The Medical Center at Bowling Green receives Get With The Guidelines Stroke Gold Plus and Target: Stroke Honor Roll Elite Plus Quality Achievement Awards

The Medical Center at Bowling Green has received the American Heart Association/American Stroke Association’s Get With The Guidelines® Stroke Gold Plus Achievement Award as well as the Target: Stroke Honor Roll Elite Plus Quality Award. These awards recognize the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

The Medical Center at Bowling Green earned the Stroke Gold Plus Award by exceeding benchmark performance on specific quality achievement measures for the diagnosis and treatment of stroke patients for 24 consecutive months. These measures include evaluation of the proper use of stroke medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

The Medical Center at Bowling Green also received the association’s Target: StrokeSM Honor Roll Elite Plus award. To qualify for this recognition, hospitals must meet or exceed quality measures over the same 24 consecutive months that were developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

“We are honored to be recognized for the hard work and dedication of our stroke care team,” said Connie Smith, President and Chief Executive Officer of Med Center Health. “Our commitment to the best in patient care has brought us Get With The Guidelines Awards several years in a row, and we are constantly pushing to improve patient outcomes even more. To achieve both the Gold Plus and Honor Roll Elite Plus Awards this year, we exceeded targets set by the American Heart and Stroke Associations over a 2-year period. This is an incredible accomplishment and our patients and their families are the ultimate benefactor of these efforts.”

“We are pleased to recognize The Medical Center at Bowling Green for their commitment to stroke care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.”

According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

Graduate Medical Education Program celebrates expansion

On Thursday, June 27, a ribbon cutting was held on the campus of The Medical Center at Bowling Green, the flagship hospital of Med Center Health, to celebrate the expansion of the Graduate Medical Education Program. The Medical Center at Bowling Green, in partnership with the University of Kentucky College of Medicine, currently offers three training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). These programs are designed to produce skilled, competent and compassionate physicians focused on delivering patient-centered, evidence-based care.

The Medical Center’s Internal Medicine Residency Program, which began in July 2015, will complete its fourth full year of operation on June 30, 2019. In July 2016, The Medical Center expanded its Graduate Medical Education Program with the addition of a Psychiatry Residency Program and a Cardiology Fellowship Program. On June 15, The Medical Center’s Internal Medicine Residency Program celebrated its second graduating class and the Cardiovascular Disease Fellowship Program celebrated its first graduating class.

Effective July 1, 2019, The Medical Center will again expand its Graduate Medical Education Program by adding three residency programs and two fellowship programs including an Obstetrics and Gynecology Residency Program, a General Surgery Residency Program, a Transitional Year Residency Program, a Pulmonary Medicine Fellowship Program, and an Interventional Cardiology Fellowship Program. As of next month, 58 residents and fellows will be enrolled in graduate medical education programs offered at The Medical Center.

As a teaching hospital, The Medical Center at Bowling Green benefits the community in a variety of ways, including physician recruitment and retention, access to more advanced healthcare, medical research, and an improved local economy.

“Med Center Health is dedicated to educating the next generation of physicians and ensuring exceptional healthcare in our region for years to come,” says Connie Smith, President and Chief Executive Officer of Med Center Health. “The physical and economic health of Bowling Green and surrounding communities will improve as more physicians choose to establish their practices in close proximity to where they received outstanding training. It is the ultimate win-win scenario.”

The Medical Center offers residents and fellows the opportunity to learn in a leading regional teaching facility with state-of-the-art technology and a diverse patient mix under supervision provided by outstanding board-certified teaching faculty.

To learn more about Graduate Medical Education at The Medical Center at Bowling Green, visit TheMedicalCenter.org/medical_education.

Medical Center EMS receives American Heart Association’s Mission: Lifeline EMS Gold Plus Recognition Award

Medical Center EMS has received the American Heart Association’s Mission: Lifeline® EMS Gold Plus Award for implementing quality improvement measures for the treatment of patients who experience severe heart attacks.

Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI) the deadliest type of heart attack caused by a blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication.

The Mission: Lifeline initiative provides tools, training and other resources to support heart attack care following protocols from the most recent evidence-based treatment guidelines. Mission: Lifeline’s EMS recognition program recognizes emergency medical services for their efforts in improving systems of care to rapidly identify suspected heart attack patients, promptly notify the hospital and trigger an early response from the awaiting hospital personnel.

“Med Center Health and Medical Center EMS are dedicated to providing optimal care for heart attack patients,” said Jim Berry, Director of Medical Center EMS. “We are pleased to be recognized for our dedication and achievements in emergency medical care efforts through Mission: Lifeline.”

“EMTs and paramedics play a vital part in the system of care for those who have heart attacks,” said Tim Henry, M.D., Chair of the Mission: Lifeline Acute Coronary Syndrome Subcommittee. “Since they often are the first medical point of contact, they can save precious minutes of treatment time by activating the emergency response system that alerts hospitals to an incoming heart attack patient. We applaud Medical Center EMS for achieving this award in following evidence-based guidelines in the treatment of people who have severe heart attacks.”

The Medical Center at Bowling Green offers life-changing procedure for patients with Atrial Fibrillation

The Medical Center at Bowling Green is the first and only hospital in our region to offer the WATCHMAN™ Left Atrial Appendage Closure (LAAC) Device for patients at risk of stroke due to Atrial Fibrillation (AF). The WATCHMAN device is an alternative to the lifelong use of blood thinners such as warfarin in people with AF not caused by a heart valve problem (also known as non-valvular AF). It is also the only device approved by the FDA for stroke prevention.

The WATCHMAN device is implanted in a one-time procedure to close off an area of the heart called the left atrial appendage (LAA). The LAA is a non-essential part of the heart where blood clots can form in patients with AF, increasing the risk of stroke. The device is permanent— it doesn’t have to be replaced and can’t be seen outside the body. The procedure is done under general anesthesia and takes about an hour. Patients commonly stay in the hospital overnight and leave the next day.

“The WATCHMAN device is an important alternative for patients with non-valvular AF at risk for a stroke, especially those with a compelling reason not to be on blood thinners,” said Deepak Gaba, MD, Electrophysiologist with Sahetya Medical Group. “I’m proud to have performed the very first implant of this device at The Medical Center at Bowling Green as it offers our patients potentially life-changing stroke risk treatment.”

About Atrial Fibrillation

Atrial fibrillation (AF) is a heart condition where the upper chambers of the heart (atrium) beat too fast and with irregular rhythm (fibrillation). AF is the most common cardiac arrhythmia, currently affecting more than five million Americans. Twenty percent of all strokes occur in patients with AF, and AF-related strokes are more frequently fatal and disabling. The most common treatment to reduce stroke risk in patients with AF is blood-thinning warfarin medication. Despite its proven efficacy, long-term warfarin medication is not well-tolerated by some patients and carries a significant risk for bleeding complications. Nearly half of AF patients eligible for warfarin are currently untreated due to tolerance and adherence issues.

For more information about cardiac services offered by Med Center Health, visit MedCenterHealth.org.

Kentucky Board of EMS recognizes Medical Center EMS for pediatric care

For the second year, as part of National EMS Week’s EMS for Children Day, the Kentucky Board of Emergency Medical Services’ (KBEMS) Kentucky EMS for Children (KYEMSC) Pediatric Recognition program recognized Medical Center EMS for going beyond what is required by the state in terms of providing pediatric care.

“Improving emergency medical care of children in all of our communities across the state is crucial,” said KYEMSC for Children Project Director Morgan Scaggs. “These agencies have gone the extra mile in their commitment to improving emergency pediatric care that sets a standard for others.”

KYEMSC developed the Voluntary EMS Pediatric Recognition program to acknowledge EMS agencies that go beyond what is required by the state in pediatric care by completing the additional program requirements.

To be recognized, an agency must designate a pediatric emergency care coordinator to ensure integration of the unique needs of pediatric patients into all aspects of emergency care, comply with national recommendations for pediatric equipment carried on the ambulance and engage in pediatric-focused community outreach activities. There are also requirements for additional pediatric-related continuing education and annual demonstration of pediatric skill competency for all EMTs and paramedics.

“Being a part of the very first group of agencies awarded this honor—and now one of only two agencies to repeat the recognition—is possible because of the continuing dedication that Medical Center EMS has to provide the best possible care to everyone in our community,” says Jim Williams, Manager of Medical Center EMS Field Operations. “We take the trust that the public gives us very seriously, and always look for ways to improve services to our community. Out of about 200 services licensed in the state, we are proud to be among the 8 progressive services that have been recognized for this honor.”

This is the second year for the recognition program and all participating agencies will need to reapply annually to demonstrate their continued commitment to excellence in pediatric emergency care.

Other agencies recognized:

• Buechel Fire Protection District
  
• Burlington Fire Protection District
  
• Georgetown Scott County EMS
  
• Hebron Fire Protection District (2nd year)
  
• Murray Calloway County Hospital Ambulance Service
  
• Somerset Pulaski County EMS
  
• Whitley County EMS
  

For more information about Medical Center EMS, visit TheMedicalCenter.org.

2019 Expectant Parent Fair bigger and better than ever

Med Center Health is delivering a bigger and better Expectant Parent Fair. This year, the Fair will be held Sunday, May 5 from 1-4 p.m. at The Medical Center-WKU Health Sciences Complex at the corner of Park Street and 31-W Bypass on The Medical Center campus. A semiannual event in the past, the Fair is being expanded and will now be held once a year.

The Expectant Parent Fair features a variety of exhibits, vendors and educational opportunities:

• Educational workshops for moms, dads and grandparents:
  
  • Q&A with a Pediatrician (Debra Sowell, MD)
    
  • Meet the Midwives (Leigh Lindsey, PhD, CNM, Courtney Maxfield, CNM, and Heather Finney, CNM)
    
  • Infant CPR Demonstration (Kimmy Rheaume, EMT)
    
  • Car Seat Safety Demonstration (Beverly Phelps, RN)
    
  • Lactation Lounge (Calista Adams, RN, IBCLC, and Stacy Mosier, RN, IBCLC)
    
• Interactive booths and demonstrations
  
• More for parents with toddlers! A special area, hosted by the Warren County Public Library, will be set aside for story time, face painting and balloon animals
  
• Photo booth
  
• Light refreshments
  
• Tours of The Medical Center’s Mother-Baby Unit
  
• Fantastic door prizes, including a year’s supply of diapers and an Owlet Baby Care baby monitor with camera!
  

This event is free. For more information, call (270) 745-1098 or visit TheMedicalCenter.org.

The Medical Center at Bowling Green Earns Blue Distinction® Centers+ Designation for Cardiac Care

Anthem Blue Cross Blue Shield has recognized The Medical Center at Bowling Green, the flagship hospital of Med Center Health, with a Blue Distinction Centers+ for Cardiac Care designation, as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated providers that show expertise in delivering improved patient safety and better health outcomes, based on objective measures that were developed with input from the medical community and leading accreditation and quality organizations.

According to the American Heart Association (AHA), cardiovascular disease is the leading cause of death globally and is expected to claim more than 23.6 million lives annually by 2030. Blue Distinction Centers+ for Cardiac Care seek to empower patients with the knowledge and tools to find quality cardiac care. To receive a Blue Distinction Centers+ designation, hospitals must demonstrate expertise in delivering safe and effective cardiac care, focusing on cardiac valve surgery, coronary artery bypass graft (CABG), and percutaneous coronary interventions (PCI) episodes of care. Hospitals receiving a Blue Distinction Centers+ designation must also demonstrate better cost-efficiency compared to their peers.

Only those hospitals that first meet nationally established quality measures for Blue Distinction Centers are considered for designation as a Blue Distinction Centers+.

“The Medical Center’s Cardiac team is committed to providing the highest standards of care to our community,” said Connie Smith, President and Chief Executive Officer of Med Center Health. “We strive to offer advanced quality usually found only in major metropolitan areas right here, close to home. We are proud that our efforts have been recognized with the Blue Distinction Center+ designation, which affirms to our patients they are receiving the best, most cost-efficient care.”

“The Medical Center’s designation as a Blue Distinction Center+ is a testament to their innovative approach to cardiac patient care,” said Dr. Jeff Reynolds, Anthem Blue Cross and Blue Shield in Kentucky medical director. “The Blue Distinction program is designed to recognize commitment to quality and to help consumers identify high performing health care providers. This is a well-deserved honor and I congratulate the entire team at The Medical Center.”

Hospitals recognized with this designation are assessed using a combination of quality information supplied by hospitals and third party data registries, and cost measures derived from Blue Cross and Blue Shield companies’ medical claims.

Since 2006, the Blue Distinction Specialty Care program has helped patients find quality specialty care in the areas of bariatric surgery, cancer care, cardiac care, cellular immunotherapy, fertility care, gene therapy, knee and hip replacements, maternity care, spine surgery, and transplants, while encouraging health care professionals to improve the care they deliver. Research shows that compared to other providers, those designated as Blue Distinction Centers demonstrate better quality and improved outcomes for patients. On average, Blue Distinction Centers+ are also 20 percent more cost-efficient than non-Blue Distinction Center+ designated providers.

For more information about the program and for a complete listing of the designated providers, visit www.bcbs.com/bluedistinction.

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Med Center Health is a not-for-profit health system with a mission to care for people and improve the quality of life in the communities we serve. Our integrated healthcare system includes hospitals in Bowling Green, Albany, Caverna (Horse Cave), Franklin and Scottsville, as well as Commonwealth Regional Specialty Hospital, a long-term, acute care hospital. Combined, the hospitals comprise 454 acute care beds and 110 extended care beds, 400+ physicians in more than 50 specialties. Med Center Health has more than 3,700 employees and 90 employed providers, and is a two-time recipient of the Gallup Great Workplace award. In FY 2018, Med Center Health provided more than $117 million in community benefit. As a resource deeply rooted in the communities we serve, Med Center Health offers more access to top-quality healthcare than any other provider in Southcentral Kentucky. A wide footprint, combined with our commitment to proactively invest in the resources our communities need, helps people heal closer to home. Learn more at MedCenterHealth.org.

About Anthem Blue Cross and Blue Shield in Kentucky:

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, an independent licensee of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Kentucky is available at www.anthem.com. Also, follow us on Twitter at https://twitter.com/anthemBCBS , or on Facebook at https://www.facebook.com/AnthemBlueCrossBlueShield

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through Blue Cross Blue Shield, The Health of America Report® series and the national BCBS Health IndexSM. For more information on BCBSA and its member companies, please visit BCBS.com. We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

About Blue Distinction Centers

Blue Distinction Centers (BDC) met overall quality measures, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable healthcare. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

Med Center Health joins campaign to register organ, eye, and tissue donors

Med Center Health has joined other area healthcare organizations to create a donation-friendly community through the Workplace Partnership for Life Hospital Organ Donation Campaign. This national initiative sponsored by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services challenges healthcare organizations to educate employees, patients, visitors, and the community about the crucial need for organ, eye, and tissue donation and give them opportunities to sign up as donors.

“One organ donor can save eight lives,” said Connie Smith, President and Chief Executive Officer of Med Center Health. “And an eye and tissue donor can improve up to 50 lives. But each year, the number of people on the waiting list grows much larger than the number of donors and transplants. Med Center Health is committed to helping reverse this trend by encouraging our staff and other members of the community to register as organ donors and to spread the word among their friends and families.”

More than 114,000 people in the U.S., including approximately 1,000 in Kentucky, are waiting for an organ transplant, and 20 of them will die each day because no organ was available. Med Center Health is reaching out to the community to support its goal of registering 100 new organ, eye, and tissue donors in the Kentucky registry before April 30, 2019.

Kentucky residents can register for organ donation at donatelifeky.org. Med Center Health asks that when prompted what influenced their decision, registrants select a Med Center Health facility.

For more information about the Workplace Partnership for Life Hospital Organ Donation Campaign, visit organdonor.gov.

DAISY Award® for Extraordinary Nurses Program Launched at Med Center Health

Med Center Health announces the launch of the DAISY Award® for Extraordinary Nurses. The DAISY Award is an international program designed to say “thank you” to nurses who have truly made a difference in the lives of their patients. Founded in 1999, the DAISY Foundation was created to honor the exceptional nurses who profoundly impacted the family of J. Patrick Barnes, who died at age 33 of medical complications from ITP (Idiopathic Thrombocytopenic Purpura). DAISY, the award’s name, is an acronym for Diseases Attacking the Immune SYstem—the type of disease Patrick suffered from.

“The DAISY Award is just one way that we can stop and reflect on the special moments that our nurses create for our patients each and every day,” says Dr. Jill Payne, RN, Executive Vice President & Chief Nursing Officer. “A simple nomination, acknowledging a nurse’s extraordinary contributions and the impact their actions had on you or your family, will stay with a nurse for life.”

Since its founding, the DAISY Award has spread across the nation as patients, patient families and co-workers found a way to express their heartfelt appreciation of nurses. The goal of the DAISY Award is to let our nurses know they are valued for their skill, education and knowledge, and for the remarkable care they provide when treating their patients.

Nurses can be nominated by patients, families, physicians, co-workers and anyone else who experiences or observes extraordinary care by a hospital nurse. Each year, a total of six Med Center Health nurses will be recognized with a DAISY Award. Four will be from The Medical Center at Bowling Green and two will be from The Medical Centers at Scottsville, Franklin, Caverna and Albany combined. People interested in sharing a story of how one of our nurses impacted a life can submit a nomination at MedCenterHealth.org/DAISY.

Learn more about the DAISY Award at daisyfoundation.org.

Med Center Health Announces 29th Annual Women in the Arts Exhibit Call For Entries

Entries are now being accepted for Med Center Health’s Women in the Arts exhibit, which is scheduled for Friday, April 12 through Sunday, April 14 in The Medical Center at Bowling Green Auditorium. The exhibit is open to any female artist over 18 years old residing in Kentucky. Artists may enter their artwork in the following categories: painting, sculpture, ceramics, works on paper, fiber works and photography. Awards include Special Purchase, Cash Merit, Honorable Mention, and ArtWorks Award.

"The creation and enjoyment of art brings a therapeutic atmosphere of comfort that is important for healing and recuperation,” says Sarah Widener, director of Community Wellness. “Many works that were shown in past Women in the Arts exhibits can be found throughout The Medical Center.”

A $20 entry fee is required covering all artwork submitted. Two pieces of artwork are allowed per person. Entry forms are available online at TheMedicalCenter.org or may be picked up at Health & Wellness in the Community Clinic building at 740 East 10th Avenue in Bowling Green. Entry forms should be returned by March 15.

For more information, call 270-745-1010 or 1-800-624-2318.

Cabinet for Health and Family Services Changes Regulation In Effort to Help Greenview Hospital After Losing Recent Battle Over Ambulance Service

The Cabinet for Health and Family Services has changed a regulation following Greenview Hospital’s recent defeat in its attempt to establish an ambulance service in Warren County. The Cabinet’s changes improperly favor TriStar Greenview Hospital, an HCA-affiliated, for-profit, Tennessee-based corporation. The newly amended regulation brazenly seeks to remove the obstacles Greenview encountered when its Certificate of Need application was denied on January 4, 2019.

“Quite honestly, we are at a loss for words,” said Wade Stone, Executive Vice President of Med Center Health. “The Cabinet unnecessarily took aim at Warren County last September by crafting special legislation to benefit Greenview. It failed to get the wording right the first time, so now it is continuing its assault on Warren County and Med Center Health by amending the regulation. The Cabinet is dead set on helping Greenview feed market share to its affiliated hospitals in Tennessee under the disguise of addressing a non-existent ‘public health crisis.’ It’s baffling at best, and we question the real motives behind such behavior.”

Med Center Health has a lawsuit pending in Franklin Circuit Court which challenges the constitutionality of the regulation issued last September. Kentucky law prohibits the creation of laws and regulations that are written for the purpose of benefiting a specific organization.

“The Cabinet’s statement accompanying the new regulation point blank admits that the Cabinet is actively trying to interfere in the CON process, a process that is supposed to be free from political interference. Both the original and amended regulations were developed for the sole purpose of benefiting one particular corporation, Greenview. Not only do these regulations threaten to disrupt what is regarded as one of the very best ambulance service operations in the Commonwealth, but they expose Warren County taxpayers to a substantial tax burden that has been avoided for nearly forty years.” Stone concluded, “We look forward to presenting evidence of these illegal actions by the Cabinet in a court of law, where political influence is checked at the door,” said Stone.

Cabinet's Amended Regulation 01/15/19

Cabinet Denies TriStar Greenview’s Ambulance Service Application

Today, the independent hearing officer assigned to hear the case involving TriStar Greenview’s certificate of need (CON) application to initiate a second ambulance service in Warren County issued a Final Order denying the application. TriStar Greenview will therefore not be able to proceed with its proposed ambulance service. The Final Order (copy attached) cancels the CON hearing scheduled for January 7-10 and 16, 2019.

“We are very pleased with the hearing officer’s decision,” said Wade Stone, Executive Vice President of Med Center Health. “The decision is very well-reasoned, and we are relieved that neither our community nor our Medical Center EMS service will be adversely affected by TriStar Greenview’s proposal,” said Stone.

Stone added, “We will continue reaching out to officials in Frankfort now that the CON application has been denied and hope they will be receptive to our position. We will convey to those officials that our committed staff and responders are offering an award-winning service to the residents of Warren County without local taxpayer subsidization that so many other Kentucky counties experience. A second ambulance service will only create confusion with dispatch, negatively affect our existing service and possibly lead to the need for taxpayer subsidy.”

Medical Center EMS is an award-winning ambulance service. It is the only ambulance service in Kentucky accredited by both the Commission on Accreditation of Ambulance Services (CAAS) and the International Academies of Emergency Dispatch® (IAED™) - both of which are gold standards within the industry.

Stone concluded, “As always, we will focus our efforts and energies toward improving the health and well-being of the communities we serve while respecting patient choice.”