2020-11-13T13:25:26-06:00 2019-12-31 454051133 FREED MAXICK CPAS PC 424 MAIN STREET SUITE 800 BUFFALO NY 142023508 990 2019-01-01 150524324 DELAWARE VALLEY HOSPITAL INC DELA 6078652197 1 TITUS PLACE WALTON NY 138561457 LUCINDA RIDER CFO 6078652197 2020-11-12 1 MARY MADONIA P00405803 7168472651 2020-11-12 104.193.28.34 2020-11-12 13:18:53 ES P 8FDDAAF62860F71EAFAD1FB1999F99665ADCE87C E567259EAED278DC20889AB4017D05C2E4F78990 2019 2021-01-29 14:40:06Z PAUL SUMMERS 1 TITUS PLACE WALTON NY 138561457 26752633 0 X WWW.NYUHS.ORG X 1950 NY TO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE,PRIMARY CARE AND WELLNESS SERVICES. 8 4 225 36 0 0 833039 1208797 24576052 24990075 95847 161825 543318 391936 26048256 26752633 0 0 0 0 9859414 10341924 0 0 220581 14231953 14429311 24091367 24771235 1956889 1981398 21521375 23538078 6071776 5893763 15449599 17644315 X INPATIENT AND ACUTE SERVICES (SEE SCHEDULE O)AS A CRITICAL ACCESS HOSPITAL AND MEMBER OF THE UHS HEALTHCARE SYSTEM, UHS DELAWARE VALLEY HOSPITAL'S MISSION IS TO PROVIDE THE COMMUNITY WITH THE HIGH QUALITY, PATIENT-CENTERED SERVICES THAT ARE MOST OFTEN NEEDED; THEREBY IMPROVING ACCESS TO CARE AND REDUCING THE NEED TO TRAVEL LONG DISTANCES. WE DO THIS BY OFFERING EMERGENCY CARE, INPATIENT SHORT-TERM ACUTE CARE, PHYSICAL REHABILITATIVE CARE AND ADDICTION TREATMENT. IN ADDITION, WE PROVIDE HIGH QUALITY PRIMARY CARE; A WIDE RANGE OF DIAGNOSTIC AND TREATMENT SERVICES; ACCESS TO TOP LOCAL SPECIALTY CARE AND AN OUTPATIENT PHARMACY. UHS DELAWARE VALLEY HOSPITAL ALSO SERVES AS THE GATEWAY FOR PATIENTS TO ACCESS THE STATE-OF-THE-ART TECHNOLOGY AND HIGHLY QUALIFIED SPECIALISTS OF THE UHS SYSTEM, WHEN MORE SPECIALIZED CARE IS NEEDED. 0 0 4896893 4488602 INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT ACUTE CARE, SWING BED AND ADDICTION TREATMENT SERVICES VIA ITS 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2019 WERE COMPRISED OF 135 ACUTE, 125 SWING BED, AND 115 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 398 PATIENT DAYS, IN ADDITION TO THE 1,658 PATIENT DAYS FOR SWING BED AND 1,822 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 4,992 LAB TESTS, 10,517 RESPIRATORY TREATMENTS, 176 X-RAYS, 44 ULTRASOUNDS, 99 CT AND 6 MRI EXAMS, 788 PHYSICAL THERAPY AND 412 OCCUPATIONAL THERAPY SESSIONS, AND 121 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED 26 ECHO EXAMS, AND 672 DIETARY CONSULTS. TO ENSURE OUR RURAL AREA RESIDENTS HAVE ACCESS TO HIGH QUALITY, EFFICIENT CARE IN A COMFORTABLE AND PRIVATE AREA, THE HOSPITAL'S IMAGING CENTER IS EQUIPPED WITH 3D MAMMOGRAPHY, ULTRASOUND, BONE DENSITY, X-RAY AND A 128-SLICE CT SUITE. MRI SERVICES ARE OFFERED ON SUNDAYS THROUGH AN AGREEMENT WITH A MOBILE VENDOR. 3515579 2399627 CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH ITS PRIMARY CARE CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE PRIMARY CARE CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. 2019 INCLUDED 11,417 VISITS IN WALTON, 860 IN ROSCOE, AND 1,938 IN DOWNSVILLE. 11922937 18101846 OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC CARDIOPULMONARY, IMAGING, LAB AND TREATMENT SERVICES AT ITS WALTON CAMPUS. THESE INCLUDE A 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE PHYSICAL AND OCCUPATIONAL REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, CARDIAC AND PULMONARY REHABILITATION AND ACCESS TO SPECIALTY SERVICES. IN 2019 THE CARDIOLOGY SPECIALTY CLINIC HAD 587 VISITS, PAIN MANAGEMENT 429; TELE-MENTAL HEALTH 699 AND TELE-DIABETES CONSULTS 34. THE HOSPITAL ALSO CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS, DIABETES EDUCATION AND CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION. IN 2019 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,287 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 68,068 TESTS, AND 7,692 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 9,504 X-RAYS, CT SCANS, MRI'S, ULTRASOUNDS, BONE DENSITY TESTS AND MAMMOGRAPHY FOR OUTPATIENT SERVICES. OTHER OUTPATIENT SERVICES PERFORMED IN 2019 INCLUDED 186 AMBULATORY PROCEDURES, 100 ENDOSCOPIES, 1,801 OPIATE ADDICTION TREATMENT SESSIONS, AND 1,093 SERVICES ASSOCIATED WITH CARDIAC AND PULMONARY REHABILITATION. THE CARDIOPULMONARY DEPARTMENT PERFORMED 1,228 TESTS AND/OR TREATMENTS. 1,946 CARDIAC RELATED TESTS WERE PERFORMED: EKGS, ECHOCARDIOGRAMS, CARDIAC HOLTER AND EVENT MONITORS. THERE WERE 317 DIETARY CONSULTS. THE HOSPITAL'S OUTPATIENT RETAIL PHARMACY FILLED 60,164 PRESCRIPTIONS. 391936 391936 20335409 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 36 0 1 225 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 NY X PAUL SUMMERS 6078652197 DELAWARE VALLEY HOSPITAL 1 TITUS WALTON NY 138561457 HELEN JOHNSTON BOARD MEMBER/BOARD CHAIR 2.00 X X 0 0 0 JOHN CARRIGG BOARD MEMBER/VICE CHAIR 2.00 55.00 X X 0 965944 39637 LARRY LIGHT BOARD MEMBER 2.00 X 0 0 0 EDWARD SNOW BOARD MEMBER/SECRETARY 2.00 X X 0 0 0 ERIN NEALE BOARD MEMBER 2.00 X 0 0 0 AMANDA HALL BOARD MEMBER/TREASURER 2.00 X X 0 0 0 DR MICHAEL FREEMAN BOARD MEMBER/MEDICAL STAFF PRESIDENT 57.00 X X 236273 0 39593 PAUL SUMMERS BOARD MEMBER/PRESIDENT/CEO 57.00 X X 240155 0 23673 DR JOHN GIANNONE CHIEF MEDICAL OFFICER 5.00 X 25000 0 0 JOAN GUARNIERI V.P. ANCILLARY SVCS 55.00 X 98709 0 13027 DOTTIE KRUPPO V.P. COMMUNITY RELATIONS 55.00 X 94010 0 20255 DEBORAH HITT V.P. QUALITY/SUPPORT SVCS 55.00 X 105311 0 21343 VICTORIA CONKLING V.P. PATIENT CARE SERVICES 55.00 X 130891 0 7223 LUCINDA RIDER CONTROLLER 55.00 X 80092 0 20365 KATHLEEN ULMSCHNEIDER STAFF NURSE 55.00 X 116139 0 21618 1126580 965944 206734 4 0 1 1 SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH NY 13815 PHYSICAL/OCC. THERAPY 584478 MEDHOST OF TENNESSEE 2739 MOMENTUM PLACE CHICAGO IL 60689 INFORMATION TECHNOLOGY 416274 MAUREEN DATA SYSTEMS INC 307 WEST 38TH STREET SUITE 180 NEW YORK NY 10018 COMPUTER SUPPORT AND SERVICES 271139 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 606936485 IMAGING SERVICE 193154 J&K PLUMBING & HEATING CO LLC 24 THORP STREET PO BOX 25 WEST VIE BINGHAMTON NY 13905 PLUMBING & HEATING 191306 14 1009562 199235 1208797 OUTPATIENT SERVICES 621400 18101846 18101846 INPATIENT AND ACUTE SERVICES 621990 4488602 4488602 CLINICS 621110 2399627 2399627 24990075 161714 161714 111 0 111 111 111 DSRIP PROJECT REVENUE 900099 185270 185270 MISC REVENUE 900099 145395 145395 61271 61271 391936 26752633 25382011 0 161825 X 1293677 840239 339173 114265 7173681 5597233 1551745 24703 230281 177316 50662 2303 1062372 818026 233722 10624 581913 448071 124090 9752 85598 85598 44452 44452 78865 78865 3883 3883 4508 4508 5980812 5241211 739601 1340411 766315 539155 34941 126639 126639 203121 50208 152913 52179 33895 16166 2118 29262 6086 1301 21875 192494 102219 90275 991061 991061 147655 115158 32497 DRUGS 3755047 3755047 BAD DEBT EXPENSE 650664 650664 MEDICAL SUPPLIES 492464 492464 EQUIPMENT 167436 167436 82760 82760 24771235 20335409 4215245 220581 4145812 3628167 2411558 2176087 607888 504567 657839 550450 25287512 15367652 9458683 9919860 3791505 5046374 448090 318209 0 1394364 21521375 23538078 1312145 1535695 2436420 2148852 277362 222663 1565235 1516651 480614 469902 6071776 5893763 X 15119182 17308649 330417 335666 15449599 17644315 21521375 23538078 X 1981398 260087 -46768 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3883 3883 0 PART II-B, LINE 1: AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY AND IROQUOIS HEALTHCARE. 330416 5250 335666 328445 1971 330416 330360 9996 11911 328445 324669 5691 330360 361539 5286 42156 324669 0.95000 0.05000 1 0 51202 51202 13070284 6302726 6767558 10624800 9064926 1559874 1541226 1541226 9919860 SAVINGS - RESTRICTED DONATIONS 13305 SAVINGS ENHANCE NBDC 1381059 1394364 DUE UNITED MED. ASSOC. 240517 DUE UHS HOSPITALS 228097 DUE TO UHS, INC. 3668 DUE FROM UHS CMH -2380 469902 X 26315288 260087 -46768 213319 26101969 650664 650664 26752633 24120571 0 24120571 650664 650664 24771235 PART V, LINE 4: PURCHASE OF CAPITAL EQUIPMENT (MEDICAL) AND IMPROVEMENT OF FACILITIES. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2019 AND 2018, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2016 TO 2019. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTEREST RATE SWAP -46,768. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 650,664. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 650,664. 1 1 X 1 X 0 1 1 0 1 1 155378 155378 0.00640 5477873 4693694 784179 0.03250 39034 28140 10894 0.00050 5672285 4721834 950451 0.03940 274918 274918 0.01140 57817 57817 0.00240 6781474 6090443 691031 0.02860 7114209 6090443 1023766 0.04240 12786494 10812277 1974217 0.08180 4925 4925 0.00020 12080 12080 0.00050 1217 1217 0.00010 18222 18222 0.00080 0 650664 375433 4418780 4388900 29880 X 1 1 1 1 DELAWARE VALLEY HOSPTITAL 1 TITUS PLACE WALTON NY 13856 X X X DELAWARE VALLEY HOSPTITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTP://WWW.NYUHS.ORG X 1 19 1 HTTP://WWW.NYUHS.ORG 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.NYUHS.ORG X HTTP://WWW.NYUHS.ORG X HTTP://WWW.NYUHS.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 5: DELAWARE VALLEY HOSPITAL HAS MEMBERSHIP IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY, AS WELL AS ON ITS WELLNESS COMMITTEE. A STAFF MEMBER ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR PARTICIPATES IN ALL DVH VOLUNTEER MEETINGS AND ACTIVELY SEEKS THEIR INPUT AND FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES INPUT AS TO WHAT THEY HEAR FROM COMMUNITY MEMBERS. PATIENT SATISFACTION SURVEYS ARE ALSO USED IN GAINING INPUT FROM OUR PATIENTS. DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6A: O'CONNOR HOSPITAL, DELHI, NYMARGARETVILLE COMMUNITY HOSPITAL, MARGARETVILLE, NY DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, DEPT OF SOCIAL SERVICES, SHERIFF'S DEPT, ALCOHOL AND DRUG ABUSE COUNCIL, PLANNING DEPT, EMERGENCY SERVICES, DRUG TREATMENT COURT, WATERSHED AFFAIRSHOSPITAL AND HEALTH SERVICES:UHS DELAWARE VALLEY HOSPITAL, BASSETT HEALTHCARE-O'CONNOR HOSPITAL AND CATSKILL AREA HOSPICEEDUCATION:ROXBURY CENTRAL SCHOOLNURSING HOMES:ROBINSON TERRACEALLIANCES:RURAL HEALTH NETWORK OF SOUTH CENTRAL NYOTHER HUMAN SERVICE AGENCIES:CORNELL COOPERATIVE EXTENSION, RURAL 3 FOR TOBACCO FREE COMMUNITIES, CANCER SERVICE PROGRAM OF DELAWARE, OTSEGO AND SCHOHARIE COUNTIES, DELAWARE OPPORTUNITIES, NY CONNECTS, FAMILY RESOURCE NETWORK, CATHOLIC CHARITIES DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN PREVENT CHRONIC DISEASE FOCUS AREA 4: PREVENTIVE CARE AND MANAGEMENT DISPARITY: UNLESS OTHERWISE NOTED THE DISPARITY FOR ALL OF THE FOLLOWING WILL BE: DVH PRIMARY CARE PATIENTS FITTING DEMOGRAPHICS AS DESCRIBED IN OBJECTIVES. INTERVENTIONS: UNLESS OTHERWISE NOTED THE INTERVENTIONS WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS REMINDERS THROUGH EHR ALERTS, MAIL, PHONE CALLS, EMAIL AND/OR E-CHART NOTIFICATIONS MEASURES: UNLESS OTHERWISE NOTED THE MEASURE WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: PERCENTAGE OF DVH PATIENTS, AS DESCRIBED, WHO COMPLY SCREENING GUIDELINES. GOAL 4.1 INCREASE CANCER SCREENING RATES 4.1.1 OBJECTIVE: BY DECEMBER 31, 2021, THE PERCENTAGE OF ADULTS, AGE 50-75 YEARS OLD, RECEIVING A COLORECTAL SCREENING WILL INCREASE. INTERVENTIONS WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS' REMINDERS THROUGH ELECTRONIC HEALTH RECORD (EHR) ALERTS, MAIL, PHONE CALLS, EMAIL AND/OR E-CHART NOTIFICATIONS YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019 64.4% OF DVH PATIENTS, WHO HAD AN INTERACTION WITH DVH WITHIN THE LAST TWO YEARS, AND ARE BETWEEN THE AGES OF 50-75 HAD APPROPRIATE COLORECTAL SCREENING. 70% IS THE GOAL FOR 2019. THE YEAR ENDED AT 67.2%, AN IMPROVEMENT FROM THE SEPTEMBER PERCENTAGE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 IS 68%YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.3 PROMOTE EVIDENCE-BASED CARE TO PREVENT AND MANAGE CHRONIC DISEASES INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES AND OBESITY. 4.3.1 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 50-85 YEARS OLD, HAVING AN ANNUAL WELL CARE VISIT WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019, 36.5% OF DVH PATIENTS, BETWEEN THE AGES OF 50-85 HAD AN ANNUAL WELL CARE VISIT. 50% IS THE GOAL FOR 2019. THE YEAR ENDED AT 38%, AN IMPROVEMENT SINCE THE SEPTEMBER MEASURE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 IS 50%.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.2 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-85 YEARS OLD, DIAGNOSED WITH HYPERTENSION WHO HAVE THEIR CONDITION ADEQUATELY CONTROLLED WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019 71.7% OF DVH PATIENTS, BETWEEN THE AGES OF 18-85 WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION, HAD THEIR BLOOD PRESSURE ADEQUATELY CONTROLLED (<140/90). THE TARGET FOR 2019 IS 71%. THE YEAR ENDED AT 73.9 %, WHICH EXCEEDED THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 IS 72.5%YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.3 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-75, WITH DIABETES, WHO HAVE HAD HBA1C TESTING WITHIN A YEAR WITH A RESULT OF <8.0% WILL INCREASE. YEAR 1 AS OF SEPTEMBER 2019 AT LEAST 69.5% OF PATIENTS AGE 18-75 YEARS OF AGE, WITH DIABETES, WILL HAVE HAD HBA1C TESTING WITHIN A YEAR AND THE RESULT WILL BE <8.0%. GOAL IS 67.2% FOR 2019. THE YEAR ENDED AT 68.3%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 67.2%YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.4 OBJECTIVE: BY DECEMBER 31, 2021 MOST PRESCRIPTIONS FOR CHRONIC DISEASE MANAGEMENT WILL BE WRITTEN FOR 90 DAYS IN ORDER TO FOSTER BETTER PATIENT COMPLIANCE AND CONVENIENCE YEAR 1 AS OF SEPTEMBER 2019, 72.6% OF PRESCRIPTIONS, WRITTEN FOR THE CHRONIC CONDITIONS OF PATIENTS WHO HAVE HAD ANY INTERACTION WITH DVH WITHIN THE LAST 2 YEARS, WILL BE WRITTEN FOR A 90 DAY SUPPLY. MEDICATION TYPES INCLUDED IN THE MEASURE: ACE INHIBITOR/ARB MEDICATIONS, DIABETES, BETA-BLOCKER, HIGH AND MODERATE AND LOW INTENSITY STATIN MEDICATIONS. GOAL IS 72% FOR 2019. THE YEAR ENDED AT 74.4%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 72%.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.4 IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES AND OBESITY 4.4.1 OBJECTIVE: A HEALTHCARE PROVIDER OR HUMAN SERVICE AGENCY WILL HAVE REFERRED MORE PARTICIPANTS TO THE CHRONIC DISEASE SELF- MANAGEMENT WORKSHOP. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE MEASURES: THE PERCENTAGE OF PARTICIPANTS REFERRED BY PRIMARY CARE PROVIDERS OR HUMAN SERVICE AGENCIES INTERVENTIONS: WORK WITH MARKETING STAFF, PRIMARY CARE PROVIDER OFFICES AND LOCAL HUMAN SERVICE AGENCIES TO PUT SYSTEMS IN PLACE TO ASSURE AWARENESS OF THE AVAILABILITY OF THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. YEAR 1 RECOGNIZED THAT MOST PARTICIPANTS ARE LEARNING OF THE PROGRAM THROUGH ONE SOLE PROVIDER OR THROUGH ADVERTISING. THERE IS A NEED TO CREATE MORE WIDELY-BASED KNOWLEDGE OF THE PROGRAM. YEAR 2 SYSTEMS WILL BE IN PLACE AND UTILIZED BY THE FALL OF 2020.YEAR 3 AT LEAST 25% OF THE PARTICIPANTS WILL HAVE BEEN REFERRED FROM AN AGENCY OR PROVIDER. 4.4.2 OBJECTIVE: ACCESS TO CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS WILL CONTINUE. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE MEASURE: NUMBER OF SERIES OF WORKSHOPS OFFERED INTERVENTIONS: HOLD CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS YEAR 1 DURING 2019, 2 SERIES OF WORKSHOPS WERE HELD IN THE SPRING. A FALL SERIES WAS OFFERED BUT THERE WERE NOT ENOUGH PARTICIPANTS TO ACTUALLY HOLD THE PROGRAM. YEAR 2 DURING 2020, AT LEAST TWO WORKSHOPS WILL BE HELD. YEAR 3 DURING 2021, AT LEAST TWO WORKSHOPS WILL BE HELD. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS FOCUS AREA 1: PROMOTE WELL-BEING GOAL 1.1: STRENGTHEN OPPORTUNITIES TO BUILD WELL-BEING AND RESILIENCE ACROSS THE LIFESPAN 1.1.1 OBJECTIVE: BY DECEMBER 31, 2020 AT LEAST ONE COMMUNITY WITHIN THE DVH SERVICE AREA WILL BE ACTIVELY WORKING TO BECOME AN AGE-FRIENDLY COMMUNITY. INTERVENTIONS: BUILD COMMUNITY WEALTH BY SERVING AS THE CATALYST TO CREATE INCLUSIVE, HEALTHY PUBLIC SPACES AND INTER-GENERATIONAL SOCIALIZATION OPPORTUNITIES MEASURES: IMPROVEMENT IN ACCESSIBILITY, SOCIALIZATION, AND WELL-BEING MEASURES YEAR 1: RESEARCHED BUILDING AGE FRIENDLY COMMUNITIES THROUGH AARP - DISCUSSED CONCEPT WITH POTENTIAL STAKEHOLDERS INCLUDING LOCAL OFFICIALS, ORGANIZATIONS, AGENCIES, SCHOOLS, POTENTIAL COMMUNITY PARTNERS AND GARNERED SUPPORT TO MOVE PROJECT FORWARD. REQUESTED AND SECURED FUNDING FROM CARE COMPASS NETWORK TO HOLD SERIES OF WORKSHOPS REGARDING AGE FRIENDLY COMMUNITIES - SET DATES, SECURED VENUE, CATERERS AND DEVELOPED INVITE LIST YEAR 2: HOLD SERIES OF WORKSHOPS BASED ON A BLEND OF AARP'S ROAD TO LIVABILITY PROGRAM AND NY STATE'S LIVABLE NY PROGRAM WHICH INCORPORATES THE IMPORTANCE OF THE SOCIAL DETERMINANTS OF HEALTH. HOLD FOLLOW-UP MEETINGS WITH APPROPRIATE INTERESTED PARTIES FROM WALTON AREA TO CREATE A COALITION OF COMMUNITY MEMBERS TO PRIORITIZE POTENTIAL AGE FRIENDLY COMMUNITY INITIATIVES; IDENTIFY NEXT STEPS AND IDENTIFY POTENTIAL COMMITTEE MEMBERS TO ADDRESS EACH INITIATIVE. MEASURES: TWO COMMITTEES WILL BE FORMED OR EXISTING COMMITTEES, INTEGRATED INTO ADDRESSING AT LEAST TWO COMPONENTS OF THE AGE FRIENDLY COMMUNITY. RECRUIT AND FORM COMMITTEE(S) OF COMMUNITY RESIDENTS, WHICH IS REPRESENTATIVE OF THE POPULATION AND ALSO INCLUDES APPROPRIATE COMMUNITY BASED ORGANIZATIONS, AGENCIES AND GOVERNMENT ENTITIES TO DEVELOP AN ACTION PLAN AND TIMELINE TO ADDRESS AT LEAST TWO COMPONENTS OF BECOMING AN AGE FRIENDLY COMMUNITY.MEASURES: COMMITTEE OBJECTIVES AND TIMELINES WILL BE DEVELOPED COMMITTEES WILL FORMULATE THEIR RESPECTIVE OBJECTIVES, BASED ON AGE FRIENDLY SERIES AND DEVELOP A WORKPLAN AND CREATE A TIMELINE TO ACHIEVE THOSE OBJECTIVES AND CHOOSE A REPRESENTATIVE TO SIT ON THE COMMUNITY COALITION. MEASURES: BEST PRACTICE, CORE MEASURES AND STAKEHOLDER ROLES WILL BE DETERMINED COMMITTEES WILL REACH CONSENSUS ON BEST PRACTICE INTERVENTIONS, CORE MEASURES AND ROLES OF STAKEHOLDERS YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.2 INCREASE ACCESSIBILITY OF PHYSICAL ENVIRONMENT BY 5% (BASELINE TO BE SET IN 2020) INTERVENTION: DEVELOP CONSENSUS ON DEVELOPMENT OF WATER STREET THROUGH FLOOD MITIGATION PROJECT AND OTHER FUNDINGMEASURES: ACCESSIBILITY OF PHYSICAL ENVIRONMENT YEAR 1: HELD DISCUSSION WITH TOWN SUPERVISOR, VILLAGE MAYOR, AND PROJECT MANAGER FOR WATER STREET PROJECT, AND CHAMBER OF COMMERCE PRESIDENT TO ASSESS FEASIBILITY OF HAVING AN IMPACT DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE. PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN (CONTINUED) ON WATER STREET USE AND DEVELOPMENT. YEAR 2: REVIEW PREVIOUS WALK AUDIT DONE BY RURAL HEALTH GROUP. COMPLETE WALK AUDIT OF WATER STREET AND DELAWARE STREET IN WALTON, NY YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.3: BY DECEMBER 31, 2021 DECREASE THE % OF ADULTS WHO REPORT FEELING ANXIETY OR FEAR, DEPRESSION OR SADNESS, HELPLESS OR HOPELESS INTERVENTIONS: SURVEY COMMUNITY MEMBERS YEAR 1: DELAWARE COUNTY COMMUNITY SURVEY COMPLETED. QUESTION- IN THE PAST YEAR, HAVE YOU OR SOMEONE CLOSE TO YOU EXPERIENCED ANY OF THE FOLLOWING: RESULTS OF THESE MEASURES INCLUDED: ANXIETY OR FEAR 49.6% - DEPRESSION OR SADNESS 55.5% - FEELING HELPLESS OR HOPELESS 30.56% YEAR 2: FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEING YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.4 BY DECEMBER 31, 2021 INCREASES THE % OF ADULTS WHO REPORT ONGOING PARTICIPATION IN AT LEAST ONE SOCIALIZATION OPPORTUNITY OTHER THAN WORK. (BASELINE TO BE SET IN 2020) INTERVENTIONS: SURVEY COMMUNITY MEMBERS MEASURES: NUMBER OF PEOPLE PARTICIPATING AT SOCIALIZATION OPPORTUNITIES. YEAR 1: DISCUSSIONS CENTERED ON CORRELATION OF ISOLATION AND FEELINGS YEAR 2: DEVELOP A SURVEY TO GET SENSE OF SOCIALIZATION ACTIVITIES AND PARTICIPATION THROUGHOUT THE COMMUNITY. FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEINGYEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS DELAWARE VALLEY HOSPITAL STAFF WILL PLAY AN INTEGRAL ROLE, WITH CARE COMPASS NETWORK STAFF TO ENSURE APPROPRIATE STAKEHOLDERS FROM ACROSS THE COUNTY ARE INVITED TO THE VARIOUS AGE-FRIENDLY WORKSHOPS. DVH STAFF WILL ALSO SECURE THE VENUE AND CATERER FOR EACH WORKSHOP. DELAWARE VALLEY STAFF WILL BE THE CATALYST AND CHAMPION TO ENSURE WALTON COMMUNITY STAKEHOLDERS HOLD FOLLOW-UP MEETINGS AND FORMULATE COMMITTEES TO FOCUS ON SPECIFIC INTERVENTIONS, BASED ON THE CONSENSUS OF THE GROUP. DVH WILL MAINTAIN REPRESENTATION ON THE STEERING COMMITTEE AND ANY OTHER SUB-COMMITTEE THAT IS APPROPRIATE. DVH WILL WORK WITH DELAWARE COUNTY MENTAL HEALTH TO CREATE SURVEY OF SOCIALIZATION ACTIVITIES. IF NECESSARY, DVH WILL ASSIST IN PROVIDING SUPPORT IN WRITING ANY GRANT APPLICATIONS. IN ADDITION, DVH WILL CONTINUE TO MEET REGULARLY WITH DELAWARE COUNTY PUBLIC HEALTH STAFF AND STAFF FROM BOTH O'CONNOR HOSPITAL AND MARGARETVILLE HOSPITAL TO CONTINUE DIALOGUE REGARDING OUR ACTIVITIES SO WE CAN IDENTIFY OPPORTUNITIES TO WORK TOGETHER. 5 1 - WALTON FAMILY HEALTH CENTER 2 TITUS PLACE WALTON NY 13856 OUTPATIENT PHYSICIAN CLINIC 2 - DOWNSVILLE FAMILY HEALTH CENTER 28315 STATE HWY 206 DOWNSVILLE NY 13755 OUTPATIENT PHYSICIAN CLINIC 3 - ROSCOE FAMILY HEALTH CENTER 1982 OLD ROUTE 17 ROSCOE NY 12776 OUTPATIENT PHYSICIAN CLINIC 4 - PHYSICAL AND OCCUPATIONAL THERAPY 121 STOCKTON AVENUE WALTON NY 13856 REHABILITATION CLINIC 5 - STATE COMMUNITY PHARMACY 121 STOCKTON AVENUE WALTON NY 13856 COMMUNITY PHARMACY PART I, LINE 7: DELAWARE VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) AS DESIGNATED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. UNLIKE NON-CAH'S THAT ARE REIMBURSED BASED ON A PROSPECTIVE REIMBURSEMENT METHODOLOGY, CAH'S ARE REIMBURSED THEIR ALLOWABLE COSTS FOR MEDICARE PURPOSES. THE MEDICARE COST REPORT (CMS 2552) AND THE MEDICAID INSTITUTIONAL COST REPORT (ICR) WAS UTILIZED FOR PURPOSES OF IDENTIFYING COSTS AND NET REVENUE. A. COSTS:I. FYE COSTS AS INDEPENDENTLY AUDITED. NON-ALLOWABLE COSTS (I.E.-PHYSICIANS, ETC.) ARE USED TO REDUCE COSTS TO ARRIVE AT ALLOWABLE COSTS.II. VARIOUS STATISTICAL BASIS ARE USED TO ALLOCATE GENERAL SERVICE COSTS (I.E.-ADMINISTRATION, PLANT OPERATIONS, HOUSEKEEPING, ETC.), VIA A "STEPDOWN" METHODOLOGY TO REVENUE PRODUCING COST CENTERS SUCH AS ANCILLARY COST CENTERS (I.E. - RADIOLOGY, LAB, PHYSICAL THERAPY, ETC.) ROUTINE COST CENTERS (MEDICAL SURGICAL, ETC.) AND OUTPATIENT COST CENTERS (EMERGENCY, CLINIC, ETC.). III. ROUTINE COSTS PER DAY ARE THEN CALCULATED BY DIVIDING DIRECT AND INDIRECT COSTS (STEPDOWN) BY TOTAL DAYS. THIS PER DAY COST CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC DAYS TO ARRIVE AT ROUTINE PAYOR COSTS.IV. ANCILLARY AND OUTPATIENT COSTS RELATED TO SPECIFIC PAYORS CAN BE DETERMINED BASED ON THE RATIO OF COST TO CHARGES (RCC).V. THE RCC IS CALCULATED BY DIVIDING THE DIRECT AND INDIRECT COSTS (STEPDOWN COSTS) BY GROSS CHARGES. THE RCC CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC GROSS CHARGES TO ARRIVE AT PAYOR SPECIFIC COSTS. B. REVENUE: I. MEDICARE: NET REVENUE IS BASED ON DVH'S ALLOWABLE COSTS (INPATIENT AND OUTPATIENT) AND ARE REIMBURSED WITH A 1% MARKUP. II. MEDICAID: NET REVENUE IS BASED ON THE FOLLOWING:A. INPATIENT - A BASE YEAR COST PER DAY TRENDED ANNUALLY FOR INFLATION.B. OUTPATIENT - MEDICAID PUBLISHED RATES.III. OTHER PAYORS: REVENUE IS BASED ON NEGOTIATED RATES OF PAYMENT. PART I, LN 7 COL(F): DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $650,664 IN PART IX, LINE 24B. THE AFOREMENTIONED BAD DEBT EXPENSE WAS USED IN THE CALCULATIONS OF SCHEDULE H, PART I, LINES 7A THRU 7K. PART II, COMMUNITY BUILDING ACTIVITIES: DELAWARE VALLEY HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH ITS MEMBERSHIP AND PARTICIPATION IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY. STAFF MEMBERS ALSO SERVE ON THE COMMUNITY AND WELLNESS COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER) AND THE COUNTY'S CRITICAL INCIDENT STRESS DEBRIEFING TEAM. WEEKLY NARCOTICS ANONYMOUS MEETINGS CONTINUE TO BE HELD AT THE HOSPITAL AND HOSPITAL STAFF PERFORMS DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG TREATMENT COURT FREE OF CHARGE. THE DELAWARE COUNTY DRUG TREATMENT COURT'S MISSION IS TO HELP CHANGE THE BEHAVIORS OF ADULT NONVIOLENT DRUG AND ALCOHOL USERS THROUGH SUPERVISION AND TREATMENT RATHER THAN JUST SENDING THEM TO JAIL. THE OVERALL GOAL IS TO HELP ADDICTED INDIVIDUALS ACHIEVE LIFELONG RECOVERY AND BECOME RESPONSIBLE AND PRODUCTIVE MEMBERS OF THE COMMUNITY. DELAWARE COUNTY'S SOLID WASTE MANAGEMENT CENTER CONTINUES TO DISTRIBUTE THE BROCHURES, PRINTED COURTESY OF DVH, REGARDING SAFE NEEDLE DISPOSAL. WHEN PATIENTS BRING THEIR USED SHARPS TO THE HOSPITAL FOR DISPOSAL, THEY ARE GIVEN A FREE, APPROPRIATELY SIZED SHARP DISPOSAL CONTAINER. THE HOSPITAL CONTINUED TO SUPPORT THE COMMUNITY HOLIDAY DINNER, THE TOWN'S VETERAN'S CLUB, CHAMBER OF COMMERCE, MUSIC ON THE DELAWARE GROUP, THE LITTLE LEAGUE ORGANIZATION, THE LOCAL TOY BANK DRIVE AND TWO 5K RUNS, THE AMERICAN HEART ASSOCIATION. THE PRESIDENT/CEO OF DELAWARE VALLEY IS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB. THE HOSPITAL CONTROLLER SERVES ON THE BOARD OF THE CULLMAN CENTER, A DAY CARE CENTER IN SIDNEY, NY. OVER THE COURSE OF EACH YEAR, DVH MEMORIALIZES PEOPLE BY DONATING TO NON-PROFIT ORGANIZATIONS RATHER THAN GETTING FLOWERS. IN 2015, THE WALTON MINISTERIAL ASSOCIATION BEGAN A HUNGER WALK TO RAISE MONEY FOR THE LOCAL FOOD BANK AND CHILDREN'S NUTRITION PROGRAMS. DELAWARE VALLEY CONTINUES TO BE THE LEADING SPONSOR OF THE EVENT AND STAFF SERVES ON THE PLANNING COMMITTEE. DVH CONTINUES TO SUPPLY OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE IS IN WHITNEY POINT, NY, OVER AN HOUR AWAY FROM DELAWARE COUNTY; ONE OF THEIR TARGET AREAS. BY PROVIDING THEM WITH FREE OFFICE SPACE, THEY HAVE A HOME BASE MORE CENTRALLY LOCATED TO THOSE THEY ARE TRYING TO SERVE. THE ORGANIZATION OFFERS MANY NAVIGATION-TYPE PROGRAMS, MOST ESPECIALLY ACCESS TO TRANSPORTATION SERVICES. THE HOSPITAL ALSO PROVIDES PHONE AND OFFICE SUPPLIES TO THEM, AT NO CHARGE. DVH WAS MADE AWARE THAT AN ORGANIZATION, THE FAMILY RESOURCE NETWORK, WHICH SERVES FAMILIES DEALING WITH DISABILITIES, NEEDED A MORE LOCAL PRIVATE, PLACE FOR THEM TO MEET WITH FAMILIES. THEIR MAIN OFFICE IS LOCATED 45 MINUTES AWAY FROM WALTON AND CLIENTS HAD DIFFICULTY GETTING THERE. DVH HAS AGREED TO LET THEM USE ITS WELLNESS ROOM FOR THOSE MEETINGS. WHEN THE LOCAL EMERGENCY SQUAD NEEDS TO RE-STOCK ITS AMBULANCE, BUT HAS NOT BROUGHT THE PATIENT TO THE HOSPITAL'S ER, THE HOSPITAL RE-STOCKS THE AMBULANCE FREE OF CHARGE. THIS CAN HAPPEN WHEN THE AMBULANCE PERSONNEL HAVE CALLED FOR A HELICOPTER EVACUATION OF THE PATIENT(S) DIRECTLY FROM THE SCENE OF THE INCIDENT. A PATIENT AND FAMILY ADVISORY COMMITTEE WAS STARTED IN 2018. THE GROUP PROVIDES DVH WITH INVALUABLE INSIGHT AS TO HOW A PATIENT INTERPRETS A MULTITUDE OF HEALTHCARE TOPICS AND DVH IS ABLE TO PROVIDE THEM WITH INSIGHT TO SOME OF THE REASONS THAT THINGS ARE DONE THE WAY THEY ARE. DURING 2019, THE GROUP WAS INSTRUMENTAL IN HELPING THE HOSPITAL TO RE-TOOL ITS ADMISSION PACKET, HEALTH HISTORY FORM AND PATIENT EDUCATION MATERIALS. WE ALSO BELIEVE IN ENCOURAGING FAMILY TOGETHERNESS. WE HELD OUR THIRD SANTA EVENT BUT THIS TIME WE ADDED A CRAFT ACTIVITY FOR EACH CHILD TO DO WITH THEIR PARENT. APPROXIMATELY 80 KIDS CAME TO THE EVENT WITH THEIR PARENTS. TO ENCOURAGE YOUNG CHILDREN TO BE SAFE AND NOT TO BE AFRAID OF HEALTHCARE PROVIDERS OR HOSPITALS, DVH HOSTED 165 SECOND GRADERS FROM 5 AREA SCHOOLS AT ITS SECOND TEDDY BEAR CLINIC. THEY LEARNED LESSONS ABOUT SAFETY HELMETS, SEAT BELTS AND POISON AND GOT TO HAVE HANDS-ON EXPERIENCE IN THE ER, RADIOLOGY, AND HELPED CARE FOR OUR MANNEQUIN PATIENT (A BIKE ACCIDENT PATIENT WHO HAD NOT WORN A HELMET). THEY ALSO TOURED AN AMBULANCE, LOOKED INSIDE THE MEDICAL HELICOPTER AND GOT TO MEET AND LEARN ABOUT WHAT A K9 OFFICER AND THEIR DOG DOES.THE PEDIATRICIAN PARTICIPATES IN THE NATIONAL REACH OUT & READ PROGRAM, AND GIVES FREE, AGE-APPROPRIATE BOOKS TO CHILDREN AT EACH WELLNESS VISIT, BEGINNING AT THE AGE OF 6 MONTHS. A FAMILY FUN DAY WAS HELD AND FEATURED A BARBECUE, A "ZOO TO YOU" WHERE CHILDREN COULD LEARN AND TOUCH A VARIETY OF ANIMALS, PARTICIPANTS COULD READ WITH OUR PEDIATRICIAN, RECEIVE A BALLOON ANIMAL, GET SOME TRAIL MIX AND THE RECIPE TO MAKE MORE AT HOME, AND SEE OUR NEW TELEHEALTH TECHNOLOGY. THE COUNTY'S PUBLIC HEALTH NURSING DEPARTMENT PERFORMED CAR SEAT CHECKS AND PROVIDED FREE CAR SEATS TO THOSE WHO NEEDED THEM. HANDWASHING TECHNIQUES WERE TAUGHT, USING A BLACK LIGHT. ADULTS WERE ALSO ABLE TO HAVE FREE BLOOD PRESSURE SCREENINGS. APPROXIMATELY 175 PEOPLE, OF ALL AGES ATTENDED THE EVENT. FINALLY, DVH PARTICIPATED IN THE CHAMBERS' LEAF PEEPING EVENT, OFFERING HEALTH INFORMATION AND SCRATCH DRAWING FOR ALL AGES. PART III, LINE 2: THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2019 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2019 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2019, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 57.7% OF THE TOTAL BAD DEBT WRITE-OFFS. PART III, LINE 4: AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. PLEASE REFER TO FOOTNOTE 1, PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION. PART III, LINE 8: BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE HOSPITAL HAS A POLICY TO PROVIDE A COMMUNITY BENEFIT TO UNINSURED PATIENTS THAT CONSISTS OF FEE DISCOUNTS. CERTAIN PATIENTS THAT WERE PROVIDED FEE DISCOUNTS WOULD HAVE LIKELY QUALIFIED UNDER THE CHARITY CARE POLICY. DELAWARE VALLEY HOSPITAL USES THE COST TO CHARGE RATIO METHODOLOGY UTILIZING AMOUNTS FROM THE 2019 MEDICARE COST REPORT FOR ALL PERTINENT CALCULATIONS IN PART III, LINE 6. PART III, LINE 9B: UHS HOSPITALS POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.UHS HOSPITALS REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. UHS HOSPITALS PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. UHS HOSPITALS ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENCING LEGAL ACTION. PART VI, LINE 2: RECRUITMENT OF HEALTHCARE PROFESSIONALS IS ALWAYS A CHALLENGE, ESPECIALLY IN OUR RURAL AREA. DELAWARE VALLEY HOSPITAL (DVH) AND ITS 3 PRIMARY CARE CENTERS MAINTAIN THEIR STANDING AS APPROVED SITES FOR PROFESSIONALS SEEKING ASSISTANCE THROUGH THE NATIONAL HEALTH SERVICE CORPS. THE HOSPITAL ALSO HOSTS BOTH RN AND CNA STUDENTS, FROM OUR LOCAL COLLEGE, (SUNY DELHI) AND BOARD OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). DVH'S CERTIFIED DIETITIAN/NUTRITIONIST HELD ONE SPECIAL PROGRAM FOR SUNY NURSING STUDENTS REGARDING DIABETES. SIX DVH RNS SERVE AS MENTORS TO SUNY DELHI RN TO BSN STUDENTS. A NURSE PRACTITIONER STUDENT SHADOWED ONE OF THE FAMILY MEDICINE PHYSICIANS. ONE OF THE HOSPITAL'S ADDICTION TREATMENT NURSES PRESENTED A PROGRAM REGARDING THE BARRIERS AND CHALLENGES TO CARING FOR RURAL ADDICTION PATIENTS. THIS WAS IMPORTANT BECAUSE THE NURSING PROFESSORS RECOGNIZED THAT MANY, IF NOT MOST OF THEIR STUDENTS ARE FROM URBAN OR SUBURBAN AREAS AND HAVE NO CONCEPT OF RURAL LIFE AND CHALLENGES. A VERY SUCCESSFUL MASH CAMP IS HELD DURING THE YEAR TO PROVIDE AN OPPORTUNITY FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT HEALTHCARE CAREERS AND ENCOURAGE THEM TO PRACTICE IN OUR RURAL COMMUNITY. IN 2019, 29 STUDENTS ATTENDED OVER A TWO DAY PERIOD. ONE OF THE ER PHYSICIAN ASSISTANTS ATTENDED A CAREER DAY AT AN AREA HIGH SCHOOL. FINALLY, THE DELAWARE COUNTY CHAMBER OF COMMERCE SPONSORS A LEADERSHIP DELAWARE PROGRAM FOR MEN AND WOMEN JUST BEGINNING THEIR CAREERS. THE PROGRAM WAS DEVELOPED TO GIVE THEM A WELL-ROUNDED VIEW OF THE SUCCESSES, CHALLENGES AND SOLUTIONS THAT A WIDE VARIETY OF BUSINESSES FACE. DELAWARE VALLEY HOSTED THIS GROUP TO MAKE THEM MORE AWARE OF HEALTHCARE IN THE AREA.THROUGHOUT 2019, THE HOSPITAL CONTINUED TO WORK HAND IN HAND WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT, O'CONNOR HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL TO DEVELOP THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND OUR INDIVIDUAL COMMUNITY SERVICE PLANS. STAFF FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY AIDED US BY RESEARCHING AREA DEMOGRAPHICS AND COMPILING THE REPORT. THE NEW NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN ARE LOCATED AT HTTPS://WWW.NYUHS.ORG/WHY-CHOOSE-US/COMMUNITY-SERVICE-REPORTS. A NEW FOUNDATION WAS CREATED IN WALTON NY THAT FOCUSES ON HOSTING "RETREATS FOR GROUPS SEEKING RENEWAL, LEARNING, AND GROWTH." ITS RESTORATIVE CARE PROGRAMS AND OFFERINGS ARE MEANT FOR GROUPS WHOSE MISSION IS TO SERVE OTHERS, INCLUDING HEALTH CARE PROVIDERS, EDUCATORS, FIRST RESPONDERS AND SOCIAL SERVICE PROVIDERS. DVH STAFF SPENT TIME HELPING TO INTRODUCE THEIR NEW-TO-THE-AREA STAFF TO OTHER SERVICE AGENCY STAFF AND PROVIDING THEM WITH CONTACT NAMES AND IDEAS FOR WAYS TO CARRY OUT SOME OF THEIR OBJECTIVES. MENTAL HEALTH AND SUBSTANCE USE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2019, MEETINGS CONTINUED WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. THE DIRECTOR OF COMMUNITY RELATIONS SITS ON A SUB-COMMITTEE OF THE COUNTY'S COMMUNITY SERVICE DEPARTMENT, FOCUSED ON MENTAL HEALTH. THE MOST CHALLENGING BARRIER IN ACCESSING CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. IN 2017, DVH BEGAN A TELE PSYCHIATRY PROGRAM WITH A PRIVATE PRACTICE PSYCHIATRIST. UNFORTUNATELY, DUE TO THE PHYSICIAN'S LIMITED PARTICIPATION WITH INSURANCE CARRIERS, MANY PATIENTS IN NEED COULD NOT BE REFERRED. IN 2018, DVH WAS ABLE TO CONTRACT WITH AN OUTSIDE VENDOR TO BEGIN A TELE-MENTAL HEALTH PROGRAM. THE PROGRAM OFFICIALLY BEGAN IN JANUARY, 2019 AND A NPP AND LCSW ARE AVAILABLE TO SEE PATIENTS THROUGH THIS TECHNOLOGY. IN 2019 DVH HOSTED BUPRENORPHINE TRAINING AND THE HOSPITAL'S VISITING PAIN MANAGEMENT CHIROPRACTOR HELD AN EDUCATION NIGHT FOR AREA CHIROPRACTORS SO THEY COULD UNDERSTAND THE ROLE THEY PLAY IN PAIN MANAGEMENT. THE HOSPITAL'S CERTIFIED ADDICTION TREATMENT RN SPOKE WITH NURSING STUDENTS AT HARTWICK COLLEGE REGARDING THE CHALLENGES FACED BY RURAL PROVIDERS IN PROVIDING CARE TO SUBSTANCE USE PATIENTS. THE HOSPITAL CONTINUES TO SERVE AS THE COLLECTION SITE FOR URINE SPECIMENS FOR THE COUNTY'S DRUG COURT.A SECOND NEED IS FOR CHRONIC DISEASE MANAGEMENT AND PREVENTION. THE HOSPITAL HAS 3 STAFF MEMBERS TRAINED TO OFFER THE PROGRAM. IN 2019, TWO PROGRAMS WERE OFFERED TO THE PUBLIC: ONE IN THE SPRING AND ONE IN THE FALL. HOWEVER, ONLY THE SPRING SESSIONS WERE COMPLETED. THERE WAS NOT ENOUGH INTEREST TO HOLD THE AUTUMN SESSION. THE HOSPITAL CONTINUED ITS LUNG MATTERS PROGRAM FOR PATIENTS DIAGNOSED WITH LUNG CONDITIONS. IN 2019, DVH SPONSORED CHAIR YOGA FOR THESE AND CARDIAC/PULMONARY REHABILITATION PATIENTS. BECAUSE NUTRITION PLAYS A HUGE ROLE IN THE HEALTH OF COMMUNITY MEMBERS, THE HOSPITAL'S DIETITIAN/NUTRITIONIST WORKED IN CONJUNCTION WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY TO PROVIDE 20 PATIENTS WITH COMPLIMENTARY DIETARY COUNSELING AS THEY PROGRESSED THROUGH THE COOPERATIVE EXTENSION'S FRUIT & VEGETABLE PROGRAM. THE HOSPITAL ALSO ACTIVELY PARTICIPATES IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR IS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS.THE HOSPITAL RECOGNIZED THAT UNLESS IT IS ABLE TO ENGAGE THE COMMUNITY IN CONVERSATIONS ABOUT MANY OF THE SOCIAL DETERMINANTS OF HEALTH, A LOT OF PROGRESS CANNOT BE MADE IN THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS. RESEARCH LED TO THE AARP AGE FRIENDLY LIVABLE COMMUNITY PROGRAM, WHICH IS GEARED TO ALL AGES. WORKING WITH THE CARE COMPASS NETWORK, WHICH AGREED TO FUND AN EVENT, LEADERS FROM AROUND THE COUNTY WERE INVITED TO ATTEND A DAY-LONG PROGRAM FEATURING NATIONALLY RENOWNED SPEAKER, ESTHER GREENHOUSE, WHO IS CONSIDERED AN EXPERT ON AGING IN PLACE. KAT FISHER FROM THE REGIONAL AARP OFFICE SPOKE ABOUT AARP'S PROGRAM. INVITATIONS WERE SENT TO LEADERS IN VARIOUS GOVERNMENT AGENCIES, SERVICE ORGANIZATIONS, SCHOOLS, CHURCHES AND COMMUNITY MEMBERS. THE PROGRAM WAS SCHEDULED FOR LATE JANUARY, 2020. PART VI, LINE 3: DELAWARE VALLEY HOSPITAL IS COMMITTED TO PROVIDING OUR PATIENTS THE KNOWLEDGE THAT WE OFFER FINANCIAL ASSISTANCE. EACH PATIENT CARE REGISTRATION AREA HAS SIGNS TELLING THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO THEM. THERE ARE ALSO BROCHURES REGARDING THE PROGRAM THROUGHOUT THE HOSPITAL'S FACILITIES AND THE INFORMATION IS ALSO POSTED ON THE WEBSITE. IF NEEDED, TRANSLATION SERVICES ARE AVAILABLE. A FINANCIAL ASSISTANCE HELP LINE IS ALSO AVAILABLE AND ADVERTISED ON ALL BILLINGS. IN 2015, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CHANGED TO PROVIDE ALL SELF-PAY PATIENTS AN AUTOMATIC 35% DISCOUNT AT THE TIME OF SERVICE. IF FURTHER ASSISTANCE IS NEEDED, THE PATIENT APPLIES THROUGH THE FINANCIAL ASSISTANCE PROGRAM. DELAWARE VALLEY ALSO OFFERS PATIENTS EASY ACCESS TO A FIDELIS REPRESENTATIVE, BY PROVIDING A SITE FOR THEM TO INTERVIEW AND ENROLL RESIDENTS IN THEIR MEDICAID MANAGED CARE PRODUCT. FIDELIS IS THE ONLY PROVIDER OF THESE SERVICES FOR DELAWARE COUNTY. PART VI, LINE 4: DELAWARE VALLEY HOSPITAL'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY. USING PERCENTAGES, BASED ON THE NUMBERS OF UNIQUE PATIENTS UTILIZING OUR PRIMARY CARE SITES IN 2019, (AS THAT IS WHERE THE HIGHEST UTILIZATION OCCURS) THE PRIMARY SERVICE AREA ENCOMPASSES WALTON, DOWNSVILLE, ROSCOE, SIDNEY CENTER, DELHI, HAMDEN, EAST BRANCH AND HANCOCK. THE PRIMARY SERVICE AREA REFLECTS WHERE 80% OF OUR PATIENTS RESIDE. THE SECONDARY SERVICE AREA CONSISTS OF THE COMMUNITIES WHERE THE NEXT 10% OF OUR PATIENTS RESIDE. THOSE COMMUNITIES INCLUDE: SIDNEY, UNADILLA, DELANCEY, LIVINGSTON MANOR, FRANKLIN, BAINBRIDGE AND ONEONTA. DELAWARE COUNTY IS LOCATED ON THE WESTERN EDGE OF THE CATSKILL MOUNTAINS IN RURAL, UPSTATE NEW YORK. ENCOMPASSING 1446.37 SQUARE MILES, THE COUNTY'S SIZE APPROXIMATES THAT OF RHODE ISLAND AND IS THE FOURTH LARGEST OF NEW YORK STATE'S 62 COUNTIES. IN FACT, ITS SIZE IS SO GREAT THAT, SEVEN COUNTIES AND THE STATE OF PENNSYLVANIA BORDER DELAWARE COUNTY. IT ALSO RANKS AS THE SIXTH MOST RURAL COUNTY IN THE STATE WITH JUST 33 PERSONS PER SQUARE MILE. ITS TOPOGRAPHY IS CHARACTERIZED BY WINDING, AND TWISTING, TWO-LANE ROADS THAT TRANSVERSE A MOUNTAINOUS TERRAIN, MAKING TRAVEL CHALLENGING, ESPECIALLY DURING THE WINTER MONTHS. TRANSPORTATION IS AN EXTREMELY CHALLENGING BARRIER TO PROVIDING PATIENT CARE. THE AREA DOES NOT HAVE PUBLIC TRANSPORTATION AND WHILE RECENTLY SOME PRIVATE TRANSPORTATION SERVICES HAVE BEGUN, THEY ARE GENERALLY TOO COST PROHIBITIVE FOR MANY TO ACCESS.THE COUNTY IS HOME TO TWO OF THE STATE'S LARGEST RESERVOIRS IN THE NEW YORK CITY WATERSHED, WHICH HAS THE LARGEST UNFILTERED DRINKING WATER SUPPLY IN THE UNITED STATES. APPROXIMATELY 55% OF DELAWARE COUNTY'S POPULATION LIES WITHIN THE WATERSHED. NEW YORK CITY HAS WORKED TO PRESERVE AND SAFEGUARD THE WATERSHED FROM ENVIRONMENTAL DEGRADATION BY MEANS OF RESTRICTIONS AND REGULATIONS ON LAND USE WITHIN AND SURROUNDING THE WATERSHED. THE INITIAL IMPACT OF THE WATERSHED ON DELAWARE COUNTY HAS BEEN TO LIMIT ECONOMIC DEVELOPMENT WHICH PREVENTS EXPANSION OF THE TAX BASE. BECAUSE OF THE ENVIRONMENTAL ECOSYSTEM OF THE WATERSHED, THERE HAVE BEEN STRICT REGULATIONS PERTAINING TO AGRICULTURAL POLLUTION AND BUILDING CONSTRUCTION. MANY PROPERTIES HAVE BEEN PURCHASED BY NYC, TO FURTHER PROTECT ITS WATERSHED. LIMITING INFRASTRUCTURE GROWTH RESULTS IN DECREASED EMPLOYMENT OPPORTUNITIES. THESE UNIQUE CIRCUMSTANCES RESULT IN HEALTH CARE RELATED CHALLENGES FOR THE COUNTY RESIDENTS. THESE LIMITATIONS ALSO IMPACT THE LOCAL HEALTH AND SOCIAL SERVICE AGENCIES AND ORGANIZATIONS AND THE DELIVERY OF CARE AND SERVICES.THESE LIMITATIONS HAVE CAUSED RESIDENTS TO SEEK ALTERNATIVES TO STIMULATE ECONOMIC GROWTH. DELAWARE COUNTY FARMERS HAVE STARTED SPECIALTY INDUSTRIES. THIS IS REFLECTED IN THE INCREASED NUMBER OF SPECIALTY FARMS. OTHER ECONOMIC DEVELOPMENTS ARE TAKING THE FORM OF TOURISM (E.G. BED AND BREAKFAST), RECREATIONAL FACILITIES COMPATIBLE WITH THE ENVIRONMENT (E.G. GOLF, SKIING, HIKING, HUNTING AND FISHING), LOW POLLUTION FARMING, AND PROFESSIONAL/BUSINESS SERVICES COMPANIES.THE MEDIAN AGE FOR MALES IS 46.5 AND FOR FEMALES IS 47.6 IN DELAWARE COUNTY, WHILE 38.8% ARE AGE 55 AND OVER, AND 22.77% OF THOSE ARE 65 YEARS AND OVER. THIS IS AN INCREASE OF 3.8% IN THE 55 YEARS AND OVER POPULATION, WHILE THE 65 AND OVER HAS INCREASED BY ALMOST 3%. 96.3% OF THE POPULATIONS ARE CAUCASIAN, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN FAMILY INCOME IS $ 44,617 AND APPROXIMATELY 16.5% OF THE POPULATION LIVES IN POVERTY, WHICH IS AN INCREASE OF 2.5%. ACCORDING TO THE 2013-2017 AMERICAN COMMUNITY SURVEY BY THE U.S. CENSUS BUREAU THE PERCENTAGE OF RELATED CHILDREN LIVING BELOW THE POVERTY LEVEL WITH A FEMALE HEAD OF HOUSEHOLD, WITH NO HUSBAND PRESENT HAS DROPPED DRAMATICALLY TO 32.8% FROM 66.7% FOR CHILDREN UNDER 5 YEARS OF AGE IN DELAWARE COUNTY. THIS IS NOW BELOW THE NEW YORK AND UNITED STATES COMPARISONS OF 37.7% AND 43.7% RESPECTIVELY. PART VI, LINE 5: DELAWARE VALLEY HOSPITAL, A CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH ITS ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE IT SERVES. ITS INPATIENT SERVICES INCLUDE ACUTE CARE FOR THOSE PATIENTS REQUIRING 96 HOURS OR LESS OF HOSPITALIZATION; LONGER TERM REHABILITATIVE CARE FOR THOSE NEEDING TIME TO GAIN STRENGTH OR STAMINA AFTER A DEBILITATING ILLNESS OR INJURY OR A SURGICAL PROCEDURE; AND INPATIENT ADDICTION TREATMENT. THE HOSPITAL ALSO PROVIDES 24-HOUR EMERGENCY CARE. DIAGNOSTIC SERVICES INCLUDE LABORATORY, CARDIOPULMONARY, AND IMAGING SERVICES. THE HOSPITAL HAS THE CAPABILITY OF PERFORMING PULMONARY FUNCTION TESTING, EKGS, CARDIAC STRESS TESTING, AND PLACING HOLTER AND EVENT MONITORS. IN THE IMAGING CENTER X-RAY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS, AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE WEEKLY. ITS OUTPATIENT REHABILITATION DEPARTMENT OFFERS PHYSICAL AND OCCUPATIONAL THERAPY, AND CARDIAC AND PULMONARY REHABILITATION PROGRAMS ARE ALSO IN PLACE. THROUGH ITS THREE PRIMARY CARE OFFICES LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE, NY PATIENTS OF ALL AGES CAN RECEIVE ACUTE AND PREVENTIVE CARE, AS WELL AS CHRONIC DISEASE MANAGEMENT. OCCUPATIONAL HEALTH SERVICES INCLUDE PRE-EMPLOYMENT AND DOT PHYSICALS, IMMUNIZATIONS, DRUG TESTING, AND ANNUAL PHYSICALS FOR FIRE DEPARTMENT MEMBERS. VISITING SPECIALISTS INCLUDE A GENERAL SURGEON, CARDIOLOGIST, PODIATRIST AND THREE PAIN MANAGEMENT PROVIDERS: A PHYSICIAN, PHYSICIAN ASSISTANT AND A CHIROPRACTOR.THE PAIN MANAGEMENT CLINIC BEGAN TO HELP PATIENTS UTILIZE ALTERNATIVE TREATMENT METHODS RATHER THAN USING OPIOIDS. THE CLINIC IS HELD THREE DAYS PER MONTH. DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST OFFERED A VARIETY OF PROGRAMS TO SEVERAL GROUPS: THE HAMDEN SENIOR CITIZENS CLUB, A LOCAL WOMEN'S GROUP AND THE DELAWARE COUNTY RETIRED TEACHERS. SHE AND OUR RN CARE COORDINATOR PARTNERED WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY TO WORK WITH THEIR CLIENTS WHO WERE ELIGIBLE FOR THE FRUIT AND VEGGIE VOUCHER PROGRAM. THE DIETITIAN AND FOOD SERVICE MANAGER EVEN HELD A CELEBRATORY EVENT AT THE END OF THE YEAR; MAKING A HEALTHY SOUP AND SALAD DINNER FOR ALL OF THE PARTICIPANTS. SHE ALSO ATTENDED THE LOCAL FARMER'S MARKET TO ANSWER QUESTIONS AND PROVIDE NUTRITION INFORMATION. THE HOSPITAL CONTINUED ITS ANNUAL PRESENCE AT THE WEEK-LONG DELAWARE COUNTY FAIR. DURING THE WEEK, THE HOSPITAL STAFF PROVIDED LOTS OF HEALTH, NUTRITION AND PHYSICAL ACTIVITY INFORMATION TO FAIRGOERS, AND AT LEAST 551 BLOOD PRESSURES WERE TAKEN; AND AT 411 PARTICIPATED IN THE NUTRITION, PHYSICAL ACTIVITY GAME, WHICH WAS OVER 100 ADDITIONAL BLOOD PRESSURE CHECKS, AND OVER 300 MORE INTERACTIONS WITH THE GAME. 35 EMPLOYEES SPENT A TOTAL OF 339 HOURS EITHER PLANNING OR MANNING THE BOOTH AT THE 6-DAY LONG EVENT.IN 2017, SEVERAL ADDITIONAL WELLNESS INITIATIVES BEGAN. TWO STAFF COMPLETED THE AMERICAN CANCER SOCIETY'S FRESH START TOBACCO CESSATION PROGRAM TRAINING. THEY WENT ON TO HOLD THREE 4 WEEK PROGRAMS IN 2017. IN 2018 ONLY ONE CLASS HAD ANY PARTICIPANTS. FOR 2019, DVH WAS GOING TO TRY AND COORDINATE THIS PROGRAM IN CONJUNCTION WITH UHS STAY HEALTHY CENTER AND OFFER IT THROUGH LIVE, INTERACTIVE VIDEOCONFERENCING. HOWEVER, UHS STAFF THAT WERE TRAINED MODERATORS LEFT THE ORGANIZATION SO NO CLASSES WERE HELD. THE HOSPITAL CONTINUED ITS LUNG MATTERS GROUP FOR PATIENTS AND CAREGIVERS DEALING WITH LUNG CONDITIONS. THE GROUP MEETS MONTHLY AND IS MANAGED BY THE HOSPITAL'S CARDIOPULMONARY REHABILITATION NURSE. SHE HAS ALSO INCLUDED HARMONICA PLAYING INTO THE MEETINGS, WHICH IS A HELPFUL TOOL IN BETTER BREATHING. DVH SUPPLIES THE HARMONICAS TO THE PARTICIPANTS FREE OF CHARGE. IN 2019, THE HOSPITAL SPONSORED CHAIR YOGA SPECIFICALLY FOR THESE PATIENTS AND THOSE WHO WERE IN CARDIAC OR PULMONARY REHABILITATION. OVER THE COURSE OF 12 WEEKS, 8 PEOPLE PARTICIPATED.IN 2017, THREE STAFF MEMBERS WERE TRAINED TO OFFER THE STANFORD UNIVERSITY, EVIDENCED-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. MARKETED AS, HAPPY HEALTHY AND WISE WORKSHOPS, THREE PROGRAMS WERE OFFERED IN 2017. THE PROGRAM IS GIVEN 2 HOURS A WEEK, FOR SIX WEEKS. IT FEATURES A "TOOLBOX" OF STRATEGIES PARTICIPANTS CAN USE TO HELP MANAGE THEIR CONDITIONS MORE SUCCESSFULLY. THE "TOOLBOX" INCLUDES PROBLEM-SOLVING, ACTION PLANNING, COMMUNICATION, UNDERSTANDING EMOTIONS, WEIGHT MANAGEMENT AND HEALTHY EATING, USING YOUR MIND, SLEEP, PHYSICAL ACTIVITY, MEDICATION MANAGEMENT, DECISION MAKING, BETTER BREATHING AND WORKING WITH HEALTH PROFESSIONALS' STRATEGIES. IN 2019, ANOTHER STAFF MEMBER WAS TRAINED AS A PEER LEADER. TWO PROGRAMS WERE HELD IN 2019, WITH 7 ATTENDING AND COMPLETING THE PROGRAM.STAFF PARTICIPATED IN THE AMERICAN HEART ASSOCIATION'S GO RED FOR WOMEN EVENT AND HEART WALK, AND THE DELAWARE COUNTY SENIOR PICNIC WHERE NUTRITION AND PHYSICAL ACTIVITY WAS THE HIGHLIGHT.AN OPEN HOUSE WAS HELD AT THE ROSCOE CENTRAL SCHOOL WHERE PARTICIPANTS PLAYED A NUTRITION AND PHYSICAL ACTIVITY GAME. PART VI, LINE 6: DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT MEMBER OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UHS IN 1981 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATIONS INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. DVH PARTICIPATES IN THE UNITED HEALTH SERVICES SYSTEM STRATEGIC PLANNING PROCESS. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSES ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND THREE OBJECTIVES: IMPROVE OUR CARE, MANAGE OUR COSTS, AND GROW OUR MARKET SHARE. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE AND DVH FURTHER DEVELOPS OBJECTIVES AS THEY RELATE TO THE HOSPITAL'S SERVICES AND THE NEEDS OF IT PATIENTS. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES BOTH LOCALLY AND REGIONALLY. THE DVH COMMUNITY SERVICE REPORT IS INCLUDED WITH THE DELAWARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, ALONG WITH THE COMMUNITY SERVICE PLANS OF O'CONNOR HOSPITAL, TRI-TOWN REGIONAL HOSPITAL, AND MARGARETVILLE HOSPITAL, ALL IN ONE DOCUMENT.CLINICAL EXCELLENCE: UHS IS FOCUSED ON BUILDING UPON PREVIOUS EFFORTS THAT ESTABLISHED A CONSISTENT SYSTEM-WIDE FOCUS FOR EVALUATING AND ASSURING EXCELLENCE IN THE DELIVERY OF CLINICAL CARE. UHS IS FOCUSED ON THE DEVELOPMENT OF A COMPREHENSIVE OUTPATIENT CARE MODEL, IMPLEMENTATION OF ELECTRONIC MEDICAL RECORDS TO SUPPORT SERVICE QUALITY AND EXCELLENCE, IMPLEMENTATION OF A MULTI-YEAR PROVIDER RECRUITMENT AND RETENTION STRATEGY, ORGANIZE UHS PROVIDERS TO ACCOMMODATE FUTURE PAYMENT METHODOLOGIES, ALONG WITH THE DEVELOPMENT OF A TALENT MANAGEMENT INITIATIVE TO REALIZE THE LONG TERM STRATEGY FOR A SUSTAINABLE WORKFORCE. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X 0 0 0 0 0 1 1 0 0 JOHN CARRIGG BOARD MEMBER/VICE CHAIR 0 792683 0 162977 0 10284 0 19000 0 20637 0 1005581 0 0 DR MICHAEL FREEMAN BOARD MEMBER/MEDICAL STAFF PRESIDENT 231188 0 5085 0 0 0 12279 0 27314 0 275866 0 0 0 PAUL SUMMERS BOARD MEMBER/PRESIDENT/CEO 209126 0 31029 0 0 0 8007 0 15666 0 263828 0 0 0 PART I, LINE 6 THE EXECUTIVE COMPENSATION INCENTIVE PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2019 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS. FORM 990, PART VII, SECTION A, LINE 5, UNRELATED PARTY DETAIL: INDIVIDUAL: MICHAEL FREEMAN, MEDICAL STAFF PRESIDENT COMPENSATION RECEIVED FROM UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES (UMA) COMPENSATION: WAGES & NON-TAXABLE BENEFITS $275,866. A COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY 161137407 245867AA4 2007-06-29 5805000 CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE 0 0 0 A 5805000 250826 5554174 2008 0 0 1 1 A 0 0 0 0 1 0 1 A 1 1 0 0 0 0 A 1 MICHAEL LAYTON BROTHER-IN-LAW OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 66778 EMPLOYEE WAGES 0 BONNIE CRAIG SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 39657 EMPLOYEE WAGES 0 MILA KATANIC-TUCKER STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS 29446 EMPLOYEE WAGES 0 NANCY VOLLKOMMER SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO 32900 EMPLOYEE WAGES 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A UHS, INC., THE ORGANIZATION'S SOLE CORPORATE MEMBER, APPOINTS THE VOTING BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE DELAWARE VALLEY HOSPITAL, INC. (DVH) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF FORM 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATIONAL PURPOSES. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMMITTEE. FORM 990, PART VI, SECTION B, LINE 15A PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY THE BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. THE COMMITTEE USES SULLIVAN-COTTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS THE BASIS FOR ESTABLISHING AN ACCEPTABLE COMPENSATION RANGE TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 5,241,211. MANAGEMENT AND GENERAL EXPENSES 739,601. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,980,812. FORM 990, PART XI, LINE 9: INTEREST RATE SWAP -46,768. FORM 990, PART XII, LINE 2C NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT HAS CHANGED DURING THE YEAR. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS. UNITED HEALTH SERVICES HOSPITALS INC 10-42 MITCHELL AVENUE BINGHAMTON NY 13903 161165049 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 PROFESSIONAL HOME CARE 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 161261977 HOME HEALTH CARE NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER 508 HIGH AVENUE ENDICOTT NY 13760 222902896 SENIOR LIVING CENTER NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER HOUSING 508 HIGH AVENUE ENDICOTT NY 13760 222902899 SENIOR HOUSING NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 CHENANGO MEMORIAL HOSPITAL 179 NORTH BROAD STREET NORWICH NY 13815 150532180 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 UNITED HEALTH SERVICES INC 20-40 MITCHELL AVENUE BINGHAMTON NY 13903 222682421 PARENT COMPANY NY 501(C)(3) 10 BOARD OF DIRECTORS UHS INC 0 TWIN TIER HOME HEALTH INC 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 222438211 HOME HEALTH CARE NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0