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We have made great strides in our new hospital. After only two years, we have become an award winning
organization for patient satisfaction and patient safety and we are on the journey to Nursing “Magnet Status.” Every day, we have the opportunity to make a real difference. We should be very proud of all that we have accomplished together.
How you feel about your work and the environment is essential to performing your best. That is the reason we conduct the annual Employee Engagement Survey. The level of your commitment to our mission enhances the workplace and contributes to a highly engaged work environment for everyone.
We will once again partner with The Gallup Organization to launch our Engagement Survey. Your survey invitation will be mailed from Gallup to your home. The invitation contains your personal and anonymous access code and a sample of the questions. When you take this year’s survey, I ask that you consider your overall work experience at Orange Regional as you respond to each question.
Your answers are completely confidential.
Your feedback is taken very seriously and helps us to
create a better workplace for everyone. If you have any questions about our Engagement Survey, please ask your manager or contact Betsy Kennally at 333-1669.
Sincerely,
Scott Batulis President & CEO
www.ormc.org
October 2013A newsletter for Orange Regional Medical Center employees, physicians and volunteers
From The President & CEO
Scott BatulisPresident & CEO
A newsletter for Orange Regional Medical Center employees, physicians and volunteers
NRC Path To Excellence Award
Our Approach To Joint Commission Readiness:
Be Prepared Every Day
On September 22, Orange Regional was recognized by the National Research Corporation (NRC) with the 2013 Path to Excellence award for ‘most improved hospital with 300 beds or more’ at their 19th Annual International Patient-Centered Care Symposium in Baltimore, Maryland. Orange Regional was one of two hospitals selected nationally for its commitment to improving the patient experience. The NRC implements surveys and performs analyses that help healthcare providers measure and improve quality and services that offer a greater understanding of patients’ experiences, preferences, risks and behaviors. The award is based on voluntary patient responses to the Hospital Care Quality Information from the Consumer Perspective Survey provided to patients after discharge. Patients rated Orange Regional very high in their overall patient experience. For more information, contact Vice President of Patient Care Services and Chief Nursing Officer, Joanne Ritter-Teitel, at 845-333-2304 or [email protected].
“This recognition reflects the amount of work our staff
has invested in improving patient care and ensuring
an excellent experience for each patient we care for,”
says Orange Regional’s Vice President of Patient
Care Services and Chief Nursing Officer, Joanne
Ritter-Teitel, PhD, RN, CEA-BC. “Thanks to that
dedication, Orange Regional has continued to see our
patient satisfaction scores rise. I want to thank and
congratulate our staff for their efforts reflected in
this honor.”
Update Leading The Way
October 2013
Fou
ndat
ion
Connections October 2013
Jerry Dunlavey is now the Executive Director of the Greater Health Valley Health System Medical Group, a new service line in development for both Sullivan and Orange Counties. In this new role, Jerry will partner with several of our health system physician leaders including Dr. Bruce Ellsweig for Primary Care, Dr. Gerald Galarneau for Specialty Care at Catskill Regional and Dr. Jim Oxley for the system-wide growth and development of our Hospitalist and Intensivist Programs. He will also assume administrative oversight for the Trauma and Acute Surgery Program, working in collaboration with Dr. Janet Shiley, Trauma Program Medical Director. Over the past several years, Jerry has developed and managed clinical programs including the Level II NICU, The Bone & Joint Center and Heart & Vascular Institute. He can be reached at 333-2312 or [email protected].
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Vice President of Patient Care Services and Chief Nursing Officer, Joanne Ritter-Teitel, PhD, RN, CEA-BC, is now the executive leader for Pediatric Services which include NICU, Neonatology providers, Pediatric Emergency Services and the recently implemented Pediatric Hospitalist Service. She will also be responsible for the System’s Emergency Medicine Services. These new responsibilities are in addition to Joanne’s current oversight of Patient Care Services and her Chief Nursing Officer duties. She can be reached at 333-2304 or [email protected].
Chief Operating Officer, Jonathan Schiller, is now the new executive lead for the Heart & Vascular Institute including interventional and non-invasive cardiology, The Bone & Joint Center and Neuroscience Services which include the Spine and Stroke Programs. Jonathan assumes these responsibilities in addition to his current duties as Chief Operating Officer. He can be reached at 333-2308 or [email protected].
One Employee Can Make A Big Difference Have You? Will You?
• Carol Struble, a tireless volunteer fundraiser for Pediatrics
• Nick Watkins for his time in playing the part of our lovable mascot “Hudson”
• Eileen Phillips for baking cookies and brownies for her mobile Pediatric pledge cart
• The Pediatric staff of 5 West who assisted the Foundation in raising over $160,000 at the 2013 Golf Classic
• Sarah Johnson, Carol Struble, Christina Platé and Ellen Calandra who have given up numerous lunch hours to man the Conference Center pledge tables
• The 250 employees who have pledged payroll deductions or one-time gifts to the new Pediatric Center Capital Campaign
• Employee Campaign Leaders Karin Kuhens, Liz Musco and Theresa Fay Conte
If you are interested in making a donation, please contact the Foundation any time or call us at 333-2333. The Foundation Office is located next to the Marketing & PR Department on the second floor of the Administration Building.
Vice President of Oncology Services and Outpatient Operations, Sandra Iberger, MBA, FACHE, FABC, is now the executive leader for the Inpatient Rehabilitation Service, including oversight of the 24-bed CARF Accredited Rehabilitation Unit and acute inpatient therapy. Sandra will also assume responsibility for the Palliative Care Program. These are new responsibilities in addition to her current oversight of Oncology Services and Outpatient Operations. She can be reached at 695-5901 or [email protected].
Hudson says “Thank you” to the following employees:
Grateful Patient ProgramThrough the Grateful Patient Program, Orange Regional’s patients and their families have the opportunity to recognize employees, physicians and volunteers who provide exceptional care and kindness. The following employees were recognized and received a commemorative pin as a symbol of their outstanding service.
Matthew AdamsShiv Cheema Dina Cowit Stacey ForbesClara IkeErin Kirwan Mark O’Brien
Maribel OcchiuzzoKelly PizarroAlyssa Ramirez Denise RheelSimone SteinNina SullivanGerri Sylvester
Sherri TerracinoElizabeth Thorpe Soray Urban-Bell Alison WesolowskiMichele WordenJose “Sammy” Zacatelco
Progressive Care Unit Secretary, Laura Decker, was chosen as a Shooting Star for going the extra mile to de-escalate a patient who wanted to leave against medical advice. She took the initiative by volunteering to play a game of cards with him and even made the cards for the patient out of index cards. As a result, the patient calmed down and stayed the night. Way to go Laura! If you experience or witness a staff member going above and beyond, tell us about it by filling out an All-Star Program Brochure, located on the Employee Portal at ormc.org/employees. For more information, contact Senior Human Resources Business Partner, Susan Heintz, at [email protected].
Two-hundred and fifty Orange Regional employees have made a difference by contributing to the Lend A Hand For Kids Campaign to benefit the New Pediatric Center. In fact, their pledges and donations total over $176,000.
Welcome New Employees
Jessica AlesandroJill Beach
De Niece BennettAndrea D’AltilioAmy Davidoff
Ashley DiDomizioAmy Jacobs
Paola LizcanoStephen Marsh
Deborah MessinaSarai Ortiz
Emily RodriguezAmbika SharmaLourelem SigueLaTonya Smiley
Tracy Von der HeydeEmily Zahradnik
Please welcome the following employees who have joined
our team to enhance the delivery of patient care at
Orange Regional.
Shooting Star
Annual Education Is Due December 31 Annual Education is one way to keep staff up-to-date on all of the required information that is important to all Hospital employees. It is also a requirement under The Joint Commission. Employee review of educational material and completion of the post tests are due by December 31. The material is available in both a Word document, for those who would like to read through the printed copy, as well as a series of PowerPoint presentations. Please note, while some of the information looks familiar, it may contain the newest information and updates. The post-test questions will help draw your attention to these updates, as they are critical for all employees to know.
In addition to the annual education, all employees must also complete the following by December 31:
• Safety Data Sheets (SDS) (course 077), which is an OSHA requirement
• Code Silver - Active Shooter module (course 076)
New hires in 2013 do not need to complete annual education but must complete Saftey Data Sheets and the Code Silver - Active Shooter module. They have been assigned in Swank and are available now. For more information or questions, please feel free to contact the Training, Education & Development Department at 333-0228.
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Culture Of Caring And Concern Below is a letter from the husband of one of our recent patients who complimented the staff of 4 South.
Mr. Scott Batulis, President & CEO:
Sir, I have very little education, but I do know the difference between good and bad. I would like to compliment the people who run this hospital, especially those who attended to my wife Emma Puglisi. The staff was very professional, polite and considerate. They checked on my wife frequently to make sure she was comfortable. All of the staff on the fourth floor was polite and respectable; and I am sure the other floors are the same. I, myself have had to stay in a hospital more than seven times and my wife has had six children in a hospital. I have a very large family, so I have made many visits to hospitals and I have never seen one like this before.
Please do not take these people for granted. It is the doctors and staff that give the hospital the reputation it has. I wish all hospitals had the staff that you have here. When people are sick and in pain, they need the kindness of the staff you have here to comfort them. I thank the staff for comforting my wife while she was in pain. She is precious to me and I do not want to see her suffer. I hope this hospital always stays the same.
One Sunday after Mass, people asked me where my wife was. I told them she was at Orange Regional Medical Center in Middletown. I told them, if they have to go to a hospital, this is the one to go to.
Respectfully Yours, Fred Puglisi
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In July, the New York State Department of Health passed a regulation that requires healthcare personnel not vaccinated against influenza to wear a surgical or procedure mask while in areas where patients may be present during the influenza season. Accordingly, Orange Regional will comply with this regulation and has adopted a corresponding policy. The new requirements apply to all personnel including members of the medical and allied health staff.
The Influenza vaccine will be provided free of charge to all hospital employees, volunteers, credentialed medical staff and allied health
professionals. If you choose to receive your flu vaccine from another provider, proof of receiving the vaccination must be submitted to the Employee Health Office. Employees who decline the vaccination are encouraged to sign a declination form, available in the Employee Health Office, and will be subject to wearing a mask in any area of the hospital where they could possibly infect patients with the influenza virus. The Commissioner of the State Department of Health will determine when the influenza virus is prevalent in our area and employees will be notified. For more information, contact Director of Employee Health, Marcia Orloff, at 333-2060 or [email protected].
Make Time For Your Flu Shot — New Regulation!
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Congratulations
Director of Nursing Informatics and Decision Support, Anita Adler, MSN, RN-BC, CNM, has been selected as an item writer, or test question writer, for the American Nurses Credentialing Center’s (ANCC) Informatics Nursing exam. The ANCC is an organization that promotes excellence in nursing and healthcare globally through credentialing programs. These credentialing programs certify and recognize individual nurses in specialty practice areas which enable nurses to demonstrate their specialty expertise and validate their knowledge to employers and patients. The ANCC recruits qualified nurses to serve as item writers for professional certification examinations across many nursing specialties. For more information, contact Anita at 333-2091 or [email protected].
Greater Hudson Valley Health System Diagnostic Imaging Administrator, Gene Bernieri, MBA, CRA, RT(R) (MR), presented “Joint Commission Sentinel Event Alert: Radiation Risks of Diagnostic Radiation – Proactive Planning Will Assure the Best Outcomes” on July 29 at the annual AHRA Annual Meeting and Exposition held in Minneapolis, Minnesota. The presentation provided an overview of the Joint Commission Sentinel Alert regarding radiation risks of diagnostic imaging and included a plan to assist organizations into full compliance. Also discussed were proven techniques to reduce radiation exposure developed by the Orange Regional Exposure Reduction Team. For more information, contact Gene at 333-1252 or [email protected].
Orange Regional Medical Center has been recognized by Medline Industries for its success and dedication in preventing catheter-associated urinary tract infections (CAUTI), the most common hospital-acquired infection. Orange Regional has been using the ERASE CAUTI Foley catheter trays and education for an average of 22 months to help reduce the risk of CAUTI. Within that time, the Hospital either maintained a zero CAUTI rate or experienced an average reduction of 97 percent in CAUTI infections. For more information, contact Director of Infection Prevention, Liz Klimczack, at 333-2173 or [email protected].
Eileen Johnston has been promoted to Accounts Payable Manager for the Greater Hudson Valley Health System. Eileen has been with Orange Regional for 23 years in various positions in the Finance division, most recently as Accounts Payable Supervisor. In her new role, Eileen will have oversight for Accounts Payable for both the Orange Regional and Catskill Regional facilities which we anticipate will result in continued improvements in efficiency and effectiveness. Eileen can be reached at 342-7339 or [email protected].
Spotlight On
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Orange Regional’s Diabetes Champions Program
In 2006, the American Diabetes Association and the American Association of Clinical Endocrinologists released a consensus statement calling for improved inpatient care for persons with diabetes. To answer the call, John’s Hopkins Medical Center began their Diabetes Nurse ‘Super-users’ Program which provided specialty training for diabetes resource nurses. Other hospitals soon followed. This year, the Orange Regional Medical Center Glycemic Improvement Team identified the need for increased diabetes knowledge for those of all disciplines caring for persons with diabetes. From this developed the Orange Regional Diabetes Champions Program. This program is a first of its kind, offering an intensive curriculum providing professionals, from many disciplines, the opportunity to learn about diabetes and diabetes management. Representatives from Catskill Regional also joined the program and the first class of Champions ‘graduated’ on September 27. They are already sharing ideas for improvement and identifying possible barriers to care within their individual disciplines.
As of 2007, 1.8 million persons in New York had diabetes and another 4.2 million had pre-diabetes, however there were only 1,000 Certified Diabetes Educators in the state. Having enough staff with advanced knowledge of diabetes management and education available in the hospital is essential. Orange Regional’s unique interdisciplinary Diabetes Champions Program will assure that floor nurses, pharmacists, case managers, dietitians and other medical professionals will be watching out for our patients with diabetes to make sure they receive exceptional healthcare during their hospital stay. For more information, contact Diabetes Clinical Coordinator, Laurie Porcaro, at 333-2495 or [email protected].
At Orange Regional, employee commitment to our mission is essential to delivering great care to our patients. Improving the workplace means creating an engaging work environment for everyone. Research has shown that how you feel about your work and the environment you work in is key to doing your best. Creating an environment that promotes accountability and reliability takes constant motivation and determination as our work atmosphere continues to change. What does engagement mean to you? Over the past 10 months, we’ve asked employees who scored within the top two quartiles of last year’s Engagement Survey for their thoughts and ideas on this question.
Centralized Telemetry Now AvailableIn September, the Centralized Telemetry Monitoring Program was initiated for remote cardiac monitoring in our Progressive Care (North and South) Units (PCU). With the oversight of our PCU Nursing Leadership and staff, who worked collaboratively with the Central Monitoring team, Biomedical Engineering, IT and Professional Practice, the transition was seamless and the Medical Surgical Units on 4 South went live with Medical Telemetry.
We successfully began Phase II of the centralized telemetry project on October 1. Medical patients are being centrally monitored on 4 South, we are holding zero patients for telemetry in our Emergency Department and our overflow unit has remained closed.
This change has also been quite seamless due to the dedication and enthusiasm of our 4 South Nursing Staff and Leadership and with the support of the Central Monitoring team, Biomedical Engineering, IT, Patient Flow, Nursing Supervision and the Emergency Department. All staff involved kept patient safety and quality at the forefront. We will continue to refine and perfect our process for admission to telemetry using our evidence-based policy to guide our practice.
In preparation for Phase III of our project, the 2 South staff is currently training and will begin accepting Surgical Telemetry patients on November 1. The success of this program is directly related to the dedication and commitment of the staff. For more information, contact Nursing Service Administrator, Emergency Services and Critical Care, Laura Mansfield, at 333-2089 or [email protected].
Front row, from L to R: Tamara Krasinski, RD (Nutrition and Food Services); Jeanet Calhoun, RN (CRMC); Kelsey Pardo, RN (5N) and Donna Charitable, RN (4N). Second row, from L to R: Kerin Mora, RN (4N); Vince Livingston, RN (CRMC); Patricia Black, RN (Case Management); Mohammed Islam, RPh (Pharmacy); Gerard Haber, RPh (Pharmacy) and Maria Sutz, RN (5N).
“Great engagement=great teamwork=exceptional patient care.” — Nursing Service Administrator, Clinical Operations,
Debra Beakes
“Teamwork.” — Mechanic Construction Coordinator,
Kevin Hosking
We will again partner with Gallup to launch our annual Employee Engagement Survey on October 23. You will receive a survey invitation in the mail at your home. The invitation contains your unique and anonymous employee code and a sample of the questions. Please take a few moments to participate in the survey online or by phone. Your answers are confidential. When you take the survey, please consider your overall work experience and answer each question as best you can. Improving the patient experience and creating an engaging and great place to work will continue as our primary focus. We know that our ability to deliver quality healthcare requires listening and working with others. If you have questions about the engagement survey, please ask your manager or contact Director of Organizational Development, Betsy Kennally, at 333-1669 or [email protected].
“Leaving one family and coming to another.”
— Inpatient Rehabilitation Registered Nurse, June Maniaci“Engagement, to me, means having a continuous
and focused commitment to work on behalf of our organization’s mission and vision statements.”
— Quality Services Nurse Reviewer, Stephanie Martir
Our employees focus every day on caring compassionately for patients and their families. Throughout the year, special weeks are dedicated to recognize specific healthcare employees. Congratulations to the following departments celebrating national recognition.
Hospital Recognition
Rehabilitation Nurses Week | September 29-October 5Rehabilitation nurses work with patients to restore their greatest level of function or independence. They help patients overcome physical obstacles and accomplish normal tasks of daily living.
National Emergency Nurses Week | October 6-12 Emergency nurses advocate for patient safety and excellence in emergency nursing practice.
Pediatric Nurses Week | October 7-13 Our Pediatric nurses are challenged to use a variety of interventions in providing nursing care to infants, children and adolescents.
Medical Surgical Nurses Week | November 1-7 Medical Surgical nurses secure medical-surgical nursing certification, resulting in better and safer healthcare.
Perioperative Nurses Week | November 11-17 Our Perioperative nurses care for patients before, during and after surgery and other invasive procedures.
Guest Services Week | October 1-5Guest Services employees and volunteers work to provide a comfortable experience beyond patients' medical care.
National Healthcare Food Service Week | October 7-13Dietary Service employees address patient needs to make sure they are nutritionally appropriate on a daily basis.
Security & Safety Week | October 13-19The Safety & Security Department helps to provide personal safety, promotes positive customer relations and protects the physical property and assets of patients, staff and visitors.
Case Management Week | October 13-19Case Management staff provide services that enhance a patient and family’s ability to cope with stressors associated with healthcare.
Sterile Processing Week | October 14-18Sterile processing technicians play an important role in patient safety. They are responsible for processing and sterilizing surgical instruments, supplies and equipment.
IN THE NEWS
The Hudson Valley Insider promoted Orange Regional’s current Art Exhibit, Life Up Close: Art Inspired by Science, featuring paintings, photographs and sculptures. The exhibit will be on display on the ground floor through November 1.
Dr. Cleveland Lewis, Medical Director of Orange Regional’s Lung Cancer Disease Management Team, was interviewed for the September 24, 2013 article in the Times Herald-Record that discussed the Hospital’s lung cancer screening program and its ability to detect the earliest stages of lung cancer.
Connections February 2013Connections October 2013 Connections October 2013
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*To view all news about Orange Regional, visit www.ormc.org/InTheNews.
The September 12, 2013 issue of the Pike County Dispatch featured an article about a group of children, between the ages of two and seven, who donated close to $200 to the Hospital’s ‘Pennies for Peds’ initiative.
Wound Healing Center Celebrates OpeningOn September 19, Orange Regional held a ribbon-cutting ceremony to commemorate the opening of its Wound Healing Center. Hospital staff, vendors and patients attended as Orange Regional’s President & CEO, Scott Batulis, thanked everyone who worked to bring wound healing services to the community. Led by Co-Medical Directors, Inocencia Carrano, MD and Cleveland Lewis, MD, the Center provides advanced wound healing therapies, hyperbaric oxygen therapy and a team of specialists who utilize proven wound care methods that are specific to the needs of chronic, non-healing wounds. The Center is open 8:00 a.m. to 4:00 p.m., Monday through Friday. For more information, call 333-7700 or visit www.ormc.org/WoundHealingCenter.
An article on Associate Medical Director of the Center for Sleep Medicine, Ofer Jacobowitz’s, participation in a U.S. Food and Drug Administration study appeared in the “Local News” section of the September 2013 issue. of MD News.
Da Vinci Robot Test Drive
On September 24, Jillian Koehnken (daughter of employee Jeanine Koehnken, CNOR, RN) test drove the da Vinci Si HD Surgical System simulator. Staff also had the opportunity to test drive the simulator in Orange Regional’s Main Lobby and representatives from Intuitive, the company that makes the robotic surgery technology, were on hand to answer questions. To learn more about Robotic Surgery at Orange Regional, visit www.ormc.org/roboticsurgery.
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C: More, the employee self-service system, is now available on the Hospital intranet so that you can view your Human Resource/Payroll information without having to log on to the Hospital Web site. C: More is located on the Human Resources page: http://info/HR/Default.aspx. Please note that the Benefits page on the intranet has been removed and that all benefit forms/documents must be accessed through C:More. If you notice that your information is outdated within the system, please complete a change form (found on the HR page). Please print, complete and forward to Human Resources. If you do not have access to a work or home computer, kiosks are set up in Human Resources at the main campus for your convenience. For more information, contact Director of Benefits, Christine Goodhart, at 695-5844 (press 5), or [email protected].
Self-Service System Now Available On Intranet
News BulletinConnections February 2013Connections October 2013 Connections October 2013
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Recent updates have been made to the compliance and HIPAA policy at Orange Regional and
all employees are required to review them. Orange Regional takes its Corporate Compliance
Program seriously and takes the necessary steps to prevent, detect and correct legal and
regulatory violations throughout the Hospital. To access the updated policy, please visit
www.ormc.org/corporatecompliance. For more information, contact Chief Compliance Officer,
Stephen Sugrue, at 333-2379 or [email protected].
HIPAA Policy Update
In September, Same Day Surgery Nurses honored their volunteer, Walt, with a small celebration for all of his assistance. Thank you, Walt, for your commitment to Orange Regional!
Cheers To The Volunteer!
Shining StarsDonna Charitable
Amir Islam
Minnie Stevens
Debra Sibilia
Quality Services Nurse Reviewer, Tina DeSmedt-Wells, RN, had her height taken by Summit
Health Nurse, Sabine Sylvain-Tassy, during her wellness screening.
Live Well, Be Well The Live Well, Be Well Program was recently launched
at Orange Regional and offers employees free tools and
resources to better understand their current health status
and assist them with managing their health risks. The
Hospital also partnered with Cigna and Summit Health
to provide free on-site wellness screenings. For more
information, log onto mycigna.com or contact Director
of Benefits, Christine Goodhart, at 695-5844 (press 5),
Ray W. Moody, M.D. Breast Center Open House In honor of Breast Cancer Awareness Month, an open house was held for employees at the Ray W. Moody, M.D. Breast Center, at the Medical Pavilion, on October 3. Visitors received tours, met our staff, had some goodies and were entered into a drawing for a gift certificate.
Connections October 2013
Save The Dates
Benefits Fair
Main CampusFriday, November 22, 2013
Conference Rooms 1, 2, & 3 (Ground Floor).
7:30 a.m. to 4:00 p.m.
Orange Regional Medical PavilionThursday, November 21, 2013
Crystal Café
10:00 a.m. to 2:00 p.m.
MedSurg Murder Mystery Dinner Presented by the Greater NY Chapter of
Academy of Medical-Surgical Nurses
Friday, November 15, 2013
Cosimo’s Brick Oven Ristorante & Bar 620 Route 211 E., Middletown
6:00 p.m.
$30 per person, $50 per couple
Reservation and payment is due on November 1 Reserve your character now!
RSVP to [email protected]
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Fearless Caregiver Conference
On September 30, Orange Regional offered a free Fearless Caregivers Conference. More than 150 attendees received practical information, advice and support on how to care for loved ones who are ill. In addition, Carol Holbert, facilitator of Orange Regional's Caregivers’ Support Group, was awarded for her commitment and for her accomplishments as a caregiver.
Upcoming Blood DriveWednesday, November 6, 2013
Donor bus will be located outside of the Main Entrance.
9:00 a.m. to 2:00 p.m.
2nd Annual Tricky Tray To Benefit
The New Pediatric EDSunday, October 26, 2013
St. Joseph’s Parish Center 111 Cottage Street, Middletown
One person can put as many tickets as they want in a given container to increase the odds of winning.
Doors open at 11:00 a.m. Light refreshments will be available for purchase. There will be raffles,
door prizes, a grand prize raffle and wonderful baskets to win!
For more information, please call Orange Regional’s Gift Shop at 333-1165 or 333-1167.
