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Headwaters Health Care

CentreAnnua l Report

> 2012-2013

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Who’s Who at Headwaters Health Care Centre

Headwaters Health Care Centre 100 Rolling Hills Drive, Orangeville, ON L9W 4X9519.941.2410 • www.headwatershealth.ca

Senior Management TeamLiz RueggPresident & Chief Executive Officer

Ken Derksen, MD, CCFP, FCFP Chief of Staff

Donna ClarkVice President, Patient Services & Chief Nursing Executive

Bruce Irwin Vice President, Corporate Services

Dave McCaigJoint Chief Financial Officer

Martha MurrayManager, Public Relations and Communications

Physician LeadersKen Derksen, MD, CCFP, FCFP Chief of Staff

Dan Mallin, MD, CCFPMedical Staff President

Alex Riddell, MDMedical Staff Vice President

Michael Stefanos, MD, FRCPC Medical Staff Secretary

Kenji Miyata, MD, CCFPChief of Anasthesia

Dan Mozeg, MD, FRCPCChief of Diagnostic Imaging

Somaiah Ahmed, MD, CCFP, EMChief of Emergency Medicine

Amy Horvat, MD, CCFPChief of Family Practice

Jeff McKinnon, MD, FRCPCChief of Medicine

Jude Umeh, MD, FRCSCChief of Obstetrics & Gynecology

Raafat Salih, MD, FRCSCChief of Surgery

Headwaters Board of DirectorsPeter HarrisChair

Rob HamiltonVice Chair

Bill WaiteTreasurer

Liz RueggSecretary

Jim AijalaSimon AtkinsJohn ChristieDonna ClarkDr. Ken DerksenJohn InnesBonnie LedsonAllan MaddenDr. Dan MallinFrans RichterBill RoyJoan WaechterJohn Wilson

Headwaters Auxiliary Executive Jim AijalaPresident

Joanne PalysVice President

Ron HayPast President

Ellen PawelkiwRecording Secretary

Linda JamesonTreasurer

Christine HannPublic Relations Officer

Carolyne Beaton and Jane SmithVolunteer Coordinators

Foundation Board of DirectorsJoan WaechterChair

Kathy ArmstrongPast Chair

Chris GittensTreasurer

Elaine CapesSecretary

Joan BurdetteExecutive Director

Danny Brackett

Cathy Campbell

Ray Conroy

Steve Doney

Peter Harris

John Lockyer

John Meek

Joanne Palys

Chris Stewart

Message from the Chair of the Board & The President and CEO.........................................................................................................4

Achievements ........................................................................................................................5

Initiatives.................................................................................................................................6

Quality & Safety Successes..................................................................................................10

Message from the Chief of Staff..........................................................................................12

Message from the Auxiliary President.................................................................................13

Message from Headwaters Health Care Foundation’s Chair of the Board and Executive Director...................................................................................14

Message from Headwaters Health Care Foundation’s Chair of the Board and Executive Director..................................................13

Financial Statements............................................................................................................16

Revenues and Expenditures.................................................................................................18

Thank You & Congratulations to Long Serving Staff & Physicians...................................19

Headwaters by the Numbers...............................................................................................20

Cover photo courtesy of Pete Paterson. Photos on page 4, 12, 14 & 15 courtesy of Jim Craigmyle Photography.

Back page image: stock.

Tab l e o f Con t e n t s

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This year, we celebrated a century of health care in our community. For 100 years, our hospital has provided high quality, safe, patient-centred care, close to home. We celebrated 100 years of caring with numerous occasions through-out the year, a birthday party for the entire community, and even a spectacular fireworks display.

In addition to our tremendous accomplishment of 100 years of health care, Headwaters staff, physicians and volunteers achieved a lot this year. We even ended the year with a small surplus! A summary of awards, achievements, initiatives, and quality and safety successes are detailed in the following pages of this 2012/2013 Annual Report.

To help lead us into the next 100 years, we were pleased to introduce our 2013-2016 Strategic Plan and our new Vision and Mission statements to accompany our reaffirmed Values (they were so timeless and important we decided to keep them as is).

Our 2013-2016 Strategic Plan reflects the direction needed to provide the most appropriate, accessible,

high quality and safe care as part of a seamless, integrated and sustainable health care system. In order to achieve those goals, we will continue to work and build partnerships with local community care providers to ensure our patients and community continue to receive the right care, in the right place, and at the right time, closer to home.

Our Vision Exceptional Experience Every Time

Our Mission To provide high quality and compassionate care, in collaboration with our partners, to optimize the health of our community.

Our ValuesCARE • CARE • CARE We are committed to caring in a sensitive, respectful and supportive way for those we serve and those we work with.

ASK • SEEK • EXPLORE We promote a culture of learning and innovation to effectively meet the evolving needs of our patients, staff and community.

BUILD BRIDGES We work collaboratively within our organization and with our external partners to ensure we provide the best possible standards of health care services.

Our Strategic Directions:• Our Patients• Our People• Our Community & Care Partners• Our Internal Systems & Processes• Our Accountability

In the past year, we accomplished a lot as a team and we have made some great strides towards providing an Exceptional Experience Every Time. Our many successes and accomplishments would not have been possible without our community’s support and the work of our dedicated staff, physicians, volunteers and many community health care partners. Thank you for the difference you make.

>> Message from the Chair of the Board & The President and CEO

Peter Harris, Chair, Board of Directors and Liz Ruegg, President & CEO

Liz RueggPresident & CEO

Peter HarrisChair, Board of Directors

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>>achievementsGet out your party hats - we have a lot to celebrate!Headwaters Receives Highest Designation from Accreditation Canada >> Accreditation Canada awarded Headwaters with Accreditation with Exemplary Standing, the highest designation a hospital can achieve. The hospital met 98.5 per cent of more than 1700 standards and criteria in the accreditation program. The external peer review included evaluation of all patient areas and administrative functions.

Emergency Wait Times at Headwaters are the Lowest >>Through the Ministry of Health and Long-Term Care’s Wait Time Strategy, Headwaters finished number 1 out of 73 participating Ontario hospitals with the lowest Emergency Department wait time in 2011/12. Headwaters exceeded the provincial benchmark (or average) for length of time to see a physician, as well as overall length of stay in the Emergency Department. Patients say Headwaters is “Tops” >> This year, in the National Research Corporation (NRC) Picker Report on Patient Ratings of Overall Satisfaction and Likelihood to Recommend for Ontario Hospitals, Headwaters was named an Ontario High Performer for Inpatient Acute (97.42 per cent positive rating), Emergency (90.36 per cent positive rating) and Maternity Care (97.23 per cent positive rating) by the Ontario Hospital Association and NRC Picker Canada. Headwaters received these top ratings from hospital patients surveyed by NRC Picker Canada on their experiences between April 1, 2010 and March 31, 2011.

Headwaters is leading the way >> At the Ontario Hospital Association’s (OHA) HealthAchieve conference and exhibition, one of the largest and most prestigious healthcare gatherings in North America, Headwaters received the Leading Practice Award in the category for Access to Care for its submission on the redesign of its Emergency Department (ED) process to reduce the “door to doctor time”. The 143 submissions were adjudicated based on originality, achieving your objective, objectivity, clarity and quality of presentation, practical implications, and relevance to hospitals and health care. Using LEAN tools, Headwaters staff explored why patients were waiting and set out to understand the root causes and challenged staff and physicians about current practices. After testing different types of “See and Treat” or “Rapid Assessment” models of care, Headwaters added 2.5 hours of physician coverage, adjusted physician and nursing schedules, rearranged furniture, developed criteria, and designed a new process to increase access to care in the ED. Headwaters has Gone Green >> In 2012, Headwaters joined the 5 Percent Club with Greening Health Care. To contribute to the health and wellbeing of our community, Headwaters has lowered its energy use by more than 5 percent since 2009. Specifically, Headwaters reduced its energy consumption by 9.4 percent and its Green House Gas (GHG) emissions by 9.5 percent.

Greening Health Care is a collaborative program that helps hospitals work together to lower their energy and operating costs.

100 Years and Counting >> This year Headwaters celebrated 100 years of caring for our community. We had a party and everyone was invited. There were numerous events throughout the year but our official birthday celebration involved a Come and Go Tea at the Lord Dufferin Centre, where member of the Lord Dufferin IODE served tea and birthday cake, a spectacular fireworks celebration, and then a formal celebration with an Honour Guard Parade, unveiling of a tree carving, a Classic Car Show, more birthday cake and musical entertainment.

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>>initiatives

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OUR PatientsNon-Invasive Blood Pressure (NIBP) Monitors Instal ledIn early 2013, Headwaters moved to automatic blood pressure and vital sign reporting. This allowed results to be electronically transferred directly to the patient’s electronic medical record, creating efficiencies in nursing documentation and in turn, patient care. A NIBP monitors were installed at every bedside and eliminated the transfer and cleaning of the units between patients, increasing our infection prevention as well.

Telehomecare - A new way to manage your healthHeadwaters, the Central West Community Care Access Centre (CCAC), family health teams, primary care providers and other health service providers have partnered with William Osler Health System (the host), the Ontario Telemedicine Network (technology and education provider) and Central West Local Health Integration Network (LHIN) to make telehomecare available in community and across the Central West LHIN. By bringing health care services right to the home with easy-to-use equipment, the Telehomecare Program is designed to keep patients in our community healthy – and at home.

The program focuses specifically on providing care to patients living with heart failure (HF) and chronic obstructive pulmonary disease (COPD) through technology in their homes. It uses telemetry monitoring to collect and transmit vital health information electronically from the patient’s home to their Telehomecare nurse.

Patient enrollment started January 28, 2013. The goal is to enroll 500 Central West LHIN patients in this program.

Thanks to telemedicine and programs like Telehomecare, this year we saved patients from having to travel 182,893 km. This equates to 38 round trips from Orangeville to Miami Beach, Florida.

Improving and growing the hospital’s infrastructureTo meet the growing demand in our community for outpatient care at Headwaters, we need to redevelop some of our existing space and create some new space for surgery and specialist clinics, like orthopaedics and oncology. By doing this, Headwaters will be better equipped to deliver high quality, efficient, and safe care, close to home.

In November of 2012, Headwaters presented a refreshed plan to the Capital Branch of the Ministry.

Removing barriers to good health and good health careBy introducing the Health Equity Impact Assessment (HEIA) Tool, a flexible and practical assessment tool, we can better identify potential health impacts (positive or negative) of a plan, policy or program on vulnerable or marginalized groups within community. By identifying those impacts, we can then make recommendations for adjustments that might mitigate negative impacts and maximize positive impacts for our patients. Headwaters has always been committed to quality and patient-centred care by removing barriers to access, and this tool will further help support us in that objective.

OUR PeOPLe

Champions for Change Our staff satisfaction survey in 2010 identified some areas of improvement:

communication, staff recognition, trust and the perception that “mistakes will be held against staff”.

Headwaters Human Resources Department engaged and empowered staff to help identify ways

to improve in those areas. A focus group made up of staff from our 17 hospital departments was

created in 2011; they called themselves the Champions for Change. On January 26, 2012 they had

their first “Champs” meeting and created a work plan. Through their efforts, they have revitalized our

staff recognition program, offered helpful suggestions on innovative ways to communicate better,

identified educational opportunities and ways to help staff manage a healthy work-life balance.

Headwaters conducted its 2013 staff satisfaction survey and looks forward to receiving the results

and engaging the Champions for Change to continue to help make Headwaters a better place

for staff.

OUR cOmmUnitY & caRe PaRtneRs

Community input is just the beginning at Headwaters In 2012, Headwaters put together

its first ever Community Advisory Council. After a public call for participants throughout the

summer, the Council met for the first time in September. The role of the Council is to provide

community and patient feedback to the hospital’s Board about programs, services and initiatives, as

well as identifying areas and ways we can improve to ensure we achieve an exceptional experience

every time. For example, the Council provided input on and revised the hospital’s statement for

patients on its philosophy of care. They are also giving feedback on the hospital website and a new

patient information guide. With all of the exciting things happening at Headwaters next year, this

group will be very busy throughout the coming years.

Telephone Town Hal l The Central West CCAC, Central West LHIN, Headwaters, Region of

Peel Health Services and William Osler Health System hosted a first-ever joint ‘Telephone Town

Hall’ to connect with people across the region about their health care services. The event took

place in December and saw over 5,000 households across the region engaged in a conversation

about local health care services. Everyone was so pleased (including our community) a second

telephone town hall is planned for May 2013.

The purpose of the Telephone Town Hall is to help area residents better understand what each

organization does and how they work together to provide health services to the community. It also

gives residents an opportunity to provide the organizations with feedback around how they might be

able to better meet the health needs of patients and their families in this area.

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• Gardens were maintained and upgraded by replacing poor quality soil, removing unwanted plants and replacing them with a few bushes and trees.

• The Hockley Valley Garden club toured our gardens and shared lots of positive feedback and comments.

• In honour of the 100th Anniversary, tree saplings were planted on the hillside below the Specialist office, in collaboration with Credit Valley Conservation.

• The Café Garden saw new sun umbrellas to shield staff, patients and visitors from the lovely summer sun.

• Thanks to proceeds from Susan Ryan’s Spring Fling, the Peace Garden is now more tranquil in appearance than ever.

Friendship Gardens in action This year, the Friendship Gardens saw a lot of activity.

Here are some of the highlights:

• New underground water systems were installed in the Friendship Garden and Specialist

Garden.

• The Kids’ Garden was totally renovated last summer. Bruce McMoose was sanded and

repainted, and now looking his best.

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OUR inteRnaL sYstems & PROcessesMeditech 5.6 In November, Headwaters upgraded its computer software to better care for you. This may sound like a technology project but it is really all about enabling staff to better care for patients (supported by technology). By upgrading the system to Meditech 5.6, this has opened the door to future changes that will help us develop a culture of safety by having better access to information in a more timely manner.

The enhanced system now electronically alerts our pharmacy to any potential interactions on a patient’s list of medications. This new electronic ability will help ensure patients receive the best, most efficient and safest care possible.

Thanks to this update, Headwaters can provide our patients with more standardized and safer care and lead us into the future.

Emergency Department Improvements Thanks to the Health Infrastructure Renewal Fund (HIRF), Headwaters was able to undertake some much needed renovations in the Emergency Department. These renovations ensured better infection control with the creation of a negative pressure room, as well as improved patient access, flow and safety in the “See and Treat” area. Many of these changes also provided better privacy for our patients. Even though the Emergency Department experienced a huge transformation this year, our wait times were still one of the lowest in the province.

OUR accOUntabiLitYFinancial partnership drives efficiencies Working together is critical to improving our local health services and delivering an exceptional experience every time. In an effort to build a stronger, more efficient and improved local health care system, Headwaters combined its financial services with William Osler Health System to create a joint Chief Financial Officer (CFO) role in December.

Partnering on the finance function allowed for greater accountability and management of financial resources and in turn, offers better value to the community. The Joint CFO role is responsible for managing the core financial functions of both Headwaters and Osler and reports to both CEOs and hospital Boards.

Health Links to improve care The Ministry of Health and Long-Term Care announced the creation of 19 Health Links across the province. Health Links represents a new model of care where all health care providers in a community (e.g. family doctors, hospitals, and community care providers) will work together to provide coordinated health care to patients – with the patient at the center. This means that care will be better coordinated from the hospital to a patient’s return home and any ongoing care in the community. Health Links will work together to identify gaps in local health care delivery and take measures to address them. The first wave of Health Links will put programs in place to meet the needs of complex patients and patients with high needs. Those are patients with multiple conditions, who access the system frequently, and at multiple entry points, resulting in a lack of coordination in care delivery.

Headwaters has been identified and approved as the coordinator for the Dufferin Area Health Link, working with Central West LHIN and various community organizations.

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>>QUaLitY & safetY sUccessesW o r k i n g To g e t h e r To w a r d a n e x c e p t i o n a l e x p e r i e n c e e v e r y t i m e

Specialized Wound Assessment Team The Wound Care Team at Headwaters is an inter-professional team with an interest in wound prevention

and management. They support and advance wound care through clinical practice, education, research

and building relationships with community partners. The team works to improve patient care and

enhance clinical outcomes.

They are responsible for:

• Promoting evidence based practice and best practice guidelines (e.g. Registered Nurses Association

of Ontario) around wound care

• Increasing awareness of products for wound care and their appropriate use, as well as review and

evaluate products

• Promoting awareness on prevention & healing for wound care

• Participation in wound care rounds and ongoing education of staff and physicians around wound

care

• Enhancing consistency and co-ordination of wound care

• Facilitating awareness and improving current practice to prevent pressure ulcers

• Reducing the prevalence of pressure ulcers both in our hospital and community

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Safe Medication Administration Task ForceTo improve the safety and quality of care provided to patients, Headwaters staff created a Task Force to decrease medication errors, review the medication administration process (how medications are handed out), and to introduce new technology in the years to come.

With the help of our Safe Medication Administration Task Force, our goal was to decrease serious medication errors by half to 0.65 per 10,000 medication orders. We exceeded the target and decreased our serious medication errors to 0.07 per 10,000 orders by: introducing a chart flagging system for visual cuing of orders requiring action, introducing computerized medication administration records (cMAR), a paper medication administration record (MAR) generated electronically, on one unit (currently in use on D Wing), synchronizing fax machine times, conducting a Plan-Do Study-Act (PDSA) for an Intravenous (IV) admixture program in one unit, training 20 frontline staff on medication safety, human factors etc., and

initiated planning and visits to other organizations for the implementation of future tools to increase safety.

Welcome Back MidwivesHeadwaters welcomed back the Midwives of Headwater Hills to the hospital’s Women’s and Children Department in May.

This was welcome news for moms-to-be in our community who want to deliver at Headwaters under the care of a midwife. The Medical Advisory Committee and Board of Directors approved hospital privileges for four midwives. This is just another step towards high quality and safe care at Headwaters, and providing an Exceptional Experience Every Time. Helping Staff Grow and Develop with eLearningEnhancing and developing the skills and knowledge of staff at Headwaters is vitally important to providing high quality and safe patient care, as well as an environment where staff can thrive.

An electronic learning system now holds required courses and quizzes such as Workplace Hazardous Materials Information System (WHMIS) and Hand Hygiene, in addition to other personal and professional development programs, like time management and cardiac rhythm interpretation.

This flexible online system now allows staff to learn and attend education sessions when they have time in their busy schedules. By providing learning independently, staff can also control how fast or slow they progress through the material.

Hand Hygiene ComplianceOur goal was to improve hand hygiene compliance before and after patient contact to 90 percent. We exceeded our target with an average of 92.5 percent this year. In order to accomplish this, we conducted regular audits on each patient care unit, provided real time feedback to individuals being audited, rewarded and recognized departments with excellent performance, used hand hygiene culture plates four times throughout the year (10 samples each) to provide visual feedback, and we trained four additional auditors for hand hygiene.

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Turnaround Time for Diagnostic Imaging ReportsOur goal was to improve turnaround time for diagnostic imaging reports within 24 hours for x-rays, Computed Tomography (CT) scans, and ultrasounds, and within 96 hours for mammography. Like hand hygiene, we exceeded our targets for CT (21.15 hours), x-ray (21.7 hours), ultrasound (21.9 hours) and mammography (39.6 hours). Can you say “wow”? We accomplished this by implementing opportunities identified in value stream maps, developing standard operating procedures for discrepant reports, initiating performance huddles, communication, and revising our registration and booking procedures.

Percentage of patients prepared for dischargeFollowing the implementation of Inpatient Discharge Phone Calls last year, Headwaters targeted an improvement in the percentage of patients who felt they were prepared for discharge to their home environment from 96 percent to 98 percent. Like so many of our targets, we met our goal this year through the use of discharge instructions developed and revised by nurses involved in our late career nursing initiative for our medicine, surgery, and obstetrics groups, by theming comments from our discharge phone calls, striving to improve in the identified key areas, and auditing our discharge process with audit tracking tools.

Thanks to all the hard work, attention to detail and dedication by our staff, physicians and volunteers, they are helping us provide an Exceptional Experience Every Time.

I would like to thank the more than 59 active physicians and more than 70 associated physicians who work tireless to provide skilled and compassionate care to the thousands of patients who come to

Headwaters each year. This was a year of increasing numbers of visits to our Emergency Department, and despite the increase, our Emergency Department wait times are among the best in Ontario. Our patient satisfaction rates in all clinical areas are at an all-time high. The average length of stay in our hospital is one of the lowest in the province when compared with hospitals of equal size. Physicians themselves have given Headwaters high marks as an excellent place in which to practice their profession.

I would like to recognize the physicians and staff in our Diagnostic Imaging Department under the leadership of Dr. Dan Mozeg for their improvements in quality metrics within this clinical area. I would also like to acknowledge, with special thanks, Dr. Louise Keevil (Diagnostic Imaging) and Dr. Harry Bergen (Surgery) who complete their practices of medicine this year. Combined, these committed physicians provided care to our community for 67 years.

As I complete my term as Chief of Staff here at Headwaters, I would like to thank the members of our Medical Advisory Committee, our

privileged physicians, Senior Management Team, the Board of Directors and of course, our dedicated staff and volunteers for their wonderful support and hard work to provide an exceptional experience every time and make Headwaters a true centre of excellence.

>> Message from the Chief of Staff

Dr. Ken Derksen, Chief of Staff

Dr. Ken Derksen MD, Chief of Staff

Thank you. Two small words that mean so much. Thank you to the 242 volunteers of Headwaters

Health Care Centre Auxiliary who contributed

33,650 hours of service this year. Our volunteers

help our community, visitors, staff and fellow

volunteers feel comfortable in what can often

be an uncomfortable environment. This could

be at the Information Desk, as a greeter in our

Emergency Department, or Ambulatory Care to

name only a few areas.

Our volunteers also contributed their time and

efforts with many fundraising activities through-

out the year. Inside the hospital, these areas

include our Coffee Bar, the Gift Shop, our break

open lottery tickets and our used book sales. We

also host annual events such as the House Tour,

Golf Tournament, Teddy Bear Clinic and Candy

Cane Fair. As a result of our very successful

fundraising activities this year, our Auxiliary

contributed $150,000 for the second year in a

row towards our five year pledge of $750,000

to the Headwaters Health Care Foundation.

Our volunteers do everything that they do with

positive attitudes and smiles on their faces,

making them true ambassadors of our hospital.

This being my first year as President, I can truly

say it has been enjoyable and has gone by very

quickly.

This year, four Auxiliary members received

their Provincial Life Membership at last year’s

Hospital Auxiliaries Association of Ontario

Convention in November. Congratulations

to Carolyne Beaton, Ann Bradbury, Don Lytle

and Gloria Porteous on a well-deserved

accomplishment.

Thank you to my Executive Committee for your

support, ideas and encouragement this year.

It has been a tremendous year and I look

forward to seeing what we accomplish in the

year ahead.

Jim AijalaAuxiliary President

>> Message from the Auxiliary President

Jim Aijala, Auxiliary President

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14 15Ron Pincoe (left) benefited from our Assess & Restore Program in 2012. “Ours is one of the best hospitals,” said Ron, “I’m very grateful for the care I’ve had there.” Ron’s story was featured in the Foundation’s Fall 2012 Newsletter. He’s shown here with his wife, Hilda.

What a transformative year it has been for Headwaters Health Care Foundation!

On October 9, 2012, Headwaters Health Care Foundation publicly unveiled the $14 million Commitment to Care Campaign. With our volunteer Campaign Chair Bob Burnside at the helm, the largest campaign in our hospital’s history was fittingly launched amid Headwaters Health Care Centre’s 100th Anniversary celebrations.

For 100 years, Headwaters Health Care Centre has provided the best health care to the residents of Dufferin-Caledon – from lifesaving emergency treatment, to life-altering surgery, from bringing new life into the world to providing comfort at the end of life. Our hospital is here when our community needs it.

As donors, your belief in our mission and your generosity sustains and inspires us. Thanks to the

passionate philanthropy of many leadership donors, both long-time supporters and new, by the end of this fiscal year the Commitment to Care Campaign had reached $11 million. Our community has already begun to reap the benefits of your philanthropy. Last year Headwaters Health Care Centre invested in leading edge equipment to care for patients in every department of the hospital – equipment such as wheelchairs, colonoscopes, ventilators, lab equipment, a state-of-the-art x-ray machine, paediatric crash carts, and upgraded operating room equipment and surgical tools.

Headwaters Health Care Centre stands as a leader in community health care. Headwaters Health Care Foundation is proud to partner with the hospital to provide the financial resources necessary to advance that excellence in patient care.

We would like to take this opportunity to express our sincere thanks to our donors, board members and many volunteers who give of their time, money and expertise to transform the lives of patients and their families.

Building the healthiest future for our community takes the commitment and generosity of exceptional individuals. Thank you for being exceptional. We couldn’t do it without you.

>> Message from our Foundation’s Chair of the Board and Executive Director

(l) Joan Waechter, Headwaters Health Care Foundation Board Chair (r) Joan Burdette, Executive Director, Headwaters Health Care Foundation

Joan WaechterFoundation Board Chair

Joan Burdette, CFREExecutive Director

The Commitment to Care Campaign will help ensure patients in this next 100 years receive the exceptional care, close to home, they have come to expect by:• expanding the current Ambulatory Care Unit facilities to create additional procedure rooms, a fourth operating

theatre, and an expanded array of outpatient clinics;

• putting cutting edge medical equipment into the hands of our talented medical professionals; and

• over the next 5 years, investing approximately $1.5 million each year in new and upgraded medical equipment, none of which is funded by any level of government.

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Assets $ $ $ Current assets

Cash 4,740,380 6,473,862 5,389,157 Restricted cash 682,015 834,953 950,066Accounts receivable 1,592,611 1,271,496 1,401,096 Other current assets 1,024,854 819,955 679,762 8,039,860 9,400,266 8,420,081

Long-term assets Investments - restricted 119,065 117,702 116,089Capital assets 40,063,012 40,290,411 39,912,821

48,221,937 49,808,379 48,448,991

LiabilitiesCurrent liabilities Accounts payable and accrued liabilities 8,313,996 7,924,966 7,487,588 Deferred revenue 1,098,828 1,750,476 874,933 9,412,824 9,675,442 8,362,521

Long-term liabilitiesLong-term employee benefits 3,730,521 3,623,421 2,986,853Capital lease obligation 478,495 749,392 803,101Deferred capital contributions 33,001,156 34,212,548 34,931,565 37,210,172 38,585,361 38,721,518

Net assets 1,598,941 1,547,576 1,364,952 48,221,937 49,808,379 48,448,991

The notes on page 17 are an integral part of these financial statements.

>> Report of the Independent Auditor on the Summary Financial StatementsTo the Board of Directors and Members of Headwaters Health Care Centre

The accompanying summary financial statements, which comprise the summary statements of financial position as at March 31, 2013, March 31, 2012 and April 1, 2011, the summary statements of operations for the year then ended and related note, are derived from the audited financial staetments of Headwaters Health Care Centre for the years ended March 31, 2013, and March 31, 2012. Those financial statements, and the summary financial statements do not reflect the effects of events that occurred subsequent to the date of our report on thos financial statements. We expressed an unmodified audit opinion on thos e financial statements in our report dated May 28, 2013.

The summary financial statements do not contain all the disclosures required by Canadian public sector accepted accounting principles. Reading the summary financial statements, therefore, is not a substitute for reading the audited financial statements of the Headwaters Health Care Centre.

Management’s Responsibility for the Summary Financial Statements Management is responsible for the preparation of a summary of the audited financial statements on the basis described in Note 1.

March 31,2013 March 31, 2012 (note 2)

April 1, 2011(note 2)

Headwaters Health Care Centre Summary statement of financial position as at March 31, 2013, March 31, 2012 and April 1, 2013

Headwaters Health Care Centre Summary statement of operations year ended March 31, 2013

2013 2012

(note 2)

Revenue $ $Ministry of Health and Long-Term Care 43,374,374 42,237,133Other 16,240,637 15,531,931

59,615,011 57,769,064

ExpensesSalaries and benefits 34,761,009 33,937,116Supplies, drugs and other 14,492,643 13,375,610Medical staff renumeration 4,985,944 5,246,682Other programs 5,249,027 5,027,007 59,488,623 57,586,415

Excess of revenue over expenses before the undernoted 126,388 182,649

Other revenue (expenses)Amortization of

Deferred capital contributions 1,091,114 1,113,077Building and land improvements (1,129,693) (1,113,102) Loss on disposal of land and building (36,444) –

(75,023) (25)Excess of expenses over revenues 51,365 182,624

Auditor’s ResponsibilityOur responsibility is to express an opinion on the summary financial statements based on our procedures, which were conducted in accordance with Canadian Auditing Standard (CAS) 810, “Engagements to Report on Summary Financial Statements.”

OpinionIn our opinion, the summary financial statements derived from the audited financial statements of Headwaters Health Care Centre for the years ended March 31, 2013, and March 31, 2012 are a fair summary of those financial statements, on the basis described in Note 1.

Deloitte LLPChartered Professional Accountants, Chartered AccountantsLicensed Public Accountants May 28, 2013

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Note 1: Basis of the summarized financial statements: Headwaters Health Care Foundation (the “Hospital”) has prepared the summary financial statements to be included as part of its annual report. The Hospital has determined that the level of aggregation presented is adequate for the readers of the annual report. These summary financial statements present the same in-formation as the audited financial statements, except for the statements of changes in net assets, the statements of cash flows and the Notes to the audited financial statements. The audited financial statements may be obtained from the Hospital, upon request.

Note 2: Adoption of a new accounting framework: The Public Sector Accounting Board (PSAB) issued new standards for government (public sector) not-for-profit organizations (“Gov-ernment NPO’s”). The Hospital has chosen to follow Public sector accounting standards including PS 4200 to PS 4270 for government not-for-profit organizations (the “new standards”).

Effective April 1, 2012, the Hospital adopted the requirements of this new accounting framework. These are the Hospital’s first financial statements prepared in accordance with this frame-work and the transitional provisions of Section 2125 - First-time adoption by government organizations (“PS 2125”) have been applied. The date of transition to the new standards is April 1, 2011 and the Hospital has prepared and presented an opening statement of financial position at the date of the transition to the new standards. This opening statement of financial position is the starting point for the Hospital’s accounting under the new standards. The impact of the adoption of the new standards on the statement of financial position as at March 31, 2012 and April 1, 2011 and statement of operations for the year ended March 31, 2012 are summarized in the audited financial statements.

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Ministry of Health and Long-Term Care

Amortization of Grants & Donations

Patient Revenues

Other Programs

Preferred Accommodation

Café, Parking, Other

Compensation

Medical Staff Renumeration

Supplies, Drugs & Others

Amortization of Equipment

Other Programs

headwaters health care centre2012 - 2013 Expenses$60,654,760

headwaters health care centre2012 - 2013 Revenues$60,706,124

71%

2%11%

9%

2%

5%

57%

8%

20%

6%

9%

Congratulations & Thank You To Our Long Service Award Winning Staff and Physicians

5 Years of Service Rosanne Alberts, Roxann Argent, Anne Augustin, Samantha Ballantine, Leona Bishop, April Breaker, Liz Carruthers, Mike Collison, Karin Darby, Barb Dumond, Janet Feiner,

Lina Garcia-Montes-Bobechko, Julie Garrett, Janet Gordanier, Shoona Hart, Lynette Hunter, Sheila Kennedy McCormick, Catherine Kurdel, Shalini Lekhi,

Christine Madill, Karen Morello, Amy Osburn, Melissa Pardoe, Sharon Peseski, Manon Racine, Katherine Ronaldson, Colleen Rose, Jennifer Shephard, Sylvia Treble,

Michelle Westcott, Lori White, Trisha Wing, Dr. Knipping, Dr. Tomini.

10 Years of ServiceTania Alexander, Lynn Armstrong, Stacey Becker, Joan Blackeney-Lemire, Shelley Buffitt,

Debra Cantin, Michael Chambers, Melissa Goulard, Christina Hand, Helen Hartley, Sheila Holder-Irvine, Frances Jamison, Patricia Lang, Karen Lyons, Brian MacIntyre,

Laura McKeown, Dona McLellan, Martin Millar, Barbara Moulton, Lisa Oram, Jacqueline Parliament, Christine Patton, Tracy Lee Pinhay, John Posavac, Jonathan Reid, Robin Reimer, Heather Robinson, Karen Russell-Dittmann, Penny Start, Christina Switzer,

Elaine Thornton, Charlotte Wallace, Scott White, Andrew Wincen, Roselyn Young, Jane Codd, Marianne Gallant, Dr. Seto.

15 Years of Service Heather Evans, Ruth Flynn, Sarah Peterson, Susan Reid, Anne Ellis, Dr. Lane Smith.

20 Years of Service Denise Elliott, Maureen Gregory, Thelma Hylton, Irena Juresic, Corry Ann Miller,

Beverley Myers, Terri-Lynn Ogilvie, Sandra Robson, Heather Wiltshire, Dr. McKinnon.

25 Years of Service Cheryle Bonter, Kelly Cartwright, Christina Davis, Kathy Densmore, Teresa Robertson,

James Ryan, Robert Savoury, Julia Switzer, Kim Symonds, Dr. Sadan Goel.

30 Years of ServiceDr. Betty Dolbear, Ruth Ann George, Judith Gummerson, Daniel Hunter, Ruth Thompson.

35 Years of Service Caroline Fletcher, Jane Howard, Sandra Murphy.

40 Years of Service Dr. Keevil.

100 Rolling Hills Drive, Orangeville, ON L9W 4X9519.941.2410 • www.headwatershealth.ca

5,778 inpatient visits 15,837 outpatient visits40,131 emergency visits 3,798 dialysis visits4,348 day surgeries 948 inpatient surgeries

691 babies delivered 831,530 laboratory tests75,288 diagnostic images 143 heart attacks treated835 chemotherapy treatments524 cataract surgeries

...and many T. Bears treated at the Auxiliary’s 19th annual Teddy Bear Clinic.

Your Hospital by the Numbers 2012 - 2013