2020-05-06T15:46:40-05:00 2019-06-30 990 2018-07-01 231352202 LEHIGH VALLEY HOSPITAL - SCHUYLKILL LEHI 4848840130 2100 MACK BLVD PO BOX 4000 ALLENTOWN PA 181054000 ROBERT THOMAS ASSISTANT TREASURER 4848840130 2020-05-06 146.115.215.83 2020-05-06 15:41:46 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8A8F8899F728990BB0FC79F6362EF820FAA63ACD 2018 2020-09-23 17:36:50Z BRIAN A NESTER 2100 MACK BLVD PO BOX 4000 ALLENTOWN PA 181054000 152537179 0 X WWW.LVHN.ORG X 2008 PA TO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE FOR THE SCHUYLKILL COMMUNITY. 17 15 1306 48 0 0 179247 131538 48810219 149043268 2259871 230056 826363 2679899 52075700 152084761 0 0 0 0 41340483 69849639 0 0 1475 28236168 79975359 69576651 149824998 -17500951 2259763 155180965 139187793 135969599 123644855 19211366 15542938 X LEHIGH VALLEY HOSPITAL - SCHUYLKILL'S MISSION IS TO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE AVAILABLE FOR THE SCHUYLKILL COUNTY COMMUNITY. 0 0 134898259 149043268 LEHIGH VALLEY HOSPITAL - SCHUYLKILL (LVH-S), THROUGH THE COMBINED EFFORTS OF ITS HIGHLY QUALIFIED MEDICAL STAFF, EMPLOYEES, AND VOLUNTEERS, OFFERS A BROAD RANGE OF HEALTHCARE SERVICES TO THE RESIDENTS OF SCHUYLKILL COUNTY, PA.INPATIENT HEALTHCARE SERVICES ARE PROVIDED IN MATERNITY, PEDIATRIC, ACUTE AND CRITICAL CARE, ACUTE INPATIENT REHABILITATION UNIT AND BEHAVIORAL HEALTH SERVICES. THERE WERE OVER 40,000 EMERGENCY DEPARTMENT VISITS DURING THE YEAR. LVH-S PROVIDES THE ONLY INPATIENT BEHAVIORAL HEALTH SERVICES IN THE COUNTY. IN FY 19 WE SERVED 165 ADOLESCENT, 771 ADULT AND 201 GERIATRIC (1137 TOTAL ADMISSIONS) IN OUR HOSPITAL. THIS SERVICE TO A VERY VULNERABLE, OFTEN UNDER OR UNINSURED POPULATION CONTINUES MEET A CRITICAL COMMUNITY NEED. ADDITIONAL WE SERVE ANOTHER VULNERABLE POPULATION WITH OUR DRUG AND ALCOHOL COUNSELING CENTER. THIS CENTER HAS NEARLY 7000 PATIENT VISITS PER YEAR.LVH-S PROVIDES A WIDE ARRAY OF DIAGNOSTIC AND TREATMENT PROGRAMS INCLUDING A HOSPITAL-BASED HOME HEALTH DEPARTMENT, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES, OCCUPATIONAL MEDICINE, AS WELL AS CT, MRI, MAMMOGRAPHY, ULTRASOUND, DEXA SCAN, NUCLEAR MEDICINE, AND OTHER IMAGING TECHNOLOGIES. WITH A HIGH INCIDENCES OF DIABETES AND VASCULAR DISEASE WE SERVE OUR COMMUNITY WITH INTERVENTIONAL RADIOLOGY, WOUND CARE AND HYPERBARIC MEDICINE. THE INDUSTRA-MED PROGRAM OF THE MEDICAL CENTER PROVIDED OCCUPATIONAL AND INDUSTRIAL HEALTH SERVICES TO OVER 200 OF THE REGION'S EMPLOYERS.THE MEDICAL CENTER PROVIDES MANY COMMUNITY OUTREACH AND EDUCATIONAL PROGRAMS THROUGHOUT THE YEAR AS WELL AS SCREENINGS, EVENTS, AND HEALTH FAIR PARTICIPATION. THROUGH A PARTNERSHIP WITH A LOCAL AREA ON AGING GROUP (DIAKON), LVH-S PROVIDES FREE FLU SHOTS TO THE VULNERABLE SENIOR CITIZEN POPULATION. DURING SEVERE FLOODING IN OUR COUNTY, LVH-S PROVIDE FREE FOOD, MEDICAL SUPPLIES, SHOWER FACILITIES AND TETANUS VACCINATIONS TO COMMUNITY MEMBERS AND FIRST RESPONDERS.ON SEPTEMBER 16, 2016, LEHIGH VALLEY HEALTH NETWORK (LVHN) AND SCHUYLKILL HEALTH SYSTEM MERGED, WITH LVHN BECOMING THE PARENT ORGANIZATION OF SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET DBA LEHIGH VALLEY HOSPITAL - SCHUYLKILL SOUTH JACKSON STREET; SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET DBA LEHIGH VALLEY HOSPITAL - SCHUYLKILL EAST NORWEGIAN STREET; SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP, INC. DBA LEHIGH VALLEY PHYSICIAN GROUP SCHUYLKILL; SCHUYLKILL REHABILITATION CENTER, INC. DBA LEHIGH VALLEY HEALTH NETWORK REHABILITATION CENTER SCHUYLKILL; AND SCHUYLKILL HEALTH SYSTEM DEVELOPMENT CORPORATION DBA LEHIGH VALLEY HEALTH NETWORK DEVELOPMENT CORPORATION - SCHUYLKILL.IN ADDITION, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET AND SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET MERGED EFFECTIVE JUNE 1, 2018. UNDER THE MERGER, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET IS THE SURVIVING ORGANIZATION. EFFECTIVE UPON MERGER, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET CHANGED ITS LEGAL NAME TO LEHIGH VALLEY HOSPITAL - SCHUYLKILL. 134898259 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 87 0 1 1306 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X X THE ORGANIZATION 4848840130 2100 MACK BLVD PO BOX 4000 ALLENTOWN PA 181054000 ANTHONY BARAN TRUSTEE 1.00 3.00 X 0 0 0 DEBRA C BLASCHAK TRUSTEE 1.00 3.00 X 0 0 0 JEANNE BOYER PORTER VICE CHAIRPERSON/TRUSTEE 1.00 3.00 X X 0 0 0 HARRY CIAVARELLA TRUSTEE (AS OF 3/13/2019) 1.00 3.00 X 0 0 0 DOUGLAS CRESWELL TRUSTEE (AS OF 6/12/2019) 1.00 3.00 X 0 0 0 ANTOINETTE EVERDALE TRUSTEE (AS OF 3/13/2019) 1.00 3.00 X 0 0 0 DARNELL FURER TRUSTEE 1.00 3.00 X 0 0 0 RICHARD GONZALEZ TRUSTEE 1.00 3.00 X 0 0 0 THOMAS L KENNEDY ESQ TRUSTEE 1.00 3.00 X 0 0 0 WILLIAM E KIRWAN CPA ESQ CHAIRPERSON/TRUSTEE 1.00 3.00 X X 0 0 0 AMRIT P NARULA MD TRUSTEE 1.00 3.00 X 0 0 0 WILLIAM J REPPY PRESIDENT/TRUSTEE 40.00 1.00 X X 344243 0 19545 LAWRENCE RIDDLES MD TRUSTEE 40.00 1.00 X 417747 0 19545 FRANKLIN K SCHOENEMAN TRUSTEE 1.00 3.00 X 0 0 0 E LORI SMITH TREASURER/TRUSTEE 1.00 3.00 X X 0 0 0 JONATHAN TARSON TRUSTEE (AS OF 6/12/2019) 1.00 3.00 X 0 0 0 TIMOTHY F TWARDZIK SECRETARY/TRUSTEE 1.00 3.00 X X 0 0 0 DIANE DOYNE ASSISTANT SECRETARY 40.00 X 63946 0 12466 JONATHAN RUSSO PATHOLOGIST 40.00 X 284937 0 19491 RICHARD BINDIE DIRECTOR, PATHOLOGY 40.00 X 276403 0 19491 KRISTINA GUERS REGISTERED NURSE 40.00 X 177182 0 6893 CYNTHIA SCHAFFER REGISTERED NURSE 40.00 X 166871 0 21082 BRIAN PAUL PHARMACIST 40.00 X 150653 0 39759 DIANE BORIS VP, FINANCE 18.00 22.00 X 196505 0 14822 SUE CURRY CHIEF NURSING OFFICER 18.00 22.00 X 203670 0 15885 THOMAS V WHALEN MD MMM FORMER TRUSTEE 0.00 X 0 991405 33933 2282157 991405 222912 33 1 1 0 EMCARE INC 7032 COLLECTIONS CENTER DRIVE CHICAGO IL 606930001 PHYSICIAN STAFFING 2463977 INTEGRATED MEDICAL GROUP PC 82 TUNNEL ROAD POTTSVILLE PA 179013869 PHYSICIAN STAFFING 1703681 SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURGH PA 152516922 DIETARY SERVICES 1119371 ALLENTOWN ANESTHESIA ASSOCIATES INC 4905 W TILGHMAN STREET SUITE 250 ALLENTOWN PA 181049131 PHYSICIAN STAFFING 920000 MARSH USA INC 1166 AVENUE OF THE AMERICAS NEW YORK NY 100362708 CONSULTING SERVICES 561965 22 131538 131538 OUTPATIENT REVENUE 621400 85326359 85326359 INPATIENT REVENUE 621990 62979839 62979839 SCHOOL OF NURSING 611600 737070 737070 149043268 243873 243873 516001 438601 77400 77400 77400 13817 -13817 -13817 -13817 MEANINGFUL USE 561439 1653313 1653313 CAFETERIA & VENDING 900099 600027 600027 GIFT SHOP SALES 900099 100849 100849 248310 248310 2602499 152084761 149043268 0 2909955 X 877492 877492 56578975 52819175 3759800 1099252 1119719 -20467 7058272 5849397 1208875 4235648 3507116 728532 6985 6985 17241323 12671123 4570200 191703 163970 26258 1475 455096 442440 12656 367921 367921 4915922 4480099 435823 219578 215567 4011 29229 28222 1007 2537276 2537276 5225661 1733453 3492208 1485918 1485918 MEDICAL SUPPLIES 19301592 19158483 143109 BAD DEBT EXPENSE 13312420 13312420 CONTRACT PERSONNEL 8748093 8748093 PURCHASED SERVICES 2851702 2551378 300324 3084940 2822012 262928 149824998 134898259 14925264 1475 4580 4105 2803059 3877030 545343 2154862 16070898 11018627 1394758 1457861 1551482 1526244 50847039 14906451 37805696 35940588 6718754 6532493 7059646 6035 313810 362302 80912939 76307646 155180965 139187793 15821380 11680025 76435463 61535963 43712756 50428867 135969599 123644855 X 13428346 9607797 179876 497649 5603144 5437492 19211366 15542938 155180965 139187793 X 2259763 382870 -6311061 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: LEHIGH VALLEY HOSPITAL - SCHUYLKILL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP). A PERCENTAGE OF THE DUES PAID TO THESE ORGANIZATIONS GOES TOWARDS LOBBYING EFFORTS. THEIR MISSION IS TO ADVANCE THE HEALTH OF INDIVIDUALS AND COMMUNITIES TO LEAD, REPRESENT, AND SERVE HEALTH CARE PROVIDER ORGANIZATIONS THAT ARE ACCOUNTABLE TO THE COMMUNITY AND COMMITTED TO HEALTH IMPROVEMENT. THE MEMBERSHIP DUES FOR AHA AND HAP ARE PAID BY LEHIGH VALLEY HOSPITAL, INC. THEREFORE, THE LOBBYING PORTION OF THE DUES ARE REFLECTED ON THE LEHIGH VALLEY HOSPITAL, INC. FORM 990, SCHEDULE C. 3340004 3340004 33641318 8848415 24792903 8808182 4120967 4687215 5057535 1937069 3120466 35940588 DUE FROM AFFILIATES 28702510 GOODWILL 46619695 SERP INVESTMENT 206719 DEFERRED COMP INSURANCE 778722 76307646 OBLIGATION UNDER CAPITAL LEASE 250822 DUE TO AFFILIATES 26505923 ACCRUED PENSION LIABILITY 21090823 DEFERRED REVENUE 14880 ESTIMATED MALPRACTICE LIABILITY 1580034 SERP LIABILITY 206719 DEFERRED COMP INSURANCE 778722 PA SALES TAX PAYABLE 944 50428867 X PART X, LINE 2: LVHN, ITS HOSPITALS, AND OTHER SUBSIDIARIES ARE GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, EXCEPT FOR TAX IMPOSED ON UNRELATED BUSINESS INCOME. THE MOST RECENT DETERMINATION LETTER, RECEIVED BY THE ORGANIZATION, IS DATED MAY 1, 2014. LVHN AND ITS SUBSIDIARIES ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740. THE ORGANIZATION'S FOR-PROFIT COMPONENTS RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR THE FUTURE TAX IMPACT OF TEMPORARY DIFFERENCES BETWEEN AMOUNTS RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS AND THEIR RESPECTIVE TAX BASES AND THE FUTURE BENEFIT OF UTILIZATION NET OPERATING LOSS CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. INCOME TAXES OF THE ORGANIZATION'S TAX-EXEMPT AND FOR-PROFIT COMPONENTS ARE NOT MATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 975366 975366 0.00710 24961489 1555858 23405631 0.17150 25936855 1555858 24380997 0.17860 234691 234691 0.00170 46875 46875 0.00030 4781585 2648934 2132651 0.01560 32020 32020 0.00020 5095171 2648934 2446237 0.01780 31032026 4204792 26827234 0.19640 1 5394488 1154960 46959626 46847047 112579 X 1 1 1 1 LEHIGH VALLEY HOSPITAL - SCHUYLKILL 420 SOUTH JACKSON STREET POTTSVILLE PA 17901 WWW.LVHN.ORG 421001 X X X LEHIGH VALLEY HOSPITAL - SCHUYLKILL 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.LVHN.ORG/ABOUT_US X X 1 18 1 WWW.LVHN.ORG/ABOUT_US 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X WWW.LVHN.ORG/OUR_SERVICES/KEY_SUPPORT_SERVICES/FINANCIAL_ASSISTANCE X WWW.LVHN.ORG/OUR_SERVICES/KEY_SUPPORT_SERVICES/FINANCIAL_ASSISTANCE X WWW.LVHN.ORG/OUR_SERVICES/KEY_SUPPORT_SERVICES/FINANCIAL_ASSISTANCE X X X X X 1 X 0 X X X 1 X 0 0 LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 5: FOR THE PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LVHN DEFINES THE COMMUNITY IT SERVES AS ALL INDIVIDUALS LIVING WITHIN THE COUNTIES THAT CONTAIN OUR HOSPITAL CAMPUSES. LVHN IS REQUIRED TO PRODUCE A CHNA HEALTH PROFILE FOR EACH OF OUR LICENSED FACILITIES IN ORDER TO ADDRESS THE LOCAL CONTEXT OF THE DIFFERENT COMMUNITIES WE SERVE. THEREFORE, LVHN HAS PRODUCED FOUR CHNA HEALTH PROFILES FOR OUR FOUR DIFFERENT LEHIGH VALLEY HOSPITAL CAMPUSES: LEHIGH VALLEY HOSPITAL - CEDAR CREST, 17TH STREET, AND MUHLENBERG, LEHIGH VALLEY HOSPITAL - SCHUYLKILL, LEHIGH VALLEY HOSPITAL - HAZLETON, AND LEHIGH VALLEY HOSPITAL - POCONO. FOR LEHIGH VALLEY HOSPITAL - CEDAR CREST, 17TH STREET, AND MUHLENBERG, THE COMMUNITY IS DEFINED AS LEHIGH AND NORTHAMPTON COUNTIES (ALSO KNOWN AS THE LEHIGH VALLEY). WE ADDITIONALLY ASSESSED HEALTH NEEDS WITHIN THE CITY OF ALLENTOWN TO REFLECT THE URBAN COMMUNITY SURROUNDING OUR 17TH STREET CAMPUS. FOR LEHIGH VALLEY HOSPITAL - SCHUYLKILL, THE HEALTH PROFILE PRESENTS THE HEALTH NEEDS OF COMMUNITY MEMBERS IN SCHUYLKILL COUNTY. FOR LEHIGH VALLEY HOSPITAL - HAZLETON, THE CHNA HEALTH PROFILE PROVIDES INFORMATION ABOUT THE HEALTH NEEDS FOR LUZERNE COUNTY WITH SPECIFIC INFORMATION ABOUT THE CITY OF HAZLETON WHERE IT WAS AVAILABLE. FINALLY, FOR LEHIGH VALLEY HOSPITAL - POCONO, THE COMMUNITY IS DEFINED AS RESIDENTS WITHIN MONROE COUNTY.WITHIN THE ENTIRE GEOGRAPHIC POPULATION THAT MAKES UP THE COMMUNITIES WE SERVE, WE PLACE A GREATER EMPHASIS ON INCLUDING INDIVIDUALS IN THE COMMUNITY WHO ARE EXPERIENCING HEALTH DISPARITIES TO A GREATER EXTENT OR WHO ARE AT-RISK FOR NEGATIVE HEALTH OUTCOMES AS A RESULT OF THE SOCIAL AND ENVIRONMENTAL FACTORS INFLUENCING THEIR HEALTH.IT IS WELL DOCUMENTED THAT THE CLINICAL CARE PROVIDED TO COMMUNITY MEMBERS ONLY ACCOUNTS FOR A SMALL PORTION OF AN INDIVIDUAL'S OVERALL HEALTH. THERE ARE MANY OTHER FACTORS THAT OCCUR OUTSIDE THE DOCTOR'S OFFICE AND HOSPITAL WALLS THAT INFLUENCE HEALTH BEYOND MEDICAL CARE. THEY INCLUDE:- SOCIAL AND ECONOMIC FACTORS, SUCH AS EDUCATION, EMPLOYMENT, AND SOCIAL SUPPORT- PHYSICAL ENVIRONMENT FACTORS, SUCH AS HOUSING, TRANSPORTATION, AND AIR QUALITY- HEALTH BEHAVIORS, SUCH AS SMOKING, DRINKING, DIET, AND EXERCISETHEREFORE, THE CHNA HEALTH PROFILE PROVIDES INFORMATION ABOUT HEALTH CARE AS WELL AS OTHER HEALTH FACTORS FOLLOWED BY HEALTH OUTCOMES. THERE ARE TWO TYPES OF DATA INCLUDED IN THE CHNA HEALTH PROFILES. THE FIRST TYPE IS QUANTITATIVE DATA, OR NUMBERS AND STATISTICS ABOUT THE OVERALL POPULATION IN THE COMMUNITY. THESE STATISTICS COME FROM A VARIETY OF LOCAL, STATE AND NATIONAL SOURCES INCLUDING THE CENSUS, THE CENTER FOR DISEASE CONTROL, THE DEPARTMENT OF EDUCATION, AND THE CENTERS FOR MEDICAID AND MEDICARE SERVICES. A MAJORITY OF THESE DATA POINTS ARE COMPILED TOGETHER THROUGH A PLATFORM CALLED THE CARES ENGAGEMENT NETWORK HEALTH PLAN TOOL, WHICH LVHN USES AS THE STARTING POINT FOR ITS CHNA HEALTH PROFILES, ADDING OTHER KEY STATE AND LOCAL DATA SOURCES TO THE DATA PROVIDED THROUGH THIS HEALTH REPORT.IN ADDITION, NON-PROFIT HOSPITAL SYSTEMS ARE REQUIRED TO OBTAIN INPUT FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH PUBLIC HEALTH EXPERTISE AND THE VULNERABLE POPULATIONS. LVHN CHOSE TO OBTAIN THIS INPUT THROUGH FOCUS GROUPS AND INTERVIEWS WITH COMMUNITY MEMBERS AND LEADERS. THIS TYPE OF DATA IS REFERRED TO AS QUALITATIVE DATA. WE PARTNERED WITH AN EXTERNAL COMMUNITY COLLABORATOR FOR EACH CAMPUS WHO HAS EXPERIENCE IN QUALITATIVE DATA COLLECTION TO CONDUCT THESE FOCUS GROUPS AND INTERVIEWS ON LVHN'S BEHALF. THIS PROCESS PROVIDED COMMUNITY MEMBERS WITH AN INDEPENDENT AND OBJECTIVE OPPORTUNITY TO IDENTIFY AND SHARE THEIR PERSONAL EXPERIENCES AND PERSPECTIVE ON THE MOST PRESSING HEALTH NEEDS FACING THEIR COMMUNITY AS WELL AS WHERE THEY WOULD LIKE LVHN TO FOCUS ITS ATTENTION. IN SCHUYLKILL COUNTY, WHICH CONTAINS LEHIGH VALLEY HOSPITAL - SCHUYLKILL, THE PARTNER WAS SCHUYLKILL VISION, A SMALL NON-PROFIT, COMMUNITY ORGANIZING GROUP IN THE COUNTY. FIVE FOCUS GROUPS AND FIVE INTERVIEWS WERE CONDUCTED BETWEEN JUNE AND AUGUST 2018 WITH A TOTAL OF 73 PARTICIPANTS IN SCHUYLKILL COUNTY.BELOW IS A SUMMARY OF THE ORGANIZATIONS REPRESENTED IN THE SCHUYLKILL COUNTY FOCUS GROUPS AND INTERVIEW AS WELL AS A SUMMARY OF THE DEMOGRAPHICS OF THOSE WHO PARTICIPATED. RESIDENTS, INCLUDING THOSE FROM LOW-INCOME POPULATIONS, WERE ALSO INCLUDED IN THE FOCUS GROUPS AND INTERVIEW IN EACH COUNTY.ORGANIZATIONS REPRESENTED:DIAKON SENIOR CENTERDIVINE MERCY CATHOLIC CHURCHINTERFAITH HEALTH NETWORKMINERSVILLE FEDERALLY QUALIFIED HEALTH CENTERNEW RINGGOLD COMMUNITY FIRE COMPANY NURSE FAMILY PARTNERSHIPPOTTSVILLE AREA SCHOOL DISTRICTSCHUYLKILL COMMUNITY ACTIONSCHUYLKILL COUNTY MENTAL HEALTHST. PETER'S UCC CHURCH DEMOGRAPHICS:GENDER: 67% FEMALE, 33% MALEAVERAGE AGE: 48; AGE RANGE: 17-82RACE: 83.7% WHITE, 16.2% OTHERETHNICITY: 65% NON-HISPANIC, 35% HISPANIC (OF ANY RACE)EDUCATION: 37% SOME COLLEGE OR HIGHER, 35% HIGH SCHOL DIPLOMA OR G.E.D., 21% LESS THAN HIGH SCHOOLEMPLOYMENT: 40% EMPLOYED, 21% HOMEMAKER, 26% RETIRED OR NOT EMPLOYED LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 6A: LVHN HAS PRODUCED FOUR CHNA HEALTH PROFILES FOR OUR FOUR DIFFERENT LEHIGH VALLEY HOSPITAL CAMPUSES: LEHIGH VALLEY HOSPITAL - CEDAR CREST, 17TH STREET, AND MUHLENBERG, LEHIGH VALLEY HOSPITAL - SCHUYLKILL, LEHIGH VALLEY HOSPITAL - HAZLETON, AND LEHIGH VALLEY HOSPITAL - POCONO. FOR LEHIGH VALLEY HOSPITAL - CEDAR CREST, 17TH STREET, AND MUHLENBERG, THE COMMUNITY IS DEFINED AS LEHIGH AND NORTHAMPTON COUNTIES (ALSO KNOWN AS THE LEHIGH VALLEY). WE ADDITIONALLY ASSESSED HEALTH NEEDS WITHIN THE CITY OF ALLENTOWN TO REFLECT THE URBAN COMMUNITY SURROUNDING OUR 17TH STREET CAMPUS. FOR LEHIGH VALLEY HOSPITAL - SCHUYLKILL, THE HEALTH PROFILE PRESENTS THE HEALTH NEEDS OF COMMUNITY MEMBERS IN SCHUYLKILL COUNTY. FOR LEHIGH VALLEY HOSPITAL - HAZLETON, THE CHNA HEALTH PROFILE PROVIDES INFORMATION ABOUT THE HEALTH NEEDS FOR LUZERNE COUNTY WITH SPECIFIC INFORMATION ABOUT THE CITY OF HAZLETON WHERE IT WAS AVAILABLE. FINALLY, FOR LEHIGH VALLEY HOSPITAL - POCONO, THE COMMUNITY IS DEFINED AS RESIDENTS WITHIN MONROE COUNTY.WITHIN THE ENTIRE GEOGRAPHIC POPULATION THAT MAKES UP THE COMMUNITIES WE SERVE, WE PLACE A GREATER EMPHASIS ON INCLUDING INDIVIDUALS IN THE COMMUNITY WHO ARE EXPERIENCING HEALTH DISPARITIES TO A GREATER EXTENT OR WHO ARE AT-RISK FOR NEGATIVE HEALTH OUTCOMES AS A RESULT OF THE SOCIAL AND ENVIRONMENTAL FACTORS INFLUENCING THEIR HEALTH. LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 6B: REPRESENTATIVES OF THE COMMUNITY INCLUDED:DIAKON SENIOR CENTERDIVINE MERCY CATHOLIC CHURCHINTERFAITH HEALTH NETWORKMINERSVILLE FEDERALLY QUALIFIED HEALTH CENTERNEW RINGGOLD COMMUNITY FIRE COMPANY NURSE FAMILY PARTNERSHIPPOTTSVILLE AREA SCHOOL DISTRICTSCHUYLKILL COMMUNITY ACTIONSCHUYLKILL COUNTY MENTAL HEALTHST. PETER'S UCC CHURCH LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 7D: OUR COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE UPON REQUEST. LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 11: COMMUNITY ENGAGEMENT1.1 PROMOTE LVHN COMMUNITY EXCHANGE (CE) TIME-BANKING PROGRAM TO INCREASE SOCIAL CONNECTIONS, NEIGHBORS HELPING NEIGHBORS.IN THE FALL OF 2017, COMMUNITY EXCHANGE LEADERSHIP MET WITH SCHUYLKILL VISION AND COUNTY REPRESENTATIVES TO DISCUSS CREATING A TIME BANK IN SCHUYLKILL COUNTY. DURING THE FORMATIVE PROCESS, COMMUNITY EXCHANGE'S FUNDING ENDED FOR THE PROGRAM IN THE LEHIGH VALLEY. SCHUYLKILL PARTNERS CONTINUED TO EXPLORE POTENTIAL WAYS TO INCLUDE TIMEBANKING IN THE WORK IN THE COUNTY.2.1 PARTNER WITH UNITED WAY 211 TO CREATE AND MAINTAIN A DATABASE (UW211 EAST) OF COMMUNITY RESOURCES, ACCESSIBLE TO LVHN CASE MANAGERS, CLINICIANS, PATIENTS, CAREGIVERS AND COMMUNITY ORGANIZATIONS.SCHUYLKILL COUNTY'S UNITED WAY HAS A CORRESPONDING STAFF MEMBER WHO IS RESPONSIBLE FOR UPDATING COUNTY RESOURCES IN UNITED WAY 211 AND A RESOURCE LISTING AVAILABLE TO COMMUNITY MEMBERS IN SCHUYLKILL COUNTY. THERE IS CURRENTLY NO FORMAL COLLABORATION WITH LVH-SCHUYLKILL, AT THIS TIME. AT-RISK POPULATIONS2.1 PUBLIC HEALTH DESTIGMATIZATION AND INFORMATIONAL CAMPAIGN TO PROMOTE IMPORTANCE OF EARLY IDENTIFICATION, CONNECTION TO TREATMENT, EMPLOYEE ASSISTANCE PROGRAMSIN FY17, THE AIM WAS TO PARTNER WITH LVHN DEPARTMENTS OF PSYCHIATRY, COMMUNITY HEALTH AND MARKETING TO DEVELOP A PUBLIC HEALTH CAMPAIGN ENTITLED "TELL YOUR STORY" TO REDUCE STIGMA AROUND MENTAL HEALTH IN PARTNERSHIP WITH NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI). THIS ALSO INCLUDED LOCAL DIGITAL STORYTELLING EFFORTS WITHIN ALLENTOWN. FY18 INCLUDED ON-GOING PLANNING AND DEVELOPMENT OF THESE EFFORTS WITH EXPANSION TO THE COUNTIES OUTSIDE OF THE LEHIGH VALLEY. THIS WORK HAS EVOLVED INTO WORK BEING LED BY SCHUYLKILL COUNTY VISION AND SCHUYLKILL COUNTY MENTAL HEALTH THROUGH THE RESILIENCY PROJECT, TRAUMA-INFORMED TRAINING, AND THE SUICIDE PREVENTION TASK FORCE. LVH-SCHUYLKILL IS A PARTICIPANT AND PARTNER IN THESE COALITIONS AND WILL CONTINUE TO INVEST IN THIS WORK IN THE 2019 IMPLEMENTATION PLAN.3.1 IN COOPERATION WITH THE CENTER FOR COUNSELING SERVICES, THE MATERNITY TEAM AND OTHERS FROM LVHSCHUYLKILL E. NORWEGIAN STREET, LVH SCHUYLKILL S. JACKSON STREET WILL CONTINUE TO OFFER A TOBACCO CESSATION PROGRAM THROUGH CHILDBIRTH FOR MOTHER AND PARTNER.3.2 DEVELOP A TOBACCO USE SURVEY FOR THE CHILDBIRTH CLASS AND AT TIME OF CHILDBIRTH.3.3 OFFER TIME TO QUIT PROGRAM, 5-6-WEEK COACHING SESSION, AT EITHER THE HOSPITAL, COMPREHENSIVE WOMEN'S HEALTH.LVH-SCHUYLKILL RECEIVED A DEPARTMENT OF HEALTH GRANT TO CREATE A SURVEY TO ASSESS CURRENT AND HISTORICAL USE OF TOBACCO DURING PREGNANCY, AS WELL AS DETERMINE KNOWLEDGE OF HARMFUL EFFECTS OF PRIMARY AND SECONDARY TOBACCO USE WHILE PREGNANT. THOSE WHO COMPLETED THE SURVEY WERE ALSO OFFERED RESOURCES FOR TOBACCO CESSATION. THE PROPOSED SERVICE FOCUSED ON POINTS OF INTERSECTION BETWEEN THE PATIENT AND THE HEALTHCARE DELIVERY SYSTEM DURING PREGNANCY. THIS INCLUDED OB-GYN PRACTICE, LABOR AND DELIVERY, AND CHILDBIRTH CLASSES. SURVEYS WERE ADMINISTERED BETWEEN APRIL 2017 AND JUNE 2017. GRANT OUTCOMES ARE AS FOLLOWS:-- THE GOAL WAS TO COLLECT 40 SURVEYS, AND THIS GOAL WAS SURPASSED BY COLLECTING 60 SURVEYS. OF THE 60 WHO COMPLETED THE SURVEY, 33% REPORTED SMOKING DAILY OR SOME DAYS WITHIN THE LAST 30 DAYS WHILE PREGNANT. 70% OF THOSE USING TOBACCO, USED IT DAILY. -- 65% WERE COLLECTED AT THE TIME OF INITIAL OB APPOINTMENT AT PHYSICIAN PRACTICE OFFICE. -- 11 PARTICIPANTS REPORTED A QUIT ATTEMPT WITHIN THE LAST 30 DAYS, AND 8 REFERRALS WERE MADE TO THE PA QUIT LINE. -- 1 OF THE 8 INDIVIDUALS REFERRED, ENGAGED WITH TIME TO QUIT. -- IN FY18, THE SURVEY CONTINUED TO BE ADMINISTERED. A TOTAL OF 598 SURVEYS WERE COMPLETED, AND 40 REFERRALS WERE MADE TO THE PA QUIT LINE.-- IN FY19, 461 SURVEYS WERE COMPLETED, AND 18 REFERRALS WERE MADE TO THE PA QUIT LINE.FROM THESE SURVEYS, WE HAVE LEARNED THE FOLLOWING:-- THE PATIENTS DEMONSTRATED AN UNDERSTANDING OF THE DANGERS IF CONTINUED NICOTINE USE WHILE PREGNANT AS WELL AS THE IMPORTANCE OF QUITTING-- PATIENTS HAD DIFFICULTY MOVING FROM CONTEMPLATION TO ACTION -- OPTIONS OF FACE TO FACE COUNSELING OR QUITLINE REFERRAL DID NOT YIELD SIGNIFICANT DIFFERENCE IN FOLLOW UP.3.4 PROMOTE TOBACCO CESSATION PROGRAMS TO OTHER OB/GYN PRACTICES ON THE MEDICAL STAFF.EVERY NEW OB PATIENT RECEIVES AN INFORMATION PACKET WITH INFORMATION ABOUT SMOKING CESSATION AND THE RISKS OF SMOKING AND ALL ARE COUNSELED ABOUT SMOKING AND PREGNANCY. -- IN FY17, THE PROCESS BEGAN WITH STAFF ASKING PATIENTS, "DO YOU SMOKE? AND IF YES, "HOW MUCH?". IN FY18, 100% OF PATIENTS COMPLETED THE TOBACCO SURVEY AT EACH APPOINTMENT WITH THE EXCEPTION OF JULY 2017, IN WHICH 63% OF PATIENTS COMPLETED THE SURVEY.-- IN FY19, 94% OF PATIENTS COMPLETED THE SURVEY AT EACH APPOINTMENT.ACCESS TO CARE1.1 MAINTAIN AND BROADLY COMMUNICATE LVHN'S FINANCIAL ASSISTANCE POLICY (FAP), PROVIDING FREE OR DISCOUNTED CARE FOR QUALIFYING PATIENTS.-- IN FY17, 449 FINANCIAL ASSISTANCE PROGRAM (FAP) APPLICATIONS WERE RECEIVED. 414 WERE APPROVED, 32 WERE DENIED, AND 3 WERE PENDING REVIEW. AVERAGE DAY TO TURNAROUND WAS 5 DAYS. -- IN FY18, 432 FAP APPLICATIONS WERE RECEIVED. 309 APPLICATIONS WERE APPROVED, 32 WERE DENIED, AND 91 ARE PENDING.-- IN FY19, 797 APPLICATIONS WERE RECEIVED. OF THOSE, 582 WERE APPROVED, 61 WERE DENIED, AND 154 ARE PENDING.3.1 RECRUIT PRIMARY CARE CLINICIANS TO IMPROVE ACCESS TO CARE FOR MEMBERS OF COMMUNITY.A FIVE YEAR RECRUITMENT PLAN WAS DEVELOPED AND INITIATED TO SUPPORT RECRUITMENT OF PRIMARY CARE CLINICIANS. THE HIRED PROVIDERS WERE FOR FAMILY MEDICINE, INTERNAL MEDICINE, AND PEDIATRICS. FROM FY17 TO FY19, 10 PHYSICIANS AND 5 APCS WERE HIRED.4.1 PROVIDE LVHN COLLEAGUES WITH CULTURAL, LINGUISTIC TRAINING VIA A VARIETY OF DELIVERY MECHANISMS.ONGOING CULTURAL AND LINGUISTIC TRAINING IS PROVIDED FOR ALL CAMPUSES AT LVHN THROUGH NEW EMPLOYEE ORIENTATION AS WELL AS THE LEARNING CURVE (TLC) QUARTERLY E-LEARNING EDUCATION BUNDLES. IN ADDITION, CAMPUSES-SPECIFIC CULTURAL AND LINGUISTIC TRAINING OPPORTUNITIES ARE PROVIDED AS NEEDED. IN FY17, LVHN'S DIVERSITY AND CULTURAL LIAISON PROVIDED AN EDUCATION SESSION TO THE LVH-SCHUYLKILL MANAGEMENT TEAM. THERE WERE 49 PARTICIPANTS IN ATTENDANCE.IN FY19, A TOTAL OF 91 PRESENTATIONS ON CULTURAL SENSITIVITY WERE PROVIDED THROUGHOUT THE NETWORK, REACHING A TOTAL 4,740 EMPLOYEES BY LVHN'S DIVERSITY AND CULTURAL LIAISON. IN ADDITION, A SESSION ON CULTURAL SENSITIVITY WAS OFFERED TO EMPLOYEES FROM FOR THE LVPG-H AND LVPG-S PRACTICES. IN APRIL 2019, AN EXTERNAL GUEST, ROBBIN CHAPMAN, WHO IS AN EXPERT ON UNCONSCIOUS BIAS IN THE WORKPLACE, PRESENTED AT THE NETWORK-WIDE MONTHLY MANAGER MEETING. APPROXIMATELY 250 EMPLOYEES ATTENDED THE PRESENTATION ENTITLED, "I CAN BE MYSELF AROUND HERE: POWERING THE FUTURE WITH COLLEAGUE ENGAGEMENT".4.2 PATIENT'S PREFERRED LANGUAGE FOR HEALTH CARE DISCUSSIONS IS RECORDED AT TIME OF REGISTRATION.FY17: AT LVH-SCHUYLKILL SOUTH JACKSON, 71,014 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS. AT LVH- SCHUYLKILL EAST NORWEGIAN, AN ADDITIONAL 38,234 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS.FY18: AT LVH-SCHUYLKILL SOUTH JACKSON, 71,291 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS. AT LVH- SCHUYLKILL EAST NORWEGIAN. 38,709 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS. THERE WERE 20 PREFERRED LANGUAGES IDENTIFIED INCLUDING ENGLISH. FY19: AT LVH-SCHUYLKILL SOUTH JACKSON, 71,497 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS. AT LVH- SCHUYLKILL EAST NORWEGIAN, 47,502 UNIQUE PATIENTS HAD A DOCUMENTED LANGUAGE RECORDED AT TIME OF REGISTRATION INCLUSIVE OF INPATIENT AND OUTPATIENT ENCOUNTERS. THERE ARE 20 PREFERRED LANGUAGES IDENTIFIED INCLUDING ENGLISH. LEHIGH VALLEY HOSPITAL - SCHUYLKILL PART V, SECTION B, LINE 18E: COLLECTION ACTIVITIES ARE LIMITED TO HOSPITAL SENDING FOUR STATEMENTS REQUESTING PAYMENT. THE STATEMENTS INCLUDE INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, SOLICITING THE PATIENT'S PARTICIPATION IN THE FINANCIAL ASSISTANCE PROGRAM. PART V, SECTION B, LINE 11 (CONTINUATION) 4.3 ASSESS AVAILABILITY OF LANGUAGE-ASSISTANCE RESOURCES IN ALL CARE DELIVERY SITES TO MEET NEEDS OF PATIENTS WITH LIMITED ENGLISH PROFICIENCY.LVHN PROVIDES INTERPRETING SERVICES AT NO CHARGE TO FOREIGN LANGUAGE AND SIGN LANGUAGE SPEAKING PATIENTS AND FAMILY MEMBERS. LVHN EMPLOYS TEN FULL-TIME INTERPRETERS IN THE INTERPRETER SERVICES DEPARTMENT. THERE ARE OVER 250 ADDITIONAL TRAINED MEDICAL INTERPRETERS WORKING IN OTHER POSITIONS AT LVHN, AS WELL AS COMMUNITY (NON-EMPLOYEES) INTERPRETERS. LVHN ALSO HAS A CONTRACTED TELEPHONIC INTERPRETING SERVICE CALLED CYRACOM FOR LANGUAGES AND HOURS NOT COVERED BY THE LIVE INTERPRETERS, AND PURCHASES SIGN LANGUAGE INTERPRETING SERVICES FROM TWO OUTSIDE VENDORS, STRATUS VIDEO FOR VIDEO REMOTE INTERPRETING (VRI) AND BERKS DEAF AND HARD OF HEARING SERVICES FOR LIVE SIGN LANGUAGE INTERPRETATION. IN ADDITION, LVHN HAS SUCCESSFULLY IMPLEMENTED A NEW SERVICE OF VRI VIA AN IPAD FOR THE LANGUAGES OF SPANISH, ASL, VIETNAMESE, CANTONESE, MANDARIN, RUSSIAN, SOMALI, BURMESE, FRENCH, HAITIAN CREOLE, HMONG, KOREAN, BOSNIAN, NEPALI, POLISH, AND PORTUGUESE. IN FY 17, A SITE VISIT WAS HELD AT LVH- SCHUYLKILL TO CONDUCT A NEEDS ASSESSMENT. LVH- SCHUYLKILL RECEIVED IPADS TO USE FOR LANGUAGE TRANSLATIONS WHICH WILL BE ROLLED OUT IN FY18. IN FY18, 101 INTERPRETER VIDEO CALLS WERE MADE USING 678 MINUTES AND RESULTED IN $588.10 IN CHARGES. IN FY19, THE NUMBER OF INTERPRETER VIDEO CALLS MADE INCREASED TO 261, RESULTING IN A TOTAL OF 2,814 MINUTES. THIS IS A 158% INCREASE ACROSS FISCAL YEARS.PREVENTION AND WELLNESS1.2 REDUCE NO-SHOWS FOR MAMMOGRAMS BY COMMUNICATING A REMINDER FOR SCHEDULED PATIENTS AND CALLING NO-SHOWS TO RESCHEDULE. THOSE UNABLE TO BE REACHED FOR NO-SHOW WILL BE SENT A LETTER.THE AVERAGE NO SHOW RATE FOR MAMMOGRAMS BETWEEN AUGUST THROUGH DECEMBER 2016 WAS 8.3%. THE AVERAGE NO SHOW RATE FOR JANUARY THROUGH JUNE 2017 WAS 5.9%.IN FY18, THE AVERAGE NO SHOW RATE WAS 7.38%. IN FY19, THE AVERAGE NO SHOW RATE WAS 8.5%.2.1 GUIDELINE DEVELOPMENT FOR ACUTE AND CHRONIC PAIN MANAGEMENT, PATIENT SCREENING FOR SAFE PRESCRIBING OF OPIOID ANALGESICS; PHYSICIAN OUTREACH AND EDUCATIONIN AUGUST 2016, LVH- SCHUYLKILL BEGAN USING OPIOID OVERDOSE RISK ASSESSMENT SCALE AND GIVING OPIOID PATIENTS NARCAN UNIVERSAL STANDING ORDERS TO OBTAIN NARCAN AT PHARMACIES. IN FY18, THE OPIOID PATHWAYS AND LINKAGE TO TREATMENT COMMITTEE CONDUCTED THREE EDUCATION SESSIONS WITH A TOTAL OF 30 PROVIDERS. THESE THREE SESSIONS INCLUDED AN OPIOID PRESCRIBER FOCUS GROUP, CHRONIC PAIN AND ADDICTION MEDICINE SYMPOSIUM, AND A RURAL ACCESS TO MEDICATION PROGRAMS (RAMP) TRAINING. IN ADDITION, TWO LARGE-GROUP PRESENTATIONS FOR LVHN EMPLOYEES INCLUDING LVH- SCHUYLKILL EMPLOYEES. THESE PRESENTATIONS WERE HELD AT THE LVPG MEMBER MEETING AND A FAMILY MEDICINE AND INTERNAL MEDICINE SAFE PRESCRIBING TRAINING. IN TOTAL THOSE TRAININGS REACHED OVER 700 EMPLOYEES.IN FY19, THE OPIOID PATHWAYS AND LINKAGE TO TREATMENT COMMITTEE CONDUCTED TWO COMMUNITY-BASED PRESENTATIONS, ONE OF WHICH WAS FOR EMS PROVIDERS, WITH A TOTAL OF 85 PEOPLE IN ATTENDANCE. IN ADDITION, THEY EXPLORED THE FEASIBILITY OF TELE-MAT AND ANALYZED DATA REGARDING THE NUMBER OF SUBSTANCE USE DISORDER CASES THAT WERE COMING INTO THE EMERGENCY DEPARTMENT.3.1 INVESTIGATE FEASIBILITY OF WORKING WITH LOCAL LAW ENFORCEMENT AND COMMUNITY ORGANIZATIONS TO OFFER A DRUG GIVE-BACK DAYLVH- SCHUYLKILL REACHED OUT TO THE LOCAL SHERIFF'S DEPARTMENT TO DISCUSS PARTNERSHIP ON DRUG GIVE-BACK DAY IN DECEMBER 2016. MULTIPLE ATTEMPTS HAVE BEEN MADE TO DISCUSS, HOWEVER, BOTH ORGANIZATIONS HAVE NOT BEEN ABLE TO CONNECT TO DETERMINE IF THIS IS FEASIBLE. THE DIALOGUE CONTINUED THROUGH FY18 AND A DRUG GIVE-BACK DAY WAS ORGANIZED BETWEEN LVH- SCHUYLKILL AND CVS. IT WAS HELD IN AUGUST 2018 DURING THE SCHUYLKILL DRUG AWARENESS DAY. 4.2 DEVELOP AND IMPLEMENT PROTOCOLS FOR TIMELY REFERRALS TO DRUG & ALCOHOL TREATMENT SYSTEM FOR PATIENTS WHO PRESENT TO THE EMERGENCY DEPARTMENT WITH ADDICTION-RELATED PROBLEMS.A REFERRAL SYSTEM WAS NOT OFFICIALLY ESTABLISHED IN FY 17, BUT ONE MEETING WAS HELD IN FEBRUARY 2017 TO DISCUSS COMMUNITY-BASED AGENCY NARCAN EDUCATION SYSTEM. THIS WILL CONTINUE TO BE DEVELOPED IN FY 18. IN MARCH OF 2017, A MEETING WAS HELD WITH CARE MANAGEMENT AND THE ED ON IMPROVING PATIENT FLOW FOR SUBSTANCE ABUSE CASES IN THE ED AND FACILITATING "WARM HAND-OFFS." A WARM HAND-OFF PROTOCOL WAS ESTABLISHED WITH THE COUNTY DRUG AND ALCOHOL SERVICES TO ENSURE CASE MANAGERS AND MENTAL HEALTH PROVIDES, EITHER INTERNALLY OR EXTERNALLY, ARE AVAILABLE TO MEET PATIENTS IN THE EMERGENCY DEPARTMENT WHEN THEY ARE STRUGGLING WITH SUBSTANCE ABUSE. AN ASSESSMENT CAN BE DONE IN THE ED AND A REFERRAL MADE DIRECTLY TO THE APPROPRIATE LEVEL OF TREATMENT. WITH THE ESTABLISHMENT OF THIS PROTOCOL, 100 REFERRALS WERE MADE TO DRUG AND ALCOHOL SERVICES FROM LVH- SCHUYLKILL IN FY18. IN FY19, THE WARM HAND-OFF PROTOCOL FROM THE EMERGENCY DEPARTMENT TO DRUG AND ALCOHOL SERVICES WAS FORMALIZED. IN THE SECOND HALF OF THE FISCAL YEAR, LVH- SCHUYLKILL EMPLOYEES PLACED 6 REFERRALS TO DRUG AND ALCOHOL SERVICES.5.1 ESTABLISH AND MAINTAIN CLOSE WORKING RELATIONSHIP WITH SCHUYLKILL COUNTY DRUG & ALCOHOL PROGRAM AND RESOURCES.IN FY 17, LVH- SCHUYLKILL HELD 5 MEETINGS WITH COLLEAGUES IN SCHUYLKILL COUNTY DRUG AND ALCOHOL. OUT OF THESE MEETINGS THERE WILL BE A NEW SERVICE CONTRACT FOR A GROUP PROVIDED TO CRIMINAL JUSTICE PATIENTS GOING THROUGH THE DRUG COURT IN THE COUNTY. THE GROUP WILL CONTINUE TO MEET THROUGH FY18. 1 MEETING WAS HELD IN FY18 DUE TO STAFFING CHANGES. THIS WILL BE REVISITED IN THE FUTURE. IN FY19, THE LVHN COLLEAGUES WORKING ON SUBSTANCE USE AND TREATMENT HAVE HAD ONGOING DIALOGUE WITH THE SCHUYLKILL COUNTY SCA OFFICE AND ARE STILL WORKING ON PROCESSES AROUND WARM HAND-OFF AND OTHER OPPORTUNITIES FOR COLLABORATION (SEE ABOVE). IN ADDITION A COUNTY-WIDE OPIOID TASK FORCE WAS CREATED WHICH COLLEAGUES FROM LVH- SCHUYLKILL ARE PARTICIPATING IN.6.1 WORK WITH SCHUYLKILL PREVENTION PARTNERSHIP TO EDUCATE SCHOOL-AGE CHILDREN IN SCHUYLKILL COUNTYFROM JULY 2016 THROUGH DECEMBER 2016, 143 PRESENTATIONS WERE GIVEN TO 3,170 STUDENTS ACROSS 8 SCHOOLS. FROM JANUARY THROUGH APRIL OF 2017, 99 SCHOOL PRESENTATIONS WERE GIVEN TO MORE THAN 2,600 STUDENTS IN GRADES K-12 ACROSS 7 SCHOOLS. IN FY18, THERE WERE 94 PRESENTATIONS FOR 8,210 STUDENTS ACROSS 35 SCHOOLS. IN FY19, THERE WERE 55 PRESENTATIONS FOR 5,611 STUDENTS ACROSS 18 SCHOOLS.7.1 IN COLLABORATION WITH SCHUYLKILL VISION, SUPPORT SELECTION OF COMMUNITY-BASED ACTIVITIES TO PROMOTE HEALTH, WELLNESS AND NUTRITION IN SCHUYLKILL COUNTY.7.2 INVITE DIETITIANS, COOKS, DIABETIC EDUCATORS AND OTHER HOSPITAL STAFF TO PARTICIPATE IN SCHUYLKILL VISION-SPONSORED HEALTH FAIRS AND EVENTS.THE FOLLOWING IS FOR BOTH 7.1 AND 7.2:DURING FY17, SCHUYLKILL VISION WAS CONTRACTED TO PROVIDE ESTABLISHED HEALTH EDUCATION PROGRAMMING IN THE THREE (3) HEALTHY SCHUYLKILL, PENNSYLVANIA COMMUNITIES: SCHUYLKILL HAVEN; MAHANOY CITY; AND, SHENANDOAH (EACH, A "REGION," TOGETHER, THE "COMMUNITY"). THEY WILL BE PROVIDING PERSONAL AND COMMUNITY EDUCATION ON TOPICS RELATED TO HEALTH AND SAFETY. THESE EDUCATIONAL PROGRAMS WILL BE PROVIDED TO ESTABLISHED COMMUNITY GROUPS OF ALL AGES WITHIN THESE AREAS. IN ADDITION TO EDUCATIONAL PROGRAMS, SCHUYLKILL VISIONS WILL FACILITATE AND/OR LEAD GROUP WALKS AND PHYSICAL ACTIVITY WITHIN THE COMMUNITIES LISTED.IN ADDITION, THEY WILL DEVELOP CURRICULUM AND DISTRIBUTE EDUCATIONAL MATERIALS FOR THE HEALTHY SCHUYLKILL SUMMER PROGRAM IN SCHUYLKILL COUNTY PUBLIC LIBRARIES. THIS PROGRAMMING OFFERS HEALTH RELATED EDUCATION, PRESENTED BY THE SUMMER READING PROGRAM FACILITATORS, TO ALL OF THE CHILDREN AND YOUTH WHO PARTICIPATE IN THE SUMMER READING PROGRAMS. IN FY17, VISION HELD 82 EVENTS AND IN FY18, AN ADDITIONAL 58 EVENTS COVERING 17 TOPICS INCLUDING PERSONAL AND COMMUNITY EDUCATION RELATED TO HEALTH AND SAFETY. THIS WORK EXPANDED IN FY19 TO 104 EVENTS, INCLUDING PREVENTIVE HEALTH SCREENINGS, GARDEN CLEAN-UPS, YOGA, AND HEALTHY SCHUYLKILL SUMMER.SOUTH-JACKSON SPECIFIC TACTICSAT-RISK POPULATIONS1.1 COORDINATE EFFORTS TO PROVIDE MENTAL HEALTH SERVICES, SUPPORT FOR PATIENTS' OTHER CONDITIONS, GROUP AND FAMILY SUPPORT, ETC. WITHIN THE INPATIENT MENTAL HEALTH UNIT.FROM JULY THROUGH DECEMBER 2016, THE REFERRAL PROCESS FOR DRUG AND ALCOHOL SERVICES FROM THE INPATIENT UNIT HAD NOT BEEN ESTABLISHED. MEETINGS WERE HELD TO ESTABLISH TRACKING OF REFERRALS WHICH WENT LIVE JANUARY 2017. IN FY18, 218 PATIENTS WERE REFERRED. 65% OF THOSE REFERRALS ATTENDED THEIR FIRST APPOINTMENT. 108 PATIENTS ATTENDED NUTRITION SESSIONS WITH A DIETICIAN ON THE INPATIENT UNIT. IN FY19, 177 PATIENTS WERE REFERRED. 37% OF THOSE REFERRALS ATTENDED THEIR FIRST APPOINTMENT. PART V, SECTION B, LINE 11 (CONTINUATION) ACCESS TO CARE AND HEALTH EQUITY2.1 INVESTIGATE FEASIBILITY OF ESTABLISHING URGENT CARE/EXPRESSCARE ACCESS AT LVHSCHUYLKILL.THE PLAN FOR URGENT CARE WAS DELAYED IN NOVEMBER 2016 DUE TO REGULATORY INTERVENTION THAT REQUIRED LVH- SCHUYLKILL MAINTAIN A FULL SERVICE ED AT BOTH CAMPUSES. THEY ARE CURRENTLY EXPLORING AT LEAST TWO DIFFERENT OPPORTUNITIES FOR URGENT CARE IN THE CITY AND SURROUNDING AREA. WHILE NO DEFINITE DATE YET SET, LVHSCHUYLKILL HAS IDENTIFIED A LIKELY SITE FOR SCHUYLKILL COUNTY'S FIRST EXPRESSCARE AND IS OPTIMISTIC TO INTRODUCE THAT SERVICE BY MARCH OF 2018. ADDITIONALLY, LVHSCHUYLKILL IS IDENTIFYING OTHER LOCATIONS IN SCHUYLKILL COUNTY WHERE EXPRESSCARE SERVICES LIKELY COULD AND WILL BE OFFERED. NO OFFICIAL ACTION HAS YET BEEN TAKEN IN THAT REGARD.IN FY18, THE SOUTH JACKSON AND EAST NORWEGIAN CAMPUSES WERE MERGED UNDER ONE LICENSE. UNDER THE NEW MERGED LICENSE, THE ED AT SOUTH JACKSON STREET IS CURRENTLY SERVING THE NEED FOR AN URGENT CARE. ACUTE SERVICES IN THE ED HAVE ALL BEEN CENTRALIZED TO EAST NORWEGIAN STREET. WHEN THE NEW FAMILY BIRTH AND NEWBORN CENTER OPENS IN JANUARY, THE SOUTH ED WILL CLOSE. IT IS ANTICIPATED THAT THE "FAST TRACK" AREA OF THE EAST ED WILL BECOME MORE AVAILABLE FOR PATIENTS.IN MAY 2019, EXPRESSCARE OPENED. DURING THE MONTHS OF MAY JULY 2019, A TOTAL OF 2,538 PATIENTS WERE SEEN.3.2 RECRUIT VARIOUS SPECIALTY PHYSICIANS TO MEET NEEDS IDENTIFIED IN THE 2016 CHNA.A FIVE YEAR RECRUITMENT GROWTH GRID AND FISCAL BUDGET WAS CREATED TO SUPPORT RECRUITMENT. IN FY18, 13 SPECIALISTS WERE HIRED: 1 CARDIOLOGIST, 1 EMERGENCY MEDICINE, 1 HOSPITAL MEDICINE, 1 OB-GYN, 1 OCCUPATIONAL MEDICINE, 1 PEDIATRIC PHYSICAL MEDICINE AND REHAB, 2 PULMONARY AND CRITICAL CARE, AND 3 RADIOLOGY PHYSICIANS WERE HIRED. 1 HEMATOLOGY/ONCOLOGY AND 1 PSYCH APC WERE HIRED.IN FY19, 3 PHYSICIANS AND 5 APCS WERE RECRUITED AND HIRED. OF THOSE APCS HIRED, 1 IS IN EMERGENCY MEDICINE, 1 IS IN UROLOGY, 2 IN GENERAL SURGERY, AND 1 PSYCHIATRY.PREVENTION AND WELLNESS1.1 OFFER LOW-COST MAMMOGRAMS IN OCTOBER AT WOMEN'S IMAGING CENTER.IN OCTOBER 2016 THERE WERE A TOTAL OF 6 LOW COST MAMMOGRAMS CONDUCTED AND IN OCTOBER 2017 THERE WERE A TOTAL OF 8 LOW COST MAMMOGRAMS CONDUCTED. LVH- SCHUYLKILL NO LONGER OFFERS LOW COST MAMMOGRAMS ON A REGULAR BASIS.1.3 CONTINUE PARTNERSHIP WITH MATERNAL & FAMILY HEALTH SERVICES IN WILKES-BARRE, PA., TO OFFER FREE MAMMOGRAMS FOR THOSE WHO CANNOT AFFORD THIS SCREENING.LVH- SCHUYLKILL WAS NOT ABLE TO FILL THE NP POSITION NEEDED TO SUPPORT THIS TACTIC IN FY17. IN OCTOBER 2017, 8 FREE MAMMOGRAMS WERE PROVIDED; HOWEVER, LVH- SCHUYLKILL IS NO LONGER WORKING WITH MATERNAL & FAMILY HEALTH SERVICES AS THEY DEVELOP THEIR OWN MATERNAL HEALTH SERVICES LOCALLY.1.4 EDUCATE COMMUNITY ON THE IMPORTANCE OF MAMMOGRAMS BY HANDING OUT SELF-BREAST EXAM SHOWER CARDS AT HEALTH FAIRS, SPEAKING ENGAGEMENTS AND ALL LOCAL OB/GYN OFFICES, AS WELL AS MAKE AVAILABLE IN WAITING AREAS OF THE HOSPITAL.IN OCTOBER EVERY YEAR (2017, 2018, AND 2019), 1,500 SELF-BREAST EXAM SHOWER CARDS AND CALENDARS ARE DISTRIBUTED AT BOTH THE IMAGING CENTER AT LVH- SCHUYLKILL AND HOSPITAL EAST CAMPUS.4.1 CREATE A COLLABORATION BETWEEN THE HOSPITAL, SCHUYLKILL COUNTY DRUG & ALCOHOL PROGRAM RESOURCES AND OB/GYN PROVIDERS IN COMMUNITY TO OFFER CONTINUUM OF CARE FOR PREGNANT MOTHERS ADDICTED TO HEROIN, INCLUDING CREATION OF TEAM TO CONSULT WHEN PREGNANT MOTHER IS ADMITTED TO THE HOSPITAL OR IDENTIFIED AT OB/GYN VISIT OFFER NUTRITION, REFERRAL FOR SUBSTANCE USE TREATMENT, AT-HOME SUPPORT, MEDICAL HOME, ETC.IN DECEMBER OF 2016, A MULTIDISCIPLINARY COMMITTEE FOR DRUG ADDICTED OB PATIENTS WAS DEVELOPED AND MET. THEIR GOAL IS TO DEVELOP A PLAN TO BETTER MANAGE THE OB PATIENTS THAT ARE GOING INTO WITHDRAWAL AS WELL AS A PREVENTION STRATEGY. THE FIRST THING THE GROUP IS WORKING ON IS DEVELOPING A STANDING ORDER SETS FOR PATIENTS ADMITTED INTO INPATIENT CARE THAT DEMONSTRATE SYMPTOMS OF WITHDRAWAL DURING THEIR STAY IN ORDER TO BETTER MANAGE THEIR STAY. NO ACTIVITY OCCURRED IN FY18, BUT DISCUSSIONS IN FY19 ARE OCCURRING TO EXPLORE TELE-MED FOR MAT PROVISION AND EXPANSION OF THE CONNECTIONS CLINIC. THE OPERATIONALIZATION OF THIS GRANT WILL OCCUR IN FY12. PART I, LINE 7: LEHIGH VALLEY HOSPITAL - SCHUYLKILL COMPUTED A COST TO CHARGE RATIO USING INFORMATION FROM THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/19) FOR THE CALCULATION OF COSTS FOR CHARITY CARE AND MEDICAID. DIRECT COSTS ARE OBTAINED FROM THE HOSPITAL COMPUTER SYSTEM FOR EACH COST CENTER FOR ALL OTHER BENEFITS. INDIRECT COSTS ARE COMPUTED UTILIZING THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/19). PART I, LINE 7G: THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A) IS $13,312,420. PART III, LINE 2: AMOUNTS REPORTED AS BAD DEBT EXPENSE ARE REPORTED NET OF APPLICABLE PATIENT PAYMENTS, INSURANCE PAYMENTS AND CONTRACTUAL ALLOWANCES AS WELL AS OTHER HOSPITAL DISCOUNTS FOR WHICH THE PATIENT IS DEEMED ELIGIBLE. THE RATIO OF COSTS-TO-CHARGES (RCC) IS APPLIED TO THE NET AMOUNT TO DETERMINE THE BAD DEBT EXPENSE. PART III, LINE 3: THIS AMOUNT IS THE COST TO PROVIDE CARE TO UNINSURED PATIENTS THAT DO NOT PARTICIPATE IN THE PROCESS TO DETERMINE IF THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE COST IS DETERMINED USING COST TO CHARGE RATIOS. THE RATIONALE FOR INCLUDING THE COST TO PROVIDE CARE TO UNINSURED PATIENTS THAT DO NOT PARTICIPATE IN THE FINANCIAL ASSISTANCE PROCESS IS THE HOSPITAL'S EXPERIENCE WITH UNINSURED PATIENTS THAT DO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROGRAM. WHEN THE HOSPITAL EVALUATES UNINSURED PATIENTS FOR FINANCIAL ASSISTANCE, THE MOST COMMON FINDING IS THAT UNINSURED PATIENTS HAVE INCOME LESS THAN 400% OF THE FEDERAL POVERTY GUIDELINE AND QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL BELIEVES THAT UNINSURED PEOPLE WHO CHOOSE NOT TO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROCESS AND HAVE THEIR ACCOUNTS WRITTEN OFF AS BAD DEBT, HAVE INCOME THAT WOULD QUALIFY FOR THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. PART III, LINE 4: BAD DEBTS - THE ORGANIZATION RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED ACCOUNTS NET OF THE AGB DISCOUNT TO RECORD THE NET SELF-PAY ACCOUNTS RECEIVABLE AT THE ESTIMATED AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT. COINSURANCES AND DEDUCTIBLES WITHIN THE THIRD-PARTY PAYER AGREEMENTS ARE THE PATIENT'S RESPONSIBILITY SO THE ORGANIZATION INCLUDES THESE AMOUNTS IN THE SELF-PAY ACCOUNTS RECEIVABLE AND CONSIDERS THESE AMOUNTS IN ITS DETERMINATION OF THE PROVISION FOR BAD DEBTS BASED ON HISTORICAL COLLECTION EXPERIENCE.IN INSTANCES WHERE THE ORGANIZATION BELIEVES A PATIENT HAS THE ABILITY TO PAY FOR SERVICES AND, AFTER APPROPRIATE COLLECTION EFFORT, PAYMENT IS NOT MADE, THE AMOUNT OF SERVICES NOT PAID IS WRITTEN-OFF AS BAD DEBTS. AMOUNTS RECORDED AS PROVISION FOR BAD DEBTS DO NOT INCLUDE CHARITY CARE. PART III, LINE 8: THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS.THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THE HOSPITAL IS TREATING MEDICARE PATIENTS DESPITE THE RISE IN UNREIMBURSED COST. PART III, LINE 9B: THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. ALL STAFF INVOLVED IN DEBT COLLECTION (EMPLOYEES OF THE MEDICAL CENTER AND ANY THIRD PARTY AGENCIES) ARE TRAINED ON THE POLICY AS WELL AS THE CHARITY CARE POLICY. IN DEALING WITH PATIENTS IN DEBT COLLECTION, STAFF WILL INFORM PATIENTS OF THE CHARITY CARE POLICY THAT IS AVAILABLE AND ALSO ANY OTHER FINANCIAL ASSISTANCE POLICIES OF THE MEDICAL CENTER THAT MAY BE APPLICABLE TO THE PATIENT. THE STAFF WILL INSTRUCT PATIENTS ON APPROPRIATE PAPERWORK THAT NEEDS TO BE COMPLETED WITH REGARDS TO CHARITY CARE OR FINANCIAL ASSISTANCE. PART VI, LINE 2: IN AN EFFORT TO IMPROVE THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY, ALL NON-PROFIT HOSPITALS AND HEALTH SYSTEMS MUST IDENTIFY AND EVALUATE THE NEEDS OF THE COMMUNITIES THEY SERVE THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. FOR THE PURPOSES OF THE CHNA, LEHIGH VALLEY HEALTH NETWORK (LVHN) DEFINES "COMMUNITY" AS ALL RESIDENTS LIVING WITHIN THE PRIMARY COUNTIES EACH LICENSED FACILITY SERVES, NAMELY LEHIGH, NORTHAMPTON, SCHUYLKILL, LUZERNE, AND MONROE COUNTIES IN PENNSYLVANIA. THE CHNA HEALTH PROFILE INCLUDES SECONDARY DATA PULLED TOGETHER FROM PUBLICALLY AVAILABLE, STATE AND LOCAL SOURCES SUCH AS THE CENTER FOR DISEASE CONTROL AND THE CENSUS BUREAU. THIS DATA WAS USED TO IDENTIFY THE TOP HEALTH AND SOCIAL NEEDS IN EACH IDENTIFIED COMMUNITY. LVHN THEN PARTNERED WITH COMMUNITY AND EDUCATIONAL INSTITUTIONS TO OBTAIN INPUT (PRIMARY DATA) FROM COMMUNITY MEMBERS IN EACH COUNTY IN ORDER TO VALIDATE THE FINDINGS OF THE SECONDARY DATA COLLECTION. THESE COMMUNITY PARTNERS CONDUCTED FOCUS GROUPS AND KEY INFORMANT INTERVIEWS TO REVIEW THE FINDINGS OF THE SECONDARY DATA COLLECTION AND ALLOW THE COMMUNITY TO IDENTIFY ANY OTHER NEEDS NOT MENTIONED. THE SECONDARY AND PRIMARY DATA WERE THEN COMBINED INTO ONE HEALTH PROFILE FOR EACH COUNTY, WHICH PROVIDES AN OVERVIEW OF THE CURRENT STATE OF HEALTH IN EACH OF THE COUNTIES LVHN SERVES. THESE REPORTS WERE REVIEWED BY LVHN EXECUTIVE LEADERSHIP AT EACH CAMPUS, AND INITIAL HEALTH NEEDS WERE PRIORITIZED BASED ON THE COMMUNITIES INPUT AND LVHN'S ABILITY TO MAKE A DIFFERENCE ON THAT HEALTH NEED. AS PART OF THE AFFORDABLE CARE ACT, STARTING IN 2013, ALL NON-PROFIT HOSPITALS AND HEALTH CARE SYSTEMS ARE REQUIRED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THE CHNA REPORT EXAMINES THE FACTORS THAT IMPACT THE HEALTH AND WELLNESS OF ALL THE PEOPLE IN A PARTICULAR GEOGRAPHIC AREA. BEYOND ITS REGULATORY FUNCTION, THE CHNA IS AN IMPORTANT OVERVIEW OF THE CURRENT STATE OF HEALTH IN OUR REGION AND IDENTIFIES POTENTIAL AREAS OF CONCERN WHICH INFORMS LEHIGH VALLEY HEALTH NETWORK'S (LVHN) POPULATION HEALTH MANAGEMENT EFFORTS. LVHN'S CHNA INCLUDES A HEALTH PROFILE, A REPORT THAT LOOKS AT ALL OF THE FACTORS THAT GO INTO MAKING PEOPLE IN A PARTICULAR AREA HEALTHY. THIS INCLUDES SOCIAL AND ENVIRONMENTAL FACTORS LIKE EMPLOYMENT, EDUCATION AND AIR QUALITY, INDIVIDUAL BEHAVIORS LIKE SMOKING OR HEALTHY EATING, AND THE QUALITY AND AVAILABILITY OF HEALTH CARE IN THEIR AREA. THIS INTRODUCTION PROVIDES AN OVERVIEW OF THE 2019 CHNA HEALTH PROFILE AND LVHN'S CHNA PROCESS. THE 2019 HEALTH PROFILE COMBINES DATA AND INFORMATION FROM LOCAL, STATE AND NATIONAL SOURCES ABOUT DISEASE, THE ENVIRONMENT, SOCIAL FACTORS AND INDIVIDUAL BEHAVIORS, WITH IDEAS, STORIES, AND EXPERIENCES FROM COMMUNITY MEMBERS AND LEADERS FROM THROUGHOUT THE COUNTIES SERVED BY LVHN. THE SECOND COMPONENT OF THE LVHN'S CHNA INCLUDES AN IMPLEMENTATION PLAN, WHICH OUTLINES OUR PLAN TO ADDRESS THE NEEDS IDENTIFIED IN THE HEALTH PROFILE OVER THE COURSE OF THE NEXT THREE YEARS. THE 2019 IMPLEMENTATION PLAN WILL BE SHARED AS A SEPARATE REPORT SOON AFTER THE HEALTH PROFILES ARE RELEASED.THE 2019 LVHN CHNA HEALTH PROFILE IS BROKEN OUT INTO THREE PRIMARY SECTIONS: DEMOGRAPHICS, HEALTH FACTORS, AND HEALTH OUTCOMES. THE DEMOGRAPHICS SECTION INCLUDES INFORMATION THAT PROVIDES A DESCRIPTION OF THE INDIVIDUALS LIVING IN THE COMMUNITY. THE HEALTH FACTORS SECTION INCLUDES INFORMATION ABOUT SOCIAL FACTORS, ENVIRONMENTAL FACTORS, HEALTH BEHAVIORS, AND THE QUALITY AND AVAILABILITY OF HEALTH CARE IN THE AREA. THE FINAL SECTION, HEALTH OUTCOMES, LOOKS AT THE OCCURRENCE OF CHRONIC CONDITIONS, SUCH AS ASTHMA AND HEART DISEASE, AS WELL AS RATES OF CANCER AND THE LEADING CAUSES OF DEATH. TO INCREASE THE READABILITY OF THE REPORT, THE COMMUNITY WILL FIND THREE TYPES OF CALL-OUT BOXES THROUGHOUT THE CHNA HEALTH PROFILES. THE FIRST TYPE SUMMARIZES SOME OF THE DATA PRESENTED ON THAT PAGE IN ORDER TO PROVIDE EASY-TO-READ, SUMMARY STATEMENTS OF IMPORTANT DATA ABOUT THE COMMUNITY. THESE SUMMARY STATEMENTS ARE ALSO COMPILED INTO ONE LIST AT THE END OF THE HEALTH PROFILE. THE SECOND TYPE PROVIDES INFORMATION FROM THE INTERVIEWS AND FOCUS GROUPS. THE THIRD TYPE OF CALL-OUT BOX HIGHLIGHTS DATA SPECIFIC TO LVHN PATIENTS, WHERE IT WAS RELEVANT. THESE REPORTS HAVE BEEN REVIEWED AND APPROVED BY LVHN'S BOARD OF TRUSTEES AS WELL AS THE COMMUNITY RELATIONS COMMITTEE OF THE BOARD.VISIT WWW.LVHN.ORG/ABOUT_US TO VIEW THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENTLY CONDUCTED CHNA AND HOW WE ARE ADDRESSING THOSE NEEDS. PART VI, LINE 3: EACH PATIENT IS REGISTERED INTO THE HOSPITAL COMPUTER SYSTEM WHEN THEY ARRIVE FOR SERVICES. AS PART OF THE REGISTRATION, INFORMATION IS OBTAINED ON ANY HEALTH INSURANCE THEY HAVE. INDIVIDUALS WITHOUT HEALTH INSURANCE ARE INFORMED AT THAT TIME OF THE MEDICAL CENTER'S CHARITY CARE POLICY. PATIENTS ARE GIVEN INFORMATION ON CONTACTING STAFF WITHIN THE HOSPITAL PATIENT ACCOUNTING DEPARTMENT TO DISCUSS APPLYING FOR THE HOSPITAL CHARITY CARE PROGRAM. SPECIFIC STAFF HAVE BEEN TRAINED AND ARE RESPONSIBLE FOR ADMINISTERING THE CHARITY CARE PROGRAM FOR THE HOSPITAL. HOSPITAL STAFF CONTACT PATIENTS WITHOUT INSURANCE AND EXPLAIN THE POLICY AND THE INFORMATION NEEDED TO APPLY. HOSPITAL STAFF WILL ALSO ASSIST PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE. THEY WILL ALSO ASSIST PATIENTS IN COMPLETING THE APPLICATION AND GATHERING THE NECESSARY FINANCIAL DOCUMENTS.THE HOSPITAL ALSO POSTS INFORMATION WITHIN THE ADMISSION AND EMERGENCY ROOM AREAS INFORMING PATIENTS THAT THERE IS A CHARITY CARE POLICY AVAILABLE. ALL REGISTRATION PERSONNEL ARE TRAINED ON THE POLICY SO THAT THEY ARE ABLE TO INFORM PATIENTS WHEN THEY ARE REGISTERED.OTHER HOSPITAL STAFF MEMBERS THAT MAY COME IN CONTACT WITH PATIENTS ARE ALSO EDUCATED REGARDING THE CHARITY CARE POLICY. THIS WOULD INCLUDE SOCIAL WORKERS, CARE MANAGERS, NURSING STAFF, AND ALL DEPARTMENT DIRECTORS. THE CHARITY CARE POLICY IS AVAILABLE ON THE HOSPITAL INTRANET WHICH IS ACCESSIBLE BY ALL EMPLOYEES. THE HOSPITAL IS ALSO IN THE PROCESS OF PLACING THE POLICY ON THE HOSPITAL WEBSITE.ALL PATIENT ACCOUNTING, CASHIERING, AND COLLECTION STAFF ARE ALSO EDUCATED ON THE CHARITY CARE POLICY AND CAN ASSIST PATIENTS IN APPLYING FOR CHARITY CARE. ALSO ALL THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE MEDICAL CENTER IN PERFORMING COLLECTIONS HAVE BEEN EDUCATED ON THE CHARITY CARE POLICY AND CAN ADVISE PATIENTS ON APPLYING FOR THIS BENEFIT. PART VI, LINE 4: LEHIGH VALLEY HOSPITAL - SCHUYLKILL (LVH-S) IS LOCATED IN POTTSVILLE, PENNSYLVANIA. THE PRIMARY SERVICE AREA OF LVH-S IS SCHUYLKILL COUNTY. SCHUYLKILL COUNTY IS A RURAL COUNTY IN PENNSYLVANIA, WITH THE CITY OF POTTSVILLE AS THE LARGEST POPULATION CENTER AND THE COUNTY SEAT. THE COUNTY IS COMPRISED OF ONE SMALL CITY AS WELL AS SEVERAL BOROUGHS AND TOWNSHIPS.BASED ON U.S. CENSUS BUREAU DATA FOR THE YEAR 2010 CENSUS, THE POPULATION OF THE PRIMARY SERVICE AREA WAS APPROXIMATELY 148,289 PEOPLE. DURING THE CALENDAR YEAR 2018, ABOUT 94.4% OF THE DISCHARGES FROM LVH-S WERE RESIDENTS OF THE PRIMARY SERVICE AREA. ACCORDING TO THE AMERICAN COMMUNITY SURVEY (U.S. CENSUS), THE ESTIMATED POPULATION FOR THE PRIMARY SERVICE AREA IN 2018 WAS 142,067.THE 2010 POPULATION OF THE SECONDARY SERVICE AREA WAS APPROXIMATELY 1,807,469, AN EXTENSIVE RURAL AREA WITH A SMALL PATIENT DISTRIBUTION THROUGHOUT. DURING THE CALENDAR YEAR 2018, ABOUT 3.7% OF THE DISCHARGES FROM LVH-S WERE RESIDENTS OF THE SECONDARY SERVICE AREA.BASED ON PROPRIETARY DATA ESTIMATES (SCANUS), THE CURRENT POPULATION OF THE COMBINED PRIMARY AND SECONDARY SERVICE AREAS IS PROJECTED, TO INCREASE APPROXIMATELY 2.4% BY THE YEAR 2024. DURING THE CALENDAR YEAR 2018, LESS THAN 1.9% OF THE DISCHARGES FROM LVH-SCHUYLKILL WERE RESIDENTS OUTSIDE THE PRIMARY AND SECONDARY SERVICE AREAS.SCHUYLKILL COUNTY HAS FOUR HOSPITALS SERVING THE COUNTY. LVH-S INCLUDES TWO LOCATIONS: SOUTH JACKSON STREET AND EAST NORWEGIAN STREET, WHICH ARE BOTH LOCATED IN POTTSVILLE AND SERVE THE MAJORITY OF THE COUNTY RESIDENTS. ST. LUKE'S OPERATES THE MINERS MEMORIAL HOSPITAL IN COALDALE, NEAR THE CARBON COUNTY BORDER, AND A HOSPITAL IN ORWIGSBURG THAT IS CO-OWNED WITH GEISINGER. PART VI, LINE 5: THE BOARD OF LVH-S IS COMPRISED OF SEVENTEEN INDIVIDUALS, FIFTEEN OF WHOM ARE FROM THE SCHUYLKILL COUNTY COMMUNITY WHO ARE NOT EMPLOYED BY THE HOSPITAL. THEY ARE INVOLVED IN EDUCATION, SOCIAL SERVICES, GERIATRIC SERVICES, MATERNAL/CHILD SERVICES, PRIMARY MEDICAL CARE, CRIMINAL JUSTICE, SMALL BUSINESS AND MANUFACTURING. ALL PHYSICIANS ARE ENCOURAGED TO APPLY FOR MEDICAL STAFF PRIVILEGES FOR THE MEDICAL CENTER.LVH-S ALSO WORKS WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP IDENTIFY COMMUNITY NEEDS AND WORK TOGETHER TO MEET THOSE NEEDS. THE MEDICAL CENTER HAS INPATIENT ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES AVAILABLE TO THE RESIDENTS OF SCHUYLKILL COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY INPATIENT CARE WITHIN THE COUNTY WITHOUT REQUIRING FAMILIES TO TRAVEL OUTSIDE OF THE COUNTY. THE MEDICAL CENTER ALSO HAS A CERTIFIED DIABETES EDUCATOR AVAILABLE TO CONSULT WITH PATIENTS AND ALSO WITH PHYSICIANS WHEN THEY HAVE A PATIENT THAT IS NEWLY DIAGNOSED WITH DIABETES. THE MEDICAL CENTER IS THE ONLY FACILITY IN THE COUNTY WITH A MATERNITY DEPARTMENT AND NEWBORN NURSERY. THIS ALLOWS COUNTY RESIDENTS TO REMAIN IN THE COUNTY FOR MATERNITY CARE. MORE THAN 50% OF THE BIRTHS EACH YEAR ARE MEDICAID.THE EMERGENCY DEPARTMENT OF LVH-S IS A 24-HOUR EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER PARTICIPATES IN MANY INSURANCE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS, AND VA. THE MEDICAL CENTER ALSO HAS A CHARITY CARE POLICY THAT PROVIDES ASSISTANCE TO ELIGIBLE INDIVIDUALS IN PROVIDING FREE OR DISCOUNTED CARE BASED ON THEIR ABILITY TO PAY AND THE FEDERAL POVERTY GUIDELINES.LVH-S ALSO PROVIDES OPPORTUNITIES TO STUDENTS IN HEALTHCARE FIELDS TO GAIN EXPERIENCE WORKING IN THE HEALTH CARE ENVIRONMENT SUCH AS NURSING STUDENTS (RN AND LPN), PHARMACY STUDENTS, PHYSICIAN ASSISTANT STUDENTS, PHYSICAL THERAPY STUDENTS, RADIOLOGY TECHNICIANS AND MEDICAL ASSISTANTS. THE MEDICAL CENTER ALSO PROVIDES A VOLUNTEER PROGRAM FOR JUNIOR HIGH AND HIGH SCHOOL STUDENTS TO BECOME FAMILIAR WITH THE MEDICAL SERVICES OFFERED AND THE EDUCATIONAL OPPORTUNITIES AVAILABLE WITHIN THE HEALTHCARE ENVIRONMENT.THE HOSPITAL ALSO SPONSORS AND PARTICIPATES IN HEALTH FAIRS AT COMMUNITY EVENTS SUCH AS THE COUNTY FAIR, EVENTS AT THE LOCAL MALL, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS AND CLINICS, VETERANS BREAKFAST EVENT, MEALS ON WHEELS, SKIN CANCER SCREENINGS, MAMMOGRAPHY SCREENINGS, SUPPORT GROUPS, AND LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE.ANY EXCESS FUNDS THAT ARE GENERATED FROM THE OPERATIONS ARE INVESTED BACK INTO THE MEDICAL CENTER BY PURCHASING THE NECESSARY CAPITAL EQUIPMENT, FUNDING CAPITAL IMPROVEMENT PROJECTS, FUNDING NEW SERVICES, IMPROVING AND EXPANDING EXISTING SERVICES, AND ANY OTHER GENERAL IMPROVEMENTS TO PATIENT CARE. X X X X X 1 1 0 0 0 0 0 0 0 WILLIAM J REPPY PRESIDENT/TRUSTEE 311016 0 27819 0 5408 0 0 0 19545 0 363788 0 0 0 LAWRENCE RIDDLES MD TRUSTEE 370766 0 48000 0 -1019 0 0 0 19545 0 437292 0 0 0 JONATHAN RUSSO PATHOLOGIST 286749 0 500 0 -2312 0 0 0 19491 0 304428 0 0 0 RICHARD BINDIE DIRECTOR, PATHOLOGY 276330 0 0 0 73 0 0 0 19491 0 295894 0 0 0 KRISTINA GUERS REGISTERED NURSE 80009 0 0 0 97173 0 0 0 6893 0 184075 0 0 0 CYNTHIA SCHAFFER REGISTERED NURSE 170055 0 500 0 -3684 0 0 0 21082 0 187953 0 0 0 BRIAN PAUL PHARMACIST 152689 0 500 0 -2536 0 0 0 39759 0 190412 0 0 0 DIANE BORIS VP, FINANCE 160430 0 38227 0 -2152 0 0 0 14822 0 211327 0 0 0 SUE CURRY CHIEF NURSING OFFICER 186930 0 19546 0 -2806 0 0 0 15885 0 219555 0 0 0 THOMAS V WHALEN MD MMM FORMER TRUSTEE 0 683396 0 147927 0 160082 0 0 0 33933 0 1025338 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM LEHIGH VALLEY HOSPITAL - SCHUYLKILL DURING CALENDAR YEAR 2018: KRISTINA GUERS, REGISTERED NURSE - $97,572 THE FOLLOWING INDIVIDUAL PARTICIPATED IN THE 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN OF LEHIGH VALLEY HOSPITAL, A RELATED ORGANIZATION, AND RECEIVED A DISTRIBUTION IN CALENDAR YEAR 2018: THOMAS V. WHALEN, MD, MMM, FORMER TRUSTEE - $139,213 A CITY OF POTTSVILLE HOSPITAL AUTHORITY 232289554 738435CQ7 2016-12-20 56602260 PURCHASE OF HOSPITAL FACILITIES 0 0 0 A 56774551 772198 55996318 6035 2018 0 0 0 1 A 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE CORPORATE MEMBER IS LEHIGH VALLEY HEALTH NETWORK, INC. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE CORPORATE MEMBER, LEHIGH VALLEY HEALTH NETWORK, INC., HAS THE POWER TO ELECT, APPOINT, APPROVE, OR REJECT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S SOLE CORPORATE MEMBER, LEHIGH VALLEY HEALTH NETWORK, INC., HAS THE POWER TO APPROVE OR REJECT CERTAIN MAJOR OPERATING DECISIONS MADE BY THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS TO REVIEW THE 990'S INCLUDES: DRAFT 1 OF THE RETURNS IS REVIEWED IN DETAIL WITH A FOCUS ON ACCURACY, COMPLETENESS, AND PERSPECTIVE BY THE LVHN VICE-PRESIDENT, FINANCE AND CONTROLLER. DRAFT 2 OF THE RETURNS IS REVIEWED BY THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER. ALL COMPENSATION DISCLOSURES ARE REVIEWED BY THE DIRECTOR, COMPENSATION - HUMAN RESOURCES. DRAFT 3 OF THE RETURNS IS REVIEWED TOGETHER WITH THE PRESIDENT & CEO, THE EXECUTIVE VICE PRESIDENT & CHIEF FINANCIAL OFFICER, THE VICE-PRESIDENT, FINANCE AND CONTROLLER AND THE DIRECTOR, TAX. FINAL RETURNS ARE REVIEWED WITH THE LVHN BOARD LEADERSHIP GROUP (THE BOARD CHAIR AND THREE VICE CHAIRS). COPIES OF ALL 990'S ARE PROVIDED TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN JANUARY 2016, LVHN IMPLEMENTED AN ELECTRONIC TOOL DESIGNED TO SEND NOTIFICATIONS AND TRACK DISCLOSURES REPORTED ON CONFLICT OF INTEREST QUESTIONNAIRES. THE NETWORK ALSO EXPANDED THE SCOPE OF THE CONFLICT OF INTEREST OR COMMITMENT POLICY, SUCH THAT ADDITIONAL COLLEAGUES ARE NOW REQUIRED TO COMPLETE A QUESTIONNAIRE EACH YEAR. PRIOR TO JANUARY, THE VP, INTERNAL AUDIT AND COMPLIANCE SERVICES ISSUED A NOTICE TO BOARD MEMBERS AND MEMBERS OF THE SENIOR MANAGEMENT COUNCIL WHEN IT WAS TIME FOR THEM TO SUBMIT THEIR CONFLICT OF INTEREST QUESTIONNAIRES. THE VP ALSO INSTRUCTED MEMBERS OF THE SENIOR MANAGEMENT COUNCIL TO IDENTIFY AND REQUEST COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES FROM INDIVIDUALS WHO HAD POTENTIAL CONFLICTS OF INTEREST AND TO PROVIDE HER WITH THE IDENTITY OF THOSE INDIVIDUALS. COMPLIANCE SERVICES TRACKED COMPLETION OF THE QUESTIONNAIRES. ALL PHYSICIANS ON LVHN'S MEDICAL STAFF ARE ALSO REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. MEDICAL STAFF SERVICES MONITORS THIS PROCESS TO ENSURE THAT ALL PHYSICIANS COMPLY. POTENTIAL CONFLICTS ARE MANAGED BY THE LVHN CONFLICT OF INTEREST COMMITTEE AND/OR BY THE BOARD OF TRUSTEES, DEPENDING ON WHOSE INTEREST(S) POSE THE CONFLICT AND THE NATURE OF THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 LEHIGH VALLEY HEALTH NETWORK 2019 EXECUTIVE COMPENSATION REVIEW IN COMPLIANCE WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS PROCESS OUTLINED IN THE INTERMEDIATE SANCTIONS REGULATIONS (ISSUED UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE); SULLIVAN COTTER AND ASSOCIATES, INC. (SULLIVAN COTTER) QUALIFIES AS AN INDEPENDENT EXECUTIVE COMPENSATION EXPERT, SPECIALIZING IN THE HEALTH CARE INDUSTRY. SULLIVAN COTTER PROVIDES ADVICE TO THE LEHIGH VALLEY HEALTH NETWORK EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES TO SUPPORT ITS ATTAINMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS. THEY ALSO SUPPORT THE COMMITTEE IN ENSURING THAT THE LVHN EXECUTIVE COMPENSATION PROGRAM IS COMPETITIVE AND ALIGNED WITH THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY. CHIEF EXECUTIVE OFFICER TOTAL COMPENSATION REVIEW: PROGRAM ANALYSIS: ANALYZE THE MARKET POSITION OF TOTAL COMPENSATION (BASE SALARY, INCENTIVE, BENEFITS, AND PERQUISITES) FOR LVHN'S PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) IN RELATION TO CEO MARKET DATA OBTAINED FOR A DEFINED PEER GROUP OF COMPARABLE HEALTH SYSTEMS. THIS INCLUDES THE PREPARATION OF TALLY SHEETS FOR THE PRESIDENT AND CEO AS WELL AS AN ANALYSIS OF FORM 990 COMPENSATION DATA. THEY ASSESS THE ALIGNMENT OF THE PRESIDENT AND CEO'S COMPENSATION WITH LVHN'S COMPENSATION PHILOSOPHY AND NOTE THE IMPLICATIONS OF THE REVIEW. SULLIVAN COTTER'S ANALYSES AND FINDINGS ARE SUMMARIZED IN A REPORT TO THE COMMITTEE THAT PROVIDES A REASONABLENESS OPINION FOR THE INTERMEDIATE SANCTIONS COMPLIANCE. THE REPORT WAS PROVIDED BY SULLIVAN COTTER AT THE AUGUST 22, 2018 EXECUTIVE COMPENSATION COMMITTEE MEETING. CEO COUNCIL EXECUTIVE TOTAL COMPENSATION REVIEW: PROGRAM ANALYSIS: ANALYZE THE MARKET POSITION OF TOTAL COMPENSATION (SALARIES, INCENTIVES, BENEFITS, AND PERQUISITES) FOR LVHN'S CEO COUNCIL EXECUTIVES (APPROXIMATELY 12 TOTAL POSITIONS) IN RELATION TO COMPARABLE POSITIONS IN PEER ORGANIZATIONS. THIS INCLUDES THE PREPARATION OF TALLY SHEETS FOR EACH INDIVIDUAL. SULLIVAN COTTER'S ANALYSES AND FINDINGS ARE SUMMARIZED IN A REPORT TO THE COMMITTEE THAT ALSO PROVIDES AN OPINION OF REASONABLENESS FOR INTERMEDIATE SANCTIONS COMPLIANCE. THE REPORT WAS PROVIDED BY SULLIVAN COTTER AT THE AUGUST 22, 2018 EXECUTIVE COMPENSATION COMMITTEE MEETING. SUMMARY OF METHODOLOGY TO CONDUCT THIS ANALYSIS, SULLIVAN COTTER: COLLECTED BACKGROUND INFORMATION REGARDING LVHN'S OPERATIONS, STRUCTURE, SIZE AND SCOPE, AS WELL AS EACH POSITION'S DUTIES. COMPILED MARKET DATA FOR CEO COUNCIL EXECUTIVES CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY APPROVED BY THE COMMITTEE DURING ITS SEPTEMBER 18, 2018 MEETING: THE MARKET DATA USED FOR LVHN SYSTEM EXECUTIVES IN THIS ASSESSMENT ARE AN EQUALLY WEIGHTED BLEND OF (1) A PEER GROUP OF 30 NOT-FOR-PROFIT HEALTH SYSTEMS LOCATED IN THE NORTHEAST REGION (EXCLUDING NEW YORK CITY) WITH NET OPERATING REVENUES BETWEEN $1.3 BILLION AND $5.0 BILLION (AVERAGE OF $2.4 BILLION), AND (2) NATIONAL DATA REFLECTING ORGANIZATIONS OF SIMILAR SCOPE AND SIZE TO LVHN. NATIONAL DATA ARE USED WHERE PEER GROUP DATA ARE NOT AVAILABLE. PEER GROUP AND NATIONAL MARKET DATA WERE ABSTRACTED FROM SULLIVAN COTTER'S 2017 SURVEY OF MANAGER AND EXECUTIVE COMPENSATION IN HOSPITALS AND HEALTH SYSTEMS, AS WELL AS OTHER PUBLISHED COMPENSATION SURVEYS REFLECTING PAY AT COMPARABLY SIZED ORGANIZATIONS, WHICH INCLUDED NATIONAL HOSPITALS AND NATIONAL MEDICAL GROUPS. SULLIVAN COTTER NOTES THAT NO MARKET DATA ARE PROVIDED FOR THE SVP, MEDICAL SERVICES AS THE RESPONSIBILITIES OF THAT POSITION ARE UNIQUE, SO NO BENCHMARK DATA ARE AVAILABLE. THEY RECOMMEND THAT THE COMMITTEE ASSESS THE COMPENSATION FOR THAT POSITION BASED ON INTERNAL EQUITY CONSIDERATIONS. COMPILED MARKET DATA FOR THE LVHN CLINICAL CHAIRS PREPARED BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) FOR THE CHAIRS OF CLINICAL DEPARTMENTS IN MEDICAL SCHOOLS, LVHN'S TRADITIONAL COMPARATOR GROUP FOR THESE JOBS. ADJUSTED THE MARKET DATA TO AN EFFECTIVE DATE OF JANUARY 1, 2019 AT AN ANNUALIZED RATE OF 3.0% BASED ON SALARY INCREASE TRENDS. COMPARED EACH COMPONENT OF LVHN'S BENEFIT PROGRAM AGAINST TYPICAL MARKET BENEFIT PRACTICES IN HEALTH SYSTEMS AND HOSPITALS BASED ON MULTIPLE PUBLISHED SURVEYS, SUPPLEMENTED BY SULLIVAN COTTER'S PROPRIETARY DATA AND EXPERIENCE. DEVELOPED MARKET TOTAL COMPENSATION DATA BY COMBINING MARKET TCC WITH TYPICAL MARKET BENEFIT COSTS. COMPARED LVHN'S TC TO MARKET RATES AND ASSESSED OVERALL POSITIONING. FOR PHYSICIAN EXECUTIVES HAVING BOTH CLINICAL AND ADMINISTRATIVE ROLES, RELEVANT MARKET DATA WERE COLLECTED BASED ON FTE ALLOCATION. SULLIVAN COTTER HAS NOT COMPLETED AN ASSESSMENT OF THE PHYSICIANS' PRODUCTIVITY OR THE FAIR MARKET VALUE (FMV) OF THEIR CLINICAL COMPENSATION, AS LVHN HAS ADVISED THAT SUCH AMOUNTS ARE APPROPRIATE AND WITHIN FMV. SULLIVAN COTTER USED THE FOLLOWING METHODOLOGY TO ASSESS THE COMPETITIVENESS AND REASONABLENESS OF LVHN'S EXECUTIVE TOTAL COMPENSATION LEVELS: COLLECTED BACKGROUND INFORMATION REGARDING LVHN'S OPERATIONS, STRUCTURE, SIZE AND SCOPE. COLLECTED INFORMATION ON EACH CEO COUNCIL EXECUTIVE MEMBER'S CURRENT COMPENSATION. DATA COLLECTED INCLUDE BASE SALARIES, ANNUAL INCENTIVE OPPORTUNITY LEVELS (TARGET AND MAXIMUM), ACTUAL ANNUAL INCENTIVE PAYOUT AMOUNTS, ANNUAL COSTS OF ALL STANDARD AND SUPPLEMENTAL BENEFITS AND ANNUAL COST AND DESCRIPTION OF EXECUTIVE PERQUISITES. REVIEWED JOB DESCRIPTIONS AND ORGANIZATIONAL CHARTS TO IDENTIFY EACH POSITION'S FUNCTIONAL RESPONSIBILITIES AND REPORTING RELATIONSHIPS. SELECTED THE APPROPRIATE BENCHMARK POSITION MATCH FOR EACH POSITION AND APPLIED PREMIUMS/DISCOUNTS TO THE MARKET DATA IN INSTANCES WHERE LVHN'S JOB DUTIES DIFFER MATERIALLY FROM BENCHMARK POSITION MATCHES. POSITION MATCHES AND MARKET ADJUSTMENTS WERE REVIEWED WITH LVHN'S SENIOR VICE PRESIDENT, HUMAN RESOURCES AND COMPENSATION STAFF. LVHN'S PROJECTED FY2018 NET REVENUES AND PHYSICIAN FTE'S WERE USED AS THE SCOPE SIZE FOR EACH ENTITY. FORM 990, PART VI, SECTION C, LINE 18 ANOTHER WEBSITE - GUIDESTAR. UPON REQUEST - HARD COPIES WITH SENIOR MANAGEMENT AND MARKETING DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH ITS ANNUAL REPORT TO THE COMMUNITY. THE ANNUAL REPORT IS DISTRIBUTED TO ALL ATTENDEES AT THE ORGANIZATIONS ANNUAL PUBLIC MEETING. THE ANNUAL REPORT IS AVAILABLE ON THE ORGANIZATION'S WEBSITE - WWW.LVHN.ORG. IN ADDITION, IT IS DISTRIBUTED VIA MAIL TO MEMBERS OF THE COMMUNITY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 9,030,171. MANAGEMENT AND GENERAL EXPENSES 3,852,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,882,288. CREDIT CARD PROCESSING FEES: PROGRAM SERVICE EXPENSES 9,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,802. COLLECTION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 706,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 706,575. STORAGE FEES: PROGRAM SERVICE EXPENSES 36,706. MANAGEMENT AND GENERAL EXPENSES 7,038. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,744. MAILING & POSTAGE FEES: PROGRAM SERVICE EXPENSES 83,241. MANAGEMENT AND GENERAL EXPENSES 2,834. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,075. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 3,511,203. MANAGEMENT AND GENERAL EXPENSES 1,636. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,512,839. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT -6,311,061. 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