2020-11-06T16:41:20-06:00 2019-12-31 ERNST & YOUNG US LLP 1101 NEW YORK AVENUE NW WASHINGTON DC 20005 990 2019-01-01 141338470 HEALTHALLIANCE HOSPITAL MARY'S AVE CAMPUS % ERIN NAGY HEAL 8459436084 105 MARYS AVENUE KINGSTON NY 12401 DR MICHAEL DOYLE EXE. DIRECTOR/CMO 8459436084 2020-11-03 true justin lowe P01866796 2023276000 173.68.23.158 26308520203115000066 2020-11-06 P 8C0075DE128CBD006CA99682002307B42C2396E3 047C777BBD395ADD529156C75D94AFF56594489C 2019 2021-01-29 14:40:06Z DR MICHAEL DOYLE 396 BROADWAY KINGSTON NY 12401 76364001 false X HTTPS://WWW.HAHV.ORG X 1902 NY THE MISSION OF HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUS IS TO PROVIDE THE HIGHEST QUALITY HEALTH CARE SERVICES TO ALL PEOPLE IN THE COMMUNITIES WE SERVE. 16 10 658 13 0 0 9563454 23544387 45254595 47990643 3056882 3292919 3699824 1297996 61574755 76125945 0 0 0 0 27827242 34199060 0 0 0 36449585 33459606 64276827 67658666 -2702072 8467279 38128586 39038683 43852665 36542780 -5724079 2495903 THE MISSION OF HEALTHALLIANCE HOSPITAL MARY'S AVENUE IS TO PROVIDE THE HIGHEST QUALITY HEALTH CARE SERVICES TO ALL PEOPLE IN THE COMMUNITIES WE SERVE. false false 52462273 0 48306692 TO PROVIDE EXCELLENT HEALTH CARE SERVICES TO ALL PATIENTS. THIS IS ACHIEVED THROUGH THE HOSPITAL'S COMMITMENT OF THE VALUES OF HOSPITALITY, COMMUNITY, STEWARDSHIP, RESPECT, PEACE, EXCELLENCE,INTEGRITY AND FISCAL RESPONSIBILITY. HEALTHALLIANCE MARY'S AVENUE CAMPUS RECORDED 19,119 PATIENT DAYS AND 1,346 SURGERIES (INPATIENT 426 & AMBULATORY 920). HEALTHALLIANCE MARY'S AVENUE CAMPUS OFFERS VARIOUS OUTPATIENT SERVICES SUCH AS SLEEP LAB, CHEMOTHERAPY, PSYCHSERVICES, BREAST CENTER AND ALL RADIOLOGIC SERVICES (CT, ULTRASOUND & CARDIAC CATH). TOTAL VISITS FOR THESE SERVICES IN 2019 WERE APPROXIMATELY 23,842. 52462273 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true true false true false false false false false false false false false false false false false true true false false false true 53 0 true 658 true false false false false false false false false false false false false X 16 10 false false false false true true true true true false false true true true true true true false true true true NY X ERIN NAGY 8459436084 741 GRANT AVENUE LAKE KATRINE NY 12499 Michael Israel Vice Chair 1.0 39.0 X 0 2552270 120185 GARY BRUDNICKI TRUSTEE/cfo 1.0 39.0 X X 0 1707598 110668 Julie Switzer Trustee 1.0 39.0 X 0 915495 89200 KARA BENNORTH TRUSTEE 1.0 39.0 X 0 715260 142846 robert ross resigned EXEC. VP/trustee 1.0 39.0 X 0 746325 78632 William Frishman MD Trustee 1.0 39.0 X 0 498791 68439 david scarpino former ceo (Resigned 12/31/18) 0.0 0.0 X 0 520041 28911 Joseph Marsicovete Chief Operating Officer 18.0 22.0 X 0 321847 20272 paul llobet md cmo (resigned 9/2/19) 18.5 21.5 X 0 273652 5826 thomas brunelleResign interim exec. dir/trustee 17.0 23.0 X 0 254482 15091 michael doyle exec. dir/cmo (As of 9/28/19) 17.0 23.0 X 0 222821 239 JANE ULRICH SR. VP OF NURSING 36.0 4.0 X 193388 0 24654 Rebecca King dir. of ambulatory services 40.0 0.0 X 163423 0 23779 AnnMarie Martinez reS EX. DIR. CLINICAL INTREGRATION 40.0 0.0 X 169666 0 9743 Thomas Collins Chair 1.0 4.25 X 0 0 0 Craig Sickler Treasurer 1.0 2.0 X 0 0 0 John Heimerdinger Trustee 1.0 7.0 X 0 0 0 Jamal Mahdavian MD TRUSTEE 1.0 2.0 X 0 0 0 Jerome Simonetty Trustee 1.0 2.0 X 0 0 0 Richard Wishnie Vice Chair 1.0 5.0 X 0 0 0 Carey Wagner Trustee 1.0 4.0 X 0 0 0 MICHAEL SHERAN MD TRUSTEE (RESIGNED 11/2019) 1.0 2.0 X 0 0 0 john bonavita-goldman trustee (effective 04/2019) 1.0 3.0 X 0 0 0 J CHRISTOPHER SMAILER trustee (effective 11/2019) 1.0 3.0 X 0 0 0 stephanie turco trustee (effective 11/2019) 1.0 2.0 X 0 0 0 526477 8728582 738485 63 true true false PHYSICIAN AT NEWBURGh PC 66 WEST GILBERT STREET RED BANK NJ 07701 Physician Fees 2481066 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 272162140 lab services 1409405 ARHC BCKNGNY01 LLC PO BOX 714459 CINCINNATI OH 452714459 PROPERTY RENTAL 704609 CBRE INC PO BOX 848844 LOS ANGELES CA 900848844 PROJECT MANAGER 484536 MORRISON MANAGEMENT SPECIALISTS IN 400 NORTHRIDGE ROAD SUITE 600 SANDY SPRINGS GA 30350 FOOD SERVICES 423855 11 0 2483 23435499 106405 0 23544387 NET PATIENT REVENUE 621300 47990643 47990643 0 0 47990643 3292919 3292919 0 0 1041233 238056 803177 0 803177 803177 0 FOOD SERVICES 900099 178770 0 0 178770 CONTRACTED SERVICE REVENUE 900099 254788 254788 0 0 REBATE REVENUE 900099 28114 28114 0 0 33147 33147 0 494819 76125945 48306692 0 4274866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24933497 19316897 5616600 0 752997 564748 188249 0 5976741 4482556 1494185 0 2535825 1901869 633956 0 0 0 0 0 192348 117177 75171 0 119491 0 119491 0 2507 0 2507 0 0 0 0 0 0 0 10523009 9307426 1215583 0 30133 0 30133 0 1743201 883121 860080 0 0 0 0 0 0 0 0 0 784567 6114 778453 0 34121 0 34121 0 0 0 0 0 12176 1510 10666 0 467952 0 467952 0 0 0 0 0 2514431 2514431 0 0 904667 0 904667 0 MEDICAL SUPPLIES 11437097 11418862 18235 0 EQUIPMENT SERVICE CONTRACTS 1410710 1248043 162667 0 ADMINISTRATIVE EXPENSES 227758 202006 25752 0 CONTRACTED SERVICES 2293884 0 2293884 0 761554 497513 264041 67658666 52462273 15196393 0 0 75246 1725202 0 0 0 0 6388462 5447510 0 0 0 0 0 0 867674 1484867 673004 856339 128440054 104945562 24131394 23494492 991298 1000353 0 0 0 0 0 0 5001508 5029920 38128586 39038683 15598295 15348986 1343950 832577 0 0 1605000 1100000 0 0 0 0 4160337 3603438 0 0 21145083 15657779 43852665 36542780 X -5758494 2461488 34415 34415 -5724079 2495903 38128586 39038683 X 8467279 4375 0 0 0 -251672 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false 0 false 0 false 0 false 0 false 0 false 0 true 2507 2507 false false SCHEDULE C, PART II-B, LINE 1J HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUS PAYS DUES TO NORTHERN METRO HOSPITAL ASSOCIATION AND HEALTHCARE ASSOCIATION OF NEW YORK STATE. IN ACCORDANCE WITH CODE SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY NORTHERN METRO HOSPITAL ASSOCIATION AND HEALTCARE ASSOCIATION OF NEW YORK STATE, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE AMOUNT ATTRIBUTED TO LOBBYING ACTIVITIES APPLICABLE TO 2019 NORTHERN METRO HOSPITAL ASSOCIATION AND HEALTHCARE ASSICATION OF NEW YORK STATE IS $2,507. 209532 209532 61633766 48719773 12913993 343400 317655 25745 55553764 53935546 1618218 10699592 1972588 8727004 23494492 INVESTMENT IN JOINT VENTURES 3884698 OTHER NON-CURRENT RECEIVABLES 1123326 OTHER ASSETS 21896 5029920 0 DUE TO RELATED PARTIES/AFFILIATES 11621168 OTHER NON-CURRENT LIABILITIES 3011376 ENVIRONMENTAL REMEDIATION 500001 POST RETIREMENT BENEFIT OBLIGATION 499784 SECURITY DEPOSITS PAYABLE 25450 15657779 true true X true X true X true true false true true 633031 343757 289274 0.00430 23659570 8503987 15155583 0.22400 24292601 8847744 15444857 0.22830 109676 1723 107953 0.00160 12350 46954 19680669 11876252 7804417 0.11530 19802695 11924929 7912370 0.11690 44095296 20772673 23357227 0.34520 true 2934421 12472345 12140607 331738 X true true 1 1 healthalliance hosp MARY'S AVE CAMPUS 105 Marys Avenue Kingston NY 12401 WWW.HAHV.ORG 5501001h X X HealthAlliance Hospital Mary's Ave 1 false false true X X X X X X X X X 19 true true true true X See Section C X true 19 true See Section C false true X 150. 300. X X true true X X X true X See Section c X See Section c X See Section c X X X X X X true X false X X true X false false PART V, SECTION B, LINE 3e The priorities consist of focus areas that impact 6 of the 8 health concerns for Ulster County outlined in the Mid-Hudson Regional Community Health Assessment 2019-2021. The New York State Prevention Agenda outlines two other priority areas that were not selected as priorities for HealthAlliance hospital 2019-2021 Community Service Plan: Promote a Healthy and Safe Environment and Prevent Communicable Diseases. Although all of these merit focus for improving population health, they were not selected due to the limited amount of resources available to address these issues and the relative severity of need demonstrated for the priority areas that were chosen. PART V, SECTION B, LINE 5 HealthAlliance of the Hudson Valley was an active member of a comprehensive 7-County Community Health Assessment which includes 17 hospitals and the local health departments of all 7 counties from the Hudson Valley. HealthAlliance staff was heavily involved in the collaboration and contributed $25,000 towards the cost of the assessment. The assessment process began in November 2017 with a meeting convened by HealtheConnections with hospitals, health systems, performing provider systems, and local health departments to discuss the benefits of collaborating on a Regional Community Health Assessment. After collective consensus, we then moved to hire Siena College Research Institute (SCRI) in December of 2017 to conduct a random sample community health survey of the Mid-Hudson Region to assess the health status and concerns of its residents. The work and collaboration continued through 2019 that ultimately led to the Mid-Hudson Region Community Health Assessment 2019-2021 (CHA). The survey administered by Siena was designed to conduct a random digit dial regional community health survey to supplement the Regional Community Health Assessment. In order to gauge the perception of residents surrounding health and resources in their communities, responses from 5,372 residents of the Mid-Hudson Region were collected. To further supplement the data collected, members of the Collaborative held 12 focus groups with service providers to understand the needs of specific communities and populations, and the barriers they face to achieving optimal health. These efforts covered feedback from underrepresented populations such as low-income, veterans, seniors, people experiencing homelessness, LGBTQ members, and people with a mental health diagnosis or those with a substance use disorder. HealthAlliance worked very closely with Ulster County Departments of Health and Mental Health (UCDOH-MH), Institute of Family Health, and hundreds of organizations serving its residents throughout Ulster County. In addition, before the focus groups took place, a Stakeholder Interview Form was sent to providers in order to supply additional insight around local factors influencing community health. This survey covered several topics, including the populations the providers serve; the issues that affect health in the communities they serve; barriers to people achieving better health; and interventions that are used to address social determinants of health. Throughout the seven counties in the Mid-Hudson Region, 285 surveys were completed by service providers. The answers to the survey varied throughout each county, and these differences were expanded upon in the focus groups. PART V, SECTION B, LINE 6A The CHNA was conducted with HealthAlliance Hospital (both Broadway and Mary's Avenue Campuses) and Ellenville Hospital. PART V, SECTION B, LINE 6B: HealthAlliance worked very closely with Ulster County Departments of Health and Mental Health (UCDOH-MH), Institute of Family Health, and hundreds of organizations serving its residents throughout Ulster County. PART V, SECTION B, LINE 7A: The CHNA has been widely available to the public through HealthAlliances website: https://www.hahv.org/Uploads/Public/Documents/HealthAlliance%20PDFs/Commun ity%20Health/HA%20CHNA%202019_2021.pdf PART V, SECTION B, LINE 10A: HealthAlliance has adopted an implementation strategy that will address the significant community health needs outlined in the hospitals CHNA which can be found on our website at: https://www.hahv.org/Uploads/Public/Documents/HealthAlliance%20PDFs/Commun ity%20Health/HA%2019-21%20CHIPworkplan.pdf PART V, SECTION B, LINE 11 Through the collaboration and partnership with Ulster County Departments of Health and Mental Health (UCDOH-MH), Ellenville Regional Hospital, and health and human service agencies, HealthAlliance Hospital, in accordance with New York State Prevention Agenda mandate, has chosen to align with our community partners in focusing on three priority areas: a. Prevent Chronic Diseases b. Promote Healthy Women, Infants, and Children c. Promote Well-Being and Prevent Mental and Substance Use Disorders The priorities consist of focus areas that impact 6 of the 8 health concerns for Ulster County outlined in the Mid-Hudson Regional Community Health Assessment 2019-2021. The New York State Prevention Agenda outlines two other priority areas that were not selected as priorities for HealthAlliance Hospital 2019-2021 Community Service Plan: Promote a Healthy and Safe Environment and Prevent Communicable Diseases. Although all of these merit focus for improving population health, they were not selected due to the limited amount of resources available to address these issues and the relative severity of need demonstrated for the priority areas that were chosen. AREAS OF FOCUS: In accordance with our Mid-Hudson Region Community Health Assessment 2019-2021, there were eight identified health needs which include cardiovascular disease, suicide, diabetes, teen pregnancy, housing, transportation, tobacco use, and infant mortality. The Mid-Hudson CHA was a collaborative effort with Westchester Medical Center Health Network (WMCHealth), Nuvance Health, Montefiore Hudson Valley Collaborative, Montefiore Nyack Hospital, Montefiore St. Lukes Cornwall, Orange Regional Medical Center, a member of the Greater Hudson Valley Health System, and St. Josephs Medical Center. HealthAlliance of the Hudson Valley, a member of WMCHealth, decided to address the countys health needs through the following implementation plan in guidance of NYS Prevention Agenda which youll find below. In addition, weve outlined all the programs that will be spearheading the following implementation plans. NYS prevention agenda priority area: Prevent chronic diseases Focus area 3: Tobacco prevention Prevention agenda goal 3.1: Prevent initiation of tobacco use Objective 3.1.6: Increase the number of municipalities that adopt retail environment policies, including those that restrict the density of tobacco retailers, keep the price of tobacco products high, and prohibit the sale of flavored tobacco products Evidence based intervention: 3.1.3 Pursue policy action to reduce the impact of tobacco marketing in lower-income and racial/ethnic minority communities, disadvantaged urban neighborhoods and rural areas. 3.1.4 Keep the price of tobacco uniformly high by regulating tobacco company practices that reduce the real price of cigarettes through discounts. 3.1.5 Decrease the availability of flavored tobacco products including menthol flavors used in combustible and non-combustible tobacco products and flavored liquids including menthol used in electronic vapor products. Disparity addressed: Low-income, racial/ethnic minorities, and disadvantaged urban and rural communities NYS prevention agenda priority area: Prevent chronic diseases Focus area 4: Chronic disease preventative care and management Prevention agenda goal 4.1: Increase cancer screening rates Objective 4.1.3: Increase the percentage of adults who receive a colorectal cancer screening based on the most recent guidelines (ages 50 75) Evidence based intervention: 4.1.5 Remove structural barriers to cancer screening such as providing flexible clinic hours, offering cancer screening in non-clinical settings (mobile mammography vans, flu clinics), offering on-site translation, transportation, patient navigation and other administrative services and working with employers to provide employees with paid leave or the option to use flex time for cancer screenings. Disparity addressed: Low-income, racial/ethnic minorities, seniors and disadvantaged urban and rural communities NYS prevention agenda priority area: Prevent chronic diseases Focus area 4: Chronic disease preventative care and management Prevention agenda goal 4.4: In the community setting, improve self-management skills for individuals with chronic diseases, including asthma, arthritis, cardiovascular disease, diabetes and prediabetes and obesity Objective 4.4.1: Increase the percentage of adults with chronic conditions (arthritis, asthma, cvd, diabetes, ckd, cancer) who have taken a course or class to learn how to manage their condition Evidence based intervention: 4.4.2 Expand access to evidence-based self-management interventions for individuals with chronic disease (arthritis, asthma, cardiovascular disease, diabetes, prediabetes, and obesity) whose condition(s) is not well-controlled with guidelines-based medical management alone. Disparity addressed: Low-income, racial/ethnic minorities, seniors and disadvantaged urban and rural communities NYS prevention agenda priority area: Promote healthy women, infants, and children Focus area 2: Perinatal and infant health Prevention agenda goal 2.2: Increase breastfeeding Objective 2.2.1: Increase the percentage of infants who are exclusively breastfed in the hospital by 10% from 47.0% (2016) to 51.7% among all infants Evidence based intervention: 2.2.2: Promote and implement maternity care practices consistent with the baby friendly hospital initiative - ten steps to successful breastfeeding Disparity addressed: Low-income, racial/ethnic minorities NYS prevention agenda priority area: Promote well-being and prevent mental and substance use disorders Focus area 2: Mental and substance use disorders prevention Prevention agenda goal 2.3: Prevent and address adverse childhood experiences (aces) Objective 2.3.3: Increase communities reached by opportunities to build resilience by at least 10 percent Evidence based intervention: 2.3.3: Grow resilient communities through education, engagement, activation/mobilization and celebration Disparity addressed: Socio-economic, regional, and LGBTQ communities Tobacco Free Action Communities Tobacco Free Action Communities in Ulster, Dutchess and Sullivan (formerly SmokeFree Dutchess and Tobacco Free Action Coalition of Ulster) is part of a network of statewide partners working to support New York State's tobacco-free goal. Each partner consists of a community engagement component and a youth action component (branded as Reality Check). Partners work to reduce the negative impact of tobacco product marketing and price promotions on youth and adults at the point of sale, increase the number of local laws and voluntary policies that prohibit tobacco use in outdoor areas, decrease secondhand smoke exposure in multi-unit housing, with an emphasis on policies that protect the health of low-income residents, and promote policies that reduce tobacco use imagery in youth-rated movies, and on the Internet and social media. Oncology Support Program The HealthAlliance Oncology Support Program, a member of Westchester Medical Health Network, is a unique support community for those affected by cancer. The program offers counseling, support groups and compassionate professionals who visit cancer patients while they are in the hospital. We also offer a comprehensive outpatient service to patients and their caregivers in the nurturing environment of the Herbert H. and Sofia P. Reuner Cancer Support House which is perceived as a "home away from home" by cancer survivors and their loved ones. Diabetes Education Center The HealthAlliance Diabetes Education Center, a member of Westchester Medical Health Network, is committed to providing individuals with skills and knowledge to manage diabetes and prevent diabetic complications. At the center we host trainings and education programs and offer information resources for our community. The Diabetes Educational Program offered is recognized by the American Diabetes Association for meeting its high-educational standards and for offering quality self-management diabetes education. Family Birth Place HealthAlliance Hospital: Broadway Campus is the only designated Baby-Friendly birth facility between Albany and Westchester County. The designation, widely considered "the gold standard" of maternity practices, means the hospital is nationally credentialed for meeting or exceeding international standards for providing optimal newborn care, including immediate mother-baby bonding and breastfeeding for the best health of the baby and the mother. We at the Family Birth Place believe that every childbearing experience is unique and that every woman is entitled to a joyful and healthy birth experience which is why our beautiful unit is designed to make your delivery a safe, natural and comfortable experience. We offer many proven methods of low intervention labor management such as birthing balls, hydrotherapy tub or shower, nitrous oxide, as well as intrathecal pain management and ep PART V, SECTION B, LINE 16A, B AND C The hospitals financial assistance policy and application are available at the following link: https://www.hahv.org/financial-assistance 2 ULSTER RADIATION & ONCOLOGY 117 Marys Avenue Kingston NY 12401 Outpatient Radiation Center COMPREHENSIVE SUPPORT SERVICES LLC 45 Pine Grove Avenue KINGSTON NY 12401 outpatient Diagnostic Imag ctr PART I, LINE 7: FINANCIAL ASSISTANCE AT COST The hospitals costing methodology was based upon worksheet 2 of the IRS 990 instructions. The cost-to-charge ratio was used for the various sub-line items of line #7. PART I, LINE 7G: SUBSIDIZED SERVICES The costs on line 7g do not include any costs attributable to physician clinics. Part III, Line 2: Methodology Used to Estimate Amount of Bad Debt Expense The amount reported on line 2 is equal to the provision for bad debt expense per the audited financial statements (AFS). The explanation of the methodology used to estimate this amount can be found in footnote #2 on pages 16-17 of the attached AUDITED FINANCIAL STATEMENTS. Part III, Line 4: Description of Bad Debt Expense The text of the footnote that describes bad debt expense can be found on pages 16-17 of the attached Audited Financial Statements. Part III, Line 8: Costing Methodology The costs on line 6 were taken directly from the cost report costs (D & E & I-series, where applicable) plus lab fee schedule costs and payments less subsidized services & Medicare losses which were taken from Exhibit 46 of the New York State Institutional Cost Report. For Healthalliance hospital mary's ave campus, there were no shortfalls from Medicare for 2019, therefore, there is no consideration for a community benefit. PART III LINE 9B: COLLECTION PRACTICES The credit and collection policy for self-pay balances provides that, in some cases, non-insured patients that do not qualify for Medicaid qualify for charity care. In those instances, the credit and collection department will follow the guidelines as set forth in the charity care policy. The charity care policy provides that the financial counselor evaluates the information provided in patients charity care applications in conjunction with federal income poverty guidelines to determine the write-off percentage. If the patient/guarantor qualifies for charity care based on the sliding scale, the patient will be required to pay the outstanding amount. A payment plan is established not to exceed 10% of the guarantors gross monthly income. PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENT For the community based strategies, HealthAlliance will continue to actively participate in a work group consisting of the public health department and health partners for the purposes of maintaining engagement with local partners over the next three year period. Initially, meetings will be held throughout the year; however frequency will be revisited throughout the timeframe to ensure that the meetings are meeting the needs of all partners. As part of the CHNA we contracted with Siena to administer a survey designed to conduct a random digit dial regional community health survey to supplement the Regional Community Health Assessment. In order to gauge the perception of residents surrounding health and resources in their communities, responses from 5,372 residents of the Mid-Hudson Region were collected. To further supplement the data collected, members of the Collaborative held 12 focus groups with service providers to understand the needs of specific communities and populations, and the barriers they face to achieving optimal health. These efforts covered feedback from underrepresented populations such as low-income, veterans, seniors, people experiencing homelessness, LGBTQ members, and people with a mental health diagnosis or those with a substance use disorder. This survey covered several topics, including the populations the providers serve; the issues that affect health in the communities they serve; barriers to people achieving better health; and interventions that are used to address social determinants of health. Throughout the seven counties in the Mid-Hudson Region, 285 surveys were completed by service providers. The answers to the survey varied throughout each county, and these differences were expanded upon in the focus groups. hahbc and hahmac believe their CHNA to be comprehensive and on-going, therefore no additional assessments outside of the CHNA are required. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE The hospital informs the patient of the availability of charity care several ways: 1. notice is on every patient bill with an application on the back of the bill 2. on the hospital website 3. all members of the patient accounting department are trained to screen patients for charity care when discussing bills and concerns regarding inability to pay 4. fliers are posted in registration areas of the hospital 5. registration clerks will identify patients without a pay source and refer the patient to a financial counselor and hand the patient a financial assistance form 6. financial counselors assist patients in securing Medicaid and screen for charity care 7. the collection agencies that HAHV engages with are aware of the charity care policy and assist patients in applying up to 180 days post-placement with them HealthAlliance is committed to: - providing access to quality healthcare services with compassion, dignity and respect for those we serve, particularly the poor and the underserved in our communities. - caring for all persons, regardless of their ability to pay for services. - assisting patients who cannot pay for part or all of the care they receive. - balancing needed financial assistance for some patients with broader fiscal responsibilities in order to sustain viability and provide the quality and quantity of services for all who may need care in a community. In accordance with aha recommendations, HealthAlliance adopted the following guiding principles when handling the billing, collection and financial support functions for our patients: - provide effective communications with patients regarding hospital bills - make affirmative efforts to help patients apply for public and private financial support programs - offer financial support to patients with limited means - implement policies for assisting low-income patients in a consistent manner - implement fair and consistent billing and collection practices for all patients with patient payment obligations HealthAlliance effectively communicates with patients regarding patient payment obligations. Financial counseling is provided to patients about their payment obligation and hospital bills. Information on hospital-based financial support policies and external programs that provide coverage for services are made available to patients during the pre-registration and registration processes and in response to patients seeking financial assistance. Information regarding the financial assistance is also provided by the onsite financial counseling staff in both inpatient and outpatient areas. Patient accounting also supports the financial counseling program by providing patients with information and applications while handling customer service calls. Our financial counselors and county Medicaid workers also provide guidance regarding the financial assistance program when necessary. Financial assistance is available on the back of every hospital bill as well as the hospital website at www.hahv.org. Financial counselors make affirmative efforts to help patients apply for public and private programs for which they may qualify and that may help them obtain and pay for healthcare services. The patient does not need to have an account with the hospital; they just have to be in a situation where they are in need of insurance coverage. Every effort is made to determine a patients eligibility prior to or at the time of admission or service. However, determination for financial support can be made during any stage of the patients stay after stabilization or collection cycle. HealthAlliance offers financial support to patients with limited means. This support is available to uninsured and underinsured patients who do not qualify for public programs or other assistance. Notification about financial assistance, including contact information, is available through the hospital website, hospital posters and flyers, financial assistance applications and hospital statements. The financial assistance policy (FAP) and application are available on our website at https://www.hahv.org/financial-assistance and are supplied in both English and Spanish as well as plain language summary format. If additional assistance is needed, HealthAlliance offers translation services for patients. HealthAlliance has an established written policy for the billing, collection and support for patients with payment obligations. The organization makes every effort to adhere to the policy and is committed to implementing and applying the policy for assisting patients with limited means in a professional, consistent manner. Educated staff members work closely with patients (including those working in patient registration and admitting, financial assistance, customer service, billing and collections) about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance status or their ability to pay for services. All patient registration staff receives in-service training regarding the financial assistance program. Patient accounting also receives information about the program and how to handle patients seeking financial assistance. Financial counselors receive in depth training to handle financial assistance requests, process applications, and manage outcomes. HealthAlliance provides several options for patients who either do not have insurance coverage or who have inadequate insurance coverage. Our many programs have been very successful and many have taken advantage of our offerings. financial counseling offers a patient the opportunity to speak to a financial counselor to determine what assistance can be accessible based on family income. Patients often shop around for the most economical healthcare and we offer price quotes. This allows the patient to know their financial obligation up front and understand the competitive pricing being offered. Despite millions of dollars of charity care distributed to needy patients every year, a consistent challenge is patients not utilizing the programs we offer. Often they dont want to provide the necessary financial information to initiate the financial aid process. Continual outreach and education is occurring to minimize confusion and improve utilization. HealthAlliance is committed to providing the best possible healthcare and is very sensitive to low income patients ability to pay. the call center offers the convenience of calling one telephone number for all billing inquiries regardless of which hospital the patient is calling about. PART VI, LINE 4: COMMUNITY INFORMATION HealthAlliance of the Hudson Valley, a member of the Westchester Medical Center Health Network (WMCHealth), operates a 315-hospital-bed health care system comprising HealthAlliance Hospital Marys Avenue campus and HealthAlliance hospital Broadway campus in Kingston, NY, and the Margaretville Hospital in Margaretville, NY. It also operates Mountainside Residential Care Center, an 82-bed nursing home in Margaretville adjacent to Margaretville Hospital. HealthAlliance is guided by the needs of its patients and their families. HealthAlliance delivers the best health care of the highest value in a safe, compassionate environment; invests in innovative technologies and leading-edge therapies to advance health care delivery; and improves the overall health and well-being of the diverse communities it serves. HealthAlliance defines its primary service area (PSA) by a federal definition that consists of the top 75% of hospital discharges from the lowest number of contiguous zip codes. Due to the geographical location of acute care hospitals under HealthAlliance, there are two distinct primary service areas that lie within ulster and Delaware counties, though not encompassing all of each county. Although defined as two service areas, HealthAlliance regards it as a single primary service area for operational community need development. The PSA population in 2017 was 119,071 while the broader population for Ulster County was 180,129 with populations concentrated in the cities of Kingston, New Paltz and Saugerties. Patients from adjacent counties also visit the hospital or one of our outpatient locations for services that may not be available in their respective communities. Ulster Countys percentage of adult smokers from 2013 to 2016 decreased from 21.1% to 15.2%. In addition, Ulster County reported a higher percentage of cigarette smoking among those with poor mental health compared to those who indicated not having poor mental health (24.5% vs 15.2%). Although cigarette use has been decreasing over time, the use of electronic vapor products, also known as e-cigarettes, has increased dramatically. Ulster County is monitoring the use of vaping, especially among the young people of the county. According to the NYSDOH, the use of e-cigarettes among high school youth increased 160% over the past 4 years. The data show a surge in binge drinking, going from 10.5% of adults reporting binge drinking in 2013-2014, to more than double that at 22.2% in 2016. Ulster County continues to show the highest rates of binge drinking compared to the region and New York State. Lastly, authorities in Ulster County have recently been focusing attention on the increasing incidence of opioid-related overdoses and deaths. Overdoses have more than doubled in the most recent five-year span measured. Overdose deaths have increased 447% since 2010, and most deaths occur in those aged 18-44 years. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH Please see narrative for Schedule H, Part V, Section B, Line 11 for a complete description of how the organizations hospital facilities furthers its exempt purposes by promoting the health of the community. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM HealthAlliance of the Hudson Valley (HAHV) is the parent company to affiliate members HealthAlliance Marys Avenue Campus, Broadway Campus, Margaretville Memorial Hospital, a rural critical access hospital and Mountainside Residential Care Center, a skilled nursing facility. This integrated healthcare system is committed to providing quality and compassionate medical care for our patients, their families and our community. In addition to service consolidation between the two Kingston hospitals, HAHV also committed to streamlining operations and improving care at the other affiliate locations. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT NEW YORK true false false false false false false false false Michael Israel Vice Chair 0 2218270 0 309000 0 25000 0 44240 0 75945 0 2672455 0 0 Julie Switzer Trustee 0 662180 0 228315 0 25000 0 44240 0 44960 0 1004695 0 0 William Frishman MD Trustee 0 498791 0 0 0 0 0 36085 0 32354 0 567230 0 0 KARA BENNORTH TRUSTEE 0 516010 0 180250 0 19000 0 111831 0 31015 0 858106 0 0 GARY BRUDNICKI TRUSTEE/cfo 0 1169901 0 512697 0 25000 0 44240 0 66428 0 1818266 0 0 Joseph Marsicovete Chief Operating Officer 0 314013 0 0 0 7834 0 6750 0 13522 0 342119 0 0 robert ross resigned 1219 EXEC. VP/trustee 0 619700 0 107625 0 19000 0 39200 0 39432 0 824957 0 0 paul llobet md cmo (resigned 9/2/19) 0 215705 0 0 0 57947 0 5826 0 0 0 279478 0 0 david scarpino former ceo (Resigned 12/31/18) 0 0 0 0 0 520041 0 0 0 28911 0 548952 0 0 michael doyle exec. dir/cmo (As of 9/28/19) 0 222694 0 0 0 127 0 0 0 239 0 223060 0 0 JANE ULRICH SR. VP OF NURSING 188242 0 0 0 5146 0 3802 0 20852 0 218042 0 0 0 thomas brunelleResigned 919 interim exec. dir/trustee 0 235297 0 0 0 19185 0 0 0 15091 0 269573 0 0 AnnMarie Martinez reS 1119 EX. DIR. CLINICAL INTREGRATION 155699 0 0 0 13967 0 0 0 9743 0 179409 0 0 0 Rebecca King dir. of ambulatory services 162907 0 0 0 516 0 3317 0 20462 0 187202 0 0 0 SCHEDULE J, PART I, LINE 3 The organization's Executive Director receives compensation from a related organization. In order to establish compensation payments, the related organization typically completes a compensation study or engages an independent consultant. The results of said study or consultant's findings are implemented into a written employment contract. All actions above are approved by the Board of Directors/Compensation Committee prior to finalization. Schedule J, Part I, line 4a The organization's top management official (CEO) retired effective 12/31/18 and was paid severance in 2019 from a related organization. David Scarpino received change-of-control payments of $520,041 in 2019 from a related organization. Paul Llobet, MD received change-of-control payments of $36,723 in 2019 from the filing organization. A Ulster County IDA 141643765 903769BZ9 2006-11-03 19290000 see part vi true true true A 17775000 0 19290000 1500000 0 0 385800 0 0 5480568 11923632 0 2006 false true true true A false false true false false 0.00600 0.00000 0.00600 false false 0.00000 false true A false false false true false false 0 false 0 false false A false part i, col (f) - description of purpose the bond were issued to payoff notes, leases, other debt and use for capital projects such as to construct hospital or to purchase equipment. THE ISSUE DATE OF PRIOR BONDS THAT WERE REFUNDED WAS 06/23/1999. part iv, line 2c - arbitrage A REVIEW OF HISTORICAL TREASURY RATES SHOWED THAT AT NO TIME WERE BOND PROCEEDS INVESTED AT A YIELD THAT EXCEEDED THE YIELD OF THE 2006 BONDS (6.44438% AS DEFINED IN THE FILED FORM 8038). FORM 990, PART VI, LINE 6 HEALTHALLIANCE, INC. IS THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUS ("HAMC"). FORM 990, PART VI, LINE 7A HEALTHALLIANCE, INC. IS THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUS AND HAS THE POWER TO ELECT AND APPOINT MEMBERS OF THE BOARDS OF DIRECTORS AND BOARD OFFICERS OF THE HOSPITALS. FORM 990, PART VI, LINE 7B ALL DECISIONS WITH RELATION TO THE MARY'S AVENUE CAMPUS ARE MADE AT THE HEALTHALLIANCE, INC. BOARD LEVEL. THESE DECISIONS INCLUDE APPROVAL/REMOVAL OF CORPORATE OFFICERS, APPROVAL OF BYLAW AMENDMENTS, REVIEW OF ANNUAL CAPITAL AND OPERATING BUDGETS, REVIEW AND/OR MODIFICATION OF ANY CERTIFICATE OF NEED APPLICATIONS, REVIEW INCURRENCE OF DEBT AND DEVELOP AND IMPLEMENT JOINT MEDICAL STAFF APPOINTMENTS. FORM 990, PART VI, LINE 11B THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX ADVISORS WITH ASSISTANCE FROM THE ORGANIZATION'S FINANCE DEPARTMENT AND OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PROVIDED TO THE BOARD OF THE ORGANIZATION FOR APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MEANS OF A SURVEY DEVELOPED AND APPROVED BY THE CHIEF COMPLIANCE OFFICER. THE SURVEY IS SENT TO ALL TRUSTEES, OFFICERS, AND KEY EXECUTIVES FOR COMPLETION. ALL SURVEY RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS IDENTIFIED IN THE RESPONSES ARE DISCUSSED WITH SENIOR MANAGEMENT AND/OR REFERRED TO THE WMCHEALTH CONFLICTS OF INTEREST COMMITTEE FOR DISCUSSION. POTENTIAL ACTIONS TO BE TAKEN IN RESPONSE TO A CONFLICT CAN BE ONE OR MORE OF THE FOLLOWING: 1) DISCLOSURE OF THE CONFLICT, 2) INDIVIDUAL RECUSAL FROM DECISIONS FOR TRANSACTIONS WHERE THAT INDIVIDUAL MAY HAVE A CONFLICT, 3) REQUEST IN WRITING THE INDIVIDUAL ALLEVIATES THE CONFLICT, OR 4) REMOVAL OF THE INDIVIDUAL FROM EMPLOYMENT. FORM 990, PART VI, LINES 15A & 15B The determination of the CEO's compensation involves the engagement of an independent compensation consultant to perform a compensation study/survey. Once completed, the findings and recommendations from the consultant are brought to the compensation committee of the board of directors. Upon the committee's review and approval, the CEO's employment contract is developed. For other top management officials, the same process is used with the exception that the findings are used to develop and execute a letter of employment versus a contract. FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 transfer to related parties - ($251,672) FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:5757510 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:4765499 WMC HEALTH NETWORK - ROCKLAND INC 100 WOODS ROAD VALHALLA NY 10595 320467873 SUPPORTING NY 501(C)(3) 12A NA false WMC HEALTH NETWORK - ULSTER INC 100 WOODS ROAD VALHALLA NY 10595 320477183 SUPPORTING NY 501(C)(3) 12A WCHCC false WESTCHESTER COUNTY HEALTH CARE CORP 100 WOODS ROAD VALHALLA NY 10595 133964321 HEALTHCARE NY 115 N/A NA false WMC NEW YORK INC 100 WOODS ROAD VALHALLA NY 10595 134107894 FUNDRAISING NY 501(C)(3) 12A WCHCC false NORTH ROAD LHCSA INC 100 WOODS road Valhalla NY 10595 465293268 HOMECARE SVCS NY 501(C)(3) 10 WCHCC false MID-HUDSON VALLEY EARLY EDUCATION CENTER 100 WOODS ROAD VALHALLA NY 10595 465534882 PRESCHOOL NY 501(C)(3) 10 WCHCC false WESTCHESTER MEDICAL CENTER FOUNDATION 100 WOODS ROAD VALHALLA NY 10595 134095845 FUNDRAISING NY 501(C)(3) 7 WCHCC false HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS 396 BROADWAY KINGSTON NY 12401 141349558 EXEMPT HOSP NY 501(C)(3) 3 HA INC false MARGARETVILLE MEMORIAL HOSPITAL 42084 STATE ROUTE 28 MARGARETVILLE NY 12455 150552726 EXEMPT HOSP NY 501(C)(3) 3 HA INC false MARGARETVILLE NURSING HOME INC 42158 STATE HIGHWAY 28 MARGARETVILLE NY 12455 223143565 NURSING HOME NY 501(C)(3) 10 MMH false MARGARETVILLE HEALTH FOUNDATION 42084 STATE HIGHWAY 28 MARGARETVILLE NY 12455 261998454 SUPPORT FDN NY 501(C)(3) 12A MMH false FASC FOUNDATION 741 GRANT AVENUE LAKE KATRINE NY 12449 264201295 SUPPORT FDN NY 501(C)(3) 7 HAH BWAY false GOOD SAMARITAN FDN FOR BETTER HEALTH 255 LAFAYETTE AVE SUFFERN NY 10901 133400353 SUPPORT FDN NY 501(C)(3) 7 BSCHSI false BON SECOURS COMMUNITY HOSPITAL FDN 255 LAFAYETTE AVE SUFFERN NY 10901 810667395 SUPPORT FDN NY 501(C)(3) 7 BSCHSI false BON SECOURS WARWICK HEALTH FOUNDATION 255 LAFAYETTE AVE SUFFERN NY 10901 141972807 SUPPORT FDN NY 501(C)(3) 7 BSCHSI false BON SECOURS CHARITY HEALTH SYSTEM INC 255 LAFAYETTE AVE SUFFERN NY 10901 912135195 SUPPORTING NY 501(C)(3) 12C, III-FI WCHCC false HEALTH ALLIANCE INC 741 GRANT AVENUE LAKE KATRINE NY 12449 261850453 SUPPORTING NY 501(C)(3) 12A WCHCC false HealthAlliance Foundation Inc 741 GRANT AVENUE LAKE KATRINE NY 12449 222511450 FUNDRAISING NY 501(C)(3) 7 HA INC false HUDSON RIVER WEST INSURANCE (BARBADOS) 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB BSCHSI C CORP false KINGSTON INSURANCE (BARBADOS) LIMITED 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB HEALTHALLIANCE C CORP false NORTHEAST PROVIDER SOLUTIONS INC 100 WOODS ROAD VALHALLA NY 10595 133991673 MSO & HEARING NY NA C CORP false WMC ADVANCED PHYSICIAN SERVICES PC 19 BRADHURST AVENUE HAWTHORNE NY 10595 264709927 PHYSICIAN OFFices NY NA C CORP false WESTCHESTER MEDICAL REGIONAL PHYS SVCS 241 NORTH ROAD POUGHKEEPSIE NY 10532 465522536 PHYSICIAN OFFices NY NA C CORP false WCHCC (BERMUDA) LIMITED VICTORIA HALL 11 VICTORIA STREET HAMILTON BD CAP INSURANCE BD NA C CORP false KINGSTON REGIONAL HEALTH CARE ENTERPRISE 396 BROADWAY KINGSTON NY 12401 161514994 INVESTMENT NY HAH BWAY C CORP false MID HUDSON PHYSICIANS PC 396 BROADWAY KINGSTON NY 12401 203564769 MEDICAL SVCS NY na C CORP false bschs medical group pc 10 franklin turnpike mahwah NJ 07430 821632215 physician offices NJ bschs c corp false false false true false false false false false false true true false true true true true true true true Schedule R, Part II, Bon Secours Charity Health System, Inc. (BSCHS) Healthalliance, Inc. has a brother-sister relationship with BSCHS's six subordinates in a group exemption within BSCHS.