52 Not-for-Profit Hospital Systems to Know

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Advocate Health Care (Oak Brook, Ill.) - 13 hospitals. This system is proud of its efforts in clinical integration to improve patient care and lower costs. For example, a collaborative effort between more than 3,400 physicians and eight of Advocate's 13 hospitals improved outcomes for patients with a broad range of conditions including asthma, diabetes and heart disease. In 2009, Thomson Reuters Research named Advocate Health Care one of the top 10 U.S. Health systems in quality and efficiency.

The largest healthcare provider in Illinois, Advocate Health Care hospitals have more than 3,000 beds and more than 28,000 employees. In January, the Chicago-area system made its first foray into downstate Illinois, acquiring 221-bed BroMenn Regional Medical Center in Normal and 25-bed Eureka Hospital. Advocate's largest hospitals are 695-bed Advocate Christ Medical Center in Oak Lawn, 645-bed Advocate Lutheran General in Park Ridge and 408-bed Advocate Illinois Masonic Medical Center in Chicago. www.advocatehealth.com

Ascension Health (St. Louis) - 65 hospitals. Ascension Health has watched patient loyalty grow since it launched efforts to improve the patient experience in fiscal 2007. The largest Catholic hospital system in the nation, this behemoth operates 65 hospitals with more than 16,800 licensed beds in 20 states and the District of Columbia. It was created in 1999 by the union of the Daughters of Charity National Health System and the Sisters of St. Joseph Health System.

Following Catholic tradition, Ascension Health takes in the uninsured and underinsured, meaning that it was left with higher levels of bad debt during the recession. In 2008, its bad debt grew by $167 million, or 23 percent. "From a human dignity standpoint, we have to get everyone insured," President and CEO Anthony Tersigni told Kaiser Health News last August. www.ascensionhealth.org

Aurora Health Care (Milwaukee) - 13 hospitals. Six years ago, Aurora began introducing healthcare kiosks, staffed by providers who deal with basic medical issues for a flat rate. Now it runs 19 such facilities, called Aurora QuickCare, with five of them in Wal-Mart Supercenters. Meanwhile, more than 3,400 physicians are affiliated with Aurora Health Care, including more than 900 who make up Aurora Medical Group and the 250 physicians in Aurora Advanced Healthcare. The system also operates Aurora Sports Medicine Institute, Vince Lombardi Cancer Clinics and Aurora Vision Center.

Aurora Health Care, made up of 13 hospitals with 2,936 beds, maintains a presence in more than 90 communities throughout eastern Wisconsin. The flagship is 742-bed Aurora St. Luke's Medical Center in Milwaukee, which is center for minimally invasive, robotically assisted heart surgery. Nick Turkal, MD, president and CEO of Aurora Health Care, is one of 30 physicians named to Becker's Hospital Review's annual Best Physician Leaders of Hospital and Health Systems list. Becker's Hospital Review also named Aurora West Allis Medical Center and Aurora BayCare Medical Center as two of the 16 best community hospitals in the nation. www.aurorahealthcare.org

Avera Health (Sioux Falls, S.D.) - 27 hospitals. This system traces its roots back to three Roman Catholic sisters who came from Ireland to the Dakota Territory in the late 1800s to educate the children of the Lakota Sioux and European settlers. In 1901 they opened their first hospital to care for victims of diphtheria and typhoid epidemics. Today, from its base in eastern South Dakota, Avera Health operates in more than 231 locations in five contiguous states, logging 2.1 million clinic and inpatient visits annually, which is more than twice the population of its service area.

The system runs 27 hospitals with a total of 1,605 beds and 13,100 physicians and employees. It also operates Avera Health Plans and Avera Medical Group, which has added 115 physicians and 12 midlevel practitioners since it started in 2008. Avera Health's flagship is 545-bed Avera McKennan Hospital & University Health Center, with 550 physicians in 60 specialties, research and teaching programs, and bone marrow, kidney and pancreas transplant programs. Avera is sponsored by the Sisters of St. Benedict of Sacred Heart Monastery of Yankton, S.D., and the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, S.D. www.avera.org

Banner Health (Phoenix) - 22 hospitals. While some other hospital systems were just getting by in 2009, Banner Health experienced its best performance year ever. Each year Banner sets strategic goals focused on clinical quality, operational management, patient experience, employee engagement and financial performance. SDI Health ranked Banner Health as one of the Top 10 integrated healthcare systems in the nation this year and one of the metrics that carried the greatest weight was financial stability.

As one of the largest secular not-for-profit health systems in the nation, Banner Health operates 22 hospitals with nearly 4,000 beds. Eleven of the hospitals are in Arizona and the rest are scattered through six other states. Banner also operates seven ASCs in the Phoenix area. The system recently opened 146-bed Cardon Children's Medical Center, part of a $356 million expansion of Banner Desert Medical Center in Mesa, Ariz. www.bannerhealth.com

Baptist Health South Florida (Coral Gables, Fla.) - 5 hospitals. Baptist Health was created in 1990, bringing together large Miami area hospitals that had been operating for decades. Its largest facility, Baptist Hospital, with 680 beds, attracts many patients from the Caribbean and Latin America. Its campus includes Baptist Children's Hospital, Baptist Cardiac & Vascular Institute, the Regional Cancer Program and the Diabetes Care Center.

The largest faith-based, not-for-profit healthcare organization in the region, Baptist Health South Florida operates five hospitals with 1,465 beds, 13,376 employees and 1,967 affiliated physicians. It posts around 70,000 admissions annually and has an annual operating revenue of $2.1 billion. The system posted net income of $131.3 million for fiscal year 2009, up from a $71.7 million loss in the previous fiscal year. www.baptisthealth.net

Baylor Health Care System (Dallas) - 23 hospitals. Baylor Health Care System is affiliated with HealthTexas Provider Network, which began with 10 physicians in 1994 and now employs 400, including primary care physicians, specialists and hospitalists. The whole system has almost 2,900 physicians on active staff and operates 17 ASCs and 88 primary care centers, specialty care centers and senior health centers.

Baylor Healthcare includes 23 hospitals that are owned, leased or affiliated with the health system. Through a for-profit subsidiary, it owns a healthcare construction company, a retail pharmacy and a hotel on the Baylor University Medical Center campus. In 2008, the system logged total operating revenue of $3.1 billion, more than 310,000 ED visits, almost 110,000admissions, more than 556,000 outpatient registrations and more than 15,000 births.

Flagship Baylor University Medical Center in Dallas started as Texas Baptist Memorial Sanitarium in 1903. Today it has 1,025 licensed beds. For 17 consecutive years, U.S. News has listed the medical center as one of America's Best Hospitals. The system won the 2008 National Quality Forum National Quality Healthcare Award recognizing role models that achieve meaningful and sustainable quality improvement. www.baylorhealth.com

BJC Healthcare (St. Louis) - 13 hospitals. This system has been spending more than $250 million a year on capital improvements such as renovation, expansion, new construction and new technology. Its Center for Healthcare Quality and Effectiveness, which coordinates patient safety and health care quality efforts, is recognized by the U.S. Agency for Healthcare Research and Quality. System hospitals partner with physicians, such as in a joint venture with Washington University Orthopedics to provide outpatient orthopedic services in a $13 million patient-centered facility that opened in 2007.

BJC takes its name from Barnes-Jewish Hospital, the system's 1,111-bed flagship in St. Louis, which took ninth place in U.S. News & World Report's honor roll of 21 Best Hospitals in the nation. The 13-hospital system has 3,200 beds, 26,500 employees, 3,260 physicians on staff and a net revenue of $3.1 billion. BJC Medical Group employs 125 physicians and offers practice management services to non-employed physicians through a service called PhyFocus. www.bjc.org

Bon Secours Health System (Marriottsville, Md.) - 18 hospitals. Bon Secours, a French term that means "good help," is a $2.6 billion not-for-profit Catholic health system that owns, manages, or is involved in a joint venture of 18 acute-care hospitals which include with 4,397 licensed beds and 16,000 employees. The system is in the middle of installing a $150 million EMR, Bon Secours ConnectCare. It is also participating in IHI's Saving 100,000 Lives campaign and 5 Million Lives Campaign and in CMS' Hospital Quality Initiative demonstration project. www.bshsi.com

Carilion Health System (Roanoke, Va.) - 8 hospitals. This system is built around a 600-physician multi-specialty group practice and eight hospitals with more than 1,200 beds. The clinic has started a "patient-centered medical home," using care coordinators to follow patients and make sure they understand their conditions, medications and available community support.

Carilion's flagship, 765-bed Roanoke Memorial Hospital, runs a Level I trauma center, a 60-bed neonatal intensive care unit and residency training. In August, the first class of medical students will start at Virginia Tech Carilion School of Medicine and Research Institute, which the system jointly run with Virginia Tech in nearby Blacksburg. President and CEO Edward Murphy, MD, is one of 30 physicians named to Becker's Hospital Review's annual Best Physician Leaders of Hospital and Health Systems list. www.carilion.com

Caritas Christi Health Care (Boston) - 6 hospitals. The system's Latin name, meaning "the charity of Christ," underscores its mission, to take care of those in need, but its leadership also realizes it has to be financially healthy. In 2008, reacting to some financial struggles, Archdiocese of Boston relinquished control of this system, allowing management to make changes that could improve financial performance and operating effectiveness. In fiscal year 2009, operating margin reached 2.3 percent and operating cash flow rose to 7.3 percent.

As New England's largest community-based hospital network, Caritas Christi operates six hospitals with 1,552 hospital beds, about 2,300 doctors and 1,900 nurses. It has close about 240,000 ED visits and 74,000 patient discharges annually. It also operates Laboure College, a small Catholic college. www.caritaschristi.org

Carolinas HealthCare System (Charlotte, N.C.) - 29 hospitals. The largest healthcare system in the Carolinas, this organization owns, leases or manages 29 hospitals with about 6,000 beds and employs more than 1,400 physicians practicing at more than 500 care locations.

The flagship is 874-bed Carolinas Medical Center in Charlotte, which has a Level I trauma center and a research institute and a large number of specialty treatment units including heart, cancer, organ transplant, and behavioral health.

Carolinas is continually expanding its relatively loose hospital network. Last year it began managing two-hospital MedWest Health System in Clyde and Silva, N.C. This year it signed an affiliation agreement with two-hospital AnMed Health in Anderson, S.C., allowing AnMed to keep its name. Carolinas also has management agreements with Stanly Regional Medical Center in Albemarle, N.C., and Scotland Regional Health Care System in Laurinburg, N.C.

With its new CMC-Steele Creek facility in Charlotte, Carolinas HealthCare is introducing a new breed of facility, a pavilion that is smaller than a community hospital yet larger and more sophisticated than a traditional medical office building or urgent care facility. Steele Creek has a full-service ED, physician practices, advanced diagnostic imaging, a lab and a pharmacy. CMC-Waxhaw is scheduled to open in 2010 and state CON approvals have been obtained for three more pavilions. www.carolinashealthcare.org

Catholic Health East (Newtown Square, Pa.)
- 34 hospitals. Catholic Health East clinicians set goals last year for achieving targeted outcomes for hospital-acquired conditions, Medicare length-of-stay reductions, prevention of acute care readmission within 30 days and decreasing the percentage of clinical denials of payment. The system also spearheaded Comprehensive Care Management program for persons as they transition into and out of its facilities and programs.

Catholic Health East was created in 1998, when Catholic Health East (CHE), Allegany Health System, Eastern Mercy Health System and Sisters of Providence Health System combined legally and operationally. The system now includes 34 acute-care hospitals and about 54,000 full-time employees in 11 eastern states from Maine to Florida. President and CEO Robert V. Stanek is a strong proponent of balancing the business needs of his Catholic organization with its mission to care for the poor and the sick. www.che.org

Catholic Health Initiatives (Denver, Colo.) - 75 hospitals. The system is redefining and reorganizing of its revenue cycle, including improved point-of-service cash collection, for an expected increase of $75 million in revenue from 2009-2014. With 66,000 employees, the system has annual revenues of about $8.6 billion and provided $536 million in charity care and community benefit in 2008.

Three Catholic healthcare systems formed Catholic Health Initiatives in 1996, and more Catholic systems have joined the organization since then. Now the second-largest Catholic healthcare system in the nation, CHI operates 75 hospitals in 19 states: Washington, Oregon, Idaho, Colorado New Mexico, North Dakota, South Dakota, Nebraska, Kansas, Minnesota, Wisconsin, Iowa, Arkansas, Kentucky, Tennessee, Ohio, Pennsylvania, Maryland and New Jersey.

Its Colorado subsidiary, Centura Health, is the state's largest healthcare provider, with 12 hospitals. Centura's flagship, 593-bed St. Anthony Central Hospital in Denver, is building a replacement hospital that will be completed in 2011. Another significant CHI area is Arkansas, with the five hospitals including 973-bed St. Vincent Infirmary Medical Center in Little Rock. In 2007, CHI acquired Saint Clare's Health System, which operates four hospitals in northwest New Jersey. www.catholichealthinit.org

Catholic Healthcare West (San Francisco) - 41 hospitals. This huge hospital system recently announced an increase in funding for electronic health records by $419 million, for a total EHR investment of $1 billion to date. The decision came after the successful introduction of the technology in eight of its hospitals, where physicians had an 87 percent adoption rate of computerized physician order entry, compared with nationwide rates of 20 percent or less, according to HIMSS Analytics.

Catholic Healthcare West is the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California, operating 41 hospitals with 8,800 beds in California, Arizona and Nevada. It also operates two health plans and five medical practice groups. Its biggest hospitals include 415-bed St. Mary Medical Center in Long Beach, 343-bed Mercy General Hospital in Sacramento, 323-bed Saint Francis Memorial Hospital in San Francisco and 316-bed California Hospital Medical Center in Los Angeles. www.chwhealth.org

CHRISTUS Health (Irving, Texas) - 35 hospitals. One of the few U.S. systems that is international, this Catholic system maintains operations in five Mexican states as well as eight U.S. states. It owns or leases 35 hospitals, 28 of which are in the United States and seven in Mexico. Eighteen of its hospitals are in Texas and nine are in Louisiana. The system has 30,000 employees and almost 9,000 physicians on its medical staffs.

CHRISTUS, which means "Christ" in Latin, was created in 1999 in a merger of the Sisters of Charity Health Care System and the Incarnate Word Health System. The system's quality management program provides a consistent platform of standards, measurements and reporting throughout the organization, enabling safe, effective, patient-centered care delivered in a timely, efficient and equitable manner.

Its hospitals tend to be small, with the largest having no more than 500 beds. The organization also owns many long-term acute care hospitals, clinics and outpatient centers. It has plans to build a $100 million hospital in Alvin, Texas, outside of Houston, and a subsidiary, CHRISTUS Santa Rosa Health System in San Antonio, recently purchased a majority interest in an ASC. www.christushealth.org

Covenant Health (Knoxville, Tenn.) - 6 hospitals. Country music singer Dolly Parton, a long-time fan, attended the February opening of Covenant Health's newest project, LeConte Medical Center, a $115 million facility replacing Fort Sanders Sevier Medical Center. The 64-year-old star's roots go deep here. She was born in a one-room cabin in the same county as the hospital, up in the Great Smoky Mountains. In addition to the Dolly Parton Family Birthing Unit, the new facility boasts four surgical suites, two endoscopy suites and a C-section suite.

Covenant Health operates six hospitals, which include more than 1,550 beds, 8,000 employees and 1,000 affiliated physicians in East Tennessee. It was created in 1996 by the consolidation of Fort Sanders Health System in Knoxville with MMC HealthCare System, parent of Methodist Medical Center in Oak Ridge, Tenn. www.covenanthealth.com

Erlanger Health System (Chattanooga, Tenn.) - 5 hospitals. The system owes its existence to Baron Frederic Emile d'Erlanger, a railroad investor who gave $5,000 to found a hospital during an 1889 visit to Chattanooga. Today Erlanger Health System operates five Tennessee-based medical campuses with 819 acute-care beds. In fiscal year 2008-2009, Erlanger had more than 27,700 inpatient admissions, almost 250,000 outpatient visits and treated more than 24,000 surgery patients.

The system partners with the University of Tennessee College of Medicine Chattanooga. More than 160 residents and fellows participate in nine residency programs and five fellowship programs at the Chattanooga campus based at Erlanger. The system runs the area's only kidney transplant program and offers the region's largest hospitalist program. www.erlanger.org

ETMC Regional Healthcare System (Tyler, Texas)
- 15 hospitals. ETMC, which stands for East Texas Medical Center, operates 15 hospitals with 1,200 beds and 6,000 employees in the Piney Woods, located east of Dallas. Its strategy is to provide care in rural areas whenever possible. Primary care provided in rural health clinics close to patients' homes and secondary care stays local at ETMC affiliate hospitals. Then comes high-level secondary and tertiary care at 448-bed ETMC Tyler, a Level I trauma center that provides cancer, neurosurgery, orthopedics and cardiovascular service lines. One of ETMC's newest acquisitions is Henderson (Texas) Memorial Hospital, a 51-bed short-term facility. www.etmc.org

Henry Ford Health System (Detroit)
- 6 hospitals. This highly integrated system, identified by Thomson Reuters as one of the top 10 U.S. health systems in quality and efficiency, includes the 95-year-old Henry Ford Medical Group, which has more than 1,000 physicians and researchers in more than 40 specialties. In addition to six hospitals with more than 2,200 beds, the system's Health Alliance Plan of Michigan provides managed care and health insurance to about 540,000 members.

Flagship Henry Ford Hospital in Detroit is a 903-bed tertiary care hospital that trains more than 700 residents in 40 specialties. The system's newest addition is 300-bed Henry Ford West Bloomfield Hospital, a high-tech, patient-friendly facility in a park-like setting. The system has more than 23,000 employees, conducts more than 78,000 ambulatory surgery procedures and admits more than 93,000 patients to its hospitals annually. Henry Ford plans to merge its physician training programs with Wayne State University School of Medicine. www.henryford.com

Hospital Sisters Health System (Springfield, Ill.)
- 13 hospitals. Hospital Sisters' Care Integration Project, launched in 2008, is creating integrated patient care models enabling physicians to cooperatively develop ambulatory care services throughout the region. At the heart of the project is a partnership between the system and Prairie Cardiovascular in Springfield, Ill., to become fully integrated as one entity. Pediatrician Richard D. Rolston, MD, is the president and CEO of HSHS Medical Group, founded in 2008, which is affiliated with the health system.

This 13-hospital Catholic system has 14,541 employees, 3,349 physicians on staff and an operating revenue of $1.7 billion. It logs 128,462 admissions, 317,276 ED visits, 23,021 inpatient surgeries and 46,947 outpatient surgeries a year. Hospitals include St. Elizabeth's Hospital in Bellevue, Ill., with about 500 beds, St. Vincent Hospital in Green Bay, Wis., with about 550 beds and Sacred Heart Hospital in Eau Claire, Wis., with 344 beds, and several small community hospitals. www.hshs.org/hshs/

Integris Health (Oklahoma City)
- 13 hospitals. This system was created with the 1995 merger of Oklahoma Health System and Southwest Medical Center. Oklahoma Health System had been created a year before with the merger of Oklahoma Healthcare Corp., parent of Baptist Medical Center, and Baptist Healthcare of Oklahoma. Today, Integris Health is Oklahoma's largest not-for-profit health care organization, with 13 hospitals that have more than 1,900 licensed beds and 2,500 affiliated physicians.

The system's biggest hospital is 561-bed Integris Baptist Medical Center, followed by 369-bed Integris Medical Center, both in Oklahoma City. Baptist Medical Center is the only Oklahoma-owned designated Magnet hospital for excellence in nursing services. In December, the system began construction of 40-bed Integris Health Edmond, after a brief postponement due to the economic downturn. www.integris-health.com

Intermountain Healthcare (Salt Lake City) - 23 hospitals. The Church of Jesus Christ of Latter-day Saints (also known as the Mormons) divested 15 hospitals in 1974 to the Intermountain community to be run as a not-for-profit healthcare system. Today the system runs 23 hospitals, all but one in Utah, comprising one-third of all hospitals in the state. The system has 2,217 beds and more than 32,000 employees and runs Intermountain Medical Group with more than 750 doctors and clinicians. It also operates an insurance company called SelectHealth; which offers SelectValue, SelectMed, and SelectCare insurance plans. SelectHealth insures around 500,000 lives in the Intermountain Region. Flagship Intermountain Medical Center in Murray, Utah, has 440 beds. The newest addition is 26-bed Intermountain Park City Medical Center. www.intermountainhealthcare.org

Iowa Health System (Des Moines, Iowa) - 26 hospitals. In January, Iowa Health System opened the first phase of its 46,000-square-foot data center, which will house patient and employee records for the whole system. The state-of-the-art center uses retina scanners for personal identification, has two-feet-thick concrete and steel reinforced walls and is able to withstand an F4 tornado.

The state's largest integrated health system and largest not-for-profit employer, Iowa Health System operates 26 hospitals in metropolitan and rural communities. Its 373-bed Iowa Methodist Medical Center is the state's largest private hospital with nearly 4,000 employees. The system logs more than 1.8 million patient visits a year, employs 20,000 people and has revenues of $2 billion a year. Moody's Investors Service recently gave Iowa Health System a high credit rating with a stable outlook, at Aa3 underlying ratings. www.ihs.org

Kaiser Foundation Hospitals (Oakland, Calif.)
- 36 hospitals. The origin of these hospitals dates back to a 12-bed facility in the Mojave Desert that served a construction crew building the Los Angeles Aqueduct in the 1930s. Healthcare personnel working for California industrialist Henry J. Kaiser devised a new method of healthcare payments that evolved into the modern HMO. Physicians in this system formed for-profit Permanente Medical Group while hospitals and the health plan formed not-for-profit Kaiser Permanente.

As or part of Kaiser Permanente, Kaiser Foundation Hospitals runs 36 hospitals in California, Oregon and Hawaii while the health plans and medical groups serve a wider geographical area, also including Colorado, Georgia, Ohio and the Washington, D.C., area. The hospitals and health plans lost money in 2008, due to declining enrollment, but posted of $2.1 billion in 2009, eve though enrollment declined further. Meanwhile, Kaiser began construction on a 314-bed hospital in Fontana, Calif., scheduled to open in fall 2013. www.kaiserpermanentejobs.org

Kettering Health Network (Dayton, Ohio) - 5 hospitals. This organization traces its name back to the same man who helped found Memorial Sloan-Kettering Cancer Center in New York, a General Motors executive named Charles F. Kettering. In 1952, Van Buren, Ohio, changed its name to Kettering in his honor and the local hospital took on the name. Today, Kettering Health Network operates five hospitals with 1,300 beds.

Kettering Medical Center has 481 certified beds and more than 1,000 employees and Grandview Medical Center in Dayton has 427 certified beds and almost 1,300 employees. In addition, the system is acquiring Fort Hamilton Hospital in Hamilton, Ohio, and broke ground last summer on a 90-bed Beavercreek Medical Center, which is expected to open in 2012. In 2009, Thomson Reuters Research named Kettering Health Network one of the top 10 U.S. Health systems in quality and efficiency. www.khnetwork.org

Memorial Hermann Healthcare System (Houston) - 11 hospitals. Memorial Hermann is the result of a 1997 merger between Hermann Healthcare System and Memorial Healthcare System to create the largest not-for-profit healthcare system in Texas. The system operates 11 hospitals with 3,517 beds and a medical staff of almost 4,200 physicians, all in the Houston area. It also operates 10 ASCs and 21 imaging centers and has a total of 19,500 employees.

Memorial Hermann's flagship, 750-bed Memorial Hermann-Texas Medical Center, is the teaching hospital for The University of Texas Medical School at Houston and home of the nation's busiest Level I trauma center. It hosts more brain and neurosurgeries than any other institution in Houston as well as 50,000 heart procedures per year. www.memorialhermann.org

Methodist Le Bonheur Healthcare (Memphis) - 7 hospitals. Methodist Le Bonheur Healthcare's Methodist North Hospital was Memphis' first private hospital to launch a fully integrated electronic medical record system, which includes an electronic medical administration record and computerized physician order entry to deliver seamless patient care. SDI Health named Methodist Le Bonheur one of the 2009 Top 100 Integrated Healthcare Networks.

This nonprofit health system, formerly Methodist Healthcare, operates seven hospitals with more than 1,600 beds, physician practices and a physician referral service. The system's flagship, 669-bed Methodist University Hospital in Memphis, is affiliated with the University of Tennessee Health Science Center. Methodist Le Bonheur is planning a $137 million, 100-bed hospital in Olive Branch, Miss. www.methodisthealth.org/portal/site/methodist/

Moses Cone Health System (Greensboro, N.C.) - 4 hospitals. This organization's flagship hospital, Moses H. Cone Memorial Hospital, in Greensboro, N.C., was named after textile patriarch Moses Cone, the founder of Cone Denim. The hospital recently won state approval for a $208.5 million expansion that will feature larger ORs, patient rooms and ED space, to begin in early 2011 and be completed in 2015. This system's four hospitals in central North Carolina have a total of more than 1,000 beds. www.mosescone.com

North Shore-LIJ Health System (Great Neck, N.Y.)
- 14 hospitals. This Long Island-based organization has the most integrated system in New York State, according to SDI Health. And North Shore University Hospital performed better than any of 247 hospitals participating in CMS's Hospital Quality Incentive Demonstration project, run by CMS and Premier. North Shore-LIJ also won the 2010 NQF National Quality Healthcare Award.

The third-largest, nonprofit, secular healthcare system in the United States, based on number of beds, North Shore-LIJ Health System has 14 hospitals with 4,344 hospital and long-term care beds, more than 7,500 affiliated physicians and more than 36,000 employees, making it the largest employer on Long Island. It has a $5 billion annual operating budget. Its flagship hospitals are 827-bed Long Island Jewish Medical Center in Hyde Park and 731-bed North Shore University Hospital in Manhasset. www.northshorelij.com

NorthShore University HealthSystem (Evanston)
- 4 hospitals. A rising four-hospital system, based in Chicago's North Shore suburbs, NorthShore University has 975 beds and 2,000 affiliated physicians, including a medical group with more than 550 physicians. NorthShore has annual revenue of over $1.5 billion and a staff of nearly 9,000. Formerly known as Evanston Northwestern Healthcare, the system changed its name when it switched affiliated medical schools from Northwestern University to the University of Chicago Pritzker School of Medicine.

In 2003, NorthShore was one of the first hospitals in the country to successfully launch a system wide EMR with demonstrable benefits in quality, safety, efficiency and service to patients. Since then, the EMR has been a tremendous driver of growth, allowing the system to implement consistent procedures and end inefficient and unsafe practices, such as handwritten records. In another innovation, patients can search online for the next available time for an MRI at nine or 10 available locations, which spreads out demand and helps the system take care of more patients.

NorthShore's flagship Evanston Hospital, with 420 beds, has teaching and research programs, as well as capabilities for trauma, cancer, perinatal and women's health. NorthShore University Research Institute has more than $100 million of grants and oversees more than 1,000 active research projects with more than 150 externally funded research faculty. www.northshore.org

Novant Health (Winston-Salem, N.C.) - 12 hospitals. In more than 30 counties across North and South Carolina and Virginia, Novant Health operates 12 hospitals with more than 3,000 beds, including an orthopedic hospital. It has 26,300 employees and hosts 119,000 surgeries, 467,000 ED visits and 117,000 discharges amounting to 706,000 inpatient days.

Novant Health was the 17th most integrated healthcare network in the nation this year, according to SDI Health. The Novant Medical Group consists of almost 1,100 physicians in 359 clinic locations seeing 3.9 million patients a year. In addition, the system also operates 100 outpatient diagnostic imaging centers through its MedQuest subsidiary. Another division provides management services for other hospitals. Novant Health has partnered with Health Management Associates on the ownership of 105-bed Lake Norman Regional Medical Center, Mooresville, N.C.

Novant operates 961-bed Forsyth Medical Center in Winston-Salem and 531-bed Presbyterian Hospital in Charlotte. In 2009, the system acquired several hospitals, including Prince William Health System in Manassas, Va. The system's Presbyterian Healthcare subsidiary is planning a new hospital in Mint Hill, N.C. Novant Health has twice received the prestigious Ernest A. Codman Award from the Joint Commission for improving system-wide the quality and safety. www.novanthealth.org

OhioHealth (Columbus, Ohio) - 8 hospitals. Nine years ago, OhioHealth stopped trying to make money on the primary care practices it had acquired in the 1990s and spun them off. Now it is back to buying up practices, but this time they tend to be specialists, and physicians' pay is tied to their patient volume. The OhioHealth Medical Specialty Foundation now employs more than 200 physicians.

In 2009, Thomson Reuters Research named OhioHealth one of the top 10 U.S. Health systems in quality and efficiency. This central Ohio system runs eight hospitals with 1,802 staffed beds, 15,000 employees and 2,500 physicians on staff. It logs almost 58,000 surgeries, more than 106,000 admissions and 1.7 million outpatient visits a year. OhioHealth operates HealthReach PPO in a joint venture with the Medical Group of Ohio. www.ohiohealth.com

OSF Health Care (Peoria, Ill.) - 7 hospitals. OSF is shorthand for Sisters of the Third Order of St. Francis, the Catholic organization that still oversees OSF Health Care. The system operates seven hospitals with 2,009 beds, and all but one of them is in central Illinois. Logging almost 56,000 acute and long-term care admissions in fiscal year 2008, the system also operates OSF HealthPlans, with nearly 80,000 members, and OSF Medical Group, with more than 210 physicians and 41 mid-level providers at 49 office locations. OSF Health Care has a 60 percent stake in a six-OR ASC. The flagship is 710-bed St Francis Medical Center in Peoria. www.osfhealthcare.org

Palmetto Health (Columbia, S.C.) - 5 hospitals. The Palmetto tree is the symbol of South Carolina, where Palmetto Health maintains all five of its hospitals with 1,138-beds, 8,400 employees and 1,000 physicians. Its 650-bed flagship, Palmetto Health Richland, is affiliated with the University of South Carolina Medical School. In Oct. 2009, Palmetto Health entered a joint venture with Greenville Hospital System University Medical Center to operate 109-bed Baptist Easley Hospital. www.palmettohealth.org

Partners HealthCare (Boston)
- 10 hospitals. The name Partners denotes the original 1993 partnership between Massachusetts General Hospital and Brigham and Women's Hospital, which has since added a number of community hospitals from the Boston suburbs to the islands of Nantucket and Martha's Vineyard. Partners is now the largest healthcare provider in Massachusetts, with 10 hospitals and 2,400 beds. Its ventures include the Harvard Clinical Research Institute and the Dana-Farber/Partners CancerCare, a collaboration with the Dana-Farber Cancer Institute. www.partners.org

Presbyterian Healthcare Services (Albuquerque, N.M.) - 7 hospitals. In addition to operating seven hospitals, with a total of 900 beds, and a medical group with more than 490 physicians and practitioners, Presbyterian Healthcare runs Presbyterian Health Plan, the state's largest health plan, with more than 440,000 enrollees. The whole system employs more than 9,000 people.

Presbyterian Hospital, the flagship with 453 beds, is the largest acute-care hospital in New Mexico, and provides a full range of medical and surgical healthcare services. The health plan was recently named New Mexico's top-ranked health plan for the second year in a row by U.S. News & World Report and The National Committee of Quality Assurance. www.phs.org

ProMedica Health System (Toledo, Ohio) - 8 hospitals. Toledo Hospital and Toledo Children's Hospital rebranded themselves as ProMedica 1986, and the system has added six more hospitals as well as an HMO, several physician practices, a health education and research center and nursing homes. In February, the system opened the ProMedica Heart and Vascular Institutes, a collaboration of physicians, technology and specialty services. The eight ProMedica hospitals in northwest Ohio and southeast Michigan have 1,272 beds and 2,900 physicians on staff. Flagship Toledo Hospital has 774 beds and 1,100 physicians on staff. www.promedica.org

Provena Health (Mokena, Ill.)
- 6 hospitals. Thomson Reuters named this system one of the top 50 U.S. health systems based on hospital clinical quality and efficiency. Its largest hospital, 480-bed Provena Saint Joseph Medical Center in Joliet, Ill., ranked among the top 5 percent in the nation in clinical quality for the past three consecutive years by HealthGrades. HealthGrades also named 356-bed Provena Mercy Medical Center in Aurora, Ill., among the top 5 percent in the nation in cardiac surgery for the second year in a row. Provena Health is a Catholic health system that includes six hospitals in Illinois with 1,568 beds. It runs Alverno-Provena Hospitals Laboratory as a joint venture with the Sisters of St. Francis Health System in Mishawaka, Ind. www.provena.org

Providence Health & Services (Renton, Wash.) - 26 hospitals. Providence Health's mantra is, "How can we do it better?" To improve quality, this health system hosts Kaizen events, a Japanese method that brings together everyone involved in an issue into intense debate on improvements. In a recent five-day Kaizen event, physicians and other caregivers came up with better ways to better manage patient handoffs and coordination of care. As a result of these efforts, Providence Regional Medical Center, the system's 468-bed flagship, breaks even on Medicare, even though its regional payor for Medicare pays about $1,000 less per enrollee than the national average.

The system operates 26 hospitals with 5,314 acute-care beds in Alaska, Washington, Montana, Oregon and California and also runs a health plan, a liberal arts university and a high school. Providence has about 50,000 employees systemwide and revenues of $7.02 billion in 2008. Providence Health Plans has a membership of more than 280,000.

In another money-saving move, the system works with physicians to standardize care. In open debate, physicians develop their own protocols. Physicians can still ignore an agreed-upon protocol, but it takes work. They have to explain why and identify an alterative therapy. In an upcoming project, Providence plans to consolidate volume for certain procedures among fewer surgeons so that they can gain more expertise. www.providence.org

St. Joseph Health System (Orange, Calif.)
- 14 hospitals. St. Joseph's origins can be traced back to a Jesuit order in 17th-century France that believed in going out into the world and performing good acts rather than being cloistered in a nunnery. Some sisters of St. Joseph came to California in 1912, and decided to dedicate themselves to healthcare in 1918, when the Spanish Influenza epidemic swept America.

Today, St. Joseph Health System operates 14 hospitals thr oughout California as well as eastern New Mexico and in western Texas. With 3,607 beds and 24,000 employees, it had $3.69 billion in total net revenue in 2008. In 2009, for the third year in a row, the Gallup Organization awarded St. Joseph Health System its highest honor, the Great Workplace Award. The flagship, 525-bed St. Joseph Hospital in Orange, is affiliated with St. Joseph Heritage Medical Group, which has 36 primary care physicians. www.stjhs.org

Saint Luke's Health System (Kansas City, Mo.)
- 11 hospitals. The health system was formed around Saint Luke's Hospital, founded in 1882 as a 50-bed facility. Today it is a 623-bed hospital with a Level I trauma center and internationally recognized cardiac and stroke care. Saint Luke's Mid America Heart Institute won kudos from the American Heart Association for performing as one of the top 10 scientific advances in 2005. In 2009, a cardiologist from the institute used advanced imagining techniques to detect hardening of the arteries in 3,500-year-old Egyptian mummies.

This 11-hospital, faith-based system operates Saint Luke's Medical Practice, with about 500 doctors. U.S. News and World Report ranked it on its 2009 Best Hospitals list for urology and its 2008 Best Hospitals list for heart and gynecology. Saint Luke's Hospital is a primary teaching hospital for the University of Missouri-Kansas City School of Medicine and home of Saint Luke's College of Nursing. www.saint-lukes.org

Sanford Health & MeritCare (Sioux Falls, S.D., and Fargo, N.D.)
- 29 hospitals. The new organization, the largest not-for-profit rural healthcare provider in the nation, is the result of a Nov. 2009 merger of Sanford Health, which has two dozen hospitals in five states, with Meritcare, North Dakota's largest health system with regional clinics and hospital sites scattered over North Dakota and Northwest Minnesota.

The new system's motto is, "Stronger together." It encompasses 29 hospitals with more than 1,600 beds, 17,400 employees, more than 800 physicians in 70 specialty areas and combined annual net revenues of $2 billion. Sanford Health's flagship is 500-bed Sanford USD Medical Center in Sioux Falls, S.D. MeritCare operates two Fargo hospitals with a total of 583 beds. Future plans include a heart hospital and new research building in Sioux Falls and a 25-bed critical access hospital in Thief River Falls, Minn. www.sanfordhealth.org

Scripps Health (San Diego.) – 4 hospitals. Scripps operates four hospitals with about 1,400 beds, more than 12,000 employees and more than 2,600 affiliated physicians throughout San Diego County. The 517-bed Scripps Mercy Hospital, San Diego's longest established hospital, was founded in 1890 and joined the Scripps Health system in 1995. Scripps Memorial Hospital La Jolla has 372 beds. The Scripps Clinic is affiliated with the Scripps Health system and has about 400 member physicians. www.scripps.org

Sentara Healthcare (Norfolk, Va.) - 8 hospitals. Sentara Healthcare ranked No. 1 on SDI Health's list of the most integrated health networks, based on factors such as services, technology, physicians and financial stability. The system operates eight hospitals with a total of 1,911 beds, a 380-physician Sentara Medical Group and nine imaging centers. Sentara's Optima Health unit provides HMO coverage and other health insurance products to about 350,000 Virginians.

The organization's 543-bed flagship, Sentara Norfolk General Hospital, boasts the area's only Level I trauma center, a burn trauma unit and a dedicated cardiac hospital with more than 100 beds. Sentara Healthcare acquired Potomac Hospital in Woodbridge, Va., in late 2009 and is building a 120-bed hospital, Sentara Princess Anne, in Virginia Beach, Va. www.sentara.com

Sharp HealthCare (San Diego) - 4 hospitals. The system started in 1955 with Donald N. Sharp Memorial Community Hospital. Today Sharp HealthCare runs four acute-care hospitals with a total of 1,657 beds. It employs more than 14,000 employees, has 2,600 physicians on staff and operates three physician medical groups and a number of urgent care and skilled nursing facilities and clinics. In Nov. 2007, Sharp HealthCare received the Malcolm Baldrige National Quality Award. The system was ranked No. 1 in California and No. 13 in the nation on SDI Health's list of top integrated health care networks. www.sharp.com

Sisters of Mercy Health System (Chesterfield, Mo.) – 19 hospitals. The organization's new electronic health records system creates a single and continuously updated electronic health record for each patient, reduces the number of forms to be filled out and gives physicians a more complete picture of the patient's medical history, test results and medications. In the future, patients will be able to schedule appointments, view test results or request prescription renewals through an Internet site.

Sisters of Mercy is the ninth largest Catholic healthcare system in the U.S., based on net patient service revenue. Its 19 hospitals, with 4,083 beds, including a specialty heart hospital, are organized into eight strategic service units, sharing mutual benefits but allowing for local management, across seven states: Arkansas, Kansas, Louisiana, Mississippi, Missouri, Oklahoma and Texas. The organization's for-profit Mercy Health Plans sells health insurance primarily in Arkansas, Missouri, and Texas.

The Sisters of Mercy system has more than 31,000 employees, more than 1,100 integrated physicians and about 4,600 physicians on medical staff. Its 859-bed St. John's Mercy Medical Center is the second largest private hospital in metropolitan St. Louis, with a Level I trauma center, a burn center, a heart and vascular hospital and graduate medical education. www.mercy.net

SSM Health Care (St. Louis) - 20 hospitals. When Roman Catholic sisters founded this system in 1872, their account ledgers identified people who could not pay as "Our Dear Lord's." Recalling those origins, the system ensures discounts for people without health insurance. SSM Health Care owns or manages some 20 acute-care hospitals with about 4,400 licensed beds in Illinois, Missouri, Oklahoma, and Wisconsin. It has nearly 23,000 employees, 5,400 physicians on staff and 3,000 volunteers, and also operates physicians' practices. SSM DePaul Health Center, a 457-bed hospital in metropolitan St. Louis, won the Premier Award for Quality in 2009.

Citing improved finances, SSM is moving forward with plans to build two replacement hospitals put on hold last year. SSM's operating income reached $108.9 million for the first three quarters of 2009, up from $15.7 million from the same period in 2008. www.ssmhc.com

Sutter Health (Sacramento, Calif.)
- 25 hospitals. Sutter Health is named after John Sutter, a Swiss immigrant whose mill near Sacramento was where a nugget of gold was discovered in 1848, triggering the California gold rush. The system is one of the largest not-for-profit systems in the nation, with 25 hospitals and about 3,500 affiliated doctors. Sutter Surgical Hospital North Valley in Yuba City, Calif., opened in May 2009 as a joint venture among Sutter North Medical Foundation, 15 surgeons and National Surgical Hospitals. Its flagship, Sutter Medical Center in Sacramento, has two campuses, 306-bed Sutter General and 346-bed Sutter Memorial Hospital. www.sutterhealth.org

Texas Health Resources (Arlington, Texas) - 14 hospitals. Formed in 1997 by the merger of Harris Methodist Health System, Presbyterian Healthcare System and Arlington Memorial Hospital Foundation, this system operates 14 hospitals with 3,355 beds, more than 18,000 employees and more than 3,600 physicians with staff privileges. The system's Research and Education Institute provides clinical studies management, medical device testing and medical training services. One of its largest hospitals is 710-bed Texas Health Harris Methodist Hospital Fort Worth. www.texashealth.org

Trinity Health (Novi. Mich.)
- 45 hospitals. The origins of Trinity Health go back to Holy Cross Sisters who helped staff military hospitals in the Civil War. Today, it owns or manages 45 hospitals with nearly 400 outpatient facilities in eight states: Maryland, Ohio, Michigan, Indiana, Iowa, Nebraska, Idaho and California. Many of its hospitals are in medium-sized cities, such as Columbus, Ohio; Battle Creek, Mich.; Boise, Idaho; and Fresno, Calif.

Trinity Health has revenues of $7 billion, employs 45,000 full-time and has an active staff of more than 8,000 physicians. It was one of the top 10 systems in Thomson Reuters' Health Systems Quality/Efficiency Study. Its Trinity Health International unit provides consulting, training, and other assistance to hospitals worldwide. It also runs a small health insurer, Mount Carmel Health Plan, in central Ohio. www.trinity-health.org

UAB Health System (Birmingham, Ala.) - 6 hospitals. UAB stands for the University of Alabama at Birmingham, which jointly runs the health system with Alabama Health Services Foundation. UAB Health System operates six hospitals with 908 beds and the Kirklin Clinic, which houses more than 700 physicians in 35 specialties.

The system's flagship, 900-bed UAB Hospital, opened in Nov. 2004 as a replacement hospital. The 11-story hospital includes 37 operating suites, two procedure rooms, three medical surgical units and four intensive care units. Eight UAB Hospital specialty programs are among U.S. News & World Report's top 50 in the nation. www.health.uab.edu

To view a list of these not-for-profit systems organized by number of hospitals, please click here.

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