1. 1 Tewksbury Hospital A fully accredited Joint Commission and CMS Certified Hospital February 2015

2. 2 Tewksbury Hospital Presentation Overview and Outline Welcome & Introductions Campus Overview Patient Population & Clinical Services Admission Process Discharge Planning Partnerships to Date Commonwealth Care Alliance Introduction/Overview Discussion

3. Tewksbury Hospital Originally founded in 1854 as an almshouse and has been in continuous operation since then. Under the auspices of the Department of Public Health, the hospital continues to evolve to meet the increasingly challenging medical and psychiatric needs of many vulnerable residents of the Commonwealth Tewksbury Hospital is a dynamic campus and health care facility with the goal of assisting patients reach their highest possible level of independent functioning, providing comprehensive treatment, care and comfort to adults with medical illness, mental illness, or comorbid medical and psychiatric disorders. 3

4. Tewksbury Hospital’s Vibrant Campus Individuals participate in 24/7 active treatment Hospital Inpatients 210 on seven (7) Medical units 161 on five (5) Psychiatric units, including the only medically enhanced psychiatric unit in the Commonwealth 298 campus clients in treatment programs 669 individuals working with a wide range of skilled staff to reach their highest level of recovery and independence to rejoin their outpatient community 4

5. 5 Tewksbury Hospital Patient Population and Clinical Services

6. 6 Tewksbury Hospital Who do we care for? Tewksbury Hospital provides patient focused medical and psychiatric care and diagnostic services within a therapeutic environment designed to meet the needs of patients with complex chronic psychological or social needs in addition to their co-morbid medical conditions. A vital link in the continuum of care with acute care hospitals, ourselves, and community discharges including personal homes, nursing homes, group homes, transitional residential treatment centers, and shelters.

7. 7 Tewksbury Hospital – Why it is not a nursing home 24/7 on site physicians Both a medical and a psychiatric board-certified MD is in house at all times (BLS and ACLS certified) 24/7 on site registered nurses and NP’s, including many with advanced certificates of specialized expertise In house Respiratory Therapy, Radiology and Laboratory Services Care provided for a patient population not accepted by nursing homes Positive CORI, SORI Complex medical care needs Significant behavioral care needs Medically compromised released DOC clients

8. 8 Tewksbury Hospital Designated Specialty Units for Patients with Complex Medical needs and associated Behavioral Issues Neuro Rehabilitation Unit Traumatic Brain Injury Post Op Orthopedic procedures – elective, emergency, post traumatic Neurologic conditions – stroke, MS, spinal cord injuries Huntington’s Disease Unit (Designated “Center of Excellence” by HDSA) Hemodialysis for behavioral patients not suitable for outpatient dialysis Medical/Post Op Services for Department of Developmental Services Clients (DDS)

9. 9 Tewksbury Hospital Specialty Units and Coordinated Services (Medical) for Patients with Complex Medical needs and Behavioral Issues Medically Enhanced Unit for Psychiatric patients Medical services for substance abuse and medical/surgical complications– Including Infections related to IV substance abuse that require prolonged (typically 6-8 weeks) of IV antibiotics All male unit for men with Leveled Sex Offense History and recent incarceration who have comorbid complex medical needs

10. 10 Tewksbury Hospital On Site Clinical Services Minimize disruptive and costly transfers and saves emergency room costs Hemodialysis Eye Services – optometry, including eyeglasses for those in need, and ophthalmology Dental care – full-time dentist and dental hygienist, including provision of dentures for those in need Podiatry care – including orthotics for those in need Radiology Ultrasound Comprehensive laboratory services, with Quest Laboratories as the reference lab for send outs if needed Physical Therapy, Occupational Therapy Speech and Language Therapy, including Swallowing evaluations Recreational Activities Therapy

11. 11 Tewksbury Hospital On Site Enhanced Clinical Services Minimize disruptive and costly transfers and saves emergency room costs Wound Vacs TPN PICC line insertions Gastric and jejunal feeding tubes Holter Monitoring Sleep Studies Tracheostomy care CPAP

12. 12 Tewksbury Hospital On Site Specialty Consultations Minimize disruptive and costly transfers and saves emergency room costs Infectious Disease Pulmonary Nephrology Endocrinology Physiatry Neurology Psychiatry Psychology Neuropsychology Substance Abuse Palliative Care Clinical Pharmacy Wound Management Pain Management

13. 13 Tewksbury Hospital Sources of Referrals Medical Acute Care Hospitals Boston Merrimack Valley Other Massachusetts hospitals Acute Rehab facilities Healthcare for the Homeless DDS – Group Homes Nursing Homes Department of Corrections Self Referrals – families/respite

14. 14 Tewksbury Hospital Support Services Clinical Social Worker assigned to every patient – many with complex discharge needs. Rehabilitation Services consist of Physical Therapy, Occupational Therapy, Speech/Language Therapy and Adaptive Equipment Registered Dietician assigned to every patient 30% of patients are on therapeutic diets 15% of patients are on texture modified diets 13% of patients are on therapeutic and texture modified combination diets Approximately 80% of current patients have a secondary diagnosis of substance abuse and/or psychiatric disorder

15. 15 Tewksbury Hospital Contact Information Sue Doherty, RNC, Admissions (978) 851-7321 X2527 Ariana O’Neill, MS, RN, CNL, CDDN, Nurse Manager (978) 851-7321 X2322