1. The Evangelical Lutheran Good Samaritan Society Meeting with Federal Communications Commission July 29, 2015

2. The Evangelical Lutheran Good Samaritan Society Case Statement “Like other eligible healthcare providers providing similar services, we believe that the Good Samaritan Society should be eligible to access Universal Service Funds for the purpose of expanding and funding its broadband capabilities in rural and frontier areas to provide for and deliver remote health care service to its patients and clients in skilled nursing facilities and other places they call home.”

3. Overview of Organization Largest not- for-profit provider of LTC and HCBS services for seniors in US; Serve over 27,000 individuals – entire continuum; 240 locations in 24 states; – Over 75% locations are in rural or frontier MSAs; – Increasing service deliveries in homes; Increasing dependence on Broadband to deliver data/provide care

4. Services Provided Home Health, Home Care, Hospice and Respite Care Senior Living with Services Assisted Living Memory and Specialty Care Post-Acute Care Services Technology enhanced remote monitoring services (LivingWell@Home) Skilled Nursing Care Adult Day Services Affordable Housing Inpatient and Outpatient Therapy Remote patient care

5. Service Area Map

6. Needs for Services Serve aging and isolated population Spanning geographic distances for healthcare delivery Growing need to communicate with other health care providers Data collection and analysis requirements (for advancing healthcare initiatives - bundled payment, ACO’s, other demonstration projects); “Bending cost curve” Healthcare Reform and the transition to collaborative partnerships to keep patients/clients healthy and out of the hospital Consumer desire for independence Engage individuals in their health and wellbeing Telehealth services in rural areas requiring use of broadband

7. Good Samaritan’s Response to Need Implementation of EMR Expand Broadband & Wireless network capabilities Remote development and delivery of wellness and telehealth (all require broadband) – Altru (remote physician care in ND) – Brighter Day Health (remote mental health services) – eLTC (telemedicine program with hospital) – LivingWell@Home (remote monitoring) More…

8. Programs/Services Altru Health System® http://www.altru.org/ Primary and Specialty Health Care: Oncology Palliative medicine Wound Care Platform allows multiple participants at diverse locations to be engaged in a patient centered plan of care Particular importance in serving rural communities where specialty care is not available Example: Devils Lake: 142 mile round trip to access primary care

9. Programs/Services Brighter Day Health™ http://brighterdayhealth.com/ Behavioral health services specific to SNF residents Visit consistency and frequency “Among residents aged 85 years or older, dementia (41.0%) was the most common mental illness, followed by mood disorders (35.3%). In 2004, approximately two thirds of nursing home residents had a diagnosis of a mental illness, and approximately one third of these had a mood disorder.” (CDC MMWR Supplement/Vol. 60 September 2, 2011) Co morbid impact of mental illness and chronic disease process’ on quality and length of life. (Public Health Research Practice and Policy Vol. 3: No. 2, April 2006)

10. Programs/Services eLTC * http://www.avera.org/ecare/eltc/ Offering urgent care visits 24/7 Provision of bedside advance care planning consultations Assessments in real time for acute changes in condition Able to provide primary care visits in prevention of unnecessary hospitalizations Review of all transition order sets (Hospital to Center; Center to Home) *Part of Avera eCare™ telehealth services

11. A Review of LivingWell@Home [Services in Two Clinics]

12. What is LivingWell@Home? Collects and Analyzes Information Vital signs, sleep patterns, movement, medication adherence, activity Information provided to formal and informal caregivers Early detection and early intervention Opportunity Statement Be the premier provider in remote patient monitoring and other services Reduce healthcare costs Improve clinical outcomes and customer satisfaction. A Program Designed To Empower Experience an optimal state of well-being Wellness and independence

13. Living Well@Home Impact 2 Clinical Partners, 60 patients total Timeframe: January 2015 through April 2015 LivingWell@Home prevented 12 hospitalizations LivingWell@Home patients realized 3 hospitalizations

14. Living Well@Home Impact 11.7% of U.S. Population lives with >3 chronic conditions (CDC) Individuals with >3 chronic conditions, over 65 years of age, contribute to 90.6% of all hospital stays (NIS-HCUPS (CDC)) This results in 2.25 hospital stays per year for individuals with >3 chronic conditions over the age of 65 Sources: NIS - HCUPS 2012Sources: NIS - HCUPS 2012; CDC - Population MCCCDC - Population MCC

15. Living Well@Home Impact Considering the rate of 2.25 hospital stays per year for this population, LW@H expects to have seen 16 hospital stays by this time for the 60 patients reviewed. LW@H prevented 12 hospitalizations Average mean charge per hospital stay $38,123* Impact: $38,123 * 12 = $457,476 Source: NIS - HCUPS 2012

16. Living Well@Home Recent Article in the News From New York Times – July 24, 2015 http://www.nytimes.com/2015/07/25/your-money/technology-while-not-a-fountain-of-youth-can- make-aging-safer.html?_r=0

17. The Evangelical Lutheran Good Samaritan Society Case Statement “Like other eligible healthcare providers providing similar services, we believe that the Good Samaritan Society should be eligible to access Universal Service Funds for the purpose of expanding and funding its broadband capabilities in rural and frontier areas to provide for and deliver remote health care service to its patients and clients in skilled nursing facilities and other places they call home.”

18. Q&A Follow-Up Steps?

19. Thank you! 19