chronic conditions among the population, and one interviewee stated: “There is a lack of knowledge in how to navigate the preventative care landscape; they do not see the value in going for preventative care, and that is true even for people with insurance.”

Action StepsFY 2020

1.B. CCHHMC will continue to conduct outreach to referral resources in order to educate them about the role of the Long Term Acute Care Hospital (LTACH), and how they can work together to promote a healthier community.

1.C. CCHHMC provides education to physicians and case managers from their host and other Short Term Acute Care Hospitals regarding LTACH criteria.

1.E. CCHHMC provides education to staff to expand the patients that they serve, including telemetry and critical care training to meet the needs of higher acuity patients.

FY 2021 FY 2022

1.A. CCHHMC will continue to participate in health fairs within surrounding counties 2-3 times per year.

1.D. CCHHMC staff will continue to attend morning ICU rounds with the host to identify and educate on what would meet LTACH criteria.


June 2019 Page 150

ProgressKey Results



ProgressKey Results

(As Appropriate)Action Steps

FY 2020 FY 2021 FY 2022

1.G. CCHHMC will continue to incentivize employees to maintain healthy lifestyles on their health plans through offering a reduction on a portion of their premiums if employees meet certain criteria.

1.F. CCHHMC will engage in a variety of employee wellness initiatives, including a health plan that is prevention driven. Initiatives include the promotion of employee and family wellness via Asset Health (formerly Accountable Health), Employee Assistance Program (EAP) through Beacon Health Options to help employees navigate various life challenges, offering need specific special programs, CHIP (Coronary Health Improvement Plan), smoking cessation opportunities, weight management, providing and highlighting healthy food options in the hospital cafeteria, promoting fitness opportunities, and continuing the tobacco-free new hire policy.

1.H. CCHHMC will support Hendrick Medical Center with the Hendrick Center for Rehabilitation, making patients and families aware of resources. Services include: physical therapy, sports medicine, occupational therapy and hand clinic, speech therapy, Lymphedema therapy, vestibular rehab, aquatics and inpatient hospital.

1.I. CCHHMC will support Hendrick Medical Center with "A Day to Take Heart," making patients and families aware of resources. "A Day to Take Heart" is an annual event for heart health education that offers free cardiac screenings, including blood pressure, cholesterol, BMI, diabetes, and carotid artery assessment. The first 100 participants receive an ECG.

1.K. CCHHMC engages in community disaster preparedness events with the host as they arise.

1.J. CCHHMC supports the Hendrick Medical Center skilled nursing facility, home health agency, and hospice program.

1.L. CCHHMC participates in the Cattle Baron's Ball community event that focuses on promoting the prevention of and education for cancer-related diagnoses.


June 2019 Page 151

ProgressKey Results



ProgressKey Results


FY 2020 FY 2021 FY 2022

1.R. CCHHMC will continue to participate in the quarterly Critical Care Collaborative, the quarterly Nursing Home Consortium and Joint Council with Host Leadership to discuss referral and admission patterns, barriers and concerns, as well as successes.

1.Q. CCHHMC will continue to train all clinical staff on BLS and ACLS for all RN and RT staff.

1.S. CCHHMC continue to host interdisciplinary team meetings on a weekly basis that include all necessary persons in discussions regarding individual patient care for a more comprehensive, patient-centered approach. CCHHMC staff encourage family members to attend as well in order to fully understand the needs of the patient.

1.P. CCHHMC educates patients and families about LTACHs and what services can be provided in conjunction with community resources through speaking at local events, providing educational brochures, and interacting with families in the facility.

1.O. CCHHMC is available to provide education on ventilator and trachea care to skilled nursing facilities by request.

1.M. CCHHMC follows up with patients during discharge and provides patients' other physicians with a copy of his/her discharge summaries as requested in order to increase collaboration across the continuum of care. In addition, patients' other physicians receive regular updates on their patient's health during their stay at the LTACH.

1.N. CCHHMC is available to speak at any community events, provide information, or participate in other educational opportunities by request.


June 2019 Page 152

ProgressKey Results



ProgressKey Results

(As Appropriate)

Priority #2: Access to Affordable Care and Reducing Health Disparities Among Specific Populations Rationale: Taylor County has several geographic- and population-based Health Professional Shortage Area designations and census tract-based Medically Underserved Area/Population designations, as defined by the U.S. Department of Health and Human Services Health Resources and Services Administration (HRSA). Interviewees discussed affordability and cost barriers as concerns that disproportionately affect Medicare, Medicaid and un/underinsured populations in the community. There were several comments raising concern that many providers in the area are no longer accepting Medicare patients and that there is limited access to healthcare services throughout the continuum of care for Medicaid and uninsured patients, which may lead to inappropriate use of the Emergency Room and/or the outmigration of such residents seeking more affordable services outside of Taylor County. One interviewee stated: “[For the uninsured patient], if you need a breast MRI you will be sent to Forth Worth or Lubbock because it is cheaper there.…these patients can’t afford to go out of town.” It was mentioned that there is a general concern surrounding healthcare funding and the ability of residents to afford healthcare. One interviewee stated: “...there needs to be better career or economic mobility for folks so they can move themselves and their families off of indigent care.” When asked about which specific groups are at risk for inadequate care, interviewees spoke about pediatric, youth, homeless, low income/working poor, elderly, non-English speaking, and veteran populations as being disproportionately challenged by barriers to accessing healthcare services in Taylor County. With regards to the pediatric population, interviewees mentioned limited access to local counselors, specifically for autism diagnoses; childhood obesity rates; and limited access to local pediatric sub-specialists as challenges for this particular population. For youth residents, interviewees mentioned higher teen pregnancy rates, issues with recreational drug use, high rates of sexually transmitted infections, and a large homeless population as challenges for the youth community in Taylor County. When speaking about the homeless population in Taylor County, interviewees raised concern surrounding the lack of local mental health services for such residents. With regards to the low income/working poor population, interviewees mentioned barriers in seeking local, affordable preventive care. For elderly residents, interviewees mentioned issues with providers changing practices and no longer accepting Medicare patients, transportation barriers in accessing healthcare services and follow-up care, a need for assistance in navigating the healthcare landscape, and an emphasis on the continued focus to address the needs of the large aging population. With regards to non-English speaking residents, interviewees noted language barriers and higher teen pregnancy rates within the Hispanic population. Lastly, when discussing challenges for Veteran residents, interviewees noted a lack of local mental health services and difficulty in accessing the VA clinic.

Objective:Participate in initiatives and create opportunities to increase access to affordable care and reduce health disparities among specific populations

Action Steps

2.A. CCHHMC will continue to provide services to eligible uninsured and underinsured individuals as outlined in their charity care policy, which is available to every patient on admission. This allows patients and/or families to know the details of how they may qualify for reduction or elimination of any balance owed by them for services we provide.

FY 2020 FY 2021 FY 2022

2.B. CCHHMC will continue to offer financial assistance and payment plan education to patients who have an economic need and meet the qualifications of the financial assistance policy. If financial assistance is needed, CCHHMC encourages patients to complete an application to see if they qualify.


June 2019 Page 153

ProgressKey Results



ProgressKey Results


FY 2020 FY 2021 FY 2022

2.G. CCHHMC staff participate in volunteering at the local Meals on Wheels organization to assist in serving the underserved population in the area.

2.E. CCHHMC will continue to host and/or participate in drive events (i.e., toiletry, food) in conjunction with local organizations as needed to benefit the community.

2.D. CCHHMC provides health education and prevention resources in multiple languages, as well as a translator phone and resources for the hearing impaired, on an as needed basis.

2.C. CCHHMC will continue to support Pathways at Hendrick Medical Center, which serves patients with a serious, chronic or life-limiting illness or injury but are not necessarily terminally or irreversibly ill. Services are provided regardless of ability to pay.

2.F. CCHHMC will continue to support Hendrick Medical Center in the aggressive recruiting underway for primary care physicians. Hendrick Provider Network is well established to recruit physicians and meet the needs of the community.


June 2019 Page 154

ProgressKey Results



ProgressKey Results

(As Appropriate)

3.A. CCHHMC will continue to actively assist the Host in the recruitment of Intensive and Pulmonary physicians.3.B. CCHHMC has affiliation agreements which allow for clinical rotations in the hospital within the nursing and respiratory areas.

3.C. CCHHMC will continue its strong referral relationship with surrounding acute care facilities to provide specialty services to patients requiring that level of care from the LTACH.

3.D. CCHHMC provides case management services and referrals that relate to mental or behavioral health conditions on an as needed basis.

Priority #3: Access to Specialty Care Services and ProvidersRationale: Many interviewees noted the number of patients leaving Taylor County for specific specialty care services such as Oncology, Orthopedics, ENT, and OB/GYN. It was mentioned that local specialty care options are unaffordable for low income and uninsured residents, and one interviewee stated: “We have an issue with [women] who are pregnant and do not have anywhere to go because they do not have any Medicaid...the private doctors will not take them until they have Medicaid.” Interviewees also mentioned limited GI coverage in the area, as well as limited access to Dermatology and Pediatric sub-specialty care. A few interviewees maintain a perception that there is a need for more specialists who are able to handle high-risk patients so that those patients do not have to leave the community for care. One interviewee stated: “There are not enough doctors who specialize in high risk patients.”Objective:Participate in initiatives and create opportunities to increase access to specialty care services and providers

Action StepsFY 2020 FY 2021 FY 2022


June 2019 Page 155

ProgressKey Results



ProgressKey Results

(As Appropriate)

A.B. CCHHMC will explore providing support through financial and/or volunteer resources to the host for their Flashback 5K event benefitting Children's Miracle Network and Hendrick Children's Hospital, as well as for their Asthma Camp that serves children in the community with respiratory related diseases.

A.A. CCHHMC provides financial and volunteer support to a Daddy/Daughter dance in Brownwood.

Additional Community Benefit ActivitiesPlease use the space below to describe any additional community benefit activities that have been implemented and are not described in the previous priorities.

FY 2020 FY 2021 FY 2022Action Steps


June 2019 Page 156

Section 3:Feedback, Comments and Paper Copies


June 2019 Page 157

A description of how to leave comments, ask questions, or provide feedback on the hospital’s current Community Health Needs Assessment Report

Input Regarding the Hospital’s Current CHNA


June 2019 Page 158

CHNA Feedback Invitation• IRS Final Regulations require a hospital facility to consider

written comments received on the hospital facility’s most recently conducted CHNA and most recently adopted Implementation Strategy in the CHNA process.

• CCH at HMC invites all community members to provide feedback on its existing CHNA and Implementation Plan.

• To provide input on this CHNA, please see details at the end of this report or respond directly to the hospital online at the site of this download.


June 2019 Page 159

Feedback, Questions or Comments?

Please address any written comments on the CHNA and Implementation Plan and/or requests for a copy of the CHNA and Implementation Plan to:

ContinueCARE Hospital at Hendrick Medical Center1900 Pine Street, 7th Floor, Jones Building

Abilene, TX 79601Email: [email protected]

Please find the most up to date contact information on the ContinueCARE Hospital at Hendrick Medical Center website under “Community Health Needs Assessment:”

https://continuecare.org/hendrick/community-health-needs-assessment/


June 2019 Page 160

Thank You!CHC ContinueCARE

7800 North Dallas Parkway, Suite 200Plano, TX 75024972‐943‐6400

www.communityhospitalcorp.com

Lisette Hudson – [email protected] Hayes – [email protected]


June 2019 Page 161

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