| Form 990, Part I, Line 1 BRIEF MISSION |
THE MISSION OF THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) IS TO IMPROVE THE HEALTH AND WELFARE OF OUR COMMUNITIES THROUGH RESPONSIVE, WHOLE-PERSON HEALTH SERVICES FOR ALL AND THE SUSTAINABLE RENEWAL OF AN INSPIRED, COMPETENT WORKFORCE THAT IS PRIVILEGED TO SERVE. TWCGME, A 501(C)(3) NONPROFIT CORPORATION AND ANCHOR MEMBER OF A GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM (GME-SNC), IN PARTNERSHIP WITH ITS AFFILIATED ENTITY AND FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKE (FQHC LAL), THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH), SERVES AS THE INDEPENDENT ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME)-ACCREDITED SPONSORING INSTITUTION OF GRADUATE MEDICAL EDUCATION RESIDENCY AND FELLOWSHIP PROGRAMS THAT TRAIN PRIMARY CARE RESIDENT AND SPECIALTY FELLOW PHYSICIANS IN A SAFETY-NET HEALTH SERVICES NETWORK OF ESSENTIAL COMMUNITY PROVIDERS. TWCGME'S TRAINING PROGRAMS OPERATING DURING THE COVERED PERIOD INCLUDE INTERNAL MEDICINE, FAMILY MEDICINE, AND PHYSICAL MEDICINE & REHABILITATION (PM&R) RESIDENCIES, AS WELL AS GERIATRICS, CARDIOVASCULAR DISEASE, AND GASTROENTEROLOGY FELLOWSHIPS. IT ALSO INCLUDES LEARNERS IN ITS INTERNAL MEDICINE-GERIATRICS INTEGRATED RESIDENCY AND FELLOWSHIP PATHWAY, COMMONLY KNOWN AS THE COMBINED MED-GERI PATHWAY. TWCGME'S GME-SNC STRATEGICALLY ENGAGES NUMEROUS PARTNERING ORGANIZATIONS IN ITS GOVERNANCE AND THE TRAINING OF ITS RESIDENTS AND FELLOWS. THESE PARTNERS INCLUDE TWCGME'S PRIMARY AFFILIATED FQHC LAL, TWCCH, AS WELL AS FOUR PARTNERING NATIONAL FQHCS, NUMEROUS CMS GME-FUNDED COMMUNITY-BASED HOSPITAL SYSTEMS, OUR REGIONAL VETERAN AFFAIRS MEDICAL CENTER, TWO CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) GME-FUNDED INPATIENT REHABILITATION FACILITIES (IRFS), OUR REGIONAL NORTHEAST PENNSYLVANIA AREA HEALTH EDUCATION CENTER (NEPA AHEC), COMMUNITY RESOURCE AGENCIES INCLUDING THE INSTITUTE, AND ALSO PATIENTS OF TWCCH AND MEMBERS OF THE COMMUNITIES SERVED AT LARGE. TWCGME AND TWCCH ALSO PROUDLY HOSTED MORE THAN 200 INTERPROFESSIONAL STUDENTS FOR CLINICAL AND EDUCATIONAL EXPERIENCES FROM MORE THAN 10 ACADEMIC-AFFILIATED INSTITUTIONS OF HIGHER EDUCATION, INCLUDING GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (GCSOM) AND A.T. STILL UNIVERSITY'S SCHOOL OF OSTEOPATHIC MEDICINE IN ARIZONA (ATSU-SOMA) AND ITS CENTRAL COAST PHYSICIAN ASSISTANT PROGRAM (ATSU-CCPAP), AND LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE (LECOM). PARTNERING COMMUNITY HEALTH CENTERS, GEISINGER, AND ATSU-SOMA HAVE AN EMPOWERED VOTING PRESENCE ON TWCGME'S GOVERNING BOARD OF DIRECTORS, AS DO COMMONWEALTH HEALTH SYSTEMS AND NEPA AHEC. COMMITTED TO COMMUNITY HEALTH NEEDS-RESPONSIVE, WHOLE-PERSON HEALTH SERVICES AND HEALTH CARE WORKFORCE DEVELOPMENT, TWCCH AND TWCGME ARE THE ORIGINATORS AND OPERATORS OF A REPLICABLE, SCALABLE, AND PROVEN GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM (GME-SNC) MODEL THAT IS INCREASINGLY BEING ADOPTED NATIONALLY AS A SOLUTION TO THE PRIMARY CARE AND PUBLIC HEALTH WORKFORCE CRISES FACING COMMUNITY-BASED SYSTEMS OF CARE. THROUGH THE ORGANIZATION'S GME-SNC FRAMEWORK, ITS MISSION IS OPERATIONALIZED BY SEAMLESSLY INTEGRATING LEARNING, WORKFORCE DEVELOPMENT, AND CARE DELIVERY, LEVERAGING THE PRESENCE OF PHYSICIAN AND INTERPROFESSIONAL HEALTH CARE LEARNERS TO DRIVE CONTINUOUS IMPROVEMENT, EXPAND ACCESS, AND SUSTAIN EXCELLENCE IN COMMUNITY-BASED PRIMARY CARE. THE GME-SNC MODEL EMBRACES COMMUNITY HEALTH CENTERS AS INTEGRATED ACADEMIC PRIMARY CARE AND WORKFORCE DEVELOPMENT PLATFORMS, POSITIONING FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) AND FQHC LOOK-ALIKES AS HIGH-PERFORMING LEARNING ORGANIZATIONS RATHER THAN RELEGATING THEM TO THE MARGINS OF WORKFORCE DESIRABILITY. IN THIS MODEL, COMMUNITY HEALTH CENTERS SERVE AS ENGINES OF EXCELLENCE, INNOVATION, AND ACCESS, ADVANCING INTENTIONAL, LOCALLY GROUNDED SOLUTIONS FOR PHYSICIAN RECRUITMENT, RETENTION, AND LONG-TERM WORKFORCE SUSTAINABILITY. ROOTED IN THE BELIEF THAT COMMUNITIES MUST HAVE THE CAPACITY TO IDENTIFY, GOVERN, AND SOLVE THEIR OWN HEALTH AND WORKFORCE CHALLENGES, AND INSPIRED BY THE PRINCIPLES OF COLLECTIVE ACTION, SHARED LEARNING, AND COMMUNITY-GOVERNED INNOVATION ARTICULATED BY NOBEL PRIZE-WINNING ECONOMIST AND POLITICAL SCIENTIST ELINOR OSTROM, THE GME-SNC MODEL REFLECTS THE CONVICTION THAT "WE" IS MORE POWERFUL THAN "I." THROUGH INTENTIONAL REENGINEERING OF TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM (THC GME-SNC) GOVERNANCE STRUCTURES IN ACCORDANCE WITH OSTROM'S POLITICAL AND ECONOMIC THEORIES OF COOPERATION AND COLLABORATION TO STEWARD COMMON-POOL RESOURCES-WORK THAT DECISIVELY DISPROVED GARRETT HARDIN'S "TRAGEDY OF THE COMMONS"-THE GME-SNC MODEL PROMOTES MUTUALLY REINFORCING, CONSENSUS-DRIVEN STRATEGIES THAT ENABLE COMMUNITIES TO ADDRESS COMPLEX PUBLIC HEALTH AND HEALTH CARE WORKFORCE CHALLENGES SUSTAINABLY. |
| Form 990, Part I, Line 1 BRIEF MISSION CONTINUED |
BY PROMOTING A CULTURE OF UNIFIED PARTICIPATORY CITIZENSHIP AND SHARED LEARNING AMONG GOVERNING BOARDS, CLINICAL CARE TEAMS, STAFF, PATIENTS, AND COMMUNITY-BASED INTERPROFESSIONAL LEARNERS, THE GME-SNC MODEL STIMULATES AND LEVERAGES EACH STAKEHOLDER GROUP'S MEANINGFUL CONTRIBUTIONS TO CONTINUOUS IMPROVEMENT IN CARE DELIVERY AND WORKFORCE DEVELOPMENT. THE COLLECTIVE IMPACT OF THIS APPROACH STRENGTHENS TALENT DEVELOPMENT, RECRUITMENT, AND RETENTION FOR COMMUNITY HEALTH CENTERS, AFFILIATED ORGANIZATIONS, AND THE BROADER COMMUNITIES THEY SERVE, WHILE ADVANCING A DURABLE, COMMUNITY-ANCHORED RESPONSE TO NATIONAL PRIMARY CARE WORKFORCE SHORTAGES, MISDISTRIBUTION, AND RELATED BARRIERS TO HEALTH CARE ACCESS AND CAREERS. BUILDING ON THIS MISSION-DRIVEN FOUNDATION, THE ORGANIZATION'S GME-SNC MODEL HAS BEEN ADVANCED, TESTED, AND PROVEN THROUGH MORE THAN A DECADE OF LIVED EXPERIENCE, MOST NOTABLY THROUGH THE CREATION, EVOLUTION, AND SUCCESSFUL MATURATION OF TWCGME'S PIONEERING NATIONAL FAMILY MEDICINE RESIDENCY (NFMR) PROGRAM. THROUGH THIS WORK, COMMUNITY-ANCHORED CLINICAL LEARNING ENVIRONMENTS DEMONSTRATED THAT FQHCS AND FQHC LOOK-ALIKES CAN FUNCTION NOT AS PERIPHERAL TRAINING SITES, BUT AS HIGH-PERFORMING ACADEMIC AND WORKFORCE DEVELOPMENT PLATFORMS CAPABLE OF TRAINING, RETAINING, AND SUSTAINING A PRIMARY CARE WORKFORCE RESPONSIVE TO LOCAL NEEDS. EVEN AMID SIGNIFICANT REGULATORY DISRUPTION AND PAINFUL PROGRAMMATIC TRANSITIONS, THE GME-SNC MODEL DID NOT RETREAT; IT EVOLVED AS DESIGNED. NFMR PARTNER SITES SUCCESSFULLY PROGRESSED INTO INDEPENDENT, ACGME-ACCREDITED SPONSORING INSTITUTIONS AND RESIDENCY PROGRAMS, WHILE OTHERS ADVANCED TOWARD THAT GOAL, AFFIRMING THE MODEL'S SCALABILITY, REPLICABILITY, AND DURABILITY. THESE REMARKABLE OUTCOMES REFLECT REAL COMMUNITIES THAT NOW TRAIN THEIR OWN PHYSICIANS, STEWARD THEIR OWN RESOURCES, AND STRENGTHEN ACCESS TO WHOLE-PERSON PRIMARY CARE, LIVING PROOF THAT INTENTIONAL, COMMUNITY-GOVERNED WORKFORCE DEVELOPMENT CAN DELIVER LASTING PUBLIC BENEFIT. |
| Form 990, Part III, Line 1 ORGANIZATION MISSION |
THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) AND ITS PRIMARY AFFILIATED ENTITY, THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH), SHARE A MISSION TO IMPROVE THE HEALTH AND WELFARE OF OUR COMMUNITIES THROUGH RESPONSIVE, WHOLE-PERSON HEALTH SERVICES FOR ALL AND THE SUSTAINABLE RENEWAL OF AN INSPIRED, COMPETENT WORKFORCE THAT IS PRIVILEGED TO SERVE. TWCGME, ALONG WITH ITS PRIMARY AFFILIATE, TWCCH, COLLABORATIVELY SHARE A PASSIONATE PURPOSE TO DEMONSTRATE AN "ACHIEVABLE BY ALL" TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM (GME-SNC) MODEL THAT COCREATES TRANSFORMATIONAL HEALTH CARE TEAMS OF LEADERS WHO EMPOWER PEOPLE, FAMILIES, AND COMMUNITIES TO OWN AND OPTIMIZE THEIR HEALTH, HEALTH CARE DELIVERY SYSTEMS, AND DEVELOPMENT OF THEIR INTERPROFESSIONAL HEALTH CARE WORKFORCE. WITH FULL ENGAGEMENT OF TWCGME STAKEHOLDERS, THE GME-SNC ASPIRES TO OPTIMIZE ITS COLLECTIVE IMPACT FRAMEWORK TO EFFECTIVELY ADDRESS AMERICA'S PRIMARY CARE WORKFORCE SHORTAGE AND MISDISTRIBUTION, AND RELATED HEALTH, HEALTH CARE, AND HEALTH CARE CAREER ACCESS NEEDS AND CHALLENGES. AS A GME-SNC, TWCGME PARTNERS WITH A NETWORK OF SAFETY-NET HEALTH SERVICES PROVIDERS AND INTEGRATES GME FEDERAL RESOURCES DIRECTLY FROM THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION'S (HRSA) THCGME PROGRAM AND THE DEPARTMENT OF VETERAN AFFAIRS' GME, AS WELL AS THROUGH ITS AFFILIATION AGREEMENTS WITH CMS GME-FUNDED PARTNERING HOSPITALS AND INPATIENT REHABILITATION FACILITIES. NOTABLY, TWCGME BECAME A PIONEER AMONG THCGME CONSORTIUM GRANTEES IN 2011, WHEN HRSA LAUNCHED THE THCGME PROGRAM. SINCE THEN, THCGME GRANTEES, INCLUDING TWCGME, HAVE BEEN DEVELOPING AND EXPANDING COMMUNITY-BASED CLINICAL LEARNING ENVIRONMENTS IN COMMUNITY HEALTH CENTERS (CHCS), PARTNERING HOSPITALS, AND SPECIALTY STAKEHOLDERS ACROSS THE NATION TO TRAIN PRIMARY CARE RESIDENTS AND FELLOW PHYSICIANS TO DELIVER HEALTH SERVICES FOR ALL WHILE SERVING HISTORICALLY MARGINALIZED POPULATIONS IN MEDICALLY UNDERSERVED SETTINGS. EVIDENCE DEMONSTRATES THAT PHYSICIANS WHO TRAIN AT CHCS ARE MORE LIKELY TO WORK IN A CHC OR OTHER UNDERSERVED SETTINGS AFTER GRADUATION, AS VALIDATED BY HRSA'S TEACHING HEALTH CENTER GME PROGRAM'S UNDENIABLE GRADUATE OUTCOMES 16 YEARS AFTER ITS INCEPTION. THIS VITAL RESPONSE TO THE PRIMARY CARE SHORTAGE MOST EFFECTIVELY TRAINS AND RETAINS PRIMARY CARE PHYSICIANS IN COMMUNITIES WHERE THEY ARE MOST NEEDED, WITH 95% OF THCGME GRADUATES REMAINING IN PRIMARY CARE PRACTICE, 86% SERVING MEDICALLY UNDERSERVED, AND 15% SERVING RURAL COMMUNITIES COMPARED TO 24%, 26%, AND 5% OF TRADITIONAL GME GRADUATES, RESPECTIVELY. |
| Form 990, Part III, Line 1 ORGANIZATION MISSION CONTINUED |
WITH A NOTABLY HIGHER-THAN-NATIONAL-AVERAGE COMPLEMENT OF PRIMARY CARE PHYSICIANS SELECTING CAREERS IN HISTORICALLY UNDERSERVED SETTINGS, INCLUDING IN FQHCS AND RURAL COMMUNITIES, AFTER GRADUATION, HRSA'S THCGME PROGRAM AND TWCGME GME-SNC'S HISTORICAL GRADUATE PRACTICE PATTERN OUTCOMES DEMONSTRATE LOGICAL, DELIVERED SOLUTIONS TO RESOLVE AMERICA'S PRIMARY CARE CRISES. YET THIS PIONEERING PROGRAM'S FUNDING REMAINS VULNERABLE, EGREGIOUSLY DISCORDANT, AND FAR BELOW ITS VALUE AND IMPACT ON OUR COUNTRY. THIS UNFORTUNATELY UNRESOLVED INADEQUATE FUNDING DEBACLE AT THE FEDERAL LEVEL CONTINUES TO LEAVE THIS NOTABLY IMPACTFUL THC GME-SNC SOLUTION UNDER-RESOURCED, NONSENSICALLY UNDERMINING ITS NATIONAL COMMUNITY BENEFIT IMPACT, DESPITE ESCALATING PRIMARY CARE SHORTAGES ACROSS OUR COUNTRY. THIS BIZARRE TRAGEDY OF THE COMMONS REALITY IS ILLUMINATED BY THE 2025 NATIONAL RESIDENCY MATCH PROGRAM OUTCOMES THAT REVEALED UNFILLED MATCH POSITIONS IN PRIMARY CARE DISCIPLINES. THIS PERSISTENT REALITY HIGHLIGHTS PERSISTENT SHORTCOMINGS IN OUR HISTORICAL, NATIONAL GRADUATE MEDICAL EDUCATION (GME) SYSTEM CHAMPIONED BY TRADITIONAL ACADEMIC MEDICAL CENTERS THAT CONTROL ISOLATED, CMS-CENTRIC GME SYSTEMS. EXPANDING GRADUATE MEDICAL EDUCATION (GME) SOLELY THROUGH THE CMS PROGRAM WILL NOT FIX PRIMARY CARE WORKFORCE DEVELOPMENT IN AMERICA. IN ESSENCE, RELYING SOLELY ON CMS FOR GME EXPANSION MAY PERPETUATE THE LIMITATIONS OF THE EXISTING NATIONAL GME SYSTEM IN SUPPORTING PRIMARY CARE. AT THE SAME TIME, TARGETED PROGRAMS LIKE THCGME HAVE SHOWN MORE PROMISING OUTCOMES WITH LESS INVESTMENT. OUR NATIONAL PRIMARY CARE CRISIS UNDERSCORES THE URGENT NEED FOR DELIBERATE SOLUTIONS SUCH AS HRSA'S THCGME PROGRAM AND TWCGME'S GME-SNC TO AFFORDABLY DELIVER HIGH-INTEGRITY, RESPONSIBLE PRIMARY CARE WORKFORCE DEVELOPMENT THAT IS RESPONSIVE TO THE HEALTH CARE NEEDS OF THE AMERICAN PEOPLE. TWCGME BELIEVES THAT THE EXISTING GME SYSTEM IS NOT ADEQUATELY STRUCTURED TO INCENTIVIZE OR SUPPORT PRIMARY CARE TRAINING. THERE ARE GAPS IN NATIONAL STRATEGIES FOR DEVELOPING A PRIMARY CARE WORKFORCE THAT ALIGNS WITH NATIONAL HEALTH CARE NEEDS, AND ADDRESSING THESE GAPS IS THE SHARED RESPONSIBILITY OF ALL HEALTH CARE STAKEHOLDERS, INCLUDING THE FEDERAL GOVERNMENT, ACGME'S SINGLE MEDICAL EDUCATION ACCREDITATION SYSTEM, CODA'S SINGLE DENTAL EDUCATION ACCREDITATION SYSTEM, AND GME SPONSORING INSTITUTIONS. AMERICA'S RAPIDLY EVOLVING HEALTH CARE LANDSCAPE AND THE SPECIFIC NEEDS OF UNDERSERVED POPULATIONS WILL NOT BE ADEQUATELY ADDRESSED WITHOUT TRANSFORMATIONAL, DELIBERATELY DESIGNED, AND INTENTIONALLY RESOURCED NATIONAL GME REFORM. DATA PUBLISHED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) IN MARCH 2024 SHOWS THAT THE NATION WILL FACE A PHYSICIAN SHORTAGE OF UP TO 86,000 BY 2036. THIS CONTINUING CRISIS COMPOUNDS THE PHYSICIAN AND PROVIDER BURNOUT CHALLENGES EXACERBATED BY THE 2020 GLOBAL PANDEMIC. TWCGME'S GME-SNC PHYSICIAN TRAINING MODEL, INSPIRED BY TEACHING HEALTH CENTER FRAMEWORKS AND COMMUNITY HEALTH ACADEMIC MEDICAL PARTNERSHIPS (CHAMPS), IS DESIGNED TO MITIGATE THE HEALTH, HEALTH CARE, AND HEALTH CARE CAREER ACCESS BARRIERS RESULTING FROM AND FURTHER PROPAGATING THIS NATIONAL SHORTAGE, WHILE GENERATING UNPRECEDENTED COLLABORATION AND COLLECTIVE ACTION STRATEGIES AT THE LOCAL COMMUNITY LEVEL FOR ADVANCEMENT OF THE QUINTUPLE AIM, ADAPTED FROM THE INSTITUTE FOR HEALTHCARE IMPROVEMENT'S TRIPLE AIM, OF IMPROVING HEALTH OUTCOMES, AND THE ACCESS, QUALITY, AFFORDABILITY, AND EXPERIENCE OF HEALTH CARE SERVICES DELIVERY FOR ALL STAKEHOLDERS. |
| Form 990, Part III, Line 1 ORGANIZATION MISSION CONTINUED |
HRSA'S THCGME PROGRAM HAS BEEN AN EFFECTIVE TOOL FOR ADDRESSING ONE OF THE MOST CRUCIAL ASPECTS OF THE PRIMARY CARE CLIFF: ACCESS TO AND AFFORDABILITY OF WHOLE-PERSON PRIMARY CARE SERVICES IN UNDERSERVED AREAS, DRIVEN BY A NATIONAL SHORTAGE OF PRIMARY CARE PHYSICIANS AND MISDISTRIBUTION. ADDITIONALLY, TEACHING HEALTH CENTER, COMMUNITY-GOVERNED GME-SNC PLATFORMS ATTRACT AND OPTIMIZE THE EDUCATIONAL CAPACITY OF COMMUNITIES FOR INTERPROFESSIONAL HEALTH CARE WORKFORCE DEVELOPMENT BY GENERATING UNPRECEDENTED COLLABORATION AND CHAMPS PARTNERSHIPS, AS EVIDENCED BY TWCGME'S THRIVING ACADEMIC INSTITUTIONAL AFFILIATIONS. TWCGME'S GME-SNC, AS A RESULT, HAS PROUDLY DELIVERED TO ITS AFFILIATE, TWCCH, 54% OF ITS PRIMARY CARE PHYSICIAN WORKFORCE, INCLUDING INTERNAL MEDICINE, FAMILY MEDICINE, AND GERIATRICS PHYSICIANS, 92% OF ITS CERTIFIED REGISTERED NURSE PRACTITIONERS, AND 88% OF ITS PHYSICIAN ASSISTANTS. MOREOVER, 50% OF TWCCH'S PUBLIC HEALTH DENTISTS RECENTLY COMPLETED NYU LANGONE HEALTH'S CODA-ACCREDITED ADVANCED EDUCATION GENERAL DENTISTRY (AEGD) RESIDENCY AT OUR HEALTH CENTER PARTICIPATING SITE, A PROGRAM LAUNCHED IN 2020. ONE-THIRD OF TWCCH'S MEDICAL ASSISTANTS COMPLETED CLINICAL TRAINING WITH THE GME-SNC, SEVERAL THROUGH OUR PARTNERSHIP WITH THE NATIONAL INSTITUTE FOR MEDICAL ASSISTANT ADVANCEMENT AND NEPA READINESS IN SKILLED EMPLOYMENT (RISE) PROGRAMS. OUR MISSION-DRIVEN PARTNERSHIP WITH THE NEPA AHEC SUPPORTS INTERPROFESSIONAL STUDENTS ROTATING WITH US AND ENSURES THE TRAINING AND CERTIFICATION OF ALL 15 TWCCH COMMUNITY HEALTH WORKERS. FIVE OF 70 CERTIFIED RECOVERY SPECIALISTS TRAINED AND CERTIFIED THROUGH GME-SNC'S ENGAGEMENT AND PROJECT PROGRESS ARE CONTINUING TO PROVIDE ADDICTION AND RECOVERY SERVICES AT TWCCH. BECAUSE OF THESE TALENT DEVELOPMENT, RECRUITMENT, AND RETENTION OUTCOMES, THE GME-SNC IS EXPLORING EXPANDED ACADEMIC PARTNERSHIPS TO INTEGRATE CLINICAL TRAINING FOR LPNS, DENTAL ASSISTANTS, CASE MANAGERS, AND INTEGRATED BEHAVIORAL AND MENTAL HEALTH PROFESSIONALS, INCLUDING MENTAL HEALTH PEER SPECIALISTS, AS WELL AS A PEDIATRIC DENTISTRY RESIDENCY PROGRAM AND A FAMILY MEDICINE CRNP PRIMARY CARE FELLOWSHIP. MANY ADDITIONAL INDIVIDUALS TRAINED IN THE GME-SNC ARE ACTIVELY PRACTICING IN REGIONAL PARTNERING ORGANIZATIONS, PREDOMINANTLY IN UNDERSERVED SETTINGS. TWCGME'S CURRENT SPONSORING INSTITUTIONAL AND PROGRAMMATIC PRIMARY HEALTH SERVICES CURRICULA ARE ROOTED IN COMMUNITY-IMMERSED, PUBLIC HEALTH NEEDS-RESPONSIVE, FULLY INTEGRATED, COMPREHENSIVE, WHOLE-PERSON PRIMARY CARE TRAINING FOR RESIDENTS IN FAMILY MEDICINE, INTERNAL MEDICINE, AND PHYSICAL MEDICINE AND REHABILITATION, AS WELL AS FOR FELLOWS IN GERIATRIC MEDICINE, CARDIOVASCULAR DISEASE, AND GASTROENTEROLOGY. RESIDENTS AND FELLOWS ARE DEEPLY IMMERSED IN COMMUNITY-DRIVEN, RESPONSIVE SOLUTIONS TO THE RELENTLESS OPIOID EPIDEMIC, CONTINUING BATTLES WITH HIV/AIDS AND HEPATITIS C, ESCALATING PUBLIC HEALTH CHALLENGES RELATED TO MENTAL HEALTH STRUGGLES, OBESITY, DIABETES, CARDIOVASCULAR DISEASE, AND CANCER, AS WELL AS THE EVER-WIDENING GAPS IN EVIDENCE-BASED CHILDHOOD AND ADULT VACCINATION RATES FOR PREVENTABLE ILLNESSES. OUR COMMUNITY-BASED TRAINING MODEL WITHIN ESSENTIAL COMMUNITY PROVIDER NETWORKS CONTINUED TO LEVERAGE CROSS-INSTITUTIONAL COLLABORATIVE LEARNING AND BROAD EXPOSURE FOR TRAINEES TO INTERPROFESSIONAL TEAM-BASED CARE, AS WELL AS A VARIETY OF HEALTH INFORMATION TECHNOLOGY PLATFORMS, FOR BOTH CARE DELIVERY AND EDUCATIONAL OUTCOMES REPORTING AND CONTINUOUS IMPROVEMENT. TWCGME'S PARTNERING CLINICAL LEARNING ENVIRONMENTS DEMONSTRATE AND ENGAGE ITS LEARNERS IN CONTINUOUS QUALITY IMPROVEMENT AND VALUE-DRIVEN WORKFLOW REDESIGN THAT PROMOTES PATIENT-CENTERED MEDICAL HOME (PCMH) PHYSICIAN-LED INTERPROFESSIONAL CARE TEAMS, LEVERAGING ENGAGED AND EMPOWERED PHYSICIANS IN PRACTICE AND TRAINING, STUDENTS, PATIENTS AND FAMILIES, ROBUST REFERRAL NETWORKS OF COMMUNITY RESOURCE AGENCIES, AND BOTH MEANINGFUL USE AND CONNECTIVITY/INTEROPERABILITY OF HEALTH AND EDUCATION INFORMATION TECHNOLOGY PLATFORMS. MISSION-DRIVEN, TOP-PERFORMING LICENSED PCMH FACULTY PRACTICE AND ROLE-MODELING WITHIN THESE SAFETY-NET LEARNING ENVIRONMENTS EFFICIENTLY OPTIMIZE WORKFLOW REDISTRIBUTION, ENABLING EVERY TEAM MEMBER, INCLUDING FRONT-LINE STAFF AND LEARNERS, TO ENGAGE IN PURPOSEFUL, MEANINGFUL PRACTICE WHILE CONTRIBUTING TO ITERATIVE, CONTINUOUS, COMMUNITY-ORIENTED QUALITY IMPROVEMENTS IN BOTH CARE DELIVERY AND EDUCATIONAL SYSTEMS. TWCGME'S SPONSORING INSTITUTION'S COMMITMENT TO ADVANCING PUBLIC HEALTH STRONGLY ALIGNS WITH THE MISSION OF COMMUNITY HEALTH CENTERS AND PARTNERING COMMUNITY-BASED HOSPITALS, AS WELL AS WITH THE ACGME'S VISIONARY SPONSORING INSTITUTION 2025 AND ITS CLINICAL LEARNING ENVIRONMENT REVIEW PROGRAM FRAMEWORK, WHICH FOCUSES ON PATIENT SAFETY, HEALTH CARE QUALITY, TEAMING, WELL-BEING, PROFESSIONALISM, AND SUPERVISION. TWCGME'S GME-SNC ENSURES THAT TRAINEES HAVE BROAD EXPOSURE TO SEAMLESS, CROSS-INSTITUTIONAL, INTERPROFESSIONAL MULTIDISCIPLINARY CLINICAL LEARNING ENVIRONMENTS THAT EXERCISE AND NURTURE THEIR ABILITIES TO CONNECT WITH PATIENTS AND FAMILIES, WHILE ENRICHING THEIR LONGITUDINAL AND TRANSITIONAL CARE DELIVERY SKILLS AND PREPARING THEM FOR ABLE, MODERN CLINICAL PRACTICE AND CAREERS OF PUBLIC SERVICE AS PUBLIC HEALTH ENTHUSIASTS. |
| Form 990, Part III, Line 2 NEW PROGRAM SERVICES CONTINUED |
AS ONE OF THE LARGEST HRSA-FUNDED TEACHING HEALTH CENTER GME-SNCS IN THE NATION, TWCGME STRUCTURED ITS GOVERNANCE WITH UNCOMMON INTENTIONALITY AND HUMILITY. EACH GNE-SNC PARTICIPATING FQHC AND FQHC-LAL WAS GRANTED AN EMPOWERED VOICE AT THE COMMUNITY-LED GOVERNING BOARD LEVEL, REFLECTING A SHARED-STEWARDSHIP PHILOSOPHY INSPIRED BY THE WORK OF NOBEL PRIZE-WINNING ECONOMIST AND POLITICAL SCIENTIST ELINOR OSTROM ON COMMON-POOL RESOURCES AND GROUNDED IN TRUST, TRANSPARENCY, COOPERATION, AND COLLECTIVE RESPONSIBILITY. THIS GOVERNANCE ARCHITECTURE REQUIRED TWCGME TO ABSORB AND MANAGE RISK ON BEHALF OF PARTNER COMMUNITIES, INCLUDING DURING PERIODS WHEN FEDERAL PROGRAM REQUIREMENTS, ACCREDITATION STANDARDS, AND FUNDING DETERMINATIONS WERE NOT FULLY ALIGNED. THE STRUCTURE WAS REFINED THROUGH THE NFMR'S LIVED EXPERIENCE, REINFORCING TWCGME'S CONVICTION THAT SUSTAINABLE WORKFORCE RENEWAL MUST BE COCREATED WITH COMMUNITIES RATHER THAN IMPOSED ON THEM. AS A LIVING EXPRESSION OF TWCGME'S GME-SNC MODEL'S SUCCESS, DURING THE COVERED PERIOD, TWCGME PROUDLY GUIDED AND SUPPORTED THE ESTABLISHMENT OF TWO NEW, INDEPENDENT, INITIAL ACGME-ACCREDITED SPONSORING INSTITUTIONS AND FAMILY MEDICINE RESIDENCY PROGRAMS WITH CONDITIONALLY AWARDED TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION FUNDING AT ITS LONGTIME NFMR PROGRAM PARTNERS, EL RIO HEALTH IN TUCSON, ARIZONA, AND HEALTHPOINT IN AUBURN, WASHINGTON. THESE TRANSITIONS REFLECT THE INTENTIONAL DESIGN OF THE NFMR AS A TIME-LIMITED INCUBATOR RATHER THAN A PERMANENT, CENTRALIZED PROGRAM, DEMONSTRATING RESPONSIBLE EXIT PLANNING AND THE LONG-TERM TRANSFER OF CAPACITY TO COMMUNITY-GOVERNED INSTITUTIONS. NOTABLY, TWCGME'S NFMR PROGRAM WAS BORN AS A PIONEERING, NATIONAL GME-SNC THAT, AT CAPACITY, TRAINED 52 FAMILY MEDICINE RESIDENTS ACROSS FOUR FQHC PARTNERS IN DIVERSE GEOGRAPHIC LOCATIONS - HEALTHPOINT, EL RIO HEALTH, UNITY HEALTH CARE IN WASHINGTON, D.C., AND HEALTHSOURCE OF OHIO IN NEW RICHMOND AND HILLSBORO - IN COLLABORATION WITH A.T. STILL UNIVERSITY'S SCHOOL OF OSTEOPATHIC MEDICINE IN ARIZONA (ATSU-SOMA). THE NFMR WAS NEVER INTENDED TO BE PERMANENT OR CENTRALIZED; IT WAS DELIBERATELY DESIGNED AS A PEER-LEARNING AND MENTORSHIP INCUBATOR, GROUNDED IN THE BELIEF THAT COMMUNITIES SHOULD ULTIMATELY GOVERN AND SUSTAIN THEIR OWN PHYSICIAN WORKFORCE. THIS DESIGN REQUIRED TWCGME TO ASSUME FRONT-LOADED FINANCIAL, REGULATORY, AND REPUTATIONAL RISKS TO PROTECT LONG-TERM PUBLIC RETURN ON INVESTMENT. THE JOURNEY WAS NOT WITHOUT PROFOUND PAIN. FOLLOWING THE ACGME RESIDENCY REVIEW COMMITTEE FOR FAMILY MEDICINE'S WITHDRAWAL OF ACCREDITATION FOR THE NFMR PROGRAM IN 2023, WITH PROGRAM OPERATIONS CONCLUDING IN JUNE 2026, TWCGME AND ITS PARTNERS WERE COMPELLED TO CONFRONT THE UNINTENDED CONSEQUENCES THAT CAN ACCOMPANY GENUINE INNOVATION WITHIN LONG-STANDING ACCREDITATION AND REGULATORY SYSTEMS. THE ACGME CITED CONCERNS WITH THE NFMR PROGRAM'S INNOVATIVE DESIGN ACROSS GEOGRAPHICALLY DISPERSED FQHCS UNDER A SINGLE PROGRAM UMBRELLA. THIS DECISION OCCURRED DESPITE THE PROGRAM'S EXCEPTIONAL OUTCOMES, INCLUDING UNPRECEDENTED GRADUATE RETENTION IN FQHCS AND MEDICALLY UNDERSERVED COMMUNITIES. IT HIGHLIGHTED THE ONGOING MISALIGNMENT BETWEEN FEDERAL WORKFORCE INVESTMENT STRATEGIES AND ACCREDITATION FRAMEWORKS. AS A RESULT, SIGNIFICANT PUBLIC INVESTMENT-BOTH SUNK COSTS AND DEMONSTRATED COMMUNITY BENEFIT-WAS PLACED AT RISK NOT DUE TO PROGRAMMATIC FAILURE, BUT DUE TO STRUCTURAL INCONGRUENCE BETWEEN ACCREDITING AND FUNDING AUTHORITIES. THIS REALITY REINFORCES TWCGME'S ONGOING RESPONSIBILITY TO ADVOCATE, EDUCATE, AND ENGAGE FEDERAL AGENCIES AND ACCREDITING BODIES REGARDING THE PRESERVATION, RECOGNITION, AND PROTECTION OF PUBLIC INVESTMENT IN COMMUNITY-BASED PHYSICIAN WORKFORCE INNOVATION. YET EVEN IN GRIEF, THE WORK DID NOT STOP. CONSISTENT WITH ACGME GUIDANCE EMPHASIZING CONSORTIUM MODELS AT THE SPONSORING INSTITUTION LEVEL, THE NFMR EVOLVED AS DESIGNED INTO INDEPENDENT, FQHC-PLATFORMED FAMILY MEDICINE RESIDENCY PROGRAMS ROOTED IN THEIR OWN COMMUNITIES. TWCGME'S FOURTH NFMR PARTNER, UNITY HEALTH CARE, REMAINS ENGAGED IN THIS PATHWAY AND HAS PREPARED AN ACGME APPLICATION UNDER TWCGME'S SPONSORING INSTITUTION. THROUGH THESE TRANSITIONS, TWCGME CONTINUES TO HONOR ITS ETHICAL OBLIGATION TO LEARNERS, COMMUNITIES, AND TAXPAYERS BY SAFEGUARDING EDUCATIONAL CONTINUITY AND PUBLIC RETURN ON INVESTMENT WHEREVER POSSIBLE. TOGETHER, THESE OUTCOMES STAND AS LIVING PROOF THAT TWCGME'S GME-SNC MODEL WORKS - NOT BECAUSE IT AVOIDS RISK, BUT BECAUSE IT ACCEPTS RESPONSIBILITY FOR RISK IN SERVICE OF PUBLIC PURPOSE. THE MODEL'S IMPACT AS A NATIONAL INCUBATOR FOR COMMUNITY-GOVERNED, MISSION-DRIVEN PHYSICIAN WORKFORCE DEVELOPMENT ROOTED IN FQHCS IS WRITTEN INTO COMMUNITIES ACROSS THE UNITED STATES THAT NOW TRAIN THEIR OWN PHYSICIANS, STEWARD THEIR OWN RESOURCES, AND CLAIM OWNERSHIP OF THEIR HEALTH FUTURES. |
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AS THE MODEL'S OUTCOMES MATURED AND PROVED SUCCESSFULLY REPLICABLE AT SCALE, TWCGME INCREASINGLY SERVED AS A NATIONAL SOURCE OF APPLIED EXPERTISE IN COMMUNITY-BASED GRADUATE MEDICAL EDUCATION AND WORKFORCE POLICY. DURING THE COVERED PERIOD, TWCGME'S PUBLIC HEALTH POLICY AND ADVOCACY DEPARTMENT CONDUCTED NONPARTISAN EDUCATIONAL ACTIVITIES TO INFORM ELECTED OFFICIALS, GOVERNMENT ADMINISTRATORS, AND PUBLIC AGENCIES ABOUT THE DESIGN, OUTCOMES, AND FISCAL STEWARDSHIP OF ITS COMMUNITY-EMBEDDED GME-SNC MODEL AS A RESPONSE TO THE NATIONAL PRIMARY CARE WORKFORCE SHORTAGE. IN ADDITION, TWCGME RESPONDED TO MULTIPLE STATE RIGHT-TO-KNOW LAWS AND FEDERAL FREEDOM OF INFORMATION ACT REQUESTS, SHARING OPERATIONAL INSIGHTS FROM COMMUNITY-BASED PRIMARY CARE AND WORKFORCE TRAINING SETTINGS TO SUPPORT EVIDENCE-INFORMED HEALTH POLICY DEVELOPMENT. CONCURRENTLY, AND INFORMED BY THE SAME POLICY, WORKFORCE, AND COMMUNITY-NEEDS ENGAGEMENT, TWCGME TRANSLATED MODEL LEARNING INTO LOCALLY RESPONSIVE PROGRAM DESIGN. DURING THE COVERED PERIOD, TWCGME LAUNCHED A NEW, REIMAGINED ACGME-ACCREDITED FAMILY MEDICINE-SCRANTON RESIDENCY PROGRAM IN JULY 2025, FOLLOWING A SUCCESSFUL ACCREDITATION SITE VISIT BY THE ACGME RESIDENCY REVIEW COMMITTEE FOR FAMILY MEDICINE (RRC-FM). THE PROGRAM WILL OFFER SIX RESIDENT POSITIONS PER YEAR AND IS GROUNDED IN IMMERSIVE, COMMUNITY-EMBEDDED TRAINING ALIGNED WITH THE SPECIFIC HEALTH NEEDS, ASSETS, AND INFRASTRUCTURE OF SCRANTON, PENNSYLVANIA. THIS PROGRAM WAS INTENTIONALLY STRUCTURED TO BE SUSTAINABLE, ADAPTABLE, AND SCALABLE FOR OTHER COMMUNITIES EXPERIENCING CRITICAL PRIMARY CARE WORKFORCE SHORTAGES, WHERE COLLABORATIVE PARTNERSHIPS CAN SUPPORT LOCALLY RESPONSIVE TRAINING ENVIRONMENTS AND STRENGTHEN LONG-TERM PHYSICIAN RECRUITMENT AND RETENTION. THIS REDESIGNED RESIDENCY PROGRAM, COMPLEMENTED BY INPATIENT AND SPECIALTY TRAINING THROUGH REGIONAL HOSPITAL OF SCRANTON SERVICES AND OBSTETRIC CARE AT MOSES TAYLOR HOSPITAL, CONTINUES TO LEVERAGE LONGSTANDING ACADEMIC AND CLINICAL PARTNERSHIPS WITH LEHIGH VALLEY HEALTH NETWORK. THIS SUCCESSFUL LAUNCH FOLLOWED A PERIOD OF EXTRAORDINARY CHALLENGE AND TRANSITION. DURING THE PRIOR COVERED PERIOD, TWCGME EXPERIENCED AN ADDITIONAL, DEEPLY DISHEARTENING ACCREDITATION DECISION BY THE ACGME RESIDENCY REVIEW COMMITTEE FOR FAMILY MEDICINE. SEPARATE FROM THE NFMR PROGRAM OUTCOMES DESCRIBED ABOVE, THE ACGME WITHDREW ACCREDITATION OF TWCGME'S LONGSTANDING REGIONAL FAMILY MEDICINE RESIDENCY (RFMR) PROGRAM, EFFECTIVE JUNE 30, 2025. MIRRORING OTHER PROGRAMS NATIONWIDE THAT RECEIVED DELAYED OR UNTIMELY ACGME ACCREDITATION WITHDRAWAL NOTICES, THE ADVERSE DECISION WAS ISSUED MONTHS AFTER A SITE VISIT AND WITHOUT INTERIM COMMUNICATION, DESPITE TWCGME'S FULL ENGAGEMENT IN THE NATIONAL RESIDENCY MATCHING PROGRAM AND RECRUITMENT OF A NEW INTERN RFMR CLASS. THIS SEQUENCE OF EVENTS COMPOUNDED THE HUMAN AND OPERATIONAL IMPACT OF THEIR DECISION. THE RFMR PROGRAM ITSELF TRACED ITS ORIGINS TO ONE OF THE EARLIEST FAMILY MEDICINE RESIDENCIES IN THE NATION, ESTABLISHED IN THE 1970S AND ORIGINALLY HOUSED WITHIN A COMMUNITY-BASED PROGRAM SPONSORED BY WILKES-BARRE GENERAL HOSPITAL, SERVING LUZERNE COUNTY, PENNSYLVANIA. WHEN FOR-PROFIT COMMONWEALTH HEALTH SYSTEMS ACQUIRED THE HOSPITAL IN THE LATE 2000S, THE NEW OWNERS STRUGGLED TO SUSTAIN THE EDUCATIONAL MISSION. TWCGME STEPPED FORWARD TO PRESERVE THIS LEGACY COMMUNITY-BASED FAMILY MEDICINE RESIDENCY AND, AFTER SIGNIFICANT TENSION, TO SAFEGUARD THE FACULTY PRACTICE CLINIC THAT SERVED AS BOTH THE RESIDENCY'S CLINICAL HOME AND AN ESSENTIAL COMMUNITY PROVIDER FOR MORE THAN 5,000 PATIENTS. THE SINGLE ACCREDITATION SYSTEM SUBSEQUENTLY MERGED THIS HISTORIC PROGRAM WITH TWCGME'S NEWER, AMERICAN OSTEOPATHIC ASSOCIATION (AOA)-ACCREDITED, HRSA-FUNDED FAMILY MEDICINE RESIDENCY SERVING LACKAWANNA COUNTY INTO A SINGLE 12-12-12 ACGME-ACCREDITED PROGRAM. WHILE CULTURAL INTEGRATION PRESENTED LONGSTANDING CHALLENGES, THE PROGRAM EVOLVED AND THRIVED THROUGH LEADERSHIP TRANSITIONS, MAINTAINING A 100% FIRST-TIME BOARD PASS RATE AND STRONG GRADUATE RETENTION IN REGIONAL, COMMUNITY-BASED PRACTICE. DURING FISCAL YEAR 2023, HOWEVER, CONTINUED CONSOLIDATION, COMMODITIZATION, AND CORPORATIZATION OF REGIONAL HEALTH SYSTEMS RESULTED IN THE ELIMINATION OF CRITICALLY NEEDED ACUTE-CARE SERVICES AND CORRESPONDING EDUCATIONAL ROTATIONS. TWO LOCAL HOSPITALS CLOSED INPATIENT PEDIATRIC SERVICES, PRECLUDING A REQUIRED FAMILY MEDICINE TRAINING EXPERIENCE. THE CONTEMPORANEOUS CLOSURE OF OBSTETRIC SERVICES AT ANOTHER HOSPITAL CREATED ADDITIONAL EDUCATIONAL GAPS, NECESSITATING TWCGME'S IMMEDIATE AND TIME-INTENSIVE OUTREACH TO SECURE NEW OBSTETRICS FACULTY TO MEET ACGME REQUIREMENTS. |
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DESPITE RAPID CORRECTIVE ACTION THAT RESOLVED ALL CITED DEFICIENCIES WITHIN WEEKS, RESIDENT DISTRESS AS REFLECTED IN ACGME SURVEYS, AND A TRIGGERED RRC-FM SITE VISIT ULTIMATELY LED TO THE WITHDRAWAL OF ACCREDITATION MONTHS LATER. GIVEN TWCGME'S PRIOR EXPERIENCE WITH AN UNSUCCESSFUL AND COSTLY ACGME APPEAL PROCESS, THE GMEC, GOVERNING BOARD, AND SPONSORING INSTITUTIONAL LEADERSHIP MADE THE DIFFICULT BUT ETHICALLY GROUNDED DECISION TO ACCEPT THE RFMR PROGRAM'S SUNSET DATE OF JUNE 30, 2025. IN FULL COMPLIANCE WITH ACGME REQUIREMENTS AND TWCGME'S MORAL AND ETHICAL COMMITMENTS TO ITS RESIDENTS, THE ORGANIZATION PROVIDED COMPREHENSIVE ADMINISTRATIVE SUPPORT TO ENSURE APPROPRIATE TRANSITION AND PLACEMENT FOR ALL AFFECTED TRAINEES. HAVING ADDRESSED THE UNDERLYING ACCREDITATION GAPS THROUGH NEW LEADERSHIP, EXPANDED FACULTY ENGAGEMENT, AND STRENGTHENED CLINICAL PARTNERSHIPS, TWCGME SUBMITTED A NEW FAMILY MEDICINE RESIDENCY APPLICATION, CULMINATING IN THE SUCCESSFUL LAUNCH OF THE FAMILY MEDICINE-SCRANTON RESIDENCY PROGRAM. AS REPORTED IN THE PRIOR FORM 990, TWCGME COMPLETED THE HIGH-INTEGRITY WIND-DOWN OF ITS COMMUNITY-BASED PSYCHIATRY RESIDENCY PROGRAM FOLLOWING THE WITHDRAWAL OF ACCREDITATION BY THE ACGME PSYCHIATRY RESIDENCY REVIEW COMMITTEE, WITH PROGRAM OPERATIONS CONCLUDING ON JUNE 30, 2024. THE ORGANIZATIONAL, WORKFORCE, AND COMMUNITY IMPLICATIONS OF THIS TRANSITION DIRECTLY SHAPED PROGRAMMATIC DECISIONS AND SERVICE DELIVERY DURING THE CURRENT COVERAGE PERIOD. THE PSYCHIATRY RESIDENCY PROGRAM HAD REPRESENTED A SIGNIFICANT COMMUNITY ASSET, EXPANDING ACCESS TO PSYCHIATRIC TRAINING AND CARE IN A REGION EXPERIENCING PERSISTENT SHORTAGES OF PSYCHIATRISTS ALONGSIDE RISING MENTAL HEALTH AND SUBSTANCE USE DISORDER NEEDS. THE WITHDRAWAL OF ACCREDITATION OCCURRED AMID SUBSTANTIAL EXTERNAL DISRUPTION TO THE LOCAL CLINICAL LEARNING ENVIRONMENT, INCLUDING THE UNANTICIPATED CLOSURE OF TWO INPATIENT PSYCHIATRIC FACILITIES AND RESULTING CONSTRAINTS ON REQUIRED EDUCATIONAL CAPACITY. DESPITE PROGRAMMATIC IMPROVEMENTS AND STRONG EDUCATIONAL OUTCOMES, THESE STRUCTURAL LIMITATIONS ULTIMATELY RENDERED THE TRAINING ENVIRONMENT UNSUSTAINABLE WITHIN EXISTING ACGME ACCREDITATION REQUIREMENTS. FOLLOWING THE ACCREDITATION WITHDRAWAL DECISION, TWCGME ACTED DECISIVELY TO UPHOLD ITS ETHICAL AND FIDUCIARY RESPONSIBILITIES TO LEARNERS. IN FULL COMPLIANCE WITH ACGME REQUIREMENTS, ALL REMAINING PSYCHIATRY RESIDENTS WERE SUCCESSFULLY SUPPORTED THROUGH ORDERLY TRANSITIONS INTO ACCREDITED PROGRAMS NATIONWIDE. PROVISIONS WERE MADE TO PRESERVE EDUCATIONAL CONTINUITY AND BOARD ELIGIBILITY, AND THE WIND-DOWN PROCESS WAS COMPLETED WITHOUT DISRUPTION TO RESIDENT PROGRESSION OR THE TRANSFER OF MEDICARE OR HRSA GRADUATE MEDICAL EDUCATION FUNDING. AFTER CAREFUL REFLECTION AND DIALOGUE WITH GOVERNING BOARDS, FACULTY, STAFF, AND COMMUNITY PARTNERS, TWCGME AND ITS AFFILIATED ENTITY, TWCCH, DECIDED NOT TO IMMEDIATELY PURSUE THE REESTABLISHMENT OF GRADUATE MEDICAL EDUCATION PROGRAMS IN PSYCHIATRY. THIS DECISION REFLECTED THE CONTINUED ABSENCE OF SUFFICIENT INPATIENT TRAINING INFRASTRUCTURE AND THE CRITICAL SHORTAGE OF PSYCHIATRY FACULTY NECESSARY TO SUSTAIN A HIGH-QUALITY EDUCATIONAL PROGRAM. AT THE SAME TIME, THE UNDERLYING NEED FOR ACCESSIBLE MENTAL AND BEHAVIORAL HEALTH SERVICES ACROSS NORTHEAST PENNSYLVANIA REMAINED ACUTE. CHNA FINDINGS CONSISTENTLY IDENTIFIED MENTAL AND BEHAVIORAL HEALTH ACCESS AS THE REGION'S MOST URGENT AND PERSISTENT CONCERN, WITH PROLONGED WAIT TIMES AND LIMITED ACCESS FOR MEDICAID, UNINSURED, AND UNDERINSURED PATIENTS. IN RESPONSE, TWCGME AND TWCCH ADVANCED AN INTEGRATED MODEL OF PHYSICAL, MENTAL, AND BEHAVIORAL HEALTH CARE EMBEDDED WITHIN TWCCH'S 13 FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS. BY INCORPORATING MENTAL AND BEHAVIORAL HEALTH SERVICES DIRECTLY INTO PRIMARY CARE SETTINGS, THE ORGANIZATION HAS REDUCED ACCESS BARRIERS, SHORTENED WAIT TIMES, AND ENSURED COORDINATED, WHOLE-PERSON CARE RESPONSIVE TO COMMUNITY NEEDS. THIS INTEGRATED CARE APPROACH ALSO REINFORCES WORKFORCE DEVELOPMENT ACROSS THE ENTERPRISE. TWCGME RESIDENTS, FELLOWS, AND INTERPROFESSIONAL LEARNERS GAIN DIRECT EXPERIENCE ADDRESSING THE INTERSECTION OF PHYSICAL, MENTAL AND BEHAVIORAL HEALTH NEEDS IN COMMUNITY-BASED SETTINGS, PREPARING FUTURE PRIMARY CARE PHYSICIANS TO MANAGE COMPLEX PATIENT NEEDS WITHIN RESOURCE-CONSTRAINED ENVIRONMENTS. |
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TO FURTHER ENHANCE ACCESS, THE ORGANIZATION EXPANDED SUPERVISED, REMOTE-DELIVERED PSYCHIATRY SERVICES FOR PATIENTS OF ALL AGES WITHIN TWCCH'S FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS. THIS STRATEGY SUPPORTS CONTINUITY OF CARE, ENHANCES CLINICAL INTEGRATION, AND MITIGATES THE IMPACT OF REGIONAL SHORTAGES OF PSYCHIATRISTS WHILE REMAINING ALIGNED WITH THE ORGANIZATION'S MISSION TO DELIVER COMPREHENSIVE, AFFORDABLE, WHOLE-PERSON PRIMARY HEALTH SERVICES. WITH THE NATIONAL SIGNIFICANCE OF ITS GME-SNC MODEL DEMONSTRATED, TWCGME THEN TURNED INWARD TO FURTHER STRENGTHEN SPONSORING INSTITUTION GOVERNANCE, QUALITY INFRASTRUCTURE, AND ACCREDITATION-ALIGNED PERFORMANCE EXPECTATIONS, ENSURING THAT INNOVATION WAS MATCHED BY OPERATIONAL MATURITY AND FIDUCIARY DISCIPLINE. THIS CONTINUED ACGME ACCREDITATION REFLECTS THE SPONSORING INSTITUTION'S SUSTAINED MATURATION OF GMEC AUTHORITY, OVERSIGHT INFRASTRUCTURE, AND COMPLIANCE DISCIPLINES, WHICH ARE NOW SYSTEMATIZED IN DAY-TO-DAY OPERATIONS AND UNDERPIN BOTH EDUCATIONAL QUALITY AND FIDUCIARY STEWARDSHIP OF PUBLIC GME RESOURCES. TWCGME FURTHER OPERATIONALIZED THESE ACCREDITATION AND GOVERNANCE ADVANCES BY STRENGTHENING ITS SPONSORING INSTITUTION QUALITY INFRASTRUCTURE, INCLUDING THE STABILIZATION AND MATURATION OF CENTRALIZED QUALITY LEADERSHIP. THE APPOINTMENT AND INTEGRATION OF DEDICATED ENTERPRISE QUALITY LEADERSHIP ROLES, NAMELY A CHIEF COMPLIANCE OFFICER AND A CHIEF CLINICAL OPERATING OFFICER, MARKED A SIGNIFICANT MILESTONE IN ALIGNING GRADUATE MEDICAL EDUCATION OVERSIGHT WITH CLINICAL QUALITY, PATIENT SAFETY, AND POPULATION HEALTH PERFORMANCE ACROSS THE SPONSORING INSTITUTION. THE DIRECTOR OF EDUCATIONAL COMPLIANCE POSITION WAS APPROVED AND INITIALLY FILLED DURING THE 2024-2025 FISCAL YEAR; FOLLOWING AN UNANTICIPATED VACANCY, THE ROLE REMAINS AN ACTIVE RECRUITMENT PRIORITY TO ENSURE CONTINUITY OF ACCREDITATION OVERSIGHT AND EDUCATIONAL COMPLIANCE FUNCTIONS. THE ORGANIZATION ALSO UNDERTOOK A COMPREHENSIVE, SPONSORING INSTITUTION-LEVEL REVIEW AND ALIGNMENT OF INFORMATION TECHNOLOGY AND DATA SYSTEMS TO STRENGTHEN ACCREDITATION OVERSIGHT, PERFORMANCE TRANSPARENCY, AND ENTERPRISE ACCOUNTABILITY ACROSS ITS GME-SNC. THIS WORK WAS DESIGNED TO REDUCE DUPLICATION, CLARIFY SYSTEM ROLES AND DATA OWNERSHIP, AND ENSURE THAT PERFORMANCE MEASUREMENT PLATFORMS CONSISTENTLY SUPPORT THE QUALITY OF GRADUATE MEDICAL EDUCATION, PATIENT SAFETY, WORKFORCE DEVELOPMENT, AND FIDUCIARY STEWARDSHIP. THE INTENTIONAL ALIGNMENT OF COMMUNITY, ORGANIZATIONAL, AND PROGRAMMATIC PERFORMANCE MEASURES WAS CREATED TO ENSURE THAT GRADUATE MEDICAL EDUCATION OPERATES WITHIN A SHARED, INTEGRATED ACCOUNTABILITY FRAMEWORK RATHER THAN FRAGMENTED OR PROGRAM-ISOLATED METRICS. IN PARALLEL, TWCGME SUPPORTED THE USE OF ROLE-APPROPRIATE, SERVICE-LINE, AND OPERATIONAL SCORECARDS THROUGH SECURE INTERNAL PLATFORMS TO INFORM CONTINUOUS IMPROVEMENT ACROSS CLINICAL LEARNING ENVIRONMENTS, POPULATION HEALTH INITIATIVES, AND ADMINISTRATIVE SUPPORT FUNCTIONS THAT DIRECTLY AFFECT RESIDENT AND FELLOW EDUCATION. COLLECTIVELY, THESE EFFORTS OPERATIONALIZED A DISCIPLINED, SYSTEMS-BASED APPROACH TO SPONSORING INSTITUTION GOVERNANCE BY LINKING CHNA FINDINGS, WORKFORCE NEEDS ASSESSMENT, STRATEGIC PLANNING, INFORMATION TECHNOLOGY INFRASTRUCTURE, AND PERFORMANCE MEASUREMENT INTO A COHERENT OVERSIGHT FRAMEWORK. THIS ALIGNMENT SUPPORTS TWCGME'S RESPONSIBILITY TO ENSURE THAT CLINICAL SERVICES, WORKFORCE PIPELINES, AND REGIONAL PARTNERSHIPS ADVANCE IN CONCERT, REINFORCING ACCREDITATION COMPLIANCE, EDUCATIONAL QUALITY, AND RESPONSIBLE STEWARDSHIP OF PUBLIC GRADUATE MEDICAL EDUCATION RESOURCES. THIS INTEGRATED GOVERNANCE AND PERFORMANCE INFRASTRUCTURE ENABLED MEANINGFUL PROGRESS TOWARD THE FULL REALIZATION OF ACGME SPONSORING INSTITUTION 2025 (SI2025) EXPECTATIONS, WHICH EMPHASIZE DEMONSTRATED OUTCOMES IN EDUCATIONAL QUALITY, PATIENT SAFETY, POPULATION HEALTH, AND CONTINUOUS PERFORMANCE IMPROVEMENT, RATHER THAN SOLELY STRUCTURAL OR PROCESS-BASED COMPLIANCE. IN PARALLEL WITH THESE ACCREDITATION, GOVERNANCE, AND QUALITY-INFRASTRUCTURE ADVANCEMENTS, TWCGME FURTHER STRENGTHENED SPONSORING INSTITUTION-LEVEL FINANCIAL GOVERNANCE AND FIDUCIARY OVERSIGHT TO SUPPORT LONG-TERM SUSTAINABILITY AND RESPONSIBLE STEWARDSHIP OF PUBLIC GRADUATE MEDICAL EDUCATION RESOURCES. DURING THE COVERED PERIOD, THE COMMUNITY-LED GOVERNING BOARDS OF TWCGME AND TWCCH APPROVED A TRANSITION OF INVESTMENT MANAGEMENT SERVICES TO MORGAN STANLEY TO MORE INTENTIONALLY ALIGN INVESTMENT OVERSIGHT WITH THE ORGANIZATION'S MISSION, VALUES, AND COMMUNITY HEALTH PRIORITIES. |
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THROUGH THIS TRANSITION, THE ORGANIZATION OPERATIONALIZED A MISSION-ALIGNED INVESTMENT GOVERNANCE FRAMEWORK THAT ENABLES EXECUTIVE LEADERSHIP AND GOVERNING BOARDS TO VERIFY THAT ORGANIZATIONAL INVESTMENTS ALIGN WITH COMMUNITY WELLNESS OBJECTIVES AND AVOID HEALTH-HARMING INDUSTRIES, WHILE MAINTAINING DISCIPLINED FIDUCIARY OVERSIGHT. THIS FRAMEWORK INCORPORATES RESTRICTION SCREENING AND VALUES-BASED INVESTMENT PRINCIPLES INTO ROUTINE INVESTMENT DECISION-MAKING, REINFORCING ALIGNMENT BETWEEN FINANCIAL STEWARDSHIP AND THE ORGANIZATION'S PUBLIC-INTEREST MISSION. THE COVERED PERIOD REPRESENTED THE FIRST FULL FISCAL YEAR IN WHICH THIS INTEGRATED, MISSION-ALIGNED INVESTMENT OVERSIGHT FRAMEWORK WAS FULLY VISIBLE TO SPONSORING INSTITUTION LEADERSHIP AND GOVERNING BOARDS. AS A RESULT OF THIS INTENTIONAL REORIENTATION, APPROXIMATELY 42% OF THE ORGANIZATION'S INVESTMENT PORTFOLIO MET THE DEFINED MISSION- AND VALUES-ALIGNED CRITERIA, UP FROM 0% BEFORE IMPLEMENTATION. IMPORTANTLY, INVESTMENT PERFORMANCE REMAINED STRONG DURING THE COVERED PERIOD, WITH PORTFOLIO APPRECIATION OF APPROXIMATELY 12%, OR $957,000, IN REALIZED/UNREALIZED GAINS AND DIVIDEND/INTEREST INCOME, DEMONSTRATING THAT MISSION ALIGNMENT AND PRUDENT FIDUCIARY STEWARDSHIP CAN BE ADVANCED CONCURRENTLY. THIS COMMITMENT WAS FORMALLY CODIFIED IN DECEMBER 2024 THROUGH THE GOVERNING BOARDS' ADOPTION OF AN UPDATED INVESTMENT POLICY STATEMENT, WHICH EXPLICITLY ARTICULATES MISSION-DRIVEN CONSIDERATIONS, IMPACT OBJECTIVES, AND FIDUCIARY RESPONSIBILITIES. AS THIS GOVERNANCE FRAMEWORK CONTINUES TO MATURE, TWCGME ANTICIPATES THAT MISSION-ALIGNED INVESTMENT ALIGNMENT WILL INCREASE OVER TIME, AS APPROPRIATE, WHILE MAINTAINING COMPLIANCE WITH FIDUCIARY STANDARDS AND LONG-TERM FINANCIAL SUSTAINABILITY. CONSISTENT WITH THIS BROADER EMPHASIS ON DISCIPLINED GOVERNANCE AND OVERSIGHT, TWCGME ALSO DIRECTED FOCUSED ATTENTION DURING THE COVERED PERIOD TO STRENGTHENING INSTITUTIONAL CLIMATE OVERSIGHT AND LEARNER ENGAGEMENT WITHIN ITS EDUCATIONAL PROGRAMS. IN RESPONSE TO ACCREDITATION-RELATED CHALLENGES IDENTIFIED IN PRIOR COVERAGE PERIODS, AS REFLECTED IN ANNUAL ACGME RESIDENT/FELLOW AND FACULTY SURVEY RESULTS, TWCGME CONTINUED TO IMPLEMENT TARGETED ACTIONS DURING THE COVERED PERIOD TO STRENGTHEN INSTITUTIONAL CLIMATE OVERSIGHT AND LEARNER ENGAGEMENT. SPONSORING INSTITUTION AND PROGRAM LEADERSHIP, IN ALIGNMENT WITH ENTERPRISE EXECUTIVE LEADERSHIP AND GOVERNING BOARDS, ESTABLISHED A STANDING SURVEY SUBCOMMITTEE OF THE GRADUATE MEDICAL EDUCATION COMMITTEE (GMEC) TO STEWARD STRUCTURED REVIEW, INTERPRETATION, AND IMPROVEMENT PROCESSES RELATED TO ACGME SURVEY OUTCOMES FOR RESIDENTS, FELLOWS, AND FACULTY. TO SUPPORT THIS WORK, TWCGME IMPLEMENTED AN INTERNAL CLIMATE SURVEY CYCLE, CONSISTING OF SHORT, TIME-LIMITED SURVEYS OF RESIDENTS, FELLOWS, AND FACULTY TARGETING SPECIFIC TOPICS ALIGNED WITH THE CATEGORIES OF THE ACGME SURVEY. A NEUTRAL THIRD PARTY WAS ENGAGED TO ADMINISTER THE SURVEYS, OVERSEE DATA COLLECTION AND ANALYSIS, AND ENSURE RESPONDENT PRIVACY AND OBJECTIVITY. AGGREGATED FINDINGS AND THIRD-PARTY ANALYSES WERE REVIEWED BY THE GMEC AND SHARED WITH PROGRAM DIRECTORS, FACULTY, AND RESIDENT AND FELLOW REPRESENTATIVES. THESE DATA-INFORMED, ITERATIVE, PROGRAM- AND INSTITUTION-LEVEL QUALITY IMPROVEMENT INITIATIVES RESULT IN MEASURABLE IMPROVEMENTS IN LEARNER AND FACULTY UNDERSTANDING OF, ENGAGEMENT WITH, AND CONFIDENCE IN TWCGME'S SPONSORING INSTITUTION'S GOVERNANCE, COMMUNICATION, AND PERFORMANCE EXPECTATIONS. TO TRANSLATE THESE GOVERNANCE AND MEASUREMENT INSIGHTS INTO SUSTAINED IMPROVEMENT OF THE LEARNING ENVIRONMENT, TWCGME ANCHORED ITS INSTITUTIONAL RESPONSE IN THE SANCTUARY MODEL FRAMEWORK. TWCGME CONTINUED ITS DEEP AND SUSTAINED INVESTMENT IN THE TRANSFORMATIONAL WORK OF ADVANCING ITS ENTERPRISE-WIDE JOURNEY TOWARD SANCTUARY MODEL CERTIFICATION, RECOGNIZING THAT PSYCHOLOGICALLY SAFE LEARNING ENVIRONMENTS, RESILIENT TEAMING STRUCTURES, AND TRAUMA-RESPONSIVE ORGANIZATIONAL CULTURES ARE FOUNDATIONAL TO HIGH-QUALITY GRADUATE MEDICAL EDUCATION. INCREASINGLY, THIS WORK SERVES NOT ONLY AS A TRAUMA-INFORMED FRAMEWORK FOR CLINICAL LEARNING ENVIRONMENTS BUT ALSO AS A CORE BACKBONE OF ORGANIZATIONAL DEVELOPMENT AND GOVERNANCE FOR THE TWCGME SPONSORING INSTITUTION, SHAPING HOW LEARNING ENVIRONMENTS ARE DESIGNED, HOW RESIDENTS AND FELLOWS ARE SUPPORTED, AND HOW FACULTY AND LEADERS ENGAGE IN SUPERVISION, ACCOUNTABILITY, AND SHARED STEWARDSHIP. |
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SEVERAL ACCOMPLISHMENTS DURING THE COVERED PERIOD REFLECTED TWCGME'S CONTINUED EVOLUTION FROM A HISTORICALLY OVEREXTENDED, TRAUMA-ORGANIZED TRAINING ENTERPRISE INTO AN ADVERSITY-COMPETENT, RESILIENCE-SKILLED SPONSORING INSTITUTION INTENTIONALLY FOCUSED ON WHOLE-PERSON PHYSICIAN DEVELOPMENT, PSYCHOLOGICALLY SAFE EDUCATIONAL CULTURES, AND SUSTAINABLE INTERPROFESSIONAL WORKFORCE PATHWAYS. THE SANCTUARY MODEL PROVIDES A BLUEPRINT FOR BOTH CLINICAL AND ORGANIZATIONAL CHANGE, PROMOTING PHYSICAL, EMOTIONAL, AND PSYCHOLOGICAL SAFETY AND RECOVERY FROM ADVERSITY BY INTENTIONALLY CREATING AN ADVERSITY-INFORMED COMMUNITY. FOR A GRADUATE MEDICAL EDUCATION SPONSORING INSTITUTION, THIS FRAMEWORK RECOGNIZES THE INHERENT VULNERABILITY OF RESIDENTS, FELLOWS, FACULTY, AND STAFF TO CUMULATIVE STRESS, MORAL INJURY, AND SYSTEMS-LEVEL ADVERSITY, AND RESPONDS THROUGH SYSTEM-WIDE STRUCTURES THAT MITIGATE HARM, STRENGTHEN RESILIENCE, AND SUPPORT BOTH THOSE WHO LEARN WITHIN AND THOSE WHO SERVE THROUGH THE ORGANIZATION. AS TWCGME HAS MATURED BEYOND ISOLATED PROGRAM-LEVEL INTERVENTIONS, THE SANCTUARY MODEL HAS INCREASINGLY BEEN USED AS A UNIFYING FRAMEWORK TO TRANSLATE TRAUMA-INFORMED PRINCIPLES INTO SPONSORING INSTITUTION-LEVEL GOVERNANCE, FACULTY DEVELOPMENT, RESIDENT AND FELLOW SUPPORT STRUCTURES, AND LEARNING ENVIRONMENT DESIGN. SANCTUARY OFFERS A STRUCTURED PATHWAY FOR TRANSFORMATION FROM SURVIVAL MODE AND SILOED EDUCATIONAL PLATFORMS TO RESILIENT, PARTICIPATORY LEARNING SYSTEMS GROUNDED IN SHARED ACCOUNTABILITY, DEMOCRATIZATION, SOCIAL RESPONSIBILITY, AND CONTINUOUS LEARNING. THIS COMMITMENT WAS OPERATIONALIZED THROUGH SUSTAINED TRAINING, GOVERNANCE ENGAGEMENT, AND WORKFORCE DEVELOPMENT INVESTMENTS ACROSS THE SPONSORING INSTITUTION. SINCE INITIATING ITS FORMAL SANCTUARY ROLLOUT IN AUGUST 2022, TWCGME HAS IMPLEMENTED MULTIPLE FIVE-DAY IMMERSION TRAINING COHORTS ACROSS THE ENTERPRISE, INCLUDING GOVERNING BOARD MEMBERS, EXECUTIVE LEADERSHIP, FACULTY, EMPLOYEES, AND RESIDENT AND FELLOW PHYSICIANS. IN JANUARY 2024, COMPLETION OF THE TRAIN-THE-TRAINER PROGRAM FURTHER STRENGTHENED INTERNAL CAPACITY TO SUSTAIN AND SCALE THIS WORK ACROSS SPONSORING INSTITUTION FUNCTIONS. SANCTUARY PRINCIPLES AND LANGUAGE HAVE ALSO BEEN INTEGRATED INTO REGULAR GOVERNING BOARD EDUCATION, REINFORCING ALIGNMENT BETWEEN GOVERNANCE, MANAGEMENT, AND ORGANIZATIONAL CULTURE. DURING THE COVERED PERIOD, SANCTUARY-ALIGNED LEARNING ENVIRONMENT AND WORKFORCE WELL-BEING INITIATIVES EXPANDED IN WAYS DIRECTLY RELEVANT TO GRADUATE MEDICAL EDUCATION, REFLECTING A DELIBERATE SHIFT FROM ISOLATED WELLNESS ACTIVITIES TOWARD INTEGRATED, SYSTEM-LEVEL SUPPORTS. THESE EFFORTS INCLUDED LEADERSHIP DEVELOPMENT TO ESTABLISH COMPETENCY EXPECTATIONS FOR MANAGERS AND SUPERVISORS; PARTICIPATION IN ENTERPRISE-WIDE CULTURE AND WORKFORCE SURVEYS TO INFORM CONTINUOUS IMPROVEMENT; AND PREPARATION FOR FULL IMPLEMENTATION OF THE SANCTUARY READINESS AND ASSESSMENT TOOLS. FOR EXAMPLE, TWCGME PARTNERS WITH ITS LONGSTANDING COMMUNITY COLLABORATOR, THE INSTITUTE, A WILKES-BARRE-BASED NONPROFIT PROVIDING COMMUNITY-BASED DATA ANALYSIS, RESEARCH, AND CONSULTING SERVICES, TO ADMINISTER SEMIANNUAL EMPLOYEE SATISFACTION SURVEYS ACROSS THE ORGANIZATION. THESE EFFORTS ARE COMPLEMENTED BY TWCGME'S REGULAR PARTICIPATION IN NATIONALLY BENCHMARKED ASSESSMENT TOOLS, INCLUDING THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ) MEDICAL OFFICE SURVEYS ON PATIENT SAFETY CULTURE (MOSOPS), PATIENT-CENTERED MEDICAL HOME ASSESSMENT (PCMH-A), AND MODERN HEALTHCARE WORKFORCE SURVEYS. COMPLEMENTARY SANCTUARY-ALIGNED SUPPORTS ALSO INCLUDED CONFIDENTIAL EMPLOYEE ASSISTANCE RESOURCES, INTEGRATION OF MENTAL HEALTH FIRST AID TRAINING INTO ACGME-ALIGNED CURRICULA, AND PARTICIPATION IN NATIONAL INITIATIVES TO REDUCE STIGMA AND STRENGTHEN HELP-SEEKING BEHAVIORS WITHIN LEARNING ENVIRONMENTS. THROUGH THIS EVOLUTION, THE SANCTUARY MODEL HAS BECOME THE SHARED ENTERPRISE FRAMEWORK THROUGH WHICH TWCGME ADVANCES ITS LEARNING CULTURE, SPONSORING INSTITUTION CLIMATE OVERSIGHT, AND LONG-TERM COMMITMENT TO RESILIENT, COMMUNITY-ROOTED GRADUATE MEDICAL EDUCATION SYSTEMS. THIS WORK DIRECTLY SUPPORTS ACCREDITATION EXPECTATIONS RELATED TO PROFESSIONALISM, WELL-BEING, SUPERVISION, TEAMING, AND PATIENT SAFETY, WHILE REINFORCING TWCGME'S RESPONSIBILITY TO STEWARD BOTH LEARNERS AND PUBLIC INVESTMENT WITH INTEGRITY AND CARE. WITH INSTITUTIONAL CLIMATE STABILIZATION AND LEARNING ENVIRONMENT SUPPORTS IN PLACE, TWCGME WAS POSITIONED TO MORE FULLY INTEGRATE SYSTEMS-BASED, POPULATION-FOCUSED COMPETENCIES INTO ITS GRADUATE MEDICAL EDUCATION CURRICULA. |
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CENTRAL TO TWCGME'S SI2025 WORK WAS THE INTENTIONAL INTEGRATION OF POPULATION HEALTH, QUALITY IMPROVEMENT, AND SYSTEMS-BASED PRACTICE CURRICULA ACROSS RESIDENCY AND FELLOWSHIP PROGRAMS, ENSURING THAT RESIDENTS AND FELLOWS UNDERSTAND HOW THEIR CLINICAL PRESENCE AND LEARNING DIRECTLY ADVANCE ORGANIZATIONAL QUALITY GOALS, PATIENT OUTCOMES, AND ACCOUNTABILITY BENCHMARKS. TO FURTHER OPERATIONALIZE THIS POPULATION HEALTH AND VALUE-BASED CARE STRATEGY ACROSS THE ENTERPRISE'S CLINICAL LEARNING ENVIRONMENTS, THE ORGANIZATION ESTABLISHED A CHIEF POPULATION HEALTH AND VALUE-BASED CARE OFFICER ROLE, STRENGTHENING ACCOUNTABILITY FOR POPULATION-LEVEL OUTCOMES, VALUE-BASED READINESS, AND DATA-INFORMED STEWARDSHIP WITHIN THE TWCCH FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER PLATFORM THAT SERVES AS TWCGME'S PRIMARY AMBULATORY TRAINING ENVIRONMENT. THIS LEADERSHIP CAPACITY DIRECTLY SUPPORTS TWCGME'S SPONSORING INSTITUTION PERFORMANCE EXPECTATIONS BY ALIGNING PREVENTIVE CARE, CHRONIC DISEASE MANAGEMENT, QUALITY IMPROVEMENT, AND COMMUNITY PARTNERSHIP UNDER A UNIFIED POPULATION HEALTH FRAMEWORK. IN SUPPORT OF THIS WORK, THE ORGANIZATION INTRODUCED A CENTRALIZED POPULATION HEALTH COMMUNICATION HUB FOR LEARNERS, FACULTY, AND STAFF. INITIALLY DESIGNED TO SUPPORT THE IMPLEMENTATION OF A NEW RESIDENT POPULATION HEALTH ROTATION, IT IS NOW AVAILABLE ENTERPRISE-WIDE TO STREAMLINE COLLABORATION, ADDRESS QUESTIONS, SHARE CONCERNS, AND DISSEMINATE POPULATION HEALTH TOOLS AND TRAINING MATERIALS. BY STRENGTHENING SHARED LEARNING AND INTERDISCIPLINARY ENGAGEMENT, THIS RESOURCE SUPPORTS THE SUSTAINABLE INTEGRATION OF POPULATION HEALTH PRINCIPLES ACROSS CLINICAL CARE DELIVERY AND GRADUATE MEDICAL EDUCATION. THROUGH THESE INTEGRATED APPROACHES, TWCGME STRENGTHENED THE LINKAGE BETWEEN GRADUATE MEDICAL EDUCATION AND ENTERPRISE-WIDE PERFORMANCE IMPROVEMENT, POSITIONING ITS SPONSORING INSTITUTION TO DEMONSTRATE MEASURABLE PROGRESS TOWARD SI2025 OUTCOMES, INCLUDING LEARNER ENGAGEMENT IN QUALITY AND SAFETY INITIATIVES, DATA-INFORMED CARE DELIVERY, AND THE ADVANCEMENT OF POPULATION HEALTH PRIORITIES WITHIN COMMUNITY-BASED CLINICAL LEARNING ENVIRONMENTS. THIS WORK REPRESENTS A CRITICAL INFLECTION POINT IN TRANSLATING ACCREDITATION STABILITY INTO SUSTAINED EDUCATIONAL EXCELLENCE AND PUBLIC ACCOUNTABILITY. IN PARALLEL WITH THESE SI2025-ALIGNED GOVERNANCE AND QUALITY INFRASTRUCTURE ADVANCES, TWCGME CONTINUED TO INTENTIONALLY CONNECT CLINICAL EDUCATIONAL PROGRAMMING ACROSS ITS AFFILIATED AMBULATORY AND HOSPITAL-BASED LEARNING ENVIRONMENTS, AIMING FOR SEAMLESS INTEGRATION AMONG EDUCATION, CLINICAL CARE DELIVERY, AND SYSTEMS-BASED PERFORMANCE. DURING THE COVERED PERIOD, TWCGME RESIDENT AND FELLOW PHYSICIANS AND INTERPROFESSIONAL LEARNERS TRAINED WITHIN A BROAD, HIGH-VOLUME CONTINUUM OF COMMUNITY-BASED, NCQA-RECOGNIZED PATIENT-CENTERED MEDICAL HOME (PCMH), CLINICAL LEARNING ENVIRONMENTS OPERATED BY TWCCH. ACROSS THESE SETTINGS, LEARNERS WERE EMBEDDED IN CARE DELIVERY THAT ENCOMPASSED MORE THAN 37,059 UNIQUE PATIENTS AND OVER 126,075 TOTAL BILLABLE VISITS BETWEEN JULY 2024 AND JUNE 2025, INCLUDING MEDICAL, BEHAVIORAL HEALTH, DENTAL, AND INPATIENT EXPERIENCES. THESE LONGITUDINAL TRAINING ENVIRONMENTS PROVIDED RESIDENT, FELLOW, AND INTERPROFESSIONAL LEARNERS WITH SUSTAINED EXPOSURE TO WHOLE-PERSON, TEAM-BASED CARE ACROSS DIVERSE SETTINGS, INCLUDING AMBULATORY PRIMARY CARE, MENTAL AND BEHAVIORAL HEALTH INTEGRATION, ORAL HEALTH SERVICES, INPATIENT HOSPITAL CARE, HOME-BASED VISITS, SKILLED NURSING AND ASSISTED LIVING FACILITIES, INPATIENT AND TRANSITIONAL REHABILITATION, AND HOSPICE CARE. COLLECTIVELY, THIS BREADTH OF CLINICAL EXPERIENCE SUPPORTS TWCGME'S ACCREDITATION-ALIGNED COMMITMENT TO PREPARING PHYSICIANS AND INTERPROFESSIONAL CLINICIANS TO CARE FOR PATIENTS ACROSS THE FULL CONTINUUM OF LIFE, HEALTH STATUS, AND CARE SETTINGS WITHIN COMMUNITY-GOVERNED SYSTEMS. CONCURRENTLY, IN RESPONSE TO THE ACCELERATING SHIFT TOWARD VALUE-BASED CARE AND EVOLVING PAYMENT MODELS, TWCGME FORMALLY INTEGRATED VALUE-BASED CARE INITIATIVES INTO ITS SPONSORING INSTITUTION POPULATION HEALTH CURRICULUM TO BETTER PREPARE RESIDENTS AND FELLOWS FOR PRACTICE WITHIN ACCOUNTABLE, DATA-INFORMED HEALTH SYSTEMS. TWCGME ALSO INVESTED SIGNIFICANT INSTITUTIONAL EFFORT IN PREPARATION FOR A FUTURE ACGME CLINICAL LEARNING ENVIRONMENT REVIEW (CLER) SITE VISIT ACROSS ITS AMBULATORY AND HOSPITAL PARTNERS. THE CLER PROGRAM, ESTABLISHED BY THE ACGME AS PART OF THE NEXT ACCREDITATION SYSTEM, PROVIDES STRUCTURED FEEDBACK TO CLINICAL LEARNING ENVIRONMENTS TO RECOGNIZE THE PUBLIC'S NEED FOR A PHYSICIAN WORKFORCE CAPABLE OF MEETING THE DEMANDS OF A RAPIDLY EVOLVING HEALTH CARE SYSTEM. CLER ASSESSMENTS FOCUS ON SIX CORE DOMAINS ESSENTIAL TO RESIDENT AND FELLOW EDUCATION: PATIENT SAFETY, HEALTH CARE QUALITY, TEAMING, SUPERVISION, WELL-BEING, AND PROFESSIONALISM. |
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TWCCH CONTINUED TO CONNECT CLINICAL EDUCATIONAL PROGRAMMING WITH TWCGME AND AFFILIATED HOSPITAL OPERATIONS, ADVANCING THE ACGME SPONSORING INSTITUTION 2025 (SI2025) VISION OF SEAMLESS INTEGRATION OF CLINICAL AND EDUCATIONAL PROGRAMMING. THIS INCLUDES WORKING TOWARD A MORE SUCCESSFUL INTEGRATION OF DENTAL, MENTAL, AND BEHAVIORAL HEALTH INTO PRIMARY HEALTH SERVICES DELIVERY. TO STEWARD THIS WORK, THE GRADUATE MEDICAL EDUCATION COMMITTEE (GMEC) MAINTAINED A STANDING CLER SUBCOMMITTEE LED BY CLINICAL LEADERSHIP FROM TWCCH, TWCGME'S PRIMARY AMBULATORY CLINICAL LEARNING ENVIRONMENT PARTNER. DURING THE COVERED PERIOD, TWCCH CONTINUED TO INVEST SIGNIFICANT EFFORT IN PREPARING FOR A SUCCESSFUL, IMPACTFUL CLER SITE VISIT FOR TWCGME'S AMBULATORY AND HOSPITAL PARTNERS. CLER MOCK SITE VISITS OCCURRED AT GEISINGER COMMUNITY MEDICAL CENTER (GCMC), TWCCH'S MID-VALLEY AND SCRANTON FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS, AND REGIONAL HOSPITAL OF SCRANTON THROUGHOUT THE YEAR. WITH THESE GOVERNANCE AND QUALITY FOUNDATIONS STRENGTHENED, TWCGME'S SPONSORING INSTITUTION WAS POSITIONED TO TRANSLATE ACCREDITATION STABILITY INTO MEASURABLE WORKFORCE OUTCOMES AT SCALE. STABILIZATION OF ITS SPONSORING INSTITUTION ENABLED TWCGME TO SUSTAIN, GRADUATE, AND DEPLOY ITS PHYSICIAN WORKFORCE AT SCALE DURING THE COVERED PERIOD, DESPITE SIGNIFICANT EXTERNAL REGULATORY DISRUPTION AFFECTING MULTIPLE TRAINING PROGRAMS. TWCGME HAS SURPASSED A HISTORIC MILESTONE, WITH MORE THAN 1,100 RESIDENT AND FELLOW PHYSICIAN GRADUATES SINCE ITS ESTABLISHMENT IN 1976 AS A COMMUNITY HEALTH NEEDS-RESPONSIVE GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM. THESE TOTAL GRADUATES INCLUDE 569 INTERNAL MEDICINE PHYSICIANS, 295 REGIONAL FAMILY MEDICINE PHYSICIANS, 166 NATIONAL FAMILY MEDICINE PHYSICIANS, 33 CARDIOVASCULAR DISEASE PHYSICIANS, 19 PSYCHIATRISTS (INCLUDING 10 WHO FAST-TRACKED TO CHILD AND ADOLESCENT PSYCHIATRY), SEVEN GASTROENTEROLOGISTS, AND 13 GERIATRICIANS. WITHIN THIS SUSTAINED WORKFORCE SCALE, TWCGME ALSO DEMONSTRATED ITS CAPACITY TO RESPONSIBLY GROW NEW, CHNA-RESPONSIVE SPECIALTY TRAINING PATHWAYS ALIGNED WITH REGIONAL ACCESS GAPS. BUILDING ON THIS SAME ACCESS-AND-TRAINING STRATEGY, TWCGME FURTHER STRENGTHENED ITS CHAMPS-ALIGNED REHABILITATION TRAINING PLATFORM THROUGH ITS LONGSTANDING PARTNERSHIP WITH ALLIED SERVICES INTEGRATED HEALTH SYSTEM AND REHABILITATION FACILITIES, THE PRIMARY CLINICAL LEARNING ENVIRONMENT FOR TWCGME'S RECENTLY LAUNCHED AND NOW THRIVING ACGME-ACCREDITED PHYSICAL MEDICINE & REHABILITATION (PM&R) RESIDENCY PROGRAM. TO ENSURE THAT PM&R RESIDENTS RECEIVE HIGH-QUALITY PEDIATRIC REHABILITATION EXPERIENCES NOT OTHERWISE AVAILABLE IN THE REGION, TWCGME AND ALLIED SERVICES INTENTIONALLY INTEGRATED THE CHILDREN'S HOSPITAL OF PHILADELPHIA (CHOP) AS A PEDIATRIC REHABILITATION ROTATION PARTNER INTO THE PROGRAM'S CURRICULUM. THIS COLLABORATION REQUIRED DELIBERATE FINANCIAL INVESTMENT AND STRATEGIC LOGISTICAL PLANNING TO RESPONSIBLY SUPPORT RESIDENT PARTICIPATION, INCLUDING COORDINATING STABLE HOUSING AND TRAVEL ARRANGEMENTS NECESSARY TO SUSTAIN THE ROTATION STRUCTURE. THE SUCCESSFUL INTEGRATION OF CHOP INTO TWCGME'S GME-SNC MODEL CONTRIBUTED TO THE PM&R RESIDENCY PROGRAM'S SUCCESSFUL ACGME ACCREDITATION SITE VISIT, RESULTING IN CONTINUED ACCREDITATION STATUS, EFFECTIVE OCTOBER 8, 2024, AND ENABLING PLANNED PROGRAM GROWTH BY EXPANDING THE APPROVED RESIDENT COMPLEMENT TO 28 POSITIONS. DURING THE COVERED PERIOD, THE PM&R PROGRAM CONTINUED TO MATURE, DEEPENING OPERATIONAL ALIGNMENT WITH ALLIED SERVICES, SUPPORTING MEASURED, SUSTAINABLE GROWTH, AND STRENGTHENING THE REGIONAL REHABILITATION PHYSICIAN WORKFORCE PIPELINE. A SUBSEQUENT ACGME ACCREDITATION DECISION OF CONTINUED ACCREDITATION WAS ISSUED ON JANUARY 12, 2026. LOOKING AHEAD, TWCGME ANTICIPATES CELEBRATING THE PROGRAM'S FIRST GRADUATING CLASS OF FIVE INAUGURAL PM&R PHYSICIANS IN JUNE 2026 THROUGH A COLLABORATIVE RESIDENCY MODEL MADE POSSIBLE BY THE SHARED STEWARDSHIP OF TWCGME, ALLIED SERVICES, NORTHEAST REHABILITATION ASSOCIATES, REGIONAL HOSPITAL OF SCRANTON, AND TWCGME'S AFFILIATED ENTITY AND ESSENTIAL COMMUNITY PROVIDER, THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH). COLLECTIVELY, THESE ACCOMPLISHMENTS REFLECT TWCGME'S ABILITY TO TRANSLATE ACCREDITATION STABILITY INTO DISCIPLINED, CHNA-ALIGNED WORKFORCE DEVELOPMENT OUTCOMES. ACROSS THE GME-SNC, GRADUATE OUTCOMES REMAINED STRONGLY ALIGNED WITH THE ORGANIZATION'S DOCUMENTED CHNA FINDINGS, DEMONSTRATING THAT LONG-TERM ACCESS TO CARE IN NORTHEAST PENNSYLVANIA IS MOST EFFECTIVELY SUSTAINED WHEN CLINICIANS TRAIN AND REMAIN IN THE COMMUNITIES THEY SERVE. |
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TWCGME'S GRADUATE MEDICAL AND DENTAL EDUCATION PIPELINES ALSO YIELDED DIRECT, MISSION-ALIGNED WORKFORCE OUTCOMES THROUGH THE RECRUITMENT AND ONBOARDING OF PROGRAM GRADUATES INTO FULL-TIME FACULTY AND ATTENDING ROLES WITHIN COMMUNITY-BASED PRIMARY CARE AND DENTAL SETTINGS, INCLUDING THE JANUARY 2025 HIRING OF A FAMILY MEDICINE PHYSICIAN FOLLOWING COMPLETION OF HER TWCGME RESIDENCY AND THE ADDITION OF TWO DENTISTS, ONE IN AUGUST 2024 AND THE OTHER IN MARCH 2025, WHO ARE BOTH GRADUATES OF THE TWCCH-NYU LANGONE HEALTH AEGD RESIDENCY PROGRAM. THESE INDIVIDUAL OUTCOMES PROVIDE TANGIBLE EVIDENCE OF TWCGME'S CORE EXEMPT-PURPOSE MISSION: PREPARING CLINICIANS WHO NOT ONLY ENTER PRACTICE IN MEDICALLY UNDERSERVED COMMUNITIES BUT WHO ALSO REMAIN TO TEACH, MENTOR, AND SUSTAIN THE NEXT GENERATION OF COMMUNITY-BASED PRIMARY CARE AND DENTAL PROFESSIONALS. THE MAJORITY OF TWCGME GRADUATES PURSUED PUBLIC HEALTH-ORIENTED AND PRIMARY CARE CAREERS IN UNDERSERVED SETTINGS, MANY IN NORTHEASTERN PENNSYLVANIA. SINCE 2012, AT LEAST 53% OF INTERNAL MEDICINE GRADUATES, 56% OF REGIONAL FAMILY MEDICINE GRADUATES, AND 74% OF NATIONAL FAMILY MEDICINE GRADUATES HAVE CHOSEN TO PRACTICE IN MEDICALLY UNDERSERVED COMMUNITIES, RURAL AREAS, AND/OR HEALTH PROFESSIONAL SHORTAGE AREAS, MOST OFTEN WITHIN FQHCS. PSYCHIATRY AND GERIATRIC MEDICINE PROGRAMS DEMONSTRATED SIMILARLY STRONG OUTCOMES, WITH 100% AND 77% OF GRADUATES, RESPECTIVELY, PRACTICING OR FURTHER TRAINING IN UNDERSERVED SETTINGS. THESE WORKFORCE OUTCOMES ARE EXCEPTIONALLY RESPONSIVE TO CHNA FINDINGS DOCUMENTING PERSISTENT PRIMARY CARE SHORTAGES, RISING CHRONIC DISEASE BURDEN, AND A RAPIDLY AGING REGIONAL POPULATION WITH INCREASING NEED FOR GERIATRIC-FOCUSED, DEMENTIA-INFORMED, AND COORDINATED CARE. THESE OUTCOMES ALSO REFLECT SUSTAINED ALIGNMENT BETWEEN GRADUATE MEDICAL EDUCATION, COMMUNITY-EMBEDDED TRAINING, AND VERIFIED REGIONAL WORKFORCE NEED. THE SCALE, RETENTION, AND DURABILITY OF TWCGME'S GRADUATE OUTCOMES REFLECT THE SUCCESSFUL STABILIZATION OF ITS SPONSORING INSTITUTION, THE MATURATION OF ITS GOVERNANCE AND ACCREDITATION INFRASTRUCTURE, AND THE EFFECTIVENESS OF ITS COMMUNITY-EMBEDDED TRAINING MODEL IN TRANSLATING EDUCATION INTO SUSTAINED ACCESS TO CARE. IN PARALLEL, TWCGME ADVANCED ACADEMIC PIPELINE CONTINUITY AND EXPANSION DURING THE COVERED PERIOD THROUGH SUSTAINED AND EXPANDED OSTEOPATHIC MEDICAL EDUCATION AND INTERPROFESSIONAL TRAINING PARTNERSHIPS. THIS INCLUDED CONTINUED COLLABORATION WITH LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE (LECOM), THROUGH WHICH TWCGME AND ITS AFFILIATED ENTITY, AND ESSENTIAL COMMUNITY PROVIDER, THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH), SERVED AS A CLINICAL TRAINING CAMPUS FOR OSTEOPATHIC MEDICAL STUDENTS. DURING THE COVERED PERIOD, THIS PARTNERSHIP WITH LECOM WAS FURTHER EXPANDED TO INCLUDE ADDITIONAL CLINICAL ROTATIONS FOR MEDICAL STUDENTS TRAINING WITHIN TWCCH'S 13 PATIENT-CENTERED MEDICAL HOME FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS ACROSS NORTHEAST PENNSYLVANIA, WHILE ALSO CREATING NEW RECIPROCAL EDUCATIONAL OPPORTUNITIES FOR TWCGME GASTROENTEROLOGY FELLOWS TO TRAIN ALONGSIDE LECOM'S AFFILIATED GASTROENTEROLOGY FELLOWSHIP PROGRAM IN ERIE, PENNSYLVANIA. COLLECTIVELY, THESE ACADEMIC PARTNERSHIPS SUPPORTED ROBUST INTERPROFESSIONAL EDUCATION ACROSS THE ENTERPRISE. DURING THE COVERED PERIOD, TWCGME, IN COLLABORATION WITH TWCCH, HOSTED MORE THAN 200 INTERPROFESSIONAL HEALTH STUDENTS FROM MORE THAN 10 ACADEMIC INSTITUTIONS, INCLUDING LECOM AND A.T. STILL UNIVERSITY'S SCHOOL OF OSTEOPATHIC MEDICINE IN ARIZONA (ATSU-SOMA), AS WELL AS ATSU'S CENTRAL COAST PHYSICIAN ASSISTANT PROGRAM (ATSU-CCPAP), A COMMUNITY-EMBEDDED PHYSICIAN ASSISTANT EDUCATION MODEL ALIGNED WITH ATSU'S HOMETOWN SCHOLARS PIPELINE IN PARTNERSHIP WITH THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND THE COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST IN CALIFORNIA. DURING THE COVERED PERIOD, TWCGME AND TWCCH WELCOMED A NEW COHORT OF 10 ATSU-SOMA SECOND-YEAR MEDICAL STUDENTS, WHO JOINED 20 UPPER-YEAR ATSU-SOMA COLLEAGUES TRAINING AND SERVING IN THE ORGANIZATION'S SERVICE AREA, AND FIVE PHYSICIAN ASSISTANT STUDENTS FROM ATSU-CCPAP. TWCGME ALSO SUPPORTED TWCCH IN DEVELOPING AND TRAINING ESSENTIAL INTERPROFESSIONAL CARE TEAM MEMBERS. THESE EFFORTS INCLUDED CONTINUED COLLABORATION WITH THE NATIONAL INSTITUTE FOR MEDICAL ASSISTANT ADVANCEMENT (NIMAA) TO TRAIN MEDICAL ASSISTANTS; PARTICIPATION IN COMMUNITY HEALTH WORKER (CHW) TRAINING PATHWAYS THROUGH THE NORTHEAST PENNSYLVANIA AREA HEALTH EDUCATION CENTER-AFFILIATED COMMUNITY HEALTH WORKER TRAINING PROGRAM AND THE NATIONAL HEALTH CORPS; AND ENGAGEMENT WITH THE LOCAL READINESS IN SKILLED EMPLOYMENT (RISE) ACADEMIC INITIATIVE. |
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IN ADDITION, TWCGME AND TWCCH LAUNCHED A NEW PHASE OF THEIR LECOM PARTNERSHIP DURING THE COVERED PERIOD, WELCOMING AN INAUGURAL COHORT OF FOUR MEDICAL STUDENTS AS PART OF THE EFFORTS TO ESTABLISH A CLINICAL CAMPUS FOR LECOM AT TWCCH'S FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS, WITH PLANS TO EXPAND THE COHORT TO UP TO 10 STUDENTS IN FUTURE ACADEMIC YEARS. THESE INTEGRATED ACADEMIC AND CLINICAL PARTNERSHIPS REINFORCE TWCGME'S ROLE IN STEWARDING A CONTINUOUS, COMMUNITY-EMBEDDED PIPELINE OF PHYSICIANS AND AN INTERPROFESSIONAL WORKFORCE ALIGNED WITH REGIONAL WORKFORCE NEEDS AND LONG-TERM ACCESS TO CARE. EXTENDING ITS GME-SNC MODEL BEYOND PHYSICIAN TRAINING, TWCGME AND ITS AFFILIATED CLINICAL ENTITY, TWCCH, ADVANCED A COORDINATED DENTAL WORKFORCE DEVELOPMENT STRATEGY DURING THE COVERED PERIOD, RECOGNIZING WORSENING ORAL HEALTH ACCESS GAPS ACROSS NORTHEAST PENNSYLVANIA. IN RESPONSE TO THESE NEEDS, THE ORGANIZATION AND ITS REGIONAL PARTNERS FORMALLY INCORPORATED THE COMMONWEALTH DENTAL CARE INITIATIVE (CDCI) TO CONDUCT FEASIBILITY AND PLANNING ACTIVITIES TO STRENGTHEN PUBLIC-INTEREST DENTAL EDUCATION AND WORKFORCE CAPACITY. FOLLOWING COMPLETION OF THE FEASIBILITY STUDY, THE CDCI WAS INTENTIONALLY RE-ENVISIONED AS A FRAMEWORK TO EXTEND THE GME-SNC MODEL INTO DENTAL EDUCATION, WITH TWCCH SERVING AS THE PRIMARY CLINICAL LEARNING ENVIRONMENT FOR DENTAL STUDENTS AND RESIDENTS. THIS APPROACH IS DESIGNED TO CREATE A LONGITUDINAL PIPELINE FROM PREDOCTORAL TRAINING INTO THE EXISTING TWCCH-NYU LANGONE HEALTH AEGD RESIDENCY PROGRAM AND POTENTIAL FUTURE PEDIATRIC DENTAL RESIDENCY PROGRAMMING. BY EMBEDDING DENTAL EDUCATION WITHIN COMMUNITY-BASED, SAFETY-NET CLINICAL SETTINGS, THIS MODEL APPLIES TWCGME'S PROVEN "TRAIN-WHERE-THEY-LIVE" STRATEGY TO ORAL HEALTH, SUPPORTING RECRUITMENT, TRAINING, AND LONG-TERM RETENTION OF DENTAL PROFESSIONALS IN COMMUNITIES WITH THE GREATEST ACCESS BARRIERS. AS PART OF THIS STRATEGY, TWCCH ALSO ADVANCED PARTNERSHIP CONVERSATIONS WITH JOHNSON COLLEGE TO ADDRESS CRITICAL SHORTAGES OF DENTISTS, DENTAL HYGIENISTS, DENTAL ASSISTANTS, AND EXPANDED-FUNCTION DENTAL ASSISTANTS, WHILE CREATING NEW EDUCATION-TO-EMPLOYMENT PATHWAYS IN ORAL HEALTH. THESE EFFORTS INCLUDE THE PLANNED EXPANSION OF DENTAL SERVICES AT TWCCH'S NEW FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER LOCATED WITHIN THE WYOMING COUNTY HEALTHCARE CENTER IN TUNKHANNOCK, PENNSYLVANIA. FOLLOWING THE 2021 CLOSURE OF TYLER MEMORIAL HOSPITAL, THE ONLY HOSPITAL IN WYOMING COUNTY, NEARLY 26,000 RESIDENTS WERE LEFT IN A RURAL HEALTH CARE DESERT. IN 2023, THE REDEVELOPMENT OF THE FORMER HOSPITAL SITE INTO THE WYOMING COUNTY HEALTHCARE CENTER CREATED AN OPPORTUNITY TO RESTORE ACCESS THROUGH A MULTI-PARTNER, NONPROFIT HEALTH HUB. DURING THE COVERED PERIOD, TWCCH ESTABLISHED THE COUNTY'S FIRST FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER AT THIS SITE, SERVING AS AN ANCHOR AT THE HUB THAT IS NOW HOUSING 22 PARTNER ORGANIZATIONS ACROSS HEALTH CARE, EDUCATION, NONPROFIT SERVICES, GOVERNMENT, AND ECONOMIC DEVELOPMENT. PLANNING FOR THE CURRENT FISCAL YEAR INCLUDED DEVELOPING A FULL-SERVICE PHARMACY AND EXPANDING DENTAL SERVICES AT THE WYOMING COUNTY HEALTHCARE CENTER, WITH DENTAL WORKFORCE TRAINING INTEGRATED INTO THESE ACCESS-RESTORATION EFFORTS. IN PARALLEL, TWCGME AND TWCCH EXPLORED ADDITIONAL ACADEMIC COLLABORATIONS WITH TEMPLE UNIVERSITY'S KORNBERG SCHOOL OF DENTISTRY, INCLUDING POTENTIAL PEDIATRIC DENTAL RESIDENCY PROGRAMMING AND CLINICAL TRAINING PARTNERSHIPS AT TEMPLE'S NEWLY ANNOUNCED RURAL DENTAL EDUCATION CENTER IN TAMAQUA, PENNSYLVANIA. ADDITIONAL PARTNERSHIPS WITH LUZERNE COUNTY COMMUNITY COLLEGE AND THE UNIVERSITY OF PITTSBURGH SCHOOL OF DENTAL MEDICINE SUPPORTED DENTAL ASSISTANT TRAINING AND RETENTION DURING THE COVERED PERIOD, RESULTING IN THE TRAINING AND RETENTION OF THREE DENTAL ASSISTANTS. COLLECTIVELY, THESE INITIATIVES REFLECT AN ANCHOR-INSTITUTION APPROACH TO ORAL HEALTH WORKFORCE DEVELOPMENT THAT INTEGRATES EDUCATION, ACCESS EXPANSION, AND ECONOMIC MOBILITY WHILE ADVANCING COMMUNITY-EMBEDDED TRAINING MODELS ALIGNED WITH VERIFIED REGIONAL NEED. THESE WORKFORCE DEVELOPMENT INITIATIVES ARE PART OF A BROADER ANCHOR-INSTITUTION STRATEGY THROUGH WHICH TWCGME AND TWCCH INTENTIONALLY ALIGN EDUCATION, EMPLOYMENT, AND COMMUNITY INVESTMENT TO STRENGTHEN REGIONAL ECONOMIC AND HEALTH SYSTEM RESILIENCE. |
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TWCGME AND TWCCH PARTICIPATED IN THE FEDERAL RESERVE BANK OF PHILADELPHIA'S ANCHOR ECONOMY INITIATIVE THROUGH THE "ANCHORS FOR EQUITY" RESEARCH IN ACTION LAB, A NATIONAL EFFORT EXAMINING HOW ANCHOR INSTITUTIONS, SUCH AS HEALTH SYSTEMS AND MEDICAL AND GRADUATE MEDICAL EDUCATION INSTITUTIONS, CAN SUSTAIN FAMILY-SUPPORTING JOBS, STRENGTHEN REGIONAL ECONOMIES, AND REDUCE BARRIERS TO OPPORTUNITY THROUGH PLACE-BASED COLLABORATION. IN NORTHEAST PENNSYLVANIA, TWCGME AND TWCCH ENGAGED IN THIS WORK ALONGSIDE A LONGSTANDING COMMUNITY PARTNER, THE INSTITUTE, WHICH WAS SELECTED FOR THE LAB GIVEN THE REGION'S HIGH CONCENTRATION OF HEALTH CARE SYSTEMS AND HIGHER-EDUCATION INSTITUTIONS, AND THE OUTSIZED ROLE OF HEALTH CARE AND EDUCATION AS LEADING EMPLOYMENT SECTORS. IN ALIGNMENT WITH TWCGME'S SPONSORING INSTITUTION RESPONSIBILITIES AND GME-SNC MODEL, THIS ANCHOR-INSTITUTION ENGAGEMENT REINFORCED THE ORGANIZATION'S COMMITMENT TO WORKFORCE PIPELINE DEVELOPMENT, ECONOMIC MOBILITY, AND COMMUNITY STEWARDSHIP, WHILE MAINTAINING DISCIPLINED, COMMUNITY-LED GOVERNANCE, COMPLIANCE OVERSIGHT, AND FINANCIAL STEWARDSHIP TO ENSURE THAT OUTWARD-FACING PARTNERSHIPS STRENGTHEN, RATHER THAN DILUTE, THE STABILITY AND ACCOUNTABILITY OF GRADUATE MEDICAL EDUCATION. CONSISTENT WITH THIS ANCHOR-INSTITUTION APPROACH, TWCGME ALSO ADVANCED ITS COMMITMENT TO PARTICIPATORY CITIZENSHIP AS A CORE EDUCATIONAL PRINCIPLE FOR GRADUATE MEDICAL EDUCATION. DURING THE COVERED PERIOD, TWCGME SUPPORTED RESIDENT, FELLOW, FACULTY, AND STAFF ENGAGEMENT IN PROFESSIONAL SOCIETY ACTIVITIES, COMMUNITY SERVICE INITIATIVES, AND EXTERNAL ADVISORY AND COMMITTEE ROLES THAT REINFORCE PHYSICIANS' RESPONSIBILITIES AS PUBLIC SERVANTS WITHIN COMMUNITY-BASED HEALTH SYSTEMS. THESE ACTIVITIES INCLUDED COLLABORATION WITH PROFESSIONAL ORGANIZATIONS SUCH AS THE ACGME, AMERICAN ASSOCIATION OF TEACHING HEALTH CENTERS (AATHC), AMERICAN COLLEGE OF PHYSICIANS (ACP), AREA HEALTH EDUCATION CENTER (AHEC) AND ITS LOCAL NORTHEAST PENNSYLVANIA AHEC, NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), PENNSYLVANIA ASSOCIATION OF COMMUNITY HEALTH CENTERS (PACHC), PENNSYLVANIA MEDICAL SOCIETY AND ITS LOCAL NORTHEAST COUNTIES MEDICAL SOCIETY, AND THE INSTITUTE. FOR EXAMPLE, TWCGME PARTICIPATED IN THE SECOND ANNUAL SPRING INTO A DAY OF GIVING POP-UP FOOD PANTRY IN MARCH 2025, IN PARTNERSHIP WITH THE EASTERN REGION OF THE PENNSYLVANIA CHAPTER OF THE ACP DAY OF GIVING, AND PROMOTED THE CONCEPT OF PARTICIPATORY CITIZENSHIP INTERNALLY TO EMPOWER TWCGME LEARNERS AND STAFF TO UNDERSTAND BETTER THEIR SHARED PUBLIC HEALTH SERVICE RESPONSIBILITIES AND THE IMPORTANT ROLE EACH PERSON PLAYS IN CONTRIBUTING TO THE ORGANIZATION'S MISSION DELIVERY. NOTABLY, TWO COMMUNITY SERVICE ACTIVITIES ARE REQUIRED ANNUALLY, RESULTING IN AT LEAST 1,200 HOURS OF DIRECT COMMUNITY SERVICE DELIVERED BY TWCGME AND TWCCH EMPLOYEES DURING THIS REPORTING PERIOD. THROUGH THESE EXPERIENCES, TWCGME INTENTIONALLY REINFORCES THE UNDERSTANDING THAT GRADUATE MEDICAL EDUCATION IS NOT SOLELY A CLINICAL ENTERPRISE, BUT A PUBLIC TRUST THAT REQUIRES PHYSICIANS TO ENGAGE THOUGHTFULLY IN COMMUNITY STEWARDSHIP, HEALTH SYSTEM GOVERNANCE, AND THE BROADER PUBLIC HEALTH CONTEXT IN WHICH CARE IS DELIVERED. THIS EMPHASIS ON PARTICIPATORY CITIZENSHIP AND PUBLIC TRUST EXTENDS BEYOND PROFESSIONAL FORMATION INTO THE ORGANIZATION'S FINANCIAL AND GOVERNANCE RESPONSIBILITIES, SHAPING HOW TWCGME AND TWCCH APPROACH STEWARDSHIP OF PUBLIC RESOURCES, SHARED RISK, AND ACCOUNTABILITY FOR POPULATION-LEVEL OUTCOMES. TWCGME AND TWCCH CONTINUED TO EXERCISE THEIR FIDUCIARY AND GOVERNANCE RESPONSIBILITIES RELATED TO VALUE-BASED CARE PARTICIPATION AND REINVESTMENT, CONSISTENT WITH THEIR ROLE AS ACCOUNTABLE STEWARDS OF PUBLIC GRADUATE MEDICAL EDUCATION RESOURCES. THE ORGANIZATION HAS LONG APPROACHED VALUE-BASED CARE AND ACCOUNTABLE CARE PARTNERSHIPS AS VEHICLES FOR COMMUNITY REINVESTMENT AND SHARED ACCOUNTABILITY, RATHER THAN SOLELY AS FINANCIAL ARRANGEMENTS. FROM ITS EARLIEST PARTICIPATION IN ACCOUNTABLE CARE MODELS, THE WRIGHT CENTER ADVANCED A VISION OF THE ACCOUNTABLE CARE ORGANIZATION (ACO) AS A FORUM FOR COLLECTIVE ACCOUNTABILITY THAT STRENGTHENS COMMUNITY-BASED PRIMARY CARE WHILE ALIGNING INCENTIVES AROUND POPULATION HEALTH IMPROVEMENT AND LONG-TERM SYSTEM RESILIENCE. AS AN FQHC LOOK-ALIKE, TWCCH IS ELIGIBLE TO PARTICIPATE IN ONLY ONE MEDICARE SHARED SAVINGS PROGRAM (MSSP) ACO AT A TIME. |
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FROM 2016 THROUGH DECEMBER 31, 2025, TWCCH PARTICIPATED CLINICALLY IN THE KEYSTONE ACCOUNTABLE CARE ORGANIZATION (KACO), WITH PATIENT ATTRIBUTION DRIVEN BY TWCCH'S PRIMARY CARE SERVICES. GOVERNANCE PARTICIPATION OCCURRED THROUGH TWCGME, WHICH HELD AN 11.1% OWNERSHIP INTEREST DURING THE COVERED PERIOD AND BORE A SHARED-SAVINGS OPPORTUNITY AND DOWNSIDE RISK UNDER MSSP ENHANCED TRACK ARRANGEMENTS. THIS STRUCTURE ENABLED TWCCH TO FOCUS ON WHOLE-PERSON PRIMARY CARE DELIVERY WHILE TWCGME EXERCISED FIDUCIARY OVERSIGHT AND STEWARDSHIP RESPONSIBILITIES ASSOCIATED WITH VALUE-BASED PARTICIPATION. AS KACO EVOLVED, TWCCH'S ATTRIBUTED PATIENT SHARE DECREASED, WHILE SHARED SAVINGS REMAINED STABLE, REFLECTING CONTINUED MISSION-ALIGNED PERFORMANCE. KACO SUBSEQUENTLY ANNOUNCED THAT IT WOULD BECOME NONOPERATIONAL EFFECTIVE DECEMBER 31, 2025, TO FACILITATE THE FORMATION OF A WHOLLY OWNED GEISINGER ACO. BEGINNING JANUARY 1, 2026, TWCCH WAS INVITED TO PARTICIPATE IN THE NEW GEISINGER ACO AS A CLINICAL PARTNER WITHOUT AN OWNERSHIP INTEREST, SHARING IN SAVINGS PROPORTIONATE TO ATTRIBUTION WHILE BENEFITING FROM THE PRESERVED CARE COORDINATION INFRASTRUCTURE. CONCURRENTLY, THE ORGANIZATION BEGAN ADVANCING A COMPLEMENTARY VALUE-BASED STRATEGY BY PARTNERING WITH ALEDADE, A PHYSICIAN-LED ORGANIZATION THAT SUPPORTS PRIMARY CARE-ANCHORED, MULTI-PAYER ACO PARTICIPATION. THIS LIMITED INITIAL ENGAGEMENT DURING THE COVERED PERIOD REFLECTED AN INTENTIONAL INCUBATION PHASE TO EVALUATE MISSION ALIGNMENT AND LONG-TERM STRATEGIC FIT. RECOGNIZING THAT SUSTAINABLE PRIMARY CARE INCREASINGLY DEPENDS ON CARE DELIVERED BEYOND TRADITIONAL VISITS, THE ORGANIZATION EXPANDED NURSE-LED CARE MANAGEMENT, CARE COORDINATION, AND INTERDISCIPLINARY TEAM-BASED SUPPORTS ALIGNED WITH VALUE-BASED REIMBURSEMENT MODELS. THE ORGANIZATION ALSO ADVANCED POPULATION HEALTH ANALYTICS BY EXPANDING THE USE OF AZARA DRVS AND EXPLORING INTEGRATION WITH ALEDADE'S TECHNOLOGY PLATFORM TO SUPPORT DATA-INFORMED CARE DELIVERY AND ACCOUNTABILITY. HAVING RECOUPED TWCGME'S LONG-STANDING INVESTMENT IN KACO FOR THE FIRST TIME, TWCGME EVALUATED HOW BEST TO DIRECT THE SHARED SAVINGS RESPONSIBLY. CONSISTENT WITH ITS GOVERNANCE ROLE, TWCGME PASSED THE MAJORITY OF SHARED SAVINGS TO TWCCH, WHICH REINVESTED THE FUNDS DIRECTLY INTO PATIENT CARE, ACCESS EXPANSION, AND MISSION-ALIGNED SERVICE DELIVERY, REINFORCING THE ENTERPRISE'S COMMITMENT TO DIRECTING VALUE-BASED RESOURCES TOWARD MEASURABLE COMMUNITY BENEFIT AND WORKFORCE SUSTAINABILITY. THIS SAME STEWARDSHIP LENS ALSO GUIDED EMPLOYEE BENEFIT SUSTAINABILITY AND MEDICATION AFFORDABILITY STRATEGIES DESCRIBED BELOW. WITH COSTS OF PROVIDING HEALTH INSURANCE FOR THE ORGANIZATION'S EMPLOYEES, INCLUDING TWCGME RESIDENTS AND FELLOWS, CONTINUING TO CLIMB BEYOND MULTIPLES OF AVERAGE INFLATION, AND WITH INCREASING CONCERN REGARDING THE ROLE PHARMACY BENEFIT MANAGERS (PBMS) PLAY IN DRIVING THE COSTS OF COMMERCIAL HEALTH INSURANCE PREMIUMS, DURING THE COVERED PERIOD, THE ORGANIZATION BEGAN RESPONSIBLY EXPLORING THE FEASIBILITY OF SELF-INSURING FOR EMPLOYEE HEALTH BENEFITS AND INTERNALIZING CERTAIN PHARMACY-RELATED SERVICES. THESE EXPLORATORY EFFORTS WERE INTENDED TO ASSESS WHETHER SUCH APPROACHES COULD ENHANCE TRANSPARENCY, AFFORDABILITY, AND ACCESS WHILE MAINTAINING FULL REGULATORY COMPLIANCE AND FISCAL PRUDENCE. THE ORGANIZATION ANTICIPATED THAT THESE STRATEGIES COULD SUPPORT TIMELY, AFFORDABLE ACCESS TO MEDICATIONS FOR PATIENTS, LEARNERS, AND STAFF WHILE STRENGTHENING STEWARDSHIP OF ENTERPRISE RESOURCES. THE EXISTING FULLY INSURED HIGHMARK HEALTH INSURANCE PLAN FOR TWCGME AND TWCCH WAS PROJECTED TO INCREASE BY APPROXIMATELY 35% IN 2026, MAKING IT FINANCIALLY UNSUSTAINABLE FOR THE ORGANIZATION AND ITS EMPLOYEES OVER THE LONG TERM. PRIOR COST-SHARING AND PLAN DESIGN ELEMENTS ALSO CONTRIBUTED TO UNINTENDED OVERUTILIZATION AND INTRODUCED DISPROPORTIONATE ORGANIZATIONAL RISK. THROUGH INTENTIONAL DISCUSSIONS AMONG EXECUTIVE LEADERSHIP AND THE TWCGME AND TWCCH COMMUNITY-LED GOVERNING BOARDS, THE ORGANIZATION EXPLORED COLLABORATIVE SELF-INSURED MODELS DESIGNED TO STRENGTHEN FINANCIAL STEWARDSHIP WHILE CONTINUING TO PROTECT EMPLOYEE AND FAMILY HEALTH. THIS EVALUATION EMPHASIZED THE VALUE OF FLEXIBILITY THROUGH BENEFIT DESIGNS THAT CAN BE TAILORED TO THE NEEDS OF THE LOCAL WORKFORCE, RATHER THAN A ONE-SIZE-FITS-ALL PACKAGE; ENHANCED COST MANAGEMENT BY PAYING ONLY FOR CARE ACTUALLY UTILIZED TO HELP CONTROL RISING HEALTH CARE COSTS AND SUSTAIN BENEFITS OVER TIME; AND INCREASED TRANSPARENCY THROUGH THE USE OF DE-IDENTIFIED, AGGREGATE DATA TO INFORM TARGETED WELLNESS INITIATIVES, INCLUDING DIABETES PREVENTION AND MANAGEMENT SUPPORTS, MENTAL AND BEHAVIORAL HEALTH RESOURCES, AND OTHER WORKFORCE WELL-BEING PROGRAMS. |
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THIS ANALYSIS CULMINATED IN BOARD APPROVAL TO TRANSITION TO A SELF-INSURED HEALTH PLAN EFFECTIVE JAN. 1, 2026, THROUGH PARTICIPATION IN THE PA MOUNTAINS HEALTHCARE ALLIANCE (PMHA). THIS TRANSITION REFLECTS A BALANCED, MISSION-ALIGNED APPROACH TO EMPLOYEE BENEFIT SUSTAINABILITY THAT RESPONSIBLY STEWARDS ORGANIZATIONAL RESOURCES WHILE SUPPORTING WORKFORCE HEALTH, WELL-BEING, AND LONG-TERM ORGANIZATIONAL RESILIENCE. IMPORTANTLY, THIS STRATEGIC SHIFT ALSO ALIGNS WITH THE ORGANIZATION'S LONGER-TERM GOAL OF EXPANDING ACCESS TO AFFORDABLE MEDICATIONS BY ESTABLISHING ON-SITE, REVENUE-NEUTRAL PHARMACIES AT TWCCH'S LARGER COMMUNITY HEALTH CENTERS, STARTING IN MARCH 2026, WITH THE OFFICIAL OPENING OF A PHARMACY AT TWCCH'S FQHC LOOK-ALIKE WILKES-BARRE TEACHING COMMUNITY HEALTH CENTER. PLANS ARE IN THE WORKS TO OPEN PHARMACIES AT OTHER HIGH-VOLUME TWCCH FQHC LOOK-ALIKE LOCATIONS. THESE INTEGRATED PHARMACY SERVICES ARE DESIGNED TO IMPROVE MEDICATION ACCESS AND ADHERENCE, REDUCE OUT-OF-POCKET COSTS FOR PATIENTS AND EMPLOYEES, AND SUPPORT CHRONIC DISEASE MANAGEMENT THROUGH COORDINATED, WHOLE-PERSON CARE DELIVERY, WITH ROBUST AND COMPLIANT 340B COST AND EXPENSE REPORTING TO ENSURE TRANSPARENCY AND RESPONSIBLE STEWARDSHIP OF RESOURCES. IN PARALLEL, THESE PHARMACY HUBS WILL SERVE AS ADDITIONAL INTERDISCIPLINARY TRAINING ENVIRONMENTS FOR TWCGME RESIDENTS, FELLOWS, AND INTERPROFESSIONAL LEARNERS, EXPANDING EXPERIENTIAL EDUCATION IN MEDICATION MANAGEMENT, POPULATION HEALTH, CHRONIC DISEASE CARE, AND TEAM-BASED PRIMARY CARE WITHIN COMMUNITY-BASED SETTINGS. TO FURTHER SUPPORT THIS WORKFORCE DEVELOPMENT OBJECTIVE, THE ORGANIZATION HAS STRENGTHENED ITS ACADEMIC COLLABORATION WITH WILKES UNIVERSITY, WITH PLANS TO INTEGRATE PHARMACY LEARNERS AND FACULTY INTO REGIONAL PHARMACY HUBS INTENTIONALLY, CREATING STRUCTURED OPPORTUNITIES FOR COLLABORATIVE LEARNING ALONGSIDE TWCGME TRAINEES AND REINFORCING INTEGRATED, PATIENT-CENTERED MEDICATION MANAGEMENT WITHIN THE TEACHING COMMUNITY HEALTH CENTER GME-SNC MODEL. TO FURTHER STRENGTHEN INTERNAL FINANCIAL CONTROLS AND FINANCIAL OVERSIGHT, THE ORGANIZATION ADVANCED ITS CONTROLLER TO THE ROLE OF CHIEF FINANCIAL OFFICER (CFO), REINFORCING DISCIPLINED FINANCIAL STEWARDSHIP AND ENTERPRISE-WIDE ACCOUNTABILITY, AND ITS CLINICAL LEADERSHIP CONTINUITY AND WORKFORCE PIPELINE MATURATION THROUGH THE APPOINTMENT OF ERIN MCFADDEN, M.D., FACP, AS TWCCH'S CHIEF MEDICAL OFFICER. DR. MCFADDEN COMPLETED HER INTERNAL MEDICINE RESIDENCY TRAINING AT TWCGME AND HAS REMAINED DEEPLY ROOTED IN THE COMMUNITIES SERVED BY TWCCH. HER APPOINTMENT REFLECTS THE ORGANIZATION'S INTENTIONAL GME-SNC STRATEGY TO TRAIN PHYSICIANS IN COMMUNITY-BASED PRIMARY CARE AND RETAIN THEM AS CLINICAL LEADERS COMMITTED TO WHOLE-PERSON, MISSION-DRIVEN CARE. ADDITIONALLY, TWCGME HIRED A VICE PRESIDENT OF ACADEMIC AFFAIRS/ASSOCIATE DESIGNATED INSTITUTIONAL OFFICIAL IN DECEMBER 2023 TO SUPPORT CLINICAL AND EDUCATIONAL INTEGRATED NETWORK (CEIN) DEVELOPMENT AND TO ALIGN GRADUATE MEDICAL EDUCATION (GME), UNDERGRADUATE MEDICAL EDUCATION (UME), INTERPROFESSIONAL MEDICAL EDUCATION (IME), AND CONTINUING MEDICAL EDUCATION (CME) STRATEGIES. DURING THE COVERED PERIOD, TWCGME ALSO ADVANCED THE PROFESSIONALIZATION AND ECONOMIC MOBILITY OF ITS GRADUATE MEDICAL EDUCATION ADMINISTRATIVE WORKFORCE THROUGH A DELIBERATE RESTRUCTURING OF GME COORDINATOR ROLES, EXPANDING RESPONSIBILITIES, STRENGTHENING ADVANCED SKILL SETS, AND ALIGNING CAREER PATHWAYS WITH THE INCREASING COMPLEXITY AND ACCOUNTABILITY DEMANDS OF A MATURE SPONSORING INSTITUTION. DURING THE COVERED PERIOD, TWCGME CONTINUED TO DEEPEN RESIDENT AND FELLOW PARTICIPATION IN SPONSORING INSTITUTION GOVERNANCE, INCLUDING THE GRADUATE MEDICAL EDUCATION COMMITTEE (GMEC), TO REINFORCE SHARED STEWARDSHIP, TRANSPARENCY, AND ACCOUNTABILITY. ENABLED BY SUSTAINED SPONSORING INSTITUTION ACCREDITATION, TWCGME ADVANCED NEW AND EXPANDED PROGRAM SERVICES DURING THE COVERED PERIOD, INCLUDING ITS ACGME-APPROVED INTERNAL MEDICINE/GERIATRICS ADVANCING INNOVATION IN RESIDENCY EDUCATION (AIRE) INTERNAL MEDICINE-GERIATRICS INTEGRATED RESIDENCY AND FELLOWSHIP PATHWAY (COMBINED MED-GERI PATHWAY). THIS FOUR-YEAR, COMPETENCY-BASED INTEGRATED TRAINING MODEL IS DESIGNED TO STRENGTHEN THE GERIATRIC PHYSICIAN WORKFORCE CAPACITY THROUGH CONTINUOUS, LONGITUDINAL EXPOSURE TO OLDER ADULTS AND COMPLEX GERIATRIC CARE SYSTEMS ACROSS COMMUNITY-BASED SETTINGS. THE PATHWAY GENERATED STRONG NATIONAL INTEREST, WITH MORE THAN 300 APPLICANTS FOR THE FIRST CLASS, REFLECTING BOTH THE GROWING DEMAND FOR INNOVATIVE GERIATRICS TRAINING MODELS AND THE URGENT NEED TO PREPARE PHYSICIANS TO MEET THE COMPREHENSIVE, WHOLE-PERSON HEALTH NEEDS OF AGING POPULATIONS. |
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THE LAUNCH OF THE COMBINED MED-GERI PATHWAY WAS PART OF A BROADER, ENTERPRISE-ALIGNED COMMITMENT TO AGE-FRIENDLY CARE DELIVERY AND GERIATRIC-COMPETENT WORKFORCE DEVELOPMENT, WHICH DIRECTLY SHAPES TWCGME'S GRADUATE MEDICAL EDUCATION CURRICULA AND CLINICAL LEARNING ENVIRONMENTS. THROUGH ITS AFFILIATED ENTITY, TWCCH, TWCGME LEARNERS TRAIN WITHIN AN INSTITUTE FOR HEALTHCARE IMPROVEMENT (IHI)-RECOGNIZED "AGE-FRIENDLY HEALTH SYSTEM PARTICIPATE IN REGIONAL COLLECTIVE-IMPACT EFFORTS TO BUILD "AGE-FRIENDLY COMMUNITIES." DEMOGRAPHIC TRENDS UNDERSCORE THE URGENCY OF THIS WORK: BASED ON 2023 DATA, THE MOST RECENT AVAILABLE, PENNSYLVANIA RANKS NINTH NATIONALLY IN THE SHARE OF RESIDENTS AGED 65 AND OLDER. IN RESPONSE, TWCGME'S EDUCATIONAL STRATEGY IS INTENTIONALLY DESIGNED TO PREPARE PHYSICIANS. IT EMBEDS THEM WITHIN INTERPROFESSIONAL CARE TEAMS THAT INCLUDE NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, LICENSED SOCIAL WORKERS, COUNSELORS, AND ALLIED HEALTH PROFESSIONALS, TO DELIVER COORDINATED, WHOLE-PERSON CARE ALIGNED WITH THE PRIORITIES AND LIVED REALITIES OF OLDER ADULTS. THIS AGE-FRIENDLY TRAINING ENVIRONMENT IS FURTHER ENRICHED BY THE ORGANIZATION'S EARLY NATIONAL ADOPTION OF THE UCLA JOHN A. HARTFORD FOUNDATION-FUNDED, AWARD-WINNING ALZHEIMER'S AND DEMENTIA CARE (ADC) PROGRAM MODEL, MAKING IT ONE OF THE FIRST HEALTH SYSTEMS IN THE COUNTRY TO IMPLEMENT THIS EVIDENCE-BASED APPROACH. TWCGME RESIDENTS AND FELLOWS GAIN DIRECT CLINICAL EXPOSURE TO DEMENTIA-INFORMED, CAREGIVER-ENGAGED MODELS OF CARE WHILE TRAINING IN PRIMARY CARE SETTINGS THAT HAVE FULLY OPERATIONALIZED THE INSTITUTE FOR HEALTHCARE IMPROVEMENT'S "4MS" AGE-FRIENDLY FRAMEWORK - WHAT MATTERS, MEDICATION, MENTATION, AND MOBILITY - ACROSS SERVICES FOR OLDER ADULTS. THESE PRINCIPLES WERE OPERATIONALIZED DURING THE COVERED PERIOD THROUGH CROSS-SECTOR EDUCATIONAL AND COMMUNITY PARTNERSHIPS CONVENED AT THE ORGANIZATION'S INAUGURAL SYMPOSIUM ON AGING, HELD IN JANUARY 2025 AT TWCCH'S FQHC LOOK-ALIKE SCRANTON TEACHING COMMUNITY HEALTH CENTER. THE SYMPOSIUM BROUGHT TOGETHER REGIONAL AGING, SOCIAL SERVICE, ACADEMIC, AND PHILANTHROPIC STAKEHOLDERS TO ADDRESS DEMENTIA-FRIENDLY COMMUNITIES, SOCIAL ISOLATION, ELDER FINANCIAL EXPLOITATION, AND COORDINATED COMMUNITY RESPONSES TO AGING. TWCGME LEARNERS AND FACULTY PARTICIPATED IN THIS CONVENING AS PART OF THEIR POPULATION HEALTH, SYSTEMS-BASED PRACTICE, AND COMMUNITY-ENGAGED LEARNING EXPERIENCES. BUILDING ON ITS SUCCESS, THE SYMPOSIUM ON AGING IS PLANNED AS AN ANNUAL FORUM TO SUSTAIN INTERDISCIPLINARY LEARNING AND COMMUNITY ALIGNMENT. EXTENDING THIS AGE-FRIENDLY, GERIATRICS-RESPONSIVE FOCUS INTO POLICY AND SYSTEMS-LEVEL LEADERSHIP, THE APRIL 2025 APPOINTMENT OF TWCCH/TWCGME'S SENIOR VICE PRESIDENT AND ENTERPRISE CHIEF OPERATIONS AND STRATEGY OFFICER TO PENNSYLVANIA'S INAUGURAL ALZHEIMER'S, DEMENTIA, AND RELATED DISORDERS ADVISORY COMMITTEE FURTHER ENSURED THAT THE PERSPECTIVES OF COMMUNITY-BASED GRADUATE MEDICAL EDUCATION, FRONTLINE CLINICIANS, AND LEARNERS INFORM STATEWIDE PLANNING AND WORKFORCE STRATEGIES. COLLECTIVELY, THESE INITIATIVES STRENGTHEN THE GERIATRIC-SENSITIVE PREPARATION OF TWCGME'S CURRENT AND FUTURE PHYSICIAN WORKFORCE WHILE ADVANCING ACCOUNTABLE, COMMUNITY-ANCHORED RESPONSES TO THE NEEDS OF AN AGING POPULATION. IN PARALLEL WITH THESE ACGME-ACCREDITED PHYSICIAN TRAINING EXPANSIONS, TWCGME ALSO ADVANCED ADDITIONAL, DISTINCT PROGRAM SERVICES DURING THE COVERED PERIOD IN DENTAL EDUCATION AND ADVANCED PRACTICE NURSING, FURTHER BROADENING ITS COMMUNITY-BASED WORKFORCE DEVELOPMENT IMPACT. TWCGME MARKED A SIGNIFICANT NATIONAL POLICY MILESTONE AFTER MORE THAN A DECADE OF ADVOCACY, ENABLING FQHCS TO SERVE AS SPONSORING INSTITUTIONS FOR ADVANCED EDUCATION IN GENERAL DENTISTRY (AEGD) RESIDENCY PROGRAMS. IN 2025, THE COMMISSION ON DENTAL ACCREDITATION (CODA) REVISED STANDARD 1-1 TO PERMIT ORGANIZATIONS THAT RECEIVE REGULAR ON-SITE INSPECTIONS THROUGH THE HRSA OPERATIONAL SITE VISIT (OSV) PROCESS TO SPONSOR AEGD PROGRAMS. THIS CHANGE EXPANDED THE CAPACITY OF COMMUNITY-BASED SAFETY-NET PROVIDERS TO DIRECTLY DEVELOP THE ORAL HEALTH WORKFORCE NEEDED TO MEET NATIONAL PRIMARY CARE AND ACCESS NEEDS. CONCURRENTLY, TWCGME CONTINUED TO SUPPORT ITS AFFILIATED ENTITY, TWCCH, IN OPERATING A FLOURISHING AEGD RESIDENCY PROGRAM THROUGH A CODA-ACCREDITED CONSORTIUM PARTNERSHIP WITH NYU LANGONE HEALTH. THIS DENTAL EDUCATION MODEL HIGHLIGHTS A KEY DISTINCTION BETWEEN CODA AND ACGME ACCREDITATION FRAMEWORKS: CODA PERMITS CONSORTIUM-BASED TRAINING STRUCTURES AT THE PROGRAM LEVEL, WHEREAS ACGME STANDARDS DO NOT, AS DEMONSTRATED BY THE PRIOR EXPERIENCE OF TWCGME'S NATIONAL FAMILY MEDICINE RESIDENCY PROGRAM. |
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IN PARALLEL, TWCGME CONTINUED TO DEVELOP AFFILIATED, COMMUNITY-EMBEDDED RESIDENCY PROGRAMS IN PARTNERSHIP WITH MISSION-ALIGNED ORGANIZATIONS TO EXPAND PHYSICIAN TRAINING CAPACITY IN UNDERSERVED COMMUNITIES. THIS INCLUDED CONTINUED PROGRESS TOWARD ESTABLISHING ADDITIONAL FAMILY MEDICINE RESIDENCY TRAINING CAPACITY IN WESTERN PENNSYLVANIA THROUGH A PARTNERSHIP MODEL UNDER ACGME REVIEW, WITH AMBULATORY TRAINING BASED AT MERCER PRIMARY CARE AND INPATIENT TRAINING SUPPORTED BY ALLEGHENY HEALTH NETWORK GROVE CITY HOSPITAL, WITH TWCGME SERVING AS THE ACGME-ACCREDITED SPONSORING INSTITUTION. TWCGME'S SPONSORING INSTITUTION ALSO ADVANCED EDUCATION AND ACCESS-FOCUSED INITIATIVES SUPPORTED THROUGH THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA), INCLUDING SUCCESSFUL RECEIPT OF A PRIMARY CARE TRAINING ENHANCEMENT (PCTE) GRANT TO STRENGTHEN LANGUAGE ACCESS AND DISABILITY ACCESS EDUCATION AND RELATED CURRICULAR AND CLINICAL PRACTICE IMPROVEMENTS FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY (LEP) AND INDIVIDUALS WITH PHYSICAL, INTELLECTUAL, AND/OR DEVELOPMENTAL DISABILITIES (PIDD). THIS ACCESS FOCUS WAS FURTHER REINFORCED THROUGH EXPANDED COMMUNITY PARTNERSHIPS AND INTEGRATED SERVICE DELIVERY, INCLUDING TWCGME'S AFFILIATED ENTITY, TWCCH, CO-LOCATING A NEW FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER WITHIN THE FRIENDSHIP HOUSE WHOLE PERSON CARE CENTER'S NEW FACILITY ON WYOMING AVENUE IN DOWNTOWN SCRANTON, PENNSYLVANIA, WHICH OPENED IN NOVEMBER 2024. IN ADDITION TO EXPANDING MUCH-NEEDED ACCESS TO COORDINATED, WHOLE-PERSON PRIMARY CARE AND MENTAL AND BEHAVIORAL HEALTH SERVICES, THIS MISSION-ALIGNED, COLLABORATIVE SITE SERVES AS AN ADDITIONAL COMMUNITY-EMBEDDED AMBULATORY CLINICAL LEARNING ENVIRONMENT FOR TWCGME RESIDENTS, FELLOWS, AND INTERPROFESSIONAL LEARNERS, STRENGTHENING EXPERIENTIAL TRAINING IN INTEGRATED, WHOLE-PERSON, PATIENT-CENTERED, TRAUMA-RESPONSIVE PRIMARY CARE AND MENTAL AND BEHAVIORAL HEALTH SERVICES FOR PATIENTS WITH COMPLEX, SERIOUS MENTAL HEALTH AND/OR SUBSTANCE USE DISORDER NEEDS. THIS SAME ACCESS-AND-TRAINING FOCUS WAS OPERATIONALIZED THROUGH TWCGME'S LONG-STANDING, MISSION-ALIGNED PARTNERSHIP WITH ALLIED SERVICES INTEGRATED HEALTH SYSTEM, WHICH SERVES AS A KEY CLINICAL LEARNING ENVIRONMENT FOR TWCGME'S ACGME-ACCREDITED PM&R RESIDENCY PROGRAM, INCLUDING PLANNED PROGRAM GROWTH AND EXPANDED TRAINING EXPERIENCES ACROSS THE REHABILITATION CONTINUUM. TWCGME ALSO ADVANCED INNOVATIVE CLINICAL TRAINING AND FELLOWSHIP DEVELOPMENT INITIATIVES TO EXPAND PHYSICIAN EXPERTISE IN HIGH-NEED SPECIALTY AREAS ALIGNED WITH COMMUNITY-IDENTIFIED GAPS, INCLUDING A POTENTIAL NEW CLINICAL ROTATION IN PROSTHETICS TO INCREASE RESIDENT AND FELLOW EXPOSURE TO COMPREHENSIVE REHABILITATION, MOBILITY, AND FUNCTION-FOCUSED CARE. IN PARALLEL, AND INFORMED BY COMMUNITY-IDENTIFIED GAPS IN WHOLE-PERSON PRIMARY CARE FOR INDIVIDUALS LIVING WITH PHYSICAL, INTELLECTUAL, AND/OR DEVELOPMENTAL DISABILITIES, THE ORGANIZATION BEGAN EXPLORATORY FEASIBILITY DISCUSSIONS DURING THE COVERED PERIOD REGARDING THE POTENTIAL FUTURE CO-LOCATION OF TWCCH'S FQHC LOOK-ALIKE PRIMARY CARE SERVICES WITHIN AN ALLIED SERVICES SETTING IN SCRANTON, PENNSYLVANIA, CONTINGENT UPON FEASIBILITY, SUSTAINABILITY, AND REGULATORY APPROVAL. TAKEN TOGETHER, THESE INITIATIVES ARE INTENTIONALLY ORGANIZED WITHIN TWCGME'S EVOLVING MULTI-INSTITUTIONAL CLINICAL AND EDUCATIONAL INTEGRATED NETWORK (CEIN), WHICH SERVES AS THE ENTERPRISE FRAMEWORK FOR ALIGNING GRADUATE MEDICAL EDUCATION, COMMUNITY-BASED PRIMARY CARE, AND AFFILIATED HOSPITAL AND SPECIALTY TRAINING ENVIRONMENTS UNDER DISCIPLINED GOVERNANCE AND STEWARDSHIP. DURING THE COVERED PERIOD, THE IMPORTANCE OF THIS FRAMEWORK INTENSIFIED AMID REGIONAL HEALTH SYSTEM TRANSITION AND OWNERSHIP UNCERTAINTY, REINFORCING THE NEED FOR STABLE, ACCREDITATION-ALIGNED CLINICAL LEARNING ENVIRONMENTS THAT PROTECT PATIENT ACCESS, EDUCATIONAL CONTINUITY, AND PUBLIC INVESTMENT. WITHIN THE CEIN, TWCGME INTEGRATES SPECIALTY-ENRICHED SERVICES, WORKFORCE PLANNING, AND EDUCATIONAL CAPACITY ASSESSMENT TO ENSURE THAT EXPANSION OF TRAINING PATHWAYS REMAINS SUSTAINABLE, COMMUNITY-RESPONSIVE, AND CONSISTENT WITH SPONSORING INSTITUTION RESPONSIBILITIES. IN ADDITION, TWCGME ADVANCED PLANNING EFFORTS FOR A FUTURE SPORTS MEDICINE FELLOWSHIP AND A PAIN MANAGEMENT FELLOWSHIP, ENVISIONED AS MULTIDISCIPLINARY TRAINING PROGRAMS THAT INTEGRATE PRIMARY CARE, REHABILITATION, BEHAVIORAL HEALTH, AND SPECIALTY SERVICES TO STRENGTHEN COMMUNITY-BASED APPROACHES TO INJURY PREVENTION, FUNCTIONAL RESTORATION, AND COMPLEX PAIN MANAGEMENT. THESE INITIATIVES REFLECT TWCGME'S INTENTIONAL STRATEGY TO EXPAND SPECIALTY TRAINING PATHWAYS THAT REMAIN ANCHORED IN WHOLE-PERSON, COMMUNITY-GOVERNED CARE DELIVERY AND INTERPROFESSIONAL COLLABORATION. |
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THIS FEASIBILITY WORK WAS CONCORDANT WITH COMPLEMENTARY TWCGME EDUCATION AND WORKFORCE DEVELOPMENT INITIATIVES UNDERTAKEN DURING THE COVERED PERIOD, INCLUDING GRANT-SUPPORTED CURRICULUM DEVELOPMENT TO STRENGTHEN THE PREPARATION OF CLINICIANS AND INTERPROFESSIONAL LEARNERS TO MEET THE COMPREHENSIVE, LIFELONG HEALTH NEEDS OF INDIVIDUALS WITH PHYSICAL AND INTELLECTUAL DISABILITIES. BY OPERATIONALIZING THESE SPECIALTY TRAINING INVESTMENTS WITHIN COMMUNITY-BASED CARE DELIVERY, THESE INTEGRATED LEARNING MODELS ARE INTENTIONALLY DESIGNED TO STRENGTHEN TWCGME'S GRADUATE MEDICAL EDUCATION MISSION BY ANCHORING SPECIALTY-ENRICHED TRAINING IN COMMUNITY-BASED PRIMARY CARE ENVIRONMENTS. BY EMBEDDING SPECIALTY FACULTY AND FELLOWS ALONGSIDE PRIMARY CARE TEAMS, TWCGME ENSURES THAT RESIDENTS AND FELLOWS, PARTICULARLY THOSE IN ITS PM&R RESIDENCY PROGRAM AND OTHER SPECIALTIES, ARE TRAINED IN SUSTAINED, RELATIONSHIP-CENTERED COLLABORATION WITH PRIMARY CARE, REINFORCING SYSTEMS-BASED PRACTICE, CONTINUITY OF CARE, AND TEAM-BASED LEARNING. THROUGH ADVANCED APPROVAL BY THE PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES, TWCCH AND TWCGME JOINTLY OPERATIONALIZED SPECIALTY-ENRICHED PRIMARY CARE CLINICS WITHIN TWCCH'S FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS, EXPANDING ACCESS TO PODIATRY, GASTROENTEROLOGY, AND CARDIOVASCULAR DISEASE SERVICES WHILE SIMULTANEOUSLY ENHANCING THE EDUCATIONAL EXPERIENCE OF TWCGME PRIMARY CARE RESIDENTS AND SPECIALTY FELLOWS. THESE CLINICS FUNCTION AS LONGITUDINAL AMBULATORY LEARNING ENVIRONMENTS WHERE TRAINEES ADDRESS UNMET POPULATION HEALTH NEEDS, INCLUDING COMPLEX, DIFFICULT-TO-CONTROL CHRONIC CONDITIONS, THROUGH REAL-TIME COLLABORATION WITH INTERPROFESSIONAL CARE TEAMS. FOR TWCGME, THIS MODEL DIRECTLY ADVANCES ACCREDITATION-ALIGNED EDUCATIONAL OUTCOMES BY INTEGRATING SPECIALTY AND PRIMARY CARE TRAINING WITHIN PATIENT-CENTERED MEDICAL HOMES, STRENGTHENING COMMUNICATION, CLOSING REFERRAL LOOPS, AND REINFORCING SHARED ACCOUNTABILITY FOR PATIENT OUTCOMES. SPECIALTY PHYSICIANS ARE TRAINED NOT IN ISOLATION, BUT AS INTEGRAL PARTNERS WITHIN COMMUNITY-EMBEDDED CARE SYSTEMS, PREPARING GRADUATES TO PRACTICE EFFECTIVELY WITHIN INTEGRATED, VALUE-BASED, AND POPULATION-FOCUSED MODELS OF CARE. AS THESE SPECIALTY-ENRICHED CLINICAL LEARNING ENVIRONMENTS EXPANDED, TWCGME EMPLOYED DATA-INFORMED PLANNING TO ENSURE THAT TRAINING CAPACITY, WORKFORCE DEVELOPMENT, AND SERVICE GROWTH REMAINED ALIGNED WITH VERIFIED REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT AND PATIENT POPULATION PRIORITIES. ONGOING EXPLORATION OF ADDITIONAL SPECIALTY-ENRICHED TRAINING OPPORTUNITIES, INCLUDING NEUROLOGY, OB/GYN, HEMATOLOGY/ONCOLOGY, DERMATOLOGY, ENDOCRINOLOGY, AND EXPANDED PODIATRY SERVICES, REFLECTS TWCGME'S ONGOING COMMITMENT TO PREPARING PHYSICIANS FOR INTERDISCIPLINARY, WHOLE-PERSON CARE DELIVERY WITHIN COMMUNITY-GOVERNED SYSTEMS. TO OPERATIONALIZE THESE SPECIALTY-ENRICHED TRAINING MODELS AT SCALE, TWCGME'S CLINICAL TRAINING CAPACITY WAS FURTHER STRENGTHENED DURING THE COVERED PERIOD THROUGH THE MISSION-DRIVEN EXPANSION OF TWCCH'S NETWORK OF FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTERS ACROSS NORTHEAST PENNSYLVANIA. THESE COMMUNITY-ANCHORED PRIMARY CARE SITES SERVE AS THE PRIMARY LONGITUDINAL AMBULATORY LEARNING ENVIRONMENTS FOR TWCGME'S RESIDENTS, FELLOWS, AND INTERPROFESSIONAL LEARNERS, PROVIDING ADDITIONAL TRAINING GROUNDS ACROSS RURAL, URBAN, AND MEDICALLY UNDERSERVED COMMUNITIES. NEW AND EXPANDED TEACHING COMMUNITY HEALTH CENTERS IN TUNKHANNOCK IN WYOMING COUNTY, NORTH SCRANTON AND JERMYN, BOTH IN LACKAWANNA COUNTY, AND WILKES-BARRE IN LUZERNE COUNTY, INCREASED ACCESS TO WHOLE-PERSON PRIMARY AND PREVENTIVE SERVICES WHILE SIMULTANEOUSLY EXPANDING EXPERIENTIAL TRAINING OPPORTUNITIES IN INTEGRATED PRIMARY CARE, MENTAL AND BEHAVIORAL HEALTH, SUBSTANCE USE DISORDER TREATMENT, GERIATRICS, SPECIALTY-ENRICHED CARE, AND POPULATION HEALTH-FOCUSED SERVICE DELIVERY. TO SUSTAIN AND RESPONSIBLY SCALE THESE INTEGRATED CLINICAL AND EDUCATIONAL PLATFORMS, TWCCH PURSUED DISCIPLINED, MISSION-ALIGNED CAPITAL STRATEGIES AND PUBLIC-SECTOR INVESTMENT SUPPORT DURING THE COVERED PERIOD. |
| Form 990, Part III, Line 2 NEW PROGRAM SERVICES CONTINUED |
TWCCH WAS AWARDED A SECOND REDEVELOPMENT ASSISTANCE CAPITAL PROGRAM (RACP) GRANT FROM THE OFFICE OF THE GOVERNOR OF PENNSYLVANIA DURING THIS COVERED PERIOD FOR ITS IMPORTANT GME-SNC EXPANSION PROJECT AT ITS FQHC LOOK-ALIKE WILKES-BARRE TEACHING COMMUNITY HEALTH CENTER. TWCCH ALSO PRESENTED THIS NEW MARKETS TAX CREDIT (NMTC) PROJECT FOR A BUILDING ADDITION TO MULTIPLE COMMUNITY DEVELOPMENT ENTITIES (CDES). SINCE THEN, SEVERAL HAVE GAUGED INTEREST, INCLUDING, IN SEPTEMBER 2025, A LETTER OF INTENT (LOI) FROM THE REINVESTMENT FUND TO ASSIST WITH THE COMPLETION OF THE RENOVATION PROJECT. AFTER TWCCH'S BOARD OF DIRECTORS APPROVED THAT LOI, THE NMTC CLOSING TOOK PLACE ON DECEMBER 10, 2025, AND FUNDING TO COMPLETE THE CONSTRUCTION PROJECT WAS PLACED IN A RESERVE ACCOUNT. THE PROJECT IS SCHEDULED FOR COMPLETION BY APRIL 2026. NOTABLY, TWCCH INVESTED APPROXIMATELY $600,000 TO $700,000 IN PREVAILING WAGES FOR CONSTRUCTION WORK AT ITS WILKES-BARRE LOCATION, DELIBERATELY DIRECTING RESOURCES TOWARD THE REGIONAL UNION WORKFORCE RATHER THAN RETAINING THEM INTERNALLY, CONSISTENT WITH THE ORGANIZATION'S BROADER PHILOSOPHY OF STEWARDING GROWTH THAT PRIORITIZES COMMUNITY PROSPERITY ALONGSIDE ORGANIZATIONAL SUSTAINABILITY. ADDITIONALLY, IN SEPTEMBER 2025, TWCCH SUBMITTED A SECOND RACP GRANT APPLICATION FOR ITS FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER IN JERMYN, PENNSYLVANIA, AND ALSO A RACP APPLICATION FOR THE PLANNED EXPANSION PROJECT AT ITS FQHC LOOK-ALIKE TEACHING COMMUNITY HEALTH CENTER IN NORTH SCRANTON, PENNSYLVANIA. THESE CAPITAL INVESTMENTS OCCURRED AMID RISING REGIONAL INSTABILITY IN HOSPITAL-BASED TRAINING INFRASTRUCTURE, UNDERSCORING THE IMPORTANCE OF ROBUST, COMMUNITY-LED AMBULATORY LEARNING ENVIRONMENTS. BEGINNING IN FISCAL YEAR 2023-2024, THE CLINICAL LEARNING ENVIRONMENTS FOR GRADUATE MEDICAL EDUCATION IN NORTHEASTERN PENNSYLVANIA BECAME INCREASINGLY UNSTABLE AFTER A MAJOR REGIONAL HOSPITAL PARTNER, COMMONWEALTH HEALTH SYSTEMS, ANNOUNCED THAT ITS REMAINING HOSPITAL SITES WERE BEING MARKETED FOR SALE. OF PARTICULAR RELEVANCE TO TWCGME'S CLINICAL TRAINING INFRASTRUCTURE WERE REGIONAL HOSPITAL OF SCRANTON, MOSES TAYLOR HOSPITAL, AND WILKES-BARRE GENERAL HOSPITAL, ALL OF WHICH SUPPORT ESSENTIAL INPATIENT SERVICES, SPECIALTY ROTATIONS, AND ACCREDITATION-REQUIRED LEARNING EXPERIENCES FOR RESIDENT AND FELLOW PHYSICIANS. THE PROPOSED SALE OF THESE FACILITIES DID NOT CLOSE AND WAS FORMALLY ABANDONED IN NOVEMBER 2024, RESULTING IN PROLONGED REGULATORY AND OPERATIONAL UNCERTAINTY THROUGHOUT THE COVERED PERIOD. THIS UNCERTAINTY MATERIALLY AFFECTED WORKFORCE MORALE, CLINICAL TRAINING STABILITY, AND LONG-TERM EDUCATIONAL PLANNING FOR SAFETY-NET PROVIDERS AND GRADUATE MEDICAL EDUCATION PARTNERS ACROSS THE REGION, INCREASING THE RISK TO CONTINUITY OF CARE AND TO ACCREDITATION-DEPENDENT TRAINING ENVIRONMENTS. DURING THIS PERIOD OF INSTABILITY, TWCGME ASSUMED A STABILIZING ROLE CONSISTENT WITH ITS RESPONSIBILITY AS THE ANCHOR OF THE GME-SNC, MOBILIZING $500,000 IN ORGANIZATIONAL RESERVES WITH GOVERNING BOARD APPROVAL AS PART OF A MULTI-PARTNER COMMUNITY EFFORT TO HELP PRESERVE ACCESS TO CRITICAL HOSPITAL-BASED SERVICES DURING MOMENTS WHEN CLOSURE RISKS APPEARED IMMINENT. THESE ACTIONS, UNDERTAKEN IN COLLABORATION WITH PHILANTHROPIC, CIVIC, LABOR, AND NONPROFIT PARTNERS, REFLECTED DISCIPLINED, VALUES-BASED STEWARDSHIP RATHER THAN ANY EXPANSION OF HOSPITAL OWNERSHIP, MANAGEMENT, OR OPERATIONAL CONTROL. SUBSEQUENTLY, THE $500,000 WAS REPLETED THROUGH SHARED SAVINGS GENERATED BY THE ORGANIZATION'S ACCOUNTABLE CARE ORGANIZATION (ACO) PARTICIPATION AND RESTORED TO ITS LONG-TERM INVESTMENT ACCOUNT WITH MORGAN STANLEY, MAINTAINING FISCAL DISCIPLINE AND BALANCE SHEET INTEGRITY. ORGANIZATIONAL LEADERSHIP ENGAGEMENT DURING THIS PERIOD ALSO SUPPORTED TWCGME'S EDUCATIONAL MISSION BY PRESERVING THE CLINICAL LEARNING ENVIRONMENTS NECESSARY FOR RESIDENT AND FELLOW TRAINING, MITIGATING DISRUPTIONS TO REQUIRED INPATIENT AND SPECIALTY ROTATIONS, AND SUSTAINING WORKFORCE CONTINUITY AMID HEIGHTENED UNCERTAINTY. THESE COLLECTIVE EFFORTS CONTRIBUTED TO THE EMERGENCE OF COMMUNITY HEALTH HUB LLC, A SCRANTON-BASED 501(C)(3) NONPROFIT ORGANIZATION COMMITTED TO ADVANCING A MORE TRANSPARENT, RESILIENT, AND COMMUNITY-GOVERNED REGIONAL HEALTH SYSTEM, WITH PARTICIPATION BY BOTH TWCCH AND TWCGME. ALTHOUGH THE DEFINITIVE PURCHASE OF COMMONWEALTH HEALTH'S SCRANTON AND WILKES-BARRE HOSPITALS BY TENOR HEALTH FOUNDATION CLOSED ON FEB. 1, 2026, THE PROLONGED SALE PROCESS AND ASSOCIATED UNCERTAINTY MATERIALLY INFLUENCED THE OPERATING ENVIRONMENT DURING THE COVERED PERIOD, COMPLICATING ACCREDITATION PLANNING, WORKFORCE STABILITY, AND EDUCATIONAL CONTINUITY FOR TWCGME. |
| Form 990, Part III, Line 2 NEW PROGRAM SERVICES CONTINUED |
THROUGHOUT THIS PERIOD, TWCGME REMAINED CLOSELY ALIGNED WITH COMMUNITY-STABILIZATION EFFORTS, RECOGNIZING THAT SAFEGUARDING ACCESS TO INPATIENT SERVICES AND PRESERVING CLINICAL TRAINING INFRASTRUCTURE WERE ESSENTIAL TO SUSTAINING GRADUATE MEDICAL EDUCATION, LEARNER WELL-BEING, AND LONG-TERM WORKFORCE RENEWAL IN MEDICALLY UNDERSERVED COMMUNITIES. IN PARALLEL, GRANT-SUPPORTED WORKFORCE DEVELOPMENT INITIATIVES EXPANDED ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES ACROSS THE REGION, INCLUDING TRAINING FOR MENTAL HEALTH CERTIFIED PEER SPECIALISTS AND SUPERVISORS. TWCGME AND TWCCH ALSO STRENGTHENED DISABILITY-ACCESS PARTNERSHIPS AND INFRASTRUCTURE IN COLLABORATION WITH COMMUNITY ORGANIZATIONS, SUPPORTED THROUGH TARGETED GRANT INVESTMENTS TO IMPROVE ACCESSIBILITY WITHIN COMMUNITY-BASED CLINICAL LEARNING ENVIRONMENTS. IN JULY 2024, TWCGME ALSO SUPPORTED THE LAUNCH OF THE NORTHEAST PENNSYLVANIA CLINICAL EDUCATION CONSORTIUM (NEPCEC), A COMMUNITY-BASED CLINICAL EDUCATION PARTNERSHIP CONVENED WITH REGIONAL STAKEHOLDERS TO EXPAND HIGH-QUALITY OSTEOPATHIC MEDICAL STUDENT CLINICAL ROTATION CAPACITY IN NORTHEASTERN PENNSYLVANIA AND STRENGTHEN THE LONG-TERM ALIGNMENT OF THE WORKFORCE PIPELINE WITH COMMUNITY-BASED GRADUATE MEDICAL EDUCATION AND PRIMARY CARE PRACTICE. NEPCEC GREW THROUGH THE YEAR AND TWC'S ENGAGEMENT EXPANDED IN JULY 2025 TO BECOME A PRIMARY LEARNING ENVIRONMENT FOR SEVERAL OF THE STUDENTS EACH BLOCK FOR PRIMARY CARE ROTATIONS. |
| Form 990, Part III, Line 4c PROGRAM SERVICE DESCRIPTION |
HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) - TEACHING HEALTH CENTER PLANNING AND DEVELOPMENT: PEDIATRIC MEDICINE (TOTAL: $198,500) PURPOSE OF ASSISTANCE: THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AWARDED FUNDING TO THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) THROUGH THE TEACHING HEALTH CENTER PLANNING AND DEVELOPMENT PROGRAM (THC-PD) TO ESTABLISH A NEW COMMUNITY-BASED RESIDENCY PROGRAM ELIGIBLE TO BE ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) AND AFFILIATED WITH THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH). GRANT FUNDS WILL SUPPORT THE DEVELOPMENT OF A NEW COMMUNITY-BASED PEDIATRIC RESIDENCY PROGRAM IN A REGION WHERE ACCESS TO PRIMARY CARE, PEDIATRIC SERVICES, AND RELATED WORKFORCE TRAINING PROGRAMS IS LIMITED. THIS INITIATIVE ALIGNS WITH THE ORGANIZATION'S MISSION TO IMPROVE THE HEALTH AND WELFARE OF OUR COMMUNITIES THROUGH RESPONSIVE, WHOLE-PERSON HEALTH SERVICES FOR ALL AND THE SUSTAINABLE RENEWAL OF AN INSPIRED, COMPETENT WORKFORCE THAT IS PRIVILEGED TO SERVE. CHILDREN LIVING WITHIN THE SERVICE AREA REPRESENT A UNIQUELY VULNERABLE POPULATION, FACING SIGNIFICANT HEALTH, GEOGRAPHIC, ECONOMIC, AND HEALTH-RELATED SOCIAL NEEDS THAT CONTRIBUTE TO BARRIERS IN ACCESS TO CARE AND HEALTH OUTCOMES. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) - RURAL RESIDENCY PLANNING AND DEVELOPMENT: FAMILY MEDICINE (TOTAL: $362,068) PURPOSE OF ASSISTANCE: THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA), IN COLLABORATION WITH THE FEDERAL OFFICE OF RURAL HEALTH POLICY (FORHP), AWARDED FUNDING TO THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) THROUGH THE RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM (RRPD). THE GRANT SUPPORTS THE COLLABORATIVE DEVELOPMENT OF A RURAL FAMILY MEDICINE RESIDENCY PROGRAM IN PARTNERSHIP WITH WAYNE MEMORIAL COMMUNITY HEALTH CENTERS TO ADDRESS THE HEALTH NEEDS OF RESIDENTS IN RURALLY DESIGNATED WAYNE COUNTY, PENNSYLVANIA. WAYNE COUNTY IS ALSO DESIGNATED AS BOTH A MEDICALLY UNDERSERVED AREA (MUA) AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). THE POPULATION FACES SIGNIFICANT HEALTH CHALLENGES, INCLUDING HIGH RATES OF OBESITY AND ASSOCIATED CARDIOVASCULAR AND OTHER CHRONIC COMORBIDITIES, PHYSICAL INACTIVITY, MENTAL AND BEHAVIORAL HEALTH CONDITIONS, AND SUBSTANCE USE DISORDERS. THE PROPOSED RURAL FAMILY MEDICINE RESIDENCY PROGRAM WILL HELP ADDRESS THESE CONCERNS BY TRAINING PHYSICIANS IN A FULL-SCOPE FAMILY MEDICINE MODEL. RESIDENT PHYSICIANS WILL RECEIVE EDUCATION AND CLINICAL EXPERIENCE IN DELIVERING WHOLE-PERSON PRIMARY AND PREVENTIVE CARE, INCLUDING MEDICAL, DENTAL, AND MENTAL AND BEHAVIORAL HEALTH SERVICES, AS WELL AS SPECIALTY SERVICES SUCH AS HEPATITIS C TREATMENT, RYAN WHITE HIV CARE, INFECTIOUS DISEASE MANAGEMENT, AND SUBSTANCE USE DISORDER TREATMENT, INCLUDING MEDICATION-ASSISTED TREATMENT (MAT). HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) - PRIMARY CARE TRAINING AND ENHANCEMENT - RESIDENCY TRAINING IN MENTAL AND BEHAVIORAL HEALTH (TOTAL: $500,092) PURPOSE OF ASSISTANCE: THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AWARDED FUNDING TO THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) THROUGH THE PRIMARY CARE TRAINING AND ENHANCEMENT GRANT FOR RESIDENCY TRAINING IN MENTAL AND BEHAVIORAL HEALTH. THIS GRANT SUPPORTS THE INTEGRATION OF ENHANCED MENTAL AND BEHAVIORAL HEALTH TRAINING WITHIN PRIMARY CARE RESIDENCY PROGRAMS, WITH A PARTICULAR EMPHASIS ON YOUTH MENTAL HEALTH. THE PROGRAM WILL BE IMPLEMENTED ACROSS NATIONAL FAMILY MEDICINE RESIDENCY (NFMR) TRAINING SITES SERVING UNDERSERVED COMMUNITIES IN WASHINGTON, DC; OHIO; WASHINGTON STATE; AND ARIZONA. THROUGH THIS FUNDING, TWCGME/NFMR WILL ENSURE THE CONSISTENT, HIGH-QUALITY, AND COST-EFFECTIVE DELIVERY OF COMPREHENSIVE TRAINING IN THE DIAGNOSIS AND MANAGEMENT OF MENTAL AND BEHAVIORAL HEALTH CONDITIONS AFFECTING PEDIATRIC, ADOLESCENT, AND YOUNG ADULT POPULATIONS SERVED BY THE FOUR PARTNERING FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). THIS INITIATIVE STRENGTHENS THE CAPACITY OF PRIMARY CARE PHYSICIANS TO ADDRESS THE GROWING MENTAL AND BEHAVIORAL HEALTH NEEDS OF YOUTH IN UNDERSERVED COMMUNITIES WHILE ENHANCING THE OVERALL INTEGRATION OF MENTAL AND BEHAVIORAL HEALTH WITHIN PRIMARY CARE SETTINGS. |
| Form 990, Part III, Line 4c PROGRAM SERVICE DESCRIPTION |
HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) - PRIMARY CARE TRAINING AND ENHANCEMENT - LANGUAGE AND DISABILITY ACCESS (TOTAL: $707,792) PURPOSE OF ASSISTANCE: THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AWARDED FUNDING TO THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) THROUGH THE PRIMARY CARE TRAINING AND ENHANCEMENT GRANT FOR THE LANGUAGE AND DISABILITY ACCESS PROGRAM. THIS GRANT IS DESIGNED TO EXPAND ACCESS TO HIGH-QUALITY PRIMARY CARE SERVICES FOR INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY (LEP) AND INDIVIDUALS WITH PHYSICAL, INTELLECTUAL, AND/OR DEVELOPMENTAL DISABILITIES (PIDD). THROUGH THIS INITIATIVE, TWCGME WILL DEVELOP AND IMPLEMENT SPECIALIZED CURRICULA FOR INTERNAL MEDICINE RESIDENTS, FACULTY, AND PRECEPTORS TO STRENGTHEN PHYSICIAN COMPETENCY IN CARING FOR PATIENTS WITH LEP AND PIDD. THE PROGRAM WILL ALSO PROVIDE TRAINING OPPORTUNITIES FOR CLINICAL STAFF AND SUPPORT FACILITY ENHANCEMENTS IN COMMUNITY-BASED SETTINGS TO IMPROVE ACCESSIBILITY AND BETTER ACCOMMODATE THE NEEDS OF INDIVIDUALS WITH DISABILITIES. BY INTEGRATING EDUCATION, WORKFORCE DEVELOPMENT, AND PRACTICE TRANSFORMATION, THIS PROGRAM ADVANCES PATIENT-CENTERED CARE FOR SOME OF THE MOST VULNERABLE POPULATIONS SERVED. SHEEHAN MEDICAL LLC - TEE SIMULATOR (TOTAL: $15,165) PURPOSE OF ASSISTANCE: A PRIVATE DONOR CONTRIBUTED A TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) SIMULATOR AND RELATED PERIPHERAL EQUIPMENT TO THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION (TWCGME) TO SUPPORT SIMULATED PROCEDURAL TRAINING. THE SIMULATOR WAS USED ONLY ONCE PRIOR TO THE DONATION. TWCGME IS AN ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME)-ACCREDITED SPONSORING INSTITUTION FOR COMMUNITY-EMBEDDED RESIDENCY AND FELLOWSHIP PROGRAMS. THE TEE SIMULATOR AND ACCOMPANYING EQUIPMENT HAVE BEEN INCORPORATED INTO TWCGME'S TRAINING CURRICULUM TO PROVIDE RESIDENTS AND FELLOWS WITH HANDS-ON, SIMULATION-BASED EDUCATION IN TEE PROCEDURES RELEVANT TO THEIR RESPECTIVE SPECIALTIES. |
| Form 990, Part III, Line 2 New program services |
DURING THE COVERED PERIOD, THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION'S (TWCGME) SPONSORING INSTITUTION RECEIVED OFFICIAL NOTIFICATION ON MAY 15, 2025, AND AGAIN ON JANUARY 12, 2026, THAT IT HAD ACHIEVED CONTINUED ACCREDITATION STATUS FROM THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), REFLECTING THE SUSTAINED EFFECTIVENESS OF GOVERNANCE, OVERSIGHT, AND COMPLIANCE ENHANCEMENTS IMPLEMENTED IN PRIOR YEARS. THIS CONTINUED ACCREDITATION PROVIDED THE OPERATIONAL AND GOVERNANCE STABILITY NECESSARY FOR TWCGME TO ADVANCE AND EXPAND, AND TO DEMONSTRATE NATIONALLY ITS TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION SAFETY-NET CONSORTIUM (GME-SNC) MODEL, AS DESCRIBED BELOW. BUILDING ON ITS SPONSORING INSTITUTION ACCREDITATION FOUNDATION, TWCGME'S SCALABLE AND REPLICABLE GME-SNC MODEL WAS ADVANCED, TESTED, AND PROVEN THROUGH THE CREATION AND EVOLUTION OF TWCGME'S PIONEERING NATIONAL FAMILY MEDICINE RESIDENCY (NFMR) PROGRAM. THAT WORK SUCCEEDED THROUGH MORE THAN A DECADE OF COURAGEOUS, VALUES-DRIVEN EFFORT THAT INTENTIONALLY CHALLENGED LONG-STANDING ASSUMPTIONS ABOUT WHERE AND HOW PHYSICIANS SHOULD BE TRAINED, WHO SHOULD GOVERN GRADUATE MEDICAL EDUCATION, AND WHOSE NEEDS SHOULD MATTER MOST IN DESIGNING THE NATION'S HEALTH CARE WORKFORCE. THIS WORK WAS UNDERTAKEN WITH FULL AWARENESS OF THE REGULATORY AND FINANCIAL RISK BORNE BY THE SPONSORING INSTITUTION IN SERVICE OF PUBLIC NEED, AND WITH AN EXPLICIT COMMITMENT TO STEWARD SIGNIFICANT PUBLIC INVESTMENT RESPONSIBLY. ROOTED IN THE TEACHING HEALTH CENTER GME LEGISLATION AND ALIGNED WITH THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)-SUPPORTED COMMUNITY HEALTH ACADEMIC MEDICAL PARTNERSHIPS (CHAMPS) FRAMEWORK, THE GME-SNC WAS CONCEIVED AS AN ACT OF PARTICIPATORY CITIZENSHIP, AN AUDACIOUS COMMITMENT TO PLACE COMMUNITY, ACCOUNTABLE GOVERNANCE, AND PUBLIC STEWARDSHIP AT THE CENTER OF GRADUATE MEDICAL EDUCATION. SINCE ITS INCEPTION IN 2013, THE NFMR HAS SERVED AS THE PRIMARY PROVING GROUND FOR TWCGME'S GME-SNC MODEL, DELIBERATELY MOVING GRADUATE MEDICAL EDUCATION OUT OF ISOLATED ACADEMIC SILOS AND INTO THE LIVED REALITIES OF COMMUNITIES FACING PERSISTENT PRIMARY CARE SHORTAGES, PHYSICIAN MALDISTRIBUTION, AND SIGNIFICANT ACCESS-TO-CARE BARRIERS. THROUGH THIS MODEL, TWCGME SERVES AS AN ACGME-ACCREDITED SPONSORING INSTITUTION, CONNECTING MISSION-ALIGNED ACADEMIC MEDICAL CENTERS, FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS), FQHC LOOK-ALIKES (FQHC-LALS), AND OTHER ESSENTIAL COMMUNITY PROVIDERS INTO SHARED EDUCATIONAL ECOSYSTEMS THAT HONOR BOTH ACCREDITATION EXCELLENCE AND MORAL ACCOUNTABILITY TO PATIENTS, FAMILIES, AND COMMUNITIES. IN DOING SO, TWCGME ASSUMED SPONSORING INSTITUTION-LEVEL RESPONSIBILITY FOR GOVERNANCE, AUDIT, COMPLIANCE, AND FINANCIAL RISK ACROSS GEOGRAPHICALLY DISTRIBUTED TRAINING ENVIRONMENTS, CONSISTENTLY MEETING FEDERAL REPORTING AND ACCOUNTABILITY EXPECTATIONS THAT ARE AS RIGOROUS AS THOSE OF A SINGLE-SYSTEM SPONSORING INSTITUTION. DURING THE COVERED PERIOD, TWCGME'S INTERNAL MEDICINE AND FAMILY MEDICINE RESIDENCY PROGRAMS, AS WELL AS ITS GERIATRIC FELLOWSHIP, WERE WHOLLY OR PARTIALLY FUNDED THROUGH THE HEALTH RESOURCES AND SERVICES ADMINISTRATION'S (HRSA) TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION (THCGME) PROGRAM. THESE HRSA-FUNDED PROGRAMS INTENTIONALLY IMMERSE PHYSICIAN LEARNERS IN FQHC AND FQHC-LAL SETTINGS AS THEIR ESSENTIAL COMMUNITY PROVIDER AMBULATORY LEARNING ENVIRONMENTS, NOT AS PERIPHERAL TRAINING SITES, BUT AS THE RIGHTFUL CENTER OF PRIMARY CARE EDUCATION. THROUGH THIS APPROACH, TWCGME STEWARDED SUBSTANTIAL FEDERAL INVESTMENT IN PHYSICIAN WORKFORCE DEVELOPMENT, TRANSLATING PUBLIC DOLLARS INTO MEASURABLE TRAINING CAPACITY, RETENTION, AND ACCESS FOR UNDERSERVED COMMUNITIES. IN DOING SO, THE GME-SNC MODEL, FIRST OPERATIONALIZED THROUGH THE NFMR, AFFIRMS THE DEEPLY HELD BELIEF THAT THE COMMUNITIES BEARING THE GREATEST HEALTH BURDENS DESERVE TO BE THE VERY PLACES WHERE THE FUTURE PHYSICIAN WORKFORCE IS FORMED. FOR THE JULY 1, 2025, ACADEMIC YEAR, TWCGME'S CARDIOVASCULAR DISEASE, GERIATRICS, AND GASTROENTEROLOGY FELLOWSHIP PROGRAMS COLLECTIVELY RECEIVED 1,178 APPLICATIONS FOR SEVEN AVAILABLE TRAINING POSITIONS, REFLECTING STRONG NATIONAL DEMAND FOR COMMUNITY-BASED, PRIMARY CARE-ANCHORED SUBSPECIALTY TRAINING THROUGH THE SPONSORING INSTITUTION'S GME-SNC FRAMEWORK. THIS LEVEL OF DEMAND WAS SIMILARLY EVIDENT ACROSS RESIDENCY PROGRAMS, WITH TWCGME RECEIVING 5,835 APPLICATIONS AND SUCCESSFULLY MATCHING 56 NEW RESIDENT PHYSICIANS THROUGH THE NATIONAL RESIDENCY MATCHING PROGRAM FOR PROGRAMS COMMENCING JULY 1, 2025. |
| Form 990, Part III, Line 4d Description of other program services |
(Expenses $ 1,762,728 including grants of $ 1,633,926)(Revenue $ 9,436,716) OTHER - COMMON PAYMASTER: IN ACCORDANCE WITH IRS REGULATIONS, TWCGME ACTS AS THE COMMON PAYMASTER FOR ITS PRIMARY AFFILIATE, THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH), A FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKE. TO OPERATIONALIZE THIS COMMON PAYMASTER FUNCTION, TWCGME AND TWCCH HAVE ESTABLISHED SHARED MISSION-DRIVEN COVENANTS AND STAFFING LEASE AGREEMENTS TO PROVIDE VARIOUS SERVICES. TWCCH COMPENSATED TWCGME THROUGH INTERCOMPANY ALLOCATION METHODOLOGIES FOR THESE SERVICES, INCLUDING CLINICAL, EXECUTIVE, ADMINISTRATIVE, AND BACK-OFFICE SUPPORT, COVERING HUMAN RESOURCES, INFORMATION TECHNOLOGY, MARKETING AND COMMUNICATIONS, FINANCE, BILLING, GRANTS, GOVERNANCE SUPPORT, GOVERNMENT RELATIONS, LEGAL, AND OTHER RELATED SERVICES. THE REVENUE RECORDED FOR THESE SUPPORT SERVICES, AS PERFORMED BY TWCGME ON BEHALF OF TWCCH, IS REPRESENTED ON LINE 2B OF THE STATEMENT OF REVENUE ($7,663,328). IN OPERATIONALIZING THE COMMON PAYMASTER FUNCTIONALITY, TWCGME HAS ENTERED INTO STAFFING LEASE AGREEMENTS WITH TWCCH FOR THE PROVISION OF CERTAIN ADMINISTRATIVE AND EXECUTIVE SERVICES. THIS CONSOLIDATED PAYROLL SYSTEM COVERS ALL EMPLOYEES EXCEPT FOR TWCCH'S PRESIDENT AND CHIEF EXECUTIVE OFFICER, CHIEF STRATEGY AND OPERATIONS OFFICER, CHIEF MEDICAL OFFICER, AND CHIEF CLINICAL OPERATING OFFICER, WHO ARE DIRECTLY EMPLOYED BY TWCCH. THE SERVICES OF TWCCH'S CHIEF EXECUTIVE AND SVP AND ENTERPRISE CHIEF OPERATIONS AND STRATEGY OFFICER ARE CONTRACTED FOR SERVICES AS KEY EMPLOYEES/EXECUTIVES OF TWCGME IN THE POSITIONS OF PRESIDENT AND CEO AND SVP AND ENTERPRISE CHIEF OPERATIONS AND STRATEGY OFFICER, RESPECTIVELY. TWCGME REPORTS ALL REMAINING EMPLOYEES ON ITS FORM W-3. THEREFORE, ALL FULL-TIME EQUIVALENTS (FTES) ARE ACCURATELY ALLOCATED TO EACH RESPECTIVE ENTITY, AVOIDING DUPLICATION, UNDER A SHARED MISSION COVENANT AND RELATED STAFFING LEASE AGREEMENTS. TWCCH REIMBURSED TWCGME FOR THESE SERVICES THROUGH WELL-VALIDATED FTE-BASED INTERCOMPANY ALLOCATION METHODOLOGIES. THROUGH THESE SHARED MISSION-DRIVEN STAFFING LEASE AGREEMENTS, TWCCH LEASES CLINICAL STAFF, MANAGEMENT SERVICES, AND BACK-OFFICE SUPPORT SERVICES FROM TWCGME, INCLUDING, BUT NOT LIMITED TO, HUMAN RESOURCES, INFORMATION TECHNOLOGY, MARKETING AND COMMUNICATIONS, FINANCE, GRANTS, GOVERNANCE SUPPORT, GOVERNMENTAL RELATIONS, LEGAL, AND OTHER ADMINISTRATIVE SUPPORT SERVICES. THE COSTS ASSOCIATED WITH THIS REVENUE, IN ADDITION TO COSTS SUPPORTING TWCGME MANAGEMENT AND GENERAL EXPENSES, ARE RECORDED AS MANAGEMENT AND GENERAL EXPENSES ON TWCGME'S FORM 990, SECTION IX (STATEMENT OF FUNCTIONAL EXPENSES), COLUMN C. OTHER - OFFICE OF RESEARCH SUPPORT AND COMPLIANCE: TWCGME FACILITATES OPPORTUNITIES FOR TRAINEES, STAFF, AND FACULTY TO PARTICIPATE IN COMMUNITY-ORIENTED PRIMARY CARE SCHOLARLY ACTIVITY AND RESEARCH, CONTINGENT UPON FUNDING AVAILABILITY. DURING THE COVERED PERIOD, TWO STAFF MEMBERS SUPPORTED THIS DEPARTMENT, COLLABORATING WITH ONE RESIDENT PHYSICIAN PROGRAM CHIEF AND TWO RESIDENT PHYSICIAN LEADERS TO ADVANCE SCHOLARLY ACTIVITY, WHICH IS SUBSEQUENTLY REPORTED TO THE ACGME TO FULFILL TRAINING PROGRAM AND SPONSORING INSTITUTIONAL ACCREDITATION REQUIREMENTS. FURTHERMORE, TWCGME OPERATES AN INSTITUTIONAL REVIEW BOARD (IRB). THE IRB'S MISSION IS TO SAFEGUARD THE RIGHTS, WELFARE, AND INFORMED PARTICIPATION OF HUMAN SUBJECTS INVOLVED IN RESEARCH CONDUCTED WITHIN TWCGME EDUCATIONAL OR TWCCH CLINICAL LEARNING ENVIRONMENTS, PARTNER ORGANIZATIONS' CLINICAL SETTINGS, OR BY TWCGME RESIDENTS, FELLOWS, AND FACULTY IN THE COMMUNITIES SERVED. THE IRB COMPRISES PHYSICIANS, EDUCATORS, ACADEMIC AND CLINICAL RESEARCH EXPERTS, AND COMMUNITY MEMBERS. |
| Form 990, Part IV, Line 28c BUSINESS TRANSACTIONS |
IN NOVEMBER 2017, TWCGME AND ITS AFFILIATED ORGANIZATION, TWCCH, EXECUTED A LEASE AGREEMENT WITH WYOMING AVENUE DEVELOPMENT, LLC TO DEVELOP AND RENT A 36,500 SQ. FT. FLAGSHIP CLINICAL, EDUCATIONAL, AND ADMINISTRATIVE HUB AT 501 SOUTH WASHINGTON AVENUE, SCRANTON, PENNSYLVANIA, A CITY THEN DESIGNATED AS FINANCIALLY DISTRESSED UNDER PENNSYLVANIA'S ACT 47. MR. JOSEPH FERRARIO WAS THE CHAIR OF TWCGME'S BOARD OF DIRECTORS AND SERVED AS A VOLUNTEER DIRECTOR ON TWCGME'S AFFILIATED ENTITIES, INCLUDING BUT NOT LIMITED TO TWCCH. ON JULY 12, 2019, MR. FERRARIO RESIGNED FROM TWCGME'S BOARD OF DIRECTORS AND FROM ALL BOARDS OF DIRECTORS OF ITS AFFILIATED ORGANIZATIONS. AT THE TIME THE LEASE TRANSACTION WAS CONSUMMATED, MR. FERRARIO OWNED MORE THAN 35% OF WYOMING AVENUE DEVELOPMENT, LLC. MR. FERRARIO'S CONFLICT OF INTEREST WAS FULLY DISCLOSED AND COMMUNICATED, ETHICALLY ASSESSED, AND APPROVED BY THE BOARD OF DIRECTORS OF TWCGME AND TWCCH BEFORE ENTERING INTO THE TRANSACTION. THE CONFLICT OF INTEREST POLICY DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 12C WAS FOLLOWED, AND A LEGAL ETHICS OPINION APPROVING AND OFFERING BEST PRACTICES FOR ADDRESSING AND MANAGING A CONFLICT OF INTEREST ON A NONPROFIT BOARD WAS OBTAINED FROM OUTSIDE LEGAL COUNSEL; ALL GUIDANCE WAS FOLLOWED. ON JULY 25, 2019, THE 15-YEAR LEASE AGREEMENT WAS AMENDED TO COMPLY WITH THE FEDERAL NEW MARKETS TAX CREDIT PROGRAM REQUIREMENTS, AND TWCGME BECAME THE SOLE LESSEE OF THE LEASED SPACE. TWCGME SUBLEASES SPACE TO TWCCH AT 501 SOUTH WASHINGTON AVENUE, SCRANTON, PENNSYLVANIA, FOR FQHC LOOK-ALIKE PRIMARY HEALTH SERVICES AND ADMINISTRATIVE OPERATIONS. THE LEASE WENT INTO EFFECT ON NOVEMBER 26, 2019, CLARIFYING THAT TWCGME WAS THE PRIMARY LESSEE OF 41,990 SQ. FT. OF SPACE, UTILIZING ADDITIONAL SPACE ON THE SECOND FLOOR FOR EDUCATIONAL AND OTHER ACTIVITIES. RENOVATIONS TO THE DEMISED PREMISES ON THE FIRST AND SECOND FLOORS OF THE BUILDING WERE COMPLETED BETWEEN EARLY 2018 AND DECEMBER 2019, WITH THE AMENDED AND RESTATED LEASE AGREEMENT FOR THE FIRST FLOOR COMMENCING ON NOVEMBER 26, 2019. |
| Form 990, Part V, Line 2a COMMON PAYMASTER |
TWCGME IS AFFILIATED WITH TWCCH (EIN: 23-2772504), WHICH SHARES A MISSION TO IMPROVE THE HEALTH AND WELFARE OF OUR COMMUNITIES THROUGH RESPONSIVE, WHOLE-PERSON HEALTH SERVICES FOR ALL AND THE SUSTAINABLE RENEWAL OF AN INSPIRED, COMPETENT WORKFORCE THAT IS PRIVILEGED TO SERVE. TO STREAMLINE OPERATIONAL EFFICIENCY, TWCGME SERVES AS THE COMMON PAYMASTER FOR BOTH TWCGME AND TWCCH, ADHERING TO IRS W-2 REPORTING REGULATIONS. THIS CONSOLIDATED PAYROLL SYSTEM COVERS ALL EMPLOYEES EXCEPT FOR TWCCH'S PRESIDENT AND CEO, CHIEF STRATEGY AND OPERATIONS OFFICER, CHIEF MEDICAL OFFICER, AND CHIEF CLINICAL OPERATING OFFICER, WHO ARE DIRECTLY EMPLOYED BY TWCCH. THE SERVICES OF TWCCH'S CHIEF EXECUTIVE AND CHIEF STRATEGY AND OPERATIONS OFFICER ARE CONTRACTED FOR SERVICES AS KEY EMPLOYEES/EXECUTIVES OF TWCGME IN THE POSITIONS OF PRESIDENT AND CEO AND SVP AND ENTERPRISE CHIEF OPERATIONS AND STRATEGY OFFICER, RESPECTIVELY. TWCGME REPORTS ALL REMAINING EMPLOYEES ON ITS FORM W-3. THEREFORE, ALL FULL-TIME EQUIVALENTS (FTES) ARE ACCURATELY ALLOCATED TO EACH RESPECTIVE ENTITY, AVOIDING DUPLICATION, UNDER A SHARED MISSION COVENANT AND RELATED STAFFING LEASE AGREEMENTS. |
| Form 990, Part VI, Line 6 ORGANIZATION MEMBERS |
NO. ALTHOUGH PREVIOUSLY, TWCGME WAS ORGANIZED AS A MEMBER NONPROFIT CORPORATION, ON FEBRUARY 10, 2023, DURING A DULY CALLED AND HELD MEMBER MEETING, TWCGME'S MEMBERSHIP VOTED AFFIRMATIVELY TO ABOLISH THE MEMBERSHIP ALTOGETHER, GIVEN THE DUPLICATIVE NATURE OF MEMBER REPRESENTATIVES BEING THE SAME PERSONS AS THOSE SERVING ON THE GOVERNING BODY, I.E., THE BOARD OF DIRECTORS. TWCGME'S BOARD OF DIRECTORS VOTED AFFIRMATIVELY TO AMEND THE BYLAWS AND REFLECT THE ORGANIZATIONAL CHANGE OF ABOLISHING CORPORATE MEMBERSHIP, AND TO AMEND AND RESTATE TWCGME'S ARTICLES OF INCORPORATION APPROPRIATELY. |
| Form 990, Part VI, Line 7a MEMBER POWERS |
NO. ALTHOUGH TWCGME WAS PREVIOUSLY ORGANIZED AS A MEMBER NONPROFIT CORPORATION, ON FEBRUARY 10, 2023, DURING A DULY CALLED AND HELD MEMBER MEETING, TWCGME'S MEMBERSHIP VOTED AFFIRMATIVELY AND UNANIMOUSLY TO ABOLISH THE MEMBERSHIP STRUCTURE, GIVEN THE DUPLICATIVE NATURE OF MEMBER REPRESENTATIVES BEING THE SAME PERSONS AS THOSE SERVING ON THE GOVERNING BOARD OF DIRECTORS. TWCGME'S BOARD OF DIRECTORS VOTED AFFIRMATIVELY AND UNANIMOUSLY TO AMEND THE NONPROFIT CORPORATION'S BYLAWS TO REFLECT THE ORGANIZATIONAL CHANGE OF ABOLISHING CORPORATE MEMBERSHIP AND TO AMEND AND RESTATE TWCGME'S ARTICLES OF INCORPORATION APPROPRIATELY. PRIOR TO FISCAL YEAR 2023-2024, SOME CORPORATE MEMBERS HAD THE RIGHT TO APPOINT MEMBERS OF THE BOARD OF DIRECTORS. THE PREVIOUS CORPORATE MEMBERSHIP STRUCTURE PROVIDED THAT CLASS I MEMBERS WHO, THROUGH AFFILIATION, COMPENSATED TWCGME'S SPONSORING INSTITUTIONAL CONSORTIUM FOR AT LEAST TEN RESIDENT AND/OR FELLOW PHYSICIAN FTES IN GME TRAINING HAD THE RIGHT TO APPOINT ONE CLASS II-A DIRECTOR TO TWCGME'S BOARD. ADDITIONALLY, CLASS I MEMBERS WHO, THROUGH AFFILIATION, COMPENSATED TWCGME'S SPONSORING INSTITUTIONAL CONSORTIUM FOR AT LEAST 25 RESIDENT AND/OR FELLOW PHYSICIAN FTES IN GME TRAINING HAD THE RIGHT TO APPOINT TWO CLASS II-A DIRECTORS TO TWCGME'S BOARD OF DIRECTORS. AT THAT TIME, PER TWCGME BYLAWS, NO CLASS I MEMBER WAS PERMITTED TO APPOINT MORE THAN TWO VOTING DIRECTORS ON TWCGME'S BOARD, AND NO CLASS I MEMBER WAS PERMITTED TO APPOINT DIRECTORS TO ANY CLASS OTHER THAN CLASS II-A. |
| Form 990, Part VI, Line 12a 12B, & 12C - CONFLICT OF INTEREST POLICY |
A WRITTEN CONFLICT OF INTEREST POLICY, CREATED AND RECOMMENDED BY THE SVP FOR ENTERPRISE INTEGRITY, HAS BEEN APPROVED BY THE PRESIDENT AND CEO AND THE BOARD OF DIRECTORS. THE SVP OF ENTERPRISE INTEGRITY AND THE CHIEF COMPLIANCE OFFICER WORK TOGETHER TO ENSURE IT IS REVIEWED, UPDATED AS NEEDED, AND RENEWED ANNUALLY OR MORE FREQUENTLY AS APPROPRIATE. THE SVP FOR ENTERPRISE INTEGRITY, ALONG WITH THE GOVERNANCE AND CHIEF COMPLIANCE OFFICERS, ENSURES THAT THE CONFLICT OF INTEREST DISCLOSURE FORM IS COMPLETED ANNUALLY BY ALL GOVERNING BOARD MEMBERS ("DIRECTORS") AND OFFICERS. TOGETHER, THIS TEAM AND THE VP OF HUMAN RESOURCES ENSURE THAT THE CONFLICT OF INTEREST DISCLOSURE FORM IS COMPLETED ANNUALLY BY EXECUTIVE MANAGEMENT AND ALL STAFF, INCLUDING KEY EMPLOYEES. SHOULD A CONFLICT OF INTEREST OR POTENTIAL CONFLICT ARISE DURING THE YEAR AMONG DIRECTORS AND OFFICERS, THE GOVERNANCE OFFICER AND THE SVP FOR ENTERPRISE INTEGRITY ENSURE THE CONFLICT OF INTEREST DISCLOSURE FORM IS UPDATED TO REFLECT THE POSSIBLE CONFLICT. POTENTIAL CONFLICTS OF DIRECTORS AND OFFICERS, IF ANY, ARE FULLY DISCLOSED, VETTED BY INTERNAL COUNSEL AND THE AUDIT/COMPLIANCE COMMITTEE, AND REVIEWED BY THE BOARD WITH OUTSIDE ETHICS CONSULTATION OBTAINED WHEN APPROPRIATE. EDUCATION ON CONFLICTS OF INTEREST IS PROVIDED TO NEW DIRECTORS AND OFFICERS DURING BOARD ORIENTATION AND TO THE FULL BOARD ANNUALLY DURING THE REVIEW, UPDATE, AND RENEWAL OF THE CONFLICT OF INTEREST POLICY. DIRECTORS OFFICERS' COMPLIANCE WITH THE POLICY IS MONITORED BY THE BOARD'S AUDIT/COMPLIANCE COMMITTEE AND SUPPORTED BY THE GOVERNANCE OFFICER AND THE SVP FOR ENTERPRISE INTEGRITY. EDUCATION ON CONFLICTS OF INTEREST, INCLUDING ANY REVISIONS TO THE CONFLICT OF INTEREST POLICY, IS PROVIDED TO NEW EMPLOYEES DURING ORIENTATION AND ANNUALLY DURING THE PERFORMANCE REVIEW PROCESS. ADHERENCE BY STAFF TO THE CONFLICT OF INTEREST POLICY IS MONITORED BY MANAGERS WITH THE SUPPORTIVE OVERSIGHT OF THE VP OF HUMAN RESOURCES, THE SVP FOR ENTERPRISE INTEGRITY, AND THE CHIEF COMPLIANCE OFFICER. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body |
TWCGME'S FORM 990 IS PREPARED BY THE SENIOR LEADERSHIP TEAM OF THE FINANCE AND ENTERPRISE DEVELOPMENT DEPARTMENTS WITH INPUT FROM THE EXECUTIVE MANAGEMENT TEAM AND PRESIDENT & CEO. AN INDEPENDENT, CONTRACTED CPA FIRM THEN REVIEWS THE DRAFT FORM 990. THE REFINED FORM 990 IS THEN DISTRIBUTED TO THE AUDIT/COMPLIANCE AND EXECUTIVE COMMITTEES OF THE BOARD OF DIRECTORS AND SUBSEQUENTLY TO THE FULL BOARD OF DIRECTORS FOR REVIEW, INPUT, AND APPROVAL FOR FEDERAL FILING. UPON COMPLETION OF THIS REVIEW, NECESSARY REVISIONS, AND APPROVAL, THE FORM 990 IS FINALIZED, SIGNED BY THE ORGANIZATION'S PRESIDENT & CEO, AND FILED WITH THE IRS. TWCGME'S THREE MOST RECENTLY FILED 990S, ALONG WITH THREE SEQUENTIAL ANNUAL REPORTS, ARE TRANSPARENTLY AVAILABLE ON OUR WEBSITE IN A DOWNLOADABLE FORMAT AND ARE KEPT IN A SECURE LOCATION AT EACH REQUIRED OPERATIONAL SITE, WHERE THEY MAY BE REVIEWED IN HARD COPY UPON REQUEST, CONSISTENT WITH IRS APPLICABLE LAWS, RULES, AND REGULATIONS. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official |
TWCGME CONTRACTS WITH ITS AFFILIATED ENTITY, THE WRIGHT CENTER FOR COMMUNITY HEALTH (TWCCH), FOR THE SERVICES OF TWCGME'S PRESIDENT AND CEO, WHO IS EMPLOYED BY AND SERVES AS PRESIDENT AND CEO OF TWCCH. CONSEQUENTLY, TWCGME DOES NOT DIRECTLY COMPENSATE THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEES OF TWCGME AND TWCCH BOARDS COLLABORATIVELY DETERMINE THE RESPECTIVE CHIEF EXECUTIVE'S COMPENSATION, ENGAGING A THIRD-PARTY EXTERNAL CONSULTANT TO CONDUCT A FORMAL, PERIODIC, OBJECTIVE, COMPREHENSIVE, ORGANIZATION-WIDE COMPENSATION STUDY, GENERALLY EVERY THREE TO FIVE YEARS. DURING CONTRACT NEGOTIATIONS WITH THE PRESIDENT AND CEO, THE RELEVANT COMPONENTS OF THE STUDY ARE APPROPRIATELY AGED AND SUPPLEMENTED BY DATA FROM SOURCES SUCH AS THE AMERICAN JOB CENTER NETWORK, MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA), FORM 990S OF COMPARABLE ORGANIZATIONS, AND COMPENSATION SURVEYS FROM THE PENNSYLVANIA AND NATIONAL ASSOCIATIONS OF COMMUNITY HEALTH CENTERS, AMONG OTHER RELEVANT REGIONAL AND NATIONAL BENCHMARKS. ANNUALLY, THE EXECUTIVE COMMITTEES COLLABORATIVELY CONDUCT A THOROUGH PERFORMANCE EVALUATION OF THE CHIEF EXECUTIVE AND THE RESPECTIVE ORGANIZATIONS, ASSESSING THE APPROPRIATENESS OF SALARY AND BENEFIT ADJUSTMENTS. THESE ADJUSTMENTS, IF MADE BETWEEN CONTRACT TERMS, ARE BENCHMARKED AGAINST PUBLICLY AVAILABLE COMPARABLE DATA. ULTIMATELY, THE CHIEF EXECUTIVE'S COMPENSATION IS DETERMINED BASED ON A ROBUST PERFORMANCE EVALUATION, ORGANIZATIONAL PERFORMANCE, AND CAREFUL CONSIDERATION OF THE INDEPENDENT COMPENSATION STUDY, MARKET COMPARABILITY, AND FINANCIAL FEASIBILITY. THE EXECUTIVE COMMITTEES' DELIBERATIONS AND DECISIONS REGARDING EXECUTIVE COMPENSATION ARE METICULOUSLY DOCUMENTED IN MEETING MINUTES WITHIN 60 DAYS OF THE EVALUATION'S COMPLETION AND THE COMPENSATION DETERMINATION. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees |
THE COMPENSATION OF ALL OTHER EMPLOYEES, INCLUDING KEY EMPLOYEES, IS DETERMINED BY THE CHIEF EXECUTIVE (TWCGME PRESIDENT & CEO) AND THE HUMAN RESOURCES DEPARTMENT, GUIDED BY A FORMAL, PERIODIC, OBJECTIVE, COMPREHENSIVE, ORGANIZATION-WIDE COMPENSATION STUDY, COMPLETED GENERALLY EVERY THREE TO FIVE YEARS. THE VP OF HR AND THE PRESIDENT & CEO MAY ALSO CONSIDER ADDITIONAL DATA IN DETERMINING COMPENSATION LEVELS WITHIN THE ORGANIZATION, SUCH AS INFORMATION FROM THE AMERICAN JOB CENTER NETWORK WEBSITE, MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA), FORM 990S OF COMPARABLE ORGANIZATIONS, AND COMPENSATION SURVEYS OF THE PENNSYLVANIA ASSOCIATION OF COMMUNITY HEALTH CENTERS AND NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, AMONG OTHER REGIONAL AND NATIONAL BENCHMARKS. AS WITH THE SERVICES OF TWCGME'S CHIEF EXECUTIVE, TWCGME ALSO LEASES THE SERVICES OF TWCCH'S CHIEF STRATEGY AND OPERATIONS OFFICER AS A KEY EMPLOYEE/EXECUTIVE FOR TWCGME IN THE POSITION OF SVP AND ENTERPRISE CHIEF OPERATIONS AND STRATEGY OFFICER. THE THIRD-PARTY EXTERNAL COMPENSATION CONSULTANT JOINTLY ENGAGED BY TWCGME AND TWCCH ALSO INCLUDES THIS POSITION, LIKE ALL EXECUTIVE POSITIONS, IN ITS FORMAL, PERIODIC, OBJECTIVE, COMPREHENSIVE, ORGANIZATION-WIDE COMPENSATION STUDY, COMPLETED GENERALLY EVERY THREE TO FIVE YEARS. |
| Form 990, Part VI, Line 19 Required documents available to the public |
TWCGME'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT IN A SECURE LOCATION AND ARE AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE AT 501 SOUTH WASHINGTON AVENUE, SUITE 1000, IN SCRANTON, PENNSYLVANIA, 18505, AND OTHER LOCATIONS AS REQUIRED BY IRS RULES AND REGULATIONS. HARD COPIES ARE PROVIDED UPON REQUEST FOR REVIEW. TWCGME'S THREE MOST RECENTLY FILED FORM 990S, ALONG WITH THREE CONSECUTIVE ANNUAL REPORTS, ARE ALSO AVAILABLE FOR DOWNLOAD ON ITS WEBSITE. |
| Form 990, Part VIII, Line 2b STATEMENT OF REVENUE |
LINE 2B ON THE STATEMENT OF REVENUE REPRESENTS THE REVENUE RECORDED FOR SUPPORT SERVICES THAT TWCGME PERFORMS AS THE COMMON PAYMASTER ON BEHALF OF TWCCH, AN AFFILIATED ORGANIZATION, PURSUANT TO INTERCOMPANY SHARED MISSION COVENANT AND RELATED LEASE AGREEMENTS. TWCGME SERVES AS THE COMMON PAYMASTER FOR TWCCH. IN OPERATIONALIZING THE COMMON PAYMASTER FUNCTIONALITY, TWCGME HAS ENTERED INTO STAFFING LEASE AGREEMENTS WITH TWCCH FOR THE PROVISION OF CERTAIN ADMINISTRATIVE AND EXECUTIVE SERVICES. TWCCH REIMBURSED TWCGME FOR THESE SERVICES THROUGH WELL-VALIDATED FTE-BASED INTERCOMPANY ALLOCATION METHODOLOGIES. THROUGH THESE SHARED MISSION-DRIVEN STAFFING LEASE AGREEMENTS, TWCCH LEASES CLINICAL STAFF, MANAGEMENT SERVICES, AND BACK-OFFICE SUPPORT SERVICES FROM TWCGME, INCLUDING, BUT NOT LIMITED TO, HUMAN RESOURCES, INFORMATION TECHNOLOGY, MARKETING AND COMMUNICATIONS, FINANCE, GRANTS, GOVERNANCE SUPPORT, GOVERNMENTAL RELATIONS, LEGAL, AND OTHER ADMINISTRATIVE SUPPORT SERVICES. THE COSTS ASSOCIATED WITH THIS REVENUE, IN ADDITION TO COSTS SUPPORTING TWCGME MANAGEMENT AND GENERAL EXPENSES, ARE RECORDED AS MANAGEMENT AND GENERAL EXPENSES ON TWCGME'S FORM 990, SECTION IX (STATEMENT OF FUNCTIONAL EXPENSES), COLUMN C. |
Attach to Form 990 or Form 990-EZ.