2019-11-12T09:16:23-06:00 2018-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2018-01-01 111631781 FLUSHING HOSPITAL MEDICAL CENTER FLUS 7186705000 4500 PARSONS BLVD FLUSHING NY 11355 BRUCE J FLANZ CEO 7186705000 2019-11-11 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2019-11-06 209.59.242.22 2019-11-11 12:40:57 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F9BA0E82A6D947CC92540FBC56E8B73643681DA5 2018 2020-03-31 21:24:44Z BRUCE J FLANZ 4500 PARSONS BLVD FLUSHING NY 11355 288653221 0 X FLUSHINGHOSPITAL.ORG X 1884 NY ACUTE CARE HOSPITAL 20 18 2119 167 0 341788 9046026 34317637 230947561 242521268 191361 8634758 3178210 3111216 243363158 288584879 0 0 0 0 174333482 177367253 0 0 0 95960159 97982971 270293641 275350224 -26930483 13234655 118314855 144705894 259608724 272765108 -141293869 -128059214 ACUTE CARE HOSPITAL 0 0 237893601 245044410 HOSPITAL SERVICES - OUTPATIENT CLINIC - EMERGENCY SERVICESCERTIFIED BEDS +331 237893601 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 36 0 1 2119 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 20 18 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X CAROLE KING 7186705000 4500 PARSONS BLVD FLUSHING NY 11355 AJ JIN TRUSTEE 2.00 X 0 0 0 ANOTONIETTA MORISCO MD TRUSTEE 2.00 X 0 0 0 ANTHONY DIMARIA MPHD TRUSTEE 2.00 X 0 252116 44318 ANTHONY MAZZA TRUSTEE 2.00 X 0 0 0 CHRIS YHWANG TRUSTEE 2.00 X 0 0 0 DARREN MEYERS TRUSTEE 2.00 X 0 0 0 DOUGLAS W SINGER TRUSTEE 2.00 X 0 0 0 GEOFFREY DOUGHLIN MD TRUSTEE 2.00 X 0 470318 31294 GERALDINE CHAPEY MPHD TRUSTEE 2.00 X 0 0 0 HON ARCHIE SPIGNER TRUSTEE 2.00 X 0 0 0 HON TIMOTHY J DUFFICY TRUSTEE 2.00 X 0 0 0 JOSEPH FERRARA TRUSTEE 2.00 X 0 0 0 JOSEPH LIANA TRUSTEE 2.00 X 0 0 0 MICHAEL RUSSO CHAIRMAN 2.00 X X 0 0 0 NEIL FOSTER PHILLIPS TRUSTEE 2.00 X 0 0 0 PATRICK SUN TRUSTEE 2.00 X 0 0 0 PHILIPPA KARERTON TRUSTEE 2.00 X 0 0 0 ROBERT REICHENBACH SECRETARY 2.00 X X 0 0 0 ROBERT W KOOP TRUSTEE 2.00 X 0 0 0 SANG KI HAN TRUSTEE 2.00 X 0 0 0 BRUCE J FLANZ PRESIDENT & CEO 10.00 55.00 X 0 1615394 43659 MOUNIR F DOSS EXEC VP & CFO 10.00 55.00 X 0 1097113 43659 ROBERT LEVINE EXEC VP & COO 40.00 X 401060 0 43948 ESSA MEHKRI DIRECTOR MD 40.00 X 358843 0 37691 GAGAN GULATI DIRECTOR MD 40.00 X 311392 0 43139 JAMES GIGLIO CHAIRPERSON 40.00 X 488276 0 46996 NAGESWARA MANDAVA CHAIRPERSON 40.00 X 499130 0 44008 OSCAR MARCILLA DIRECTOR MD 40.00 X 459986 0 25853 2518687 3434941 404565 291 0 1 0 MARTIN CLEARWATER AND BELL 220 E 42ND ST NY NY 10017 LEGAL SERVICES 795410 PRICEWATERHOUSE COOPERS LLP PO BOX 7247-8001 PHILADELPHIA PA 10181 ACCOUNTING SERVICES 242000 WOUNDCARE SERVICES 5220 BELFORT ROAD JACKSONVILLE FL 45263 PROFESSIONAL SERVICES 213038 NIGHTHAWK RADIOLOGY SERVICES 25983 NETWORK PLACE CHICAGO IL 48267 PROFESSIONAL SERVICES 175202 KPMG PEAT MARWICK LLP PO BOX 120001 DALLAS TX 75312 PROFESSIONAL SERVICES 169920 6 155972 33210329 951336 34317637 PATIENT SERVICES 611600 199217929 199217929 CAPITATION REVENUE 611600 32655987 32655987 OTHER PHYSICAN BILLINGS 621400 5981734 5981734 PHARMACY RX BILLING 621400 2799135 2799135 I&R TEACHING INCOME 621400 1495115 1495115 371368 371368 242521268 85782 85782 581434 0 581434 581434 581434 8534976 14000 0 0 8534976 14000 8548976 8548976 74982 155972 68342 6640 6640 CHARGE BACK 900099 1497856 1497856 CAFETERIA AND VENDING MACHINE 900099 414591 414591 REBATES AND REFUNDS 900099 396980 396980 213715 213715 2523142 288584879 245044410 0 9222832 431258 374803 56455 129436632 112169785 17266847 9101323 8462650 638673 28536576 25745267 2791309 9861464 8545945 1315519 5499996 5499996 435756 377626 58130 250920 217447 33473 33279 33279 21072906 20679297 393609 65045 56368 8677 474046 410808 63238 3668005 3178693 489312 4331695 3714758 616937 4944 4944 -583660 -505800 -77860 7646949 6626846 1020103 7208950 5889821 1319129 MEDICAL & SURGICAL SUPP 21715743 21715743 PROVISION FOR BAD DEBT 4619763 4619763 PURCHASED SERVICES 2232232 2232232 COLLECTION AGENCY 1843376 1843376 17463026 13343326 4119700 275350224 237893601 37456623 0 86960 5656003 49892440 67209359 2860536 2734191 4040578 6275570 222659450 190894458 36955442 31764992 21693737 24682125 2785162 6383654 118314855 144705894 61209623 63130357 792549 936541 17586255 13729471 180020297 194968739 259608724 272765108 X -141293869 -128059214 -141293869 -128059214 118314855 144705894 13234655 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 0 0 0 1 33279 0 0 0 33279 0 PART II-B, LINE 1: FLUSHING HOSPITAL MEDICAL CENTER IS A MEMBER OF AN ASSOCIATION OF WHICH SOME OF THEIR DUES ARE ALLOCATED TO GRASS ROOTS LOBBYING IN REGARD TO THEIR NEEDS IN SERVICING AND PROVIDING HEALTHCARE TO: 1199 $14,603 HANYS $8,076 GNYNHA $10,600 5167090 5167090 78661772 67088672 11573100 134300704 123805786 10494918 4529884 4529884 31764992 INVESTMENTS - OTHER SECURITIES 24682125 C 24682125 MEDICAL MALPRACTICE 27050357 DUE TO RELATED ORGANIZATIONS 161717235 DUE TO THIRD PARTY 6201147 194968739 X 763338644 -3768752 -3768752 767107396 -478522517 -478522517 288584879 750798000 480067539 480067539 270730461 4619763 4619763 275350224 PART X, LINE 2: THE MEDICAL CENTER QUALIFIES AS A TAX-EXEMPT NONPROFIT CORPORATION UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTY REVENUES 1,580,829. PROVISION FOR BAD DEBT EXPENSES -4,619,763. INTERCOMPANY ELIMINATIONS -729,818. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAPITATION EXPENSES -478,454,175. FUNDRAISING EXPENSES -68,342. PART XII, LINE 2D - OTHER ADJUSTMENTS: CAPITATION EXPENSES 478,454,175. RELATED PARTY EXPENSES 2,274,840. INTERCOMPANY ELMINATIONS -729,818. FUNDRAISING EXPENSES 68,342. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 4,619,763. CELEBRATION 2018 161979 129579 32400 687 34720 700 1011 GOLF GOUTING 68975 26393 42582 28113 3111 230954 155972 74982 687 62833 700 4122 68342 6640 1 1 1 X 1 X 1 1 0 1 1 22219801 4132388 18087413 0.06570 120415202 117189293 3225909 0.01170 142635003 121321681 21313322 0.07740 17 56721 928685 928685 0.00340 35030726 13070537 21960189 0.07980 22667878 17561000 5106878 0.01850 17 56721 58627289 30631537 27995752 0.10170 17 56721 201262292 151953218 49309074 0.17910 1 4619763 39253523 38109959 1143564 X 1 1 1 1 FLUSHING HOSPITAL MEDICAL CENTER 4500 PARSONS BLVD FLUSHING NY 11355 X X X FLUSHING HOSPITAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.FLUSHINGHOSPITAL.COM 1 13 1 WWW.FLUSHINGHOSPITAL.COM 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 1 X WWW.FLUSHINGHOSPITAL.COM X WWW.FLUSHINGHOSPITAL.COM X 1 0 1 0 0 FLUSHING HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 5: PUBLIC PARTICIPATIONPARTICIPANTS IN THE DEVELOPMENT OF THE COMMUNITY SERVICE PLAN INCLUDED STAFF FROM PUBLIC AFFAIRS, ADMINISTRATION, AS WELL AS MEDICAL STAFF, THE HOSPITAL'S BOARD OF TRUSTEES, THE HOSPITAL'S COMMUNITY ADVISORY BOARD (CAB), AND THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC DOHMH).THE DEPARTMENT OF PUBLIC AFFAIRS CONDUCTED A SURVEY DURING THE MONTH OF SEPTEMBER 2013 TO HELP IDENTIFY WHICH HEALTH RELATED ISSUES WERE MOST IMPORTANT TO THE COMMUNITY. EACH OF THE COMMUNITY ORGANIZATIONS THAT PARTICIPATED IN THE SURVEY PROCESS WERE PROVIDED WITH A LIST OF COMMON HEALTH ISSUES AND ASKED TO INDICATE WHICH ISSUES THEY FELT WERE THE THREE MOST IMPORTANT FACTORS FOR A HEALTHY COMMUNITY. THE SURVEYS REVEALED THAT COMMUNITY MEMBERS HAD MANY CONCERNS INCLUDING CHILDHOOD OBESITY, HYPERTENSION, NUTRITION, DIABETES, ASTHMA, SEXUALLY TRANSMITTED DISEASES, AS WELL AS TOBACCO USE AND BREASTFEEDING. FLUSHING HOSPITAL IS PARTNERING ON SEVERAL PREVENTION PROJECTS WITH COMMUNITY BASED ORGANIZATIONS AND WITH NYC DOHMH AS PART OF ITS TAKE CARE NEW YORK (TCNY) PROGRAM TO ADDRESS THESE PROBLEMS.PRIOR TO DISTRIBUTING THESE SURVEYS, A BRIEF INTRODUCTION AND EXPLANATION OF THE SURVEY WAS GIVEN TO THOSE IN ATTENDANCE, EITHER BY THE LEADERSHIP OF THE HOST ORGANIZATION OR BY A MEMBER OF THE PUBLIC AFFAIRS STAFF. THE RESPONDENTS WERE TOLD THAT THE SURVEYS WERE ANONYMOUS AND WOULD BE USED BY THE STAFF OF THE HOSPITAL TO BETTER UNDERSTAND WHAT THE COMMUNITY BELIEVES ARE IMPORTANT PROBLEMS TO BE ADDRESSED.THE ORGANIZATIONS SURVEYED WERE:COMMUNITY BOARD 6 - 24 RESPONSESASSOCIATED CHAPTER OF ASIAN PHYSICIANS - 30 RESPONSESCOMMUNITY BOARD 3 - 39 RESPONSESCOMMUNITY BOARD 7 -34 RESPONSESDISTRICT SERVICE COUNCIL - COMMUNITY BOARD 7 - 15 RESPONSESTWO INITIATIVES THAT THE HOSPITAL HAS CHOSEN TO ADDRESS AS PART OF THE COMMUNITY SERVICE PLAN AND THE NUMBER OF PEOPLE WHO INDICATED THAT THESE INITIATIVES ARE IMPORTANT:SMOKING CESSATION-71EDUCATING AND ENCOURAGING MOTHERS TO BREAST FEED-11SEVERAL DISCUSSIONS HAVE BEEN HELD WITH THE HOSPITAL'S CAB, HIGHLIGHTING THE SERVICE AREA'S HEALTH PROBLEMS, INCLUDING THE TWO PROBLEMS THAT WERE BEING CONSIDERED AS PREVENTION AGENDA PRIORITIES FOR THE HOSPITAL'S 2013 COMMUNITY SERVICE PLAN.AT THE MARCH 12, 2013 CAB MEETING MRS. MARIA SMILIOS, RN, ASSISTANT DIRECTOR OF NURSING FOR PERINATAL, PEDIATRICS AND NICU, DISCUSSED THE BENEFITS OF INCREASING EXCLUSIVE BREASTFEEDING, AND THE HOSPITAL'S PARTICIPATION IN LATCH ON NYC, A PROGRAM INITIATED BY NYC DOHMH AND ENDORSED BY NYS DOH, GYNHA, HHC, AAP, AAFP AND SAHM WHICH SUPPORTS NEW MOTHERS TO BREAST FEED THEIR NEWBORNS AND CONTINUE AFTER THEIR DISCHARGE FROM THE HOSPITAL. CURRENTLY THERE ARE 27 HOSPITALS WITHIN THE NYC AREA THAT ARE PARTICIPATING, INCLUDING JAMAICA AND FLUSHING HOSPITALS UNDER THE MEDISYS HEALTH NETWORK.IN 2009, THE HOSPITAL HAD, WITH THE HELP OF ITS CAB, SELECTED DECREASING TOBACCO USE AS ONE OF ITS PREVENTION AGENDA PRIORITIES FOR THE COMMUNITY SERVICE PLAN. SINCE THAT TIME THE HOSPITAL HAS WORKED CLOSELY WITH QUEENS QUITS TO INCREASE REFERRALS TO THEIR PROGRAM. AT THE APRIL 12, 2011 CAB MEETING REPRESENTATIVES FROM QUEENS QUITS REVIEWED HOW THE PROGRAM WORKS, A SYNOPSIS OF RELEVANT STATISTICS, AND THEIR OUTREACH EFFORTS IN PARTNERSHIP WITH LOCAL HOSPITALS AND HEALTH CENTERS. QUEENS QUITS LITERATURE WAS PROVIDED FOR DISTRIBUTION BY CAB MEMBERS TO THE COMMUNITY GROUPS THEY REPRESENT.THROUGH THESE DISCUSSIONS CAB MEMBERS GAINED A BETTER UNDERSTANDING OF THE IMPORTANCE OF DECREASING TOBACCO USE AND INCREASING EXCLUSIVE BREASTFEEDING, AND EXPRESSED SUPPORT FOR THE HOSPITAL'S PLANS TO ADDRESS THESE HIGH PRIORITY PREVENTION INITIATIVES.2014 ACHIEVEMENTSIN SUPPORT OF THE HOSPITAL'S DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PLANNING PROCESS, A THOROUGH COMMUNITY NEEDS ASSESSMENT (CNA) WAS PERFORMED. THIS ASSESSMENT SHOWED THE SAME HEALTH NEEDS DESCRIBED IN THE 2013 COMMUNITY SERVICE PLAN (CSP), BUT IN GREATER DETAIL DUE TO THE AVAILABILITY OF A VAST AMOUNT OF DATA ON UTILIZATION, HEALTH STATUS AND THE SOCIAL DETERMINANTS OF HEALTH. IN ADDITION, THE ASSESSMENT IDENTIFIED SERVICE GAPS THAT NEED TO BE FILLED IN ORDER TO ACHIEVE THE TRIPLE AIM - BETTER HEALTH, BETTER HEALTHCARE AND CONSUMER EXPERIENCE, AND LOWER COSTS.FLUSHING HOSPITAL'S PRIORITIES ARE IN LINE WITH THE FINDINGS OF THE CNA AND THE PRIORITIES IDENTIFIED BY THE NEW YORK STATE (NYS) PREVENTION AGENDA AS WELL AS NEW YORK CITY'S TAKE CARE NEW YORK (TCNY) PROGRAM: TOBACCO-FREE LIVING, HEALTHY EATING, ACTIVE LIVING, HEART HEALTH, HIV PREVENTION, MENTAL HEALTH PROMOTION, ALCOHOL AND SUBSTANCE ABUSE REDUCTION, CANCER PREVENTION, HEALTHY INDOOR AND OUTDOOR AIR, QUALITY PREVENTIVE CARE, CHILDREN AND YOUTH, AND RESOURCES FOR EMERGENCY PREPAREDNESS. THE HOSPITAL HAS CHOSEN TO FOCUS ITS PREVENTION ACTIVITIES ON TWO OF THESE AREAS: 1) TOBACCO-FREE LIVING AND 2) CHILDREN AND YOUTH - PROMOTING EXCLUSIVE BREASTFEEDING. IN ADDITION, FLUSHING HOSPITAL PARTICIPATES WITH THE NYCDOHMH ON EIGHT OF THEIR SIXTEEN SPECIFIC COMMUNITY HEALTH INTERVENTIONS, AND HAS BEEN NAMED AS A TCNY PARTNER FOR THESE EFFORTS. IN ADDITION TO TOBACCO FREE LIVING AND PROMOTING EXCLUSIVE BREASTFEEDING, SOME HIGHLIGHTS OF THESE EFFORTS INCLUDE:- DIABETES PREVENTION PROGRAM (DPP) LIFESTYLE COACHING.- EIGHT PATIENT NAVIGATORS AND ONE BILINGUAL (SPANISH) REGISTERED DIETITIAN ATTENDED TRAINING IN NOVEMBER; THE REGISTERED DIETITIAN ACHIEVED CERTIFICATION IN DECEMBER 2014 AS A CERTIFIED DIABETES EDUCATOR (CDE).- THE HOSPITAL IS CURRENTLY ENROLLING PRE-DIABETIC PATIENTS FOR CLASSES STARTING IN JANUARY 2015. - THE FOOD & NUTRITION DEPARTMENT ACHIEVED SILVER STATUS IN THE NYCDOHMH'S HEALTHY HOSPITAL FOOD INITIATIVE, A PROGRAM THAT PROMOTES HEALTHIER FOOD CHOICES IN HOSPITALS.- WORKING WITH THE NYCDOHMH GOOD CHOICE PROGRAM. "GOOD CHOICE IS AN INITIATIVE DESIGNED TO HELP ORGANIZATIONS AND HOSPITALS EASILY FIND AND PURCHASE HEALTHIER FOODS AND BEVERAGES FROM FOOD DISTRIBUTORS THAT MEET THE NYC FOOD STANDARDS." - THE CLINICAL NUTRITION DEPARTMENT PRESENTS MULTIPLE MONTHLY NUTRITION LECTURES AT LOCAL COMMUNITY CENTERS. 1) TOBACCO-FREE LIVING GOALS: ELIMINATE SMOKING AND OTHER TOBACCO USE ON HOSPITAL CAMPUS AND GROUNDS. INCREASE NUMBER OF OUTPATIENT AND INPATIENT TOBACCO USERS AGED 13 AND ABOVE WHO RECEIVE AN INTERVENTION INCLUDING COUNSELING, REFERRAL FOR TREATMENT,EDUCATE THE COMMUNITY ABOUT THE DANGERS OF TOBACCO USE AND HOW TO QUIT.ACTIVITIES ACCOMPLISHED: JOINED NYCDOHMH TOBACCO-FREE HOSPITALS CAMPAIGN IN 2012, RECEIVED BRONZE STAR IN 2013, AND SILVER STAR IN 2014.ISSUED EMPLOYEE POLICY AND POSTED APPROPRIATE SIGNS ON CAMPUS.INFORMED STAFF OF INSURANCE BENEFITS FOR SMOKING CESSATION AND SERVICES AVAILABLE IN OCCUPATIONAL HEALTH SERVICE.INCLUDED POLICY AS WELL AS BENEFITS AND SERVICES AVAILABLE IN EMPLOYEE ORIENTATION AND REORIENTATION, AND ALSO IN EMPLOYEE HANDBOOK. MEDICAL DIRECTOR OF OCCUPATIONAL HEALTH SERVICE WAS CERTIFIED IN SMOKING CESSATION COUNSELING AT THE RUTGERS UNIVERSITY PROGRAM, AND FOUR RESPIRATORY THERAPISTS HAVE RECEIVED TRAINING TO BECOME CERTIFIED TOBACCO TREATMENT SPECIALIST. (CTTS)REMINDERS OF POLICY AND BENEFITS WILL BE MADE AT REGULAR MEETINGS OF DEPARTMENT HEADS AND INDIVIDUAL DEPARTMENTS. TRAIN PROVIDERS ON COMPLETION OF TOBACCO USE SCREENS IN EPIC EHR.SCHEDULE QUEENS QUITS TO PROVIDE EDUCATION SESSIONS ON COUNSELING, REFERRAL AND TREATMENT FOR ALL PROVIDERS.SEND FOUR RESPIRATORY THERAPISTS TO BE CERTIFIED IN SMOKING CESSATION COUNSELING AND WORK WITH INPATIENTS.HIRE ONE ASTHMA EDUCATOR WHO WILL EARN CERTIFICATION IN SMOKING CESSATION COUNSELING AND WORK WITH OUTPATIENTS.PROVIDE QUARTERLY REPORTS TO CLINICAL AND ADMINISTRATIVE LEADERSHIP ON COUNSELING, REFERRAL AND MEDICATION PRESCRIBED.ENTER CURRENT INFORMATION IN THE NYCDOHMH SYSTEM IN ORDER TO EARN A GOLD STAR IN THEIR TOBACCO-FREE HOSPITALS CAMPAIGN.ESTABLISH ORGANIZATION-WIDE PERFORMANCE IMPROVEMENT PROGRAM CONCERNING TOBACCO USE.2) PROMOTING EXCLUSIVE BREASTFEEDING GOALS:EXCLUSIVE BREASTFEEDING FOR AS MANY PATIENTS AS CLINICALLY POSSIBLE.BABY FRIENDLY DESIGNATION.EDUCATE THE COMMUNITY ON THE BENEFITS OF BREASTFEEDING.ACTIVITIES ACCOMPLISHED: FULLY IMPLEMENT BREAST-FEEDING CURRICULUM FROM EVIDENCE-BASED SOURCES BY TRIMESTER FOR ALL PREGNANT PATIENTS.DEVELOPED AND BEGIN IMPLEMENTATION NURSING CURRICULUM TO PREPARE INPATIENT AND OUTPATIENT MATERNAL-CHILD RNS TO SIT FOR THE EXAMINATION CERTIFICATION IN LACTATION COUNSELING.DEVELOPED A 4 HOUR PROVIDER EDUCATIONAL PROGRAM FOCUSED ON THE BENEFITS OF BREASTFEEDING AND THE PROVIDER APPROACH TO PROMOTE THIS HEALTH CHOICE BY ALL PATIENTS; MANDATORY FOR OB/GYN, PEDIATRICS, FAMILY MEDICINE AND MEDICINE. PART V, SECTION B, LINE 3: PUBLIC PARTICIPATION DEVELOPED A 4 HOUR PROVIDER EDUCATIONAL PROGRAM FOCUSED ON THE BENEFITS OF BREASTFEEDING AND THE PROVIDER APPROACH TO PROMOTE THIS HEALTH CHOICE BY ALL PATIENTS; MANDATORY FOR OB/GYN, PEDIATRICS, FAMILY MEDICINE AND MEDICINE.DEVELOPED A MANDATORY EDUCATIONAL PROGRAM TO EDUCATE GENERAL STAFF WHO INTERACT WITH PATIENTS (E.G., REGISTRARS, HOUSEKEEPERS, MANAGERS).ACTIVE PARTICIPATION IN LATCH ON NYC, NY STATE'S GREATER BEGINNINGS, AND THE COHORT STUDY.ACTIVITIES ACCOMPLISHED CONTINUE TO MAKE AVAILABLE PRIVATE AREAS FOR BREASTFEEDING IN ALL AMBULATORY CARE LOCATIONS.OFFER TO THE COMMUNITY CHILD BIRTH EDUCATION CLASSES WITH BREASTFEEDING COMPONENT ON CAMPUS TWO TIMES EACH MONTH.PROMOTE BREASTFEEDING VIA POSTERS AT ALL AMBULATORY CARE AND INPATIENT SITES.REMINDERS OF THE EXCLUSIVE BREASTFEEDING GOAL WILL BE MADE AT ALL REGULAR MEETINGS OF DEPARTMENT HEADS AND INDIVIDUAL DEPARTMENTS.CONTINUE TO PARTICIPATE IN COMMUNITY HEALTH FAIRS AND PROVIDE EDUCATIONAL MATERIALS AS WELL AS COUNSELING ON THE BENEFITS OF BREASTFEEDING.CONTINUE PARTNERSHIP WITH WIC BY ENSURING THAT ALL ELIGIBLE PATIENTS ARE REFERRED FOR ADDITIONAL ASSISTANCE. PART I, LN 7 COL(F): BAD DEBT EXPENSE IS ESTIMATED BASED ON AGING OF THE ACCOUNTS RECEIVABLE AND GETS ADJUSTED BASED ON ACTUAL WRITE OFF. ACTUAL ACCOUNT WRITE OFF IS AS FOLLOWS: PATIENTS WHO ARE ENTITLED TO FINANCIAL ASSISTANCE ARE GIVEN DISCOUNT BASED ON OUR CHARITY CARE POLICY (MEDICAID RATE). IF THE PATIENT DOESN'T PAY THE BALANCE OF THEIR ACCOUNT AFTER RECEIVING 3 BILLS THEN THE ACCOUNT BALANCE GETS TRANSFER TO THE COLLECTION AGENCY. IF THE COLLECTION AGENCY CAN'T COLLECT AFTER EXHAUSTING THEIR EFFORTS THEN THE ACCOUNT GETS RETURNED AS UNCOLLECTIBLE AND THE HOSPITAL WRITES OFF THE ACCOUNT AS BAD DEBT. BAD DEBT RELATED TO LINE 3: BAD DEBT EXPENSE IS ALLOCATED TO THE PATIENTS WHO ARE ENTITLED TO FINANCIAL AID BASED ON CHARITY CARE VOLUME PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: FLUSHING HOSPITAL PROGRAMS SUPPORT THE CITY OF NEW YORK'S TAKE CARE NEW YORK (TCNY) PROGRAM IN THE FOLLOWING WAYS:1. HAVE A REGULAR DOCTOR OR OTHER HEALTH CARE PROVIDER: FLUSHING'S AMBULATORY CARE SERVICES ARE DESIGNED TO PROMOTE CONTINUITY OF CARE BYALLOWING PATIENTS TO CHOOSE A PHYSICIAN WHO WILL BE DESIGNATED AS THEIRPRIMARY CARE PROVIDER. THE DESIGNATED PROVIDER IS RESPONSIBLE FOR ENSURING THAT HIS/HER PATIENTS ARE GIVEN AGE APPROPRIATE SCREENING, IMMUNIZATION AND EDUCATION.2. BE TOBACCO-FREE: SMOKING CESSATION IS ONE OF THE HOSPITAL'S PREVENTION PRIORITIES AND WAS DISCUSSED IN THE PREVIOUS SECTION.3. KNOW YOUR HIV STATUS: THE HOSPITAL PROVIDES HIV COUNSELING AND TESTING WITH STAFF THAT ROUTINELY PERFORMS THIS FUNCTION IN BOTH THE EMERGENCY DEPARTMENT AND CLINICS. IF REQUIRED, PATIENTS ARE REFERRED FOR SERVICES TO JAMAICA HOSPITAL'S INFECTIOUS DISEASE CLINIC OR TO OTHER COMMUNITY PROGRAMS.4. GET HELP FOR DEPRESSION: FLUSHING HOSPITAL'S MEDICAL PROVIDERS INCORPORATE DEPRESSION SCREENING DURING ROUTINE MEDICAL EXAMINATIONS AND ONGOING CARE. CHILDREN AND ADULTS NEEDING FURTHER SERVICES ARE REFERRED TO FLUSHING?S FULL SERVICE PSYCHIATRY DEPARTMENT OR OTHER COMMUNITY PROGRAMS.5. LIVE FREE OF DEPENDENCE ON ALCOHOL AND DRUGS: DURING ROUTINE MEDICAL EXAMINATIONS PATIENTS HAVE THE OPPORTUNITY TO RECEIVE SCREENING FOR ALCOHOL AND DRUG USE. AS NECESSARY, PATIENTS WILL BE GIVEN PREVENTIVE COUNSELING AND TREATMENT OPTIONS, INCLUDING FLUSHING HOSPITAL'S IN-PATIENT AND OUT-PATIENT TREATMENT PROGRAMS FOR CHEMICAL DEPENDENCY. 6. GET CHECKED FOR CANCER: FLUSHING HOSPITAL IS A MEMBER OF THE STATE'S HEALTHY LIVING PARTNERSHIP PROGRAM, WHICH PROVIDES COVERAGE FOR CERVICAL, BREAST, AND COLON CANCER SCREENINGS TO UNINSURED AND UNDERINSURED PATIENTS WHO MEET THE ELIGIBILITY AND SCREENING CRITERIA. THE HOSPITAL RECEIVES GRANT FUNDING FOR BREAST HEALTH CARE FROM THE AVON FOUNDATION AND KOMEN FOUNDATION TO HELP SUPPORT CASE MANAGEMENT, OUTREACH AND BREAST CARE SERVICES TARGETED TO THE ASIAN AND SOUTH ASIAN POPULATIONS. FLUSHING HOSPITAL WAS PRIVILEGED TO BE PART OF THE "COLONOSCOPY SCREENING NAVIGATOR PROGRAM," WHICH RECEIVED ONE YEAR SEED FUNDING BY THE NYCDOH. THE PROGRAM HAS BEEN SHOWN TO BE EFFECTIVE AND THE HOSPITAL HAS MADE A COMMITMENT TOCONTINUE THE PROGRAM WITHOUT GRANT FUNDING.7. THE HOSPITAL PARTICIPATES IN THE NYC'S VACCINE FOR CHILDREN PROGRAM (VFC) PROVIDING IMMUNIZATIONS TO CHILDREN UP TO 19 YEARS OF AGE AGAINST CHILDHOOD DISEASES AND INFLUENZA TO ELIGIBLE CHILDREN INCLUDING THOSE WITHOUT HEALTH COVERAGE SEEN IN OUR AMBULATORY CARE NETWORK. INFLUENZA VACCINE IS OFFERED TO ADULTS DURING RECOMMENDED VACCINATION MONTH.8. HAVE A SAFE AND HEALTH HOME: ANTICIPATORY GUIDANCE ON SAFETY IN THE HOME IS PROVIDED BY THE HOSPITAL'S PEDIATRIC, FAMILY MEDICINE AND REHABILITATION PROFESSIONALS. AT HEALTH FAIRS IN THE COMMUNITY, FIRE, HOME AND AUTOMOTIVE SAFETY INFORMATION IS ROUTINELY MADE AVAILABLE TO ATTENDEES. 9. HAVE A HEALTHY BABY: THE HOSPITAL FOLLOWS PRENATAL CARE GUIDELINES ADOPTED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THESE PROGRAMS ASSIST PREGNANT WOMEN AND THEIR FAMILIES TO OBTAIN NECESSARY MEDICAL CARE AND SUPPORTIVE SERVICES, WITH THE GOAL OF IMPROVING BIRTH OUTCOMES AND REDUCING CHILD ABUSE.10. BREAST FEEDING: THE HOSPITAL IS SUPPORTING BREASTFEEDING MOTHERS BY PARTICIPATING IN "LATCH ON NYC," A NEW CITY-WIDE INITIATIVE. FLUSHING HOSPITAL IS WELL ON ITS WAY TO BEING DESIGNATED AS A "BABY FRIENDLY" HOSPITAL, A GLOBAL INITIATIVE THAT PROMOTES, PROTECTS, AND SUPPORTS BREASTFEEDING THROUGH TEN STEPS TO SUCCESSFUL BREASTFEEDING. WE HAVE REGISTERED WITH BABY FRIENDLY USA TO BEGIN THE PROCESS IN THE "4-D PATHWAY TO BABY-FRIENDLY DESIGNATION." WE HAVE COMPLETED THE DISSEMINATION PHASE AND HAVE STARTED THE SECOND PHASE, THE DESIGNATION PHASE. MANY STAFF MEMBERS HAVE TAKEN THE CERTIFIED LACTATION COUNSELOR (CLC) COURSE PROVIDED BY THE NYCDOH. WE OFFER AND ENCOURAGE OUR PATIENTS TO ATTEND FREE BREASTFEEDING SUPPORT GROUPS HELD ON A WEEKLY BASIS. FREE LACTATION COUNSELING IS OFFERED TO ALL PATIENTS AFTER DISCHARGE.WE ARE WORKING CLOSELY WITH THE NYCDOH BY EDUCATING AND ENCOURAGING THE IMMUNIZATION OF ALL HEALTHCARE PERSONNEL THAT ARE IN CONTACT WITH WOMEN OF CHILDBEARING AGE, NEWBORNS AND CHILDREN WITH TDAP TO PREVENT THE TRANSMISSION OF PERTUSSIS. ALL PREGNANT AND POSTPARTUM WOMEN ARE OFFERED THE VACCINE AS A STANDING ORDER AND IN NOVEMBER 2014, 85% OF OUR POSTPARTUM PATIENTS RECEIVED THE VACCINE. ADDITIONALLY, ALL FAMILY MEMBERS ARE INSTRUCTED ON THE IMPORTANCE OF RECEIVING THE VACCINE. PART III, LINE 4: FINANCIAL STATEMENTS BAD DEBT & CHARITY CARE FOOTNOTE:FLUSHING HOSPITAL PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MATTER OF POLICY, FLUSHING HOSPITAL PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED AS CHARITY CARE. FLUSHING HOSPITAL PROVIDES CHARITY CARE IN THE AMOUNT OF THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. SINCE PAYMENT OF THIS DIFFERENCE IS NOT SOUGHT, CHARITY CARE ALLOWANCES ARE NOT REPORTED AS REVENUE. REMAINING UNCOLLECTED BALANCES AFTER CHARITABLE ALLOWANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. THE ESTIMATED COSTS OF PROVIDING CHARITY SERVICES ARE BASED ON A CALCULATION WHICH APPLIES A RATIO OF COST TO CHARGES TO THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. TOTAL FORGONE CHARGES FOR CHARITY CARE TOTALED $16,007,398 AND $14,806,104 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY. THIS EQUATED TO AN APPROXIMATE COST OF $7,678,748 AND $6,508,763 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY. PART III, LINE 8: ALLOWABLE COSTS ARE FROM THE HOSPITAL COST REPORT THAT GETS FILED WITH MEDICARE EVERY YEAR. COST METHODOLOGY THAT IS USED TO CALCULATE MEDICARE ALLOWABLE COST IS RATIO OF COST TO CHARGES BASED ON MEDICARE GUIDELINES. MEDICARE ALLOWABLE COST ON LINE 6 DOESN'T INCLUDE COST OF RESIDENCY PROGRAM AND SUPERVISORY PHYSICIAN COST WHICH IS OVER $35 MILLION. EXCLUSION OF THESE COSTS RESULTED IN A SURPLUS ON LINE 7. PART III, LINE 9B: THE HOSPITAL OFFERS INSTALLMENT PLANS FOR THE PAYMENT OF OUTSTANDING BALANCES FOR PATIENTS APPROVED FOR FINANCIAL AID. THE HOSPITAL DOES NOT MANDATE THAT THE MONTHLY INSTALLMENT PAYMENT ARRANGEMENT EXCEED 10% OF THE APPLICANT'S GROSS MONTHLY INCOME. THERE IS NO ACCELERATOR OR SIMILAR CLAUSE UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED WHEN A PATIENT MISSES MAKING A PAYMENT.THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 40 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTIONS AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTIONS AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING A LEGAL ACTION. PART VI, LINE 2: ACCESSIBILITY TO PRIMARY HEALTHCARE REMAINS A CONCERN FOR SOME RESIDENTS IN FLUSHING HOSPITAL'S PRIMARY SERVICE AREA, AS 13.6% OF THE RESIDENTS OF WEST QUEENS AND 11% OF THE RESIDENTS OF FLUSHING-CLEARVIEW HAVE REPORTED THAT THERE WAS AN OCCASION WHEN THEY HAVE NOT BEEN ABLE TO RECEIVE MEDICAL CARE WITHIN THE PAST YEAR WHEN THEY NEEDED IT. THESE PERCENTAGES OF FLUSHING HOSPITAL SERVICE AREA RESIDENTS WHO WERE UNABLE TO ACCESS HEALTHCARE SERVICES WERE HIGHER THAN THOSE OBSERVED IN QUEENS OVERALL (10.1%) OR NYC OVERALL (9.6%). REASONS FOR A PERSON'S INABILITY TO RECEIVE NEEDED MEDICAL SERVICES RANGE FROM APPOINTMENT AVAILABILITY TO FINANCIAL MEANS (INCLUDING INSURANCE AND MEDICAID/MEDICARE COVERAGE). ACCORDING TO NEW YORK CITY'S 2015 COMMUNITY HEALTH PROFILES, 38% AND 36% OF ADULT RESIDENTS OF COMMUNITY DISTRICTS 3 AND 4 (WEST QUEENS), RESPECTIVELY, REPORTED THAT THEY DID NOT HAVE HEALTH INSURANCE. THESE TWO COMMUNITY DISTRICTS IN WEST QUEENS CONTAINED THE HIGHEST PERCENTAGES OF UNINSURED ADULT RESIDENTS (OUT OF 59 COMMUNITY DISTRICTS); THE QUEENS AND NYC AVERAGES FOR ADULTS WHO LACK HEALTH INSURANCE WERE 22% AND 20%, RESPECTIVELY. COMPARED WITH THE OTHER NEIGHBORHOODS INCLUDED IN THE QUEENS 2014 COMMUNITY NEEDS ASSESSMENT (PREPARED FOR NEW YORK STATE'S DSRIP PROGRAM), WEST QUEENS HAD THE LOWEST RATIO (10.6) OF CLINICS [I.E., HOSPITAL-BASED EXTENSION CLINICS, FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS), AND COMPREHENSIVE CARE DIAGNOSTIC AND TREATMENT CENTERS (D&TCS)] TO RESIDENTS WHO ARE MEDICAID BENEFICIARIES OR ARE UNINSURED. FLUSHING HAD THE THIRD LOWEST RATIO (14.6); BY COMPARISON, NEIGHBORHOOD OF JAMAICA AND THE QUEENS SERVICE AREA OVERALL HAD RESPECTIVE RATIOS OF 72.5 AND 27.9 CLINICS TO RESIDENTS WHO ARE MEDICAID BENEFICIARIES OR UNINSURED. THESE RATIOS POINT TO THE UNMET MEDICAL NEEDS OF THESE QUEENS NEIGHBORHOODS.OBESITY, AIR QUALITY/SMOKING, AND THE NEED FOR ADDITIONAL BEHAVIORAL HEALTH SERVICES WERE PRIORITY HEALTH ISSUES HIGHLIGHTED IN THE DATA ANALYSES THAT FLUSHING HOSPITAL CONDUCTED FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE HEALTH CONCERNS WERE ALSO IDENTIFIED BY RESIDENTS OF THE COMMUNITY DISTRICTS OF FLUSHING AND CORONA, WHO TOOK PART IN FOCUS GROUPS AND SURVEYS IN THE SPRING OF 2016 AS PART OF NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S (DOHMH) TAKE CARE NEW YORK (TCNY) 2020 INITIATIVE. ON THE TCNY 2020 SURVEYS, FLUSHING AND CORONA RESIDENTS ALSO NAMED PHYSICAL ACTIVITY AS A HEALTH ISSUE, UNDERSCORING THE NEED FOR MORE EXERCISE PROGRAMS AND EDUCATIONAL OPPORTUNITIES TO HELP RESIDENTS MAINTAIN A HEALTHY WEIGHT. BREASTFEEDING, WHICH LOWERS THE RISK OF DEATH FROM INFECTIOUS DISEASES IN A CHILD'S FIRST TWO YEARS OF LIFE, AND CAN ALSO REDUCE THE RISK OF CHILDHOOD OBESITY, AS WELL AS THE RISK OF A WOMAN DEVELOPING BREAST OR OVARIAN CANCER , IS STILL NOT PRACTICED AS OFTEN IN PARTS OF FLUSHING OR WEST QUEENS AS IT IS IN NEW YORK CITY OVERALL. FLUSHING HOSPITAL HAS FOCUSED SIGNIFICANT RESOURCES ON IMPROVING RATES OF EXCLUSIVE BREASTFEEDING AMONG WOMEN WHO DELIVER AT THE HOSPITAL , AS WELL AS AMONG MOTHERS IN THE COMMUNITY, AND HOPES TO SOON BE DESIGNATED AS A BABY FRIENDLY HOSPITAL FOR OFFERING AN OPTIMAL LEVEL OF CARE FOR INFANT FEEDING AND MOTHER/BABY BONDING. SMOKING AND SECONDHAND SMOKE, AS WELL AS HOUSEHOLD/OUTDOOR AIR POLLUTION, WERE IDENTIFIED AS ONGOING COMMUNITY HEALTH CONCERNS THAT ARE CORRELATED WITH CHRONIC DISEASE, SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), AS WELL AS CANCER. RESPONDING TO THE NEEDS OF THE COMMUNITY, FLUSHING HOSPITAL HAS FOCUSED ON IMPROVING TOBACCO CESSATION RATES AND HAS BEEN AWARDED GOLD STAR STATUS FROM THE NYC DOHMH'S TOBACCO-FREE HOSPITALS CAMPAIGN IN RECOGNITION OF ITS TOBACCO CESSATION PROGRAMMING AND SUCCESSES. FLUSHING HOSPITAL ADDRESSED THE FIVE PRIORITY AREAS IDENTIFIED BY THE NEW YORK STATE DEPARTMENT OF HEALTH IN ITS PREVENTION AGENDA 2013-2018: 1) PREVENT CHRONIC DISEASE; 2) PROMOTE A HEALTHY AND SAFE ENVIRONMENT; 3) PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN; 4) PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE; AND 5) PREVENT HIV, STDS, VACCINE PREVENTABLE DISEASES AND HEALTHCARE-ASSOCIATED INFECTIONS. WITHIN EACH PRIORITY AREA, FLUSHING HOSPITAL ANALYZED AND SUMMARIZED DATA RELEVANT TO "FOCUS AREAS" (E.G., "REDUCE OBESITY AND "REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE" ARE FOCUS AREAS FOR THE PREVENT CHRONIC DISEASES PRIORITY). DATA WERE PRIMARILY OBTAINED FROM THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE'S (NYC DOHMH) 2015 COMMUNITY HEALTH PROFILES AND COMMUNITY HEALTH SURVEYS (EPIQUERY); THE NEW YORK STATE DEPARTMENT OF HEALTH'S DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM'S CLINICAL METRICS AND PERFORMANCE DATA; COMMUNITY-WIDE SURVEYS THAT WERE ADMINISTERED AS PART OF DATA COLLECTION FOR THE 2014 QUEENS COMMUNITY NEEDS ASSESSMENT (CNA); AND FOCUS GROUPS IN THE SPRING OF 2016 THAT WERE CONVENED BY THE NYC DOHMH IN NEIGHBORHOODS ACROSS THE CITY'S FIVE BOROUGHS AS PART OF NEW YORK CITY'S TAKE CARE NEW YORK (TCNY) 2020 INITIATIVE. COMMUNITY CONSULTATIONS WERE HELD IN NEIGHBORHOODS THROUGHOUT NYC TO VOTE ON LOCAL PRIORITIES IDENTIFIED BY THE NYC HEALTH DEPARTMENT FOR THE TCNY 2020 INITIATIVE. THE CORONA TCNY 2020 COMMUNITY CONSULTATION WAS CONVENED ON JANUARY 11, 2016, AND THE FLUSHING TCNY 2020 COMMUNITY CONSULTATION WAS HELD ON JANUARY 13, 2016; THESE TWO COMMUNITY CONSULTATIONS WERE HELD WITHIN FLUSHING HOSPITAL'S PRIMARY SERVICE AREA. TCNY 2020'S FOUR OBJECTIVES (1. CREATE HEALTHIER NEIGHBORHOODS; 2. SUPPORT HEALTHY LIVING; 3. PROMOTE HEALTHY CHILDHOODS; 4. INCREASE ACCESS TO QUALITY CARE) ARE ALIGNED WITH THE FIVE PRIORITY AREAS OF NEW YORK STATE'S PREVENTION AGENDA.NYC HAS DIFFERENT WAYS OF DESCRIBING AND CATEGORIZING NEIGHBORHOODS, WHICH IS RELEVANT TO HOW COMMUNITY HEALTH DATA ARE ANALYZED AND PRESENTED. NEIGHBORHOODS ARE TYPICALLY DEFINED ACCORDING TO EITHER NYC COMMUNITY DISTRICTS OR UNITED HEALTH FUND NEIGHBORHOODS. THERE ARE 59 NYC COMMUNITY DISTRICTS, WHICH WERE ESTABLISHED BY LOCAL LAW IN 1975. UNITED HEALTH FUND (UHF) NEIGHBORHOODS CONSIST OF 34 NEIGHBORHOODS MADE UP OF ADJOINING ZIP CODE AREAS, DESIGNATED TO APPROXIMATE NYC COMMUNITY PLANNING DISTRICTS. FLUSHING HOSPITAL'S PRIMARY SERVICE AREA HAS TRADITIONALLY BEEN DEFINED AS COVERING THE QUEENS NEIGHBORHOODS OF FLUSHING-CLEARVIEW (FC; ALSO KNOWN AS NORTH QUEENS) AND WEST QUEENS (WQ). THESE NEIGHBORHOODS, AS DEFINED BY THE UHF (AN INDEPENDENT, NONPROFIT, HEALTH SERVICES RESEARCH AND PHILANTHROPIC ORGANIZATION), DO NOT MAP EXACTLY ON TO DISTINCT COMMUNITY DISTRICTS.MOST OF THE CHARTS IN THIS REPORT REFLECT FLUSHING HOSPITAL'S SERVICE AREA DATA FROM THE NYC DOHMH'S COMMUNITY HEALTH PROFILES AND COMMUNITY HEALTH SURVEYS. BECAUSE THE COMMUNITY HEALTH PROFILE DATA ARE ORGANIZED BY COMMUNITY DISTRICT, AND THE COMMUNITY HEALTH SURVEY DATA ARE ORGANIZED BY UNITED HEALTH FUND NEIGHBORHOOD, FLUSHING HOSPITAL HAS USED BOTH WAYS TO DESCRIBE NEIGHBORHOODS. ADDITIONALLY, DSRIP DATA WERE AGGREGATED INTO UHF NEIGHBORHOODS TO BETTER CAPTURE AND DESCRIBE FHMC'S SERVICE AREA. FLUSHING HOSPITAL WORKED WITH THE NEW YORK ACADEMY OF MEDICINE'S (NYAM) CENTER FOR EVALUATION AND APPLIED RESEARCH TO CONDUCT PRIMARY DATA COLLECTION AND ANALYSIS FOR THE QUEENS CNA, INCLUDING FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND COMMUNITY-WIDE SURVEYS. FOCUS GROUP PARTICIPANTS WERE JOINTLY SELECTED BY FHMC AND NYC HEALTH + HOSPITALS (FORMERLY KNOWN AS THE NEW YORK CITY HEALTH AND HOSPITALS CORPORATION). IN ALL, 605 SURVEYS OF COMMUNITY RESIDENTS, 18 FOCUS GROUPS, AND 22 KEY INFORMANT INTERVIEWS WITH QUEENS RESIDENTS, PROVIDERS, AND OTHER STAKEHOLDERS WERE CONDUCTED TO CAPTURE COMMUNITY MEMBER AND STAKEHOLDER PERSPECTIVES ON HEALTH ISSUES AND ADDRESS ANTICIPATED GAPS IN THE SECONDARY DATA. THE FINDINGS FROM THESE PRIMARY DATA ANALYSES WERE COMBINED WITH ANALYSES OF SECONDARY DATA SETS PROVIDED BY THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC DOHMH) AND NEW YORK STATE DEPARTMENT OF HEALTH (NYS DOH). FOR THE DSRIP PROGRAM'S QUEENS COMMUNITY NEEDS ASSESSMENT, FLUSHING HOSPITAL'S PARTNER, NYC HEALTH + HOSPITALS, CONDUCTED DETAILED SECONDARY DATA ANALYSES OF ITS SERVICE AREAS WHICH OVERLAPPED WITH FHMC'S. TOGETHER, THE ANALYSES OF PRIMARY AND SECONDARY DATA HIGHLIGHT THE KEY HEALTH CONCERNS AND HEALTH NEEDS OF RESIDENTS, OVERALL, AND ACCORDING TO NEIGHBORHOOD AND SOCIODEMOGRAPHIC CHARACTERISTICS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPOLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO IDENTIFY METHODS BY WHICH PATIENTS AND/OR FAMILY MEMBERS ARE NOTIFIED OF THE FLUSHING HOSPITAL FINANCIAL AID POLICY.PROCEDURE: NOTIFICATION TO PATIENTS:FLUSHING HOSPITAL DEVELOPED AND HAS PUBLICLY AVAILABLE A CLEAR AND UNDERSTANDABLE WRITTEN SUMMARY OF ITS FINANCIAL ASSISTANCE POLICIES AND ENSURES THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE POLICIES. THE HOSPITAL HAS A 24-HOUR EMERGENCY DEPARTMENT AND NOTIFIES PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE DURING THE INTAKE AND REGISTRATION PROCESS THROUGH THE POSTING OF CONSPICUOUS AND LANGUAGE APPROPRIATE INFORMATION AND THROUGH INFORMATION ON ALL BILLS AND STATEMENTS SENT TO PATIENTS. PART VI, LINE 4: THERE ARE GAPS IN PRIMARY MEDICAL CARE AND MENTAL HEALTH CARE ACROSS QUEENS, WHICH ARE ALSO EVIDENT IN FLUSHING HOSPITAL'S SERVICE AREA. QUEENS HAS SEVEN NEIGHBORHOODS THAT ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA); THIS DESIGNATION IS BASED ON FOUR FACTORS: THE RATIO OF PRIMARY MEDICAL CARE PHYSICIANS PER 1,000 POPULATION, INFANT MORTALITY RATE, PERCENTAGE OF THE POPULATION WITH INCOMES BELOW THE POVERTY LEVEL, AND PERCENTAGE OF THE POPULATION AGE 65 OR OVER. ELMHURST, A NEIGHBORHOOD WITHIN FLUSHING HOSPITAL'S PRIMARY SERVICE AREA, IS IN A DESIGNATED MUA (CORONA SERVICE AREA). ELMHURST IS ALSO DESIGNATED AS A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) BY HRSA, MEANING THERE ARE LESS PRIMARY CARE PROFESSIONALS THAN ARE NECESSARY TO ACCOMMODATE THE POPULATION LIVING IN THAT AREA. CENSUS TRACTS WITHIN WEST QUEENS ARE ALSO DESIGNATED AS MENTAL HEALTH HPSAS (LONG ISLAND CITY/WOODSIDE), MEANING THERE ARE FEWER MENTAL HEALTH CARE PROFESSIONALS THAN ARE NECESSARY TO ACCOMMODATE THE POPULATION LIVING IN THOSE AREAS. NEAR FLUSHING HOSPITAL'S SERVICE AREA, THERE IS ONE FACILITY (THE FLOATING HOSPITAL, BASED IN LONG ISLAND CITY, QUEENS) THAT RECEIVED MENTAL HEALTH HPSA DESIGNATION BECAUSE IT PROVIDES MENTAL HEALTH SERVICES TO AN AREA OR POPULATION GROUP DESIGNATED AS HAVING A SHORTAGE OF MENTAL HEALTH PROFESSIONALS AND HAVE INSUFFICIENT CAPACITY TO MEET THE PSYCHIATRIC NEEDS OF THE AREA OR POPULATION GROUP.POVERTY AND ITS EFFECTS ON HEALTH, PARTICULARLY ON MENTAL/BEHAVIORAL HEALTH AND NUTRITION, ARE OF SIGNIFICANCE IN FLUSHING AND WEST QUEENS. WHEREAS 15% OF QUEENS RESIDENTS REPORTED ANNUAL INCOMES THAT FELL BELOW TWICE THE FEDERAL POVERTY LEVEL (2009-2013 AMERICAN COMMUNITY SURVEY, U.S. CENSUS), 14.6% OF FLUSHING, 20.5% OF JACKSON HEIGHTS (WEST QUEENS), AND 22.4% OF ELMHURST/CORONA (WEST QUEENS) RESIDENTS HAD ANNUAL INCOMES THAT FELL BELOW TWICE THE FEDERAL POVERTY LEVEL. FLUSHING RESIDENTS IDENTIFIED "UNMET MENTAL HEALTH NEEDS" AS A CONCERN IN THE TCNY 2020 INITIATIVE. OVERALL, 53% OF QUEENS CNA SURVEY RESPONDENTS REPORTED THAT THEY WORRIED ABOUT NOT HAVING ENOUGH TO EAT. HOWEVER, MORE THAN HALF (53%) OF QUEENS CNA SURVEY RESPONDENTS FROM WEST QUEENS REPORTED THEY WERE OBESE, COMPARED WITH 44% OF THE FULL SAMPLE OF QUEENS CNA SURVEY RESPONDENTS. RELATED TO OBESITY IS THE ISSUE OF LOW BREASTFEEDING RATES. FLUSHING AND WEST QUEENS WERE THE COMMUNITIES WITH THE LOWEST RATES OF EXCLUSIVE BREASTFEEDING (I.E., FEEDING AN INFANT BREASTMILK AND NOT GIVING THE INFANT ANY OTHER FOOD OR DRINK, EVEN WATER) IN 2012 AND 2013. SINCE BREASTFEEDING PROMOTES THE LOSS OF PREGNANCY-RELATED WEIGHT GAIN AMONG MOTHERS AND REDUCES THE RISK OF A CHILD DEVELOPING OBESITY OR BEING OVERWEIGHT, THIS IS A HEALTH ISSUE THAT NEEDS TO BE ADDRESSED.FLUSHING-CLEARVIEW: FLUSHING-CLEARVIEW, WITH A TOTAL RESIDENT POPULATION OF ALMOST 262,000, HAS A SIGNIFICANT ASIAN COMMUNITY. ABOUT HALF (49.5%) OF FLUSHING'S RESIDENTS ARE ASIAN AND MORE THAN A THIRD (37%) OF FLUSHING'S RESIDENTS ARE WHITE. SLIGHTLY LESS THAN 2% OF FLUSHING'S RESIDENTS ARE BLACK AND 16.5% IDENTIFY AS HISPANIC/LATINO (REGARDLESS OF RACE). A QUARTER OF FLUSHING'S RESIDENTS RECEIVE MEDICAID AND 13% OF RESIDENTS RECEIVE MEDICARE. FLUSHING-CLEARVIEW HAS SEVERAL POSITIVE HEALTH INDICATORS THAT STAND OUT FROM OTHER NEIGHBORHOODS IN QUEENS. FLUSHING HAD THE 4TH LOWEST NON-FATAL ASSAULT HOSPITALIZATION RATE (17 PER 100,000 POPULATION) AMONG THE COMMUNITY DISTRICTS; THE NON-FATAL ASSAULT HOSPITALIZATION RATES (PER 100,00 POPULATION) WERE 41 IN QUEENS AND 64 IN NYC. ALCOHOL-RELATED HOSPITALIZATIONS WERE SIMILARLY LOW IN FLUSHING, WHICH HAD THE 2ND LOWEST RATE (357/100,000 POPULATION) AMONG THE COMMUNITY DISTRICTS. THE ALCOHOL-RELATED HOSPITALIZATION RATES IN QUEENS AND NYC WERE 638 AND 1,019 PER 100,000 POPULATION. FLUSHING ALSO HAD THE 2ND LOWEST DRUG-RELATED HOSPITALIZATION RATE (166 PER 100,000 POPULATION) AMONG ALL 59 NYC COMMUNITY DISTRICTS; DRUG-RELATED HOSPITALIZATION RATES IN QUEENS AND NYC WERE 357 AND 907 PER 100,000 POPULATION, RESPECTIVELY. FLUSHING HAD THE 3RD LOWEST PERCENTAGE OF PRETERM BIRTHS (6.0%) AMONG ALL OF THE COMMUNITY DISTRICTS, JUST LESS THAN OF THE PRETERM BIRTH PERCENTAGE IN QUEENS (8.4%) AND ONLY 2/3 OF NYC'S PERCENTAGE (9.0%). FLUSHING-CLEARVIEW ALSO HAS SOME HEALTH CONCERNS. A PRIMARY HEALTH ISSUE IS THE LOW RATE OF BREASTFEEDING AMONG MOTHERS RESIDING IN FLUSHING. IN 2013, FLUSHING (COMMUNITY DISTRICT 7) HAD THE SMALLEST PERCENTAGE OF INFANTS FED EXCLUSIVELY BREAST MILK DURING THE FIRST 5 DAYS OF LIFE (11.2%) AMONG ALL OF NYC'S 59 COMMUNITY DISTRICTS; IT HAD THE 2ND LOWEST PERCENTAGE (16.1%) IN 2012, JUST BEHIND ELMHURST-CORONA. THE NYC AVERAGE FOR EXCLUSIVE BREASTFEEDING WAS 31.7% IN 2012 AND 32.1% IN 2013. COMMUNITY DISTRICT PRIORITIES FOR FLUSHING, AS IDENTIFIED IN THE TAKE CARE NEW YORK 2020 COMMUNITY CONSULTATIONS, INCLUDE AIR QUALITY, PHYSICAL ACTIVITY, CHILD-CARE, OBESITY, AND UNMET MEDICAL NEED. WEST QUEENS: WITH A TOTAL RESIDENT POPULATION OF ALMOST 470,000, WEST QUEENS HAS DIVERSE COMMUNITY THAT IS DIFFERENT THAN FLUSHING'S POPULATION PROFILE. ABOUT HALF (51%) OF THE RESIDENTS OF WEST QUEENS IDENTIFY AS HISPANIC/LATINO (REGARDLESS OF RACE). MORE THAN A QUARTER (26%), ARE ASIAN AND 45% RESIDENTS ARE WHITE. SEVEN PERCENT OF WEST QUEENS' RESIDENTS ARE BLACK. THIRTEEN PERCENT OF RESIDENTS OF WEST QUEENS RECEIVE MEDICARE AND 24% OF RESIDENTS RECEIVE MEDICAID. WEST QUEENS ALSO HAS SEVERAL POSITIVE HEALTH INDICATORS THAT SET THE NEIGHBORHOOD APART FROM OTHERS IN QUEENS. ELMHURST-CORONA (QUEENS COMMUNITY DISTRICT 4) HAD THE 4TH LOWEST DRUG-RELATED HOSPITALIZATION RATE (216 PER 100,000 POPULATION; COMPARED WITH 357/100,000 IN QUEENS AND 907/100,000 IN NYC) AND THE 4TH LOWEST PERCENTAGE OF ADULTS WHO ARE CURRENT SMOKERS (11%; COMPARED WITH 15% IN QUEENS AND NYC). ELMHURST-CORONA HAD THE 5TH LOWEST STROKE HOSPITALIZATION RATE (190 PER 100,000 POPULATION) AMONG ALL OF THE COMMUNITY DISTRICTS; THE STROKE HOSPITALIZATION RATES IN QUEENS AND NYC WERE 305 AND 319 PER 100,000 POPULATION, RESPECTIVELY. ELMHURST-CORONA HAD THE 5TH HIGHEST LIFE EXPECTANCY (84.1 YEARS); LIFE EXPECTANCIES IN NYC RANGED FROM 74.1 YEARS TO 85.4 YEARS.LACK OF HEALTH INSURANCE IS THE CHIEF HEALTH CONCERN IDENTIFIED BY THE 2015 NYC COMMUNITY HEALTH PROFILES IN WEST QUEENS. JACKSON HEIGHTS (QUEENS COMMUNITY DISTRICT 3) AND ELMHURST-CORONA WERE THE COMMUNITY DISTRICTS WITH THE 1ST (38%) AND 2ND (36%) HIGHEST PERCENTAGES OF ADULTS WITHOUT HEALTH INSURANCE. TO PROVIDE A COMPARISON, 20% OF NYC ADULT RESIDENTS AND 22% OF QUEENS ADULT RESIDENTS WERE UNINSURED. IN 2012, ELMHURST-CORONA (COMMUNITY DISTRICT 4) HAD THE SMALLEST PERCENTAGE OF INFANTS FED EXCLUSIVELY BREAST MILK DURING THE FIRST 5 DAYS OF LIFE (15.9%). IT HAD THE 2ND LOWEST PERCENTAGE (12.3%) OF EXCLUSIVE BREASTFEEDING IN 2013, JUST BEHIND FLUSHING'S PERCENTAGE. COMMUNITY DISTRICT PRIORITIES FOR WEST QUEENS, AS IDENTIFIED IN THE TAKE CARE NEW YORK 2020 COMMUNITY CONSULTATIONS, INCLUDE AIR QUALITY, PHYSICAL ACTIVITY, CONTROLLED HIGH BLOOD PRESSURE, OBESITY, AND SUGARY DRINK CONSUMPTION. PART VI, LINE 5: FLUSHING HOSPITAL'S PRIORITIES ARE IN LINE WITH THE PRIORITIES IDENTIFIED BY THE NYS PREVENTION AGENDA AS WELL AS TAKE CARE NEW YORK (TCNY) 2020.ALTHOUGH FHMC COULD HAVE ALSO SELECTED OTHER INITIATIVES TO HIGHLIGHT IN ITS PREVENTION AGENDA, BASED UPON COMMUNITY HEALTH STATISTICS AND CONSUMER NEEDS/UTILIZATION SURVEYS, ITS RESOURCES AND CAPABILITIES ARE BEST SUITED TO FOCUS ON:- DECREASING TOBACCO USE WITHIN THE COMMUNITY, AND- INCREASING RATES OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN THE SERVICE AREA FHMC ELECTED TO ADDRESS THESE TWO PARTICULAR HEALTH NEEDS SINCE THEY WILL MAKE A SIGNIFICANT IMPACT ON THE COMMUNITY'S HEALTH AND CREATE SUSTAINABLE QUALITY OF LIFE IMPROVEMENTS. BECAUSE OF ITS CURRENT AND PAST EFFORTS ON THESE TWO PRIORITIES, FLUSHING HOSPITAL EARNED A GOLD STAR FOR ITS ACCOMPLISHMENTS WITH NYC'S TOBACCO-FREE HOSPITAL CAMPAIGN, AND IS IN THE FINAL PHASE OF BEING DESIGNATED AS A BABY FRIENDLY HOSPITAL. THE HOSPITAL HAS INCORPORATED COMMUNITY INPUT FROM MANY ORGANIZATIONS AND INDIVIDUALS INTO ITS SELECTION OF PRIORITIES, AS DESCRIBED IN DETAIL IN THE SECTION ON DATA SOURCES AND COMMUNITY INPUT. AT ITS MEETING ON AUGUST 10, 2016, FLUSHING'S COMMUNITY ADVISORY BOARD AGREED WITH THE ABOVE PRIORITIES, AND ON NOVEMBER 15, 2016 THE HOSPITAL'S BOARD OF TRUSTEES APPROVED THE PLAN.THE HOSPITAL HAS WORKED ON MANY OTHER PREVENTION ACTIVITIES, AND HAS PARTNERED WITH THE CITY DOHMH ON TAKE CARE NEW YORK (TCNY) 2016, OTHER GOVERNMENT AGENCIES, AND COMMUNITY-BASED ORGANIZATIONS (CBOS), IMPLEMENTING A VARIETY OF EVIDENCE-BASED INTERVENTIONS, IN ADDITION TO TOBACCO CESSATION AND EXCLUSIVE BREASTFEEDING:- ADOPTING THE HEALTHY HOSPITAL FOOD INITIATIVE.- TRACKING AND REPORTING THE BLOOD PRESSURE CONTROL SCORES OF PATIENTS IN THE HOSPITAL AMBULATORY FOOTPRINT.- SUPPORTING AND PROMOTING THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP) FOR OVERWEIGHT AND OBESE ADULTS WITH PRE-DIABETES OR WOMEN WITH HISTORY OF GESTATIONAL DIABETES.- ENSURING ROUTINE OFFERING OF HIV TESTING IN EMERGENCY DEPARTMENTS AND ALL OUTPATIENT CLINICS.- PROMOTING APPROPRIATE AND JUDICIOUS PRESCRIBING OF OPIOID ANALGESICS.CURRENTLY THE HOSPITAL IS PARTNERING WITH THE CITY DOHMH ON ITS TCNY 2020 AGENDA, WHICH HAS FOUR OBJECTIVES, EACH WITH SEVERAL INDICATORS OF PROGRESS. THESE OBJECTIVES ARE ALIGNED WITH THE STATE'S PREVENTION AGENDA PRIORITIES, DESCRIBED IN DETAIL ABOVE, AS WELL AS THE DSRIP PROJECTS THAT THE HOSPITAL IS IMPLEMENTING. THE HOSPITAL DEVOTES CONSIDERABLE RESOURCES TO MOST OF THE CITY AND STATE PREVENTION OBJECTIVES DESCRIBED BELOW WITH A FEW EXCEPTIONS WHERE THE HOSPITAL WOULD HAVE NO AGENCY, SUCH AS DECREASING THE JAIL POPULATION, INCREASING HOMES WITH NO MAINTENANCE DEFECTS AND OTHERS THAT GOVERNMENT AGENCIES AND CBOS ARE BETTER SUITED TO ADDRESS.TCNY 20201. PROMOTE HEALTHY CHILDHOODS (ALIGNED WITH NYS PRIORITY: PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN)THE FIRST INDICATOR IS BABIES BORN IN BABY FRIENDLY HOSPITALS. THE HOSPITAL IS IN THE FINAL PHASE OF BEING DESIGNATED AS A BABY FRIENDLY HOSPITAL. THE SECOND INDICATOR IS TEENAGE PREGNANCY. REDUCING TEENAGE PREGNANCY IS A VERY HIGH PRIORITY FOR THE HOSPITAL. THE HOSPITAL IS PROVIDING LONG ACTING CONTRACEPTIVES FOR ALL AGE GROUPS, INCLUDING ADOLESCENTS IN ITS AMBULATORY CARE CENTER (ACC). CITY GOVERNMENT AND CBOS ARE BETTER SUITED TO WORK TOWARDS IMPROVEMENT IN THE OTHER TWO INDICATORS: OPENINGS IN CHILD CARE CENTERS AND HIGH SCHOOL GRADUATION.2. CREATE HEALTHIER NEIGHBORHOODS (ALIGNED WITH NYS PRIORITY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT)THE HOSPITAL IS WORKING ON SEVERAL OF THE INDICATORS UNDER THIS OBJECTIVE, INCLUDING FALL-RELATED HOSPITALIZATIONS BY THOROUGH DOCUMENTATION AND ANALYSIS OF FALLS PATIENTS AND REFERRAL TO EVIDENCE-BASED FALLS PREVENTION PROGRAMS IN THE COMMUNITY, AIR QUALITY BY VIRTUE OF ITS WORK ON TOBACCO CESSATION, CHILDREN'S VISITS TO EMERGENCY DEPARTMENTS FOR ASTHMA BY BEING PART OF THE QUEENS ASTHMA COALITION AND BY WORKING ON DSRIP PROJECT 3.D.III - EVIDENCE-BASED ASTHMA MANAGEMENT IN COLLABORATION WITH ITS PARTNERS IN THE ACP PPS TO MAKE SURE PATIENTS ARE PROPERLY DIAGNOSED, HAVE AN ASTHMA ACTION PLAN, AND ONGOING HEALTH COACHING. CITY GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS ARE BETTER SUITED TO WORK TOWARDS THE OTHER FOUR INDICATORS: ASSAULT HOSPITALIZATIONS, HOMES WITH NO MAINTENANCE DEFECTS, JAIL POPULATION, AND SOCIAL COHESION.3. SUPPORT HEALTHY LIVING (ALIGNED WITH NYS PRIORITY: PREVENT CHRONIC DISEASE)PATIENT NAVIGATORS, NUTRITIONISTS, DIABETES EDUCATORS, SOCIAL WORKERS AND THERAPISTS SUPPORT PHYSICIANS AND OTHER PROVIDERS IN EDUCATING AND COACHING PATIENTS ON MAKING LIFE STYLE CHANGES RELATED TO ALL THE INDICATORS UNDER THIS OBJECTIVE: OBESITY, SUGARY DRINKS, PHYSICAL ACTIVITY, SODIUM INTAKE, SMOKING, BINGE DRINKING AND OVERDOSE DEATHS. REDUCING TOBACCO USE HAS BEEN COVERED EXTENSIVELY IN THIS REPORT. BESIDES ADDRESSING NUTRITION AND EXERCISE ON AN INDIVIDUAL BASIS WITH PATIENTS, THE HOSPITAL PROMOTES HEALTHY EATING IN THE COMMUNITY. TWO REGISTERED DIETITIANS HOSTED A FARMER'S MARKET TOUR IN CORONA QUEENS ON OCTOBER 7, 2016. EDUCATIONAL MATERIALS WERE DISTRIBUTED ALONG WITH 2-3 HEALTH BUCKS (PER FAMILY), RECIPES, AND MAPS OF NYC FARMERS' MARKETS.4. INCREASE ACCESS TO QUALITY CARE (ALIGNED WITH NYS PRIORITY: PROMOTE MENTAL HEALTH AND SUBSTANCE ABUSE AND PREVENT HIV AND STDS VACCINE PREVENTABLE DISEASES AND HEALTHCARE ASSOCIATED INFECTIONS)THE HOSPITAL IS WORKING ON SEVERAL OF THE INDICATORS UNDER THIS OBJECTIVE, INCLUDING UNMET MENTAL HEALTH NEED. THERE IS A CLINICAL COORDINATOR FOR INTEGRATED CARE IN THE ACC. THIS PERSON SERVES AT A MINIMUM AS A DEPRESSION CARE MANAGER (DCM), BUT ALSO SERVES TO ENGAGE PATIENTS WITH ANY BEHAVIORAL HEALTH PROBLEM IN TREATMENT AND REFERRAL. IN ADDITION, SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) IS BEING ADMINISTERED IN THE ACC TO DETECT SUBSTANCE ABUSE PROBLEMS. ALSO, THE MENTAL HEALTH CLINIC HAS AN ADULT NURSE PRACTITIONER WHO CONDUCTS ALL HEALTH SCREENING ASSESSMENTS AND EITHER TREATS MEDICAL PROBLEMS AS A PRIMARY CARE PRACTITIONER, REFERS PATIENTS BACK TO THEIR PRIMARY CARE PHYSICIAN, AND COORDINATES BEHAVIORAL HEALTH AND MEDICAL CARE FOR ALL PATIENTS. FINALLY, THE BEHAVIORAL HEALTH DEPARTMENT WAS RECENTLY AWARDED A $1 MILLION NYSDOH GRANT TITLED "PARTNERSHIP INNOVATION FOR OLDER ADULTS." TO CARRY OUT THIS PROJECT, FLUSHING HOSPITAL HAS BECOME A PARTNER WITH NEW YORK CITY DEPARTMENT FOR THE AGING (NYC DFTA) AND ARMS ACRES, A MAJOR SUBSTANCE ABUSE PROVIDER, TO DEVELOP INTEGRATED CARE SERVICES IN SENIOR CENTERS AND OTHER FACILITIES. SEVERAL YEARS AGO THE HOSPITAL ADDRESSED ANOTHER INDICATOR - UNMET MEDICAL NEED BY INCREASING ITS AMBULATORY CARE CAPACITY WITH SUPPORT FROM A HEAL NY GRANT, THEREBY REDUCING WAIT TIMES FOR APPOINTMENTS TO ENCOURAGE PATIENTS TO TAKE ADVANTAGE OF COMPREHENSIVE PREVENTIVE AND PRIMARY HEALTH CARE. CONTROLLED HIGH BLOOD PRESSURE IS RECEIVING ADDED ATTENTION THROUGH DSRIP PROJECTS 3.B.I AND 3.C.I - EVIDENCE-BASED CARDIOVASCULAR MANAGEMENT AND DIABETES CARE - FOR ALL PATIENTS IN PARTNERSHIP WITH THE ACP PPS. THE HOSPITAL CONTINUES TO TRY TO AFFECT NEW HIV DIAGNOSES AND HIV VIRAL SUPPRESSION INDICATORS BY OFFERING HIV TESTING IN ITS EMERGENCY DEPARTMENT AND ACC.MANY PREVENTION ACTIVITIES ARE UNDERTAKEN BY THE HOSPITAL, SOME OF THEM DOCUMENTED IN THIS SECTION AND OTHERS DOCUMENTED IN THE NARRATIVES FOR EACH OF THE FIVE NYS PREVENTION AGENDA PRIORITY AREAS. STAFF IN MANY AREAS OF THE HOSPITAL HAVE TAKEN IT UPON THEMSELVES TO DEVELOP PREVENTION AND EDUCATION PROGRAMS FOR PATIENTS AND COMMUNITY RESIDENTS, OFTEN IN PARTNERSHIP WITH LOCAL CBOS AND GOVERNMENT AGENCIES. THE HOSPITAL PLACES A HIGH VALUE ON THE IMPORTANT WORK OF PREVENTION, COMMUNITY OUTREACH AND EDUCATION. THESE ACTIVITIES WILL NOT ONLY REDUCE DISEASE AND DISABILITY WITHIN OUR COMMUNITY, BUT WILL ALSO ENABLE THE HOSPITAL TO PROSPER UNDER VALUE-BASED PAYMENT ARRANGEMENTS. PART VI, LINE 6: AFFILIATED HEALTH CARE: MEDISYS HEALTH SYSTEM PART VI, LINE 7, REPORTS FILED WITH STATES NY PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CONTINUATION: IMPLEMENTATION PLAN AND PROGRESS REPORT 2018THE CHARTS ON THE FOLLOWING PAGES OUTLINE GOALS, OBJECTIVES, IMPLEMENTATION PLANS AND 2016 ACHIEVEMENTS FOR THE HOSPITAL'S TWO PREVENTION AGENDA PRIORITIES:- PREVENT CHRONIC DISEASES - FOCUS 2: TOBACCO CESSATION - PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN - FOCUS 1: BREASTFEEDING FHMC COMMUNITY SERVICE PLAN 2016 20182018 UPDATEPRIORITY 1: DECREASE TOBACCO USE WITHIN THE COMMUNITYSUCCESSES:- THE HOSPITAL HAS HELD L9 OUTREACH EVENTS RELATED TO SMOKING CESSATION. MORE EVENTS ARE PLANNED FOR THIS YEAR WITH STAFF WHO SPEAK ENGLISH, SPANISH AND CHINESE, REACHING MORE THAN 800 PEOPLE, OF WHOM 20 EXPRESSED INTEREST IN QUITTING, AND THREE ATTENDED A CLASS.- SMOKING CESSATION COUNSELING PROMPTS WERE INTRODUCED INTO THE EPIC EHR AT DISCHARGE FOR ALL INPATIENT SMOKERS, RESULTING IN 100% COUNSELING COMPLIANCE.- UPDATED EHR TO INCLUDE EMERGING ELECTRONIC NICOTINE DELIVERY SYSTEMS, SUCH AS E-CIGARETTES, VAPORIZERS AND HOOKA PENS.- CONTINUE TO OFFER PROVIDE COUNSELING AND MEDICATION FREE OF CHARGE TO ALL EMPLOYEES. HOSPITAL STAFF PHYSICIAN CONTINUES TO PARTICIPATE IN A NYS QUITLINE PHYSICIAN TASK FORCE, ASSISTING WITH REVIEW OF QUITLINE MARKETING MATERIALS AND OUTREACH COMMUNICATIONS TO HEALTHCARE PROVIDERS, WITH THE ULTIMATE GOAL OF FACILITATING CHANGES IN HOW NY STATE HEALTH SYSTEMS OFFER TOBACCO CESSATION SERVICES. CHALLENGES- SOME EMPLOYEES REMAIN RELUCTANT TO DISCLOSE THEIR SMOKING ADDICTION, FEARING HEALTH INSURANCE RATE INCREASES OR OTHER WORKPLACE RESTRICTIONS, EVEN THOUGH THESE RESTRICTIONS HAVE NOT BEEN IMPOSED. THIS LIMITS DISTRIBUTION OF AVAILABLE BENEFITS AND INTERVENTIONS.- MANY PHYSICIANS CONSIDER TOBACCO CONTROL INTERVENTIONS AND OTHER PREVENTIVE CARE MEASURES AS NOT INTEGRAL TO THEIR ROUTINE PATIENT CARE ENCOUNTERS. PROVIDERS REPORT THAT THE MANY MANDATORY ASSESSMENTS THAT MUST BE PERFORMED AT EACH ENCOUNTER LEAVE LITTLE OR NO TIME TO ADDRESS TOBACCO USE.- DIFFICULTY ENGAGING COMMUNITY PHYSICIANS TO TAKE ADVANTAGE OF THE SMOKING CESSATION SERVICES AVAILABLE IN OUR NETWORK.- THE MULTITUDE OF PSYCHOSOCIAL ISSUES AFFECTING MANY PATIENTS WITH BEHAVIORAL HEALTH ISSUES. SMOKING CESSATION OFTEN IS NOT A PRIORITY GIVEN THE OTHER PRESSING ISSUES INCLUDING HOMELESSNESS, UNEMPLOYMENT, AND FOOD INSECURITY. IN ADDITION THESE PATIENTS MAY BE SELF-MEDICATING BY SMOKING.- ALTHOUGH MANY EXPRESS INTEREST AND SIGN UP FOR A SMOKING CESSATION CLASS, OFTEN THEY DO NOT ATTEND.- NEED FOR CONSTANT REPETITION ABOUT THE HEALTH RISKS OF SMOKING AND THE BENEFITS OF QUITTING. SMOKERS WILL DECIDE TO QUIT SMOKING ONLY WHEN THEY ARE PSYCHOLOGICALLY READY. THEREFORE, IT IS IMPORTANT THAT THEIR MEDICAL PROVIDERS DISCUSS THE ISSUE WITH THEM AS OFTEN AS POSSIBLE, AND ADDRESS ANY LINGERING OBSTACLES THAT MAY HOLD THEM BACK.- COMBATING SMOKING HABITS AGAINST POWERFUL TOBACCO INDUSTRY IS A WORK IN PROGRESS. MASSIVE SPREAD OF E-CIGARETTES WITH ITS DECEPTIVE ADVERTISING REQUIRES NEW AND FLEXIBLE RESPONSE FROM HEALTH CARE PROVIDERS. WE WILL CONTINUE TO SEEK THE MOST EFFECTIVE WAYS TO CONVEY THE MESSAGE OF WELL-KNOWN TOBACCO RELATED HEALTH HAZARDS TO OUR PATIENTS AT EVERY STEP OF THEIR CARE AS WELL AS TO THE SURROUNDING COMMUNITIES. NEW YORK STATE PRIORITY AREA: PREVENT CHRONIC DISEASESFOCUS AREA 2: REDUCE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE.GOAL #2.2: PROMOTE TOBACCO USE CESSATION, ESPECIALLY AMONG LOW SOCIOECONOMIC STATUS (SES) POPULATION AND THOSE WITH POOR MENTAL HEALTH.FHMC PRIORITY 1: DECREASE TOBACCO USE WITHIN THE COMMUNITYGOAL 1: ELIMINATE TOBACCO USE ON HOSPITAL CAMPUS.OUTCOME OBJECTIVE - DECREASE SMOKING PREVALENCE AMONG STAFF.ACHIEVEMENTS YEAR TO DATE - OFFER COUNSELING AND MEDICATION TO ALL SMOKERS FREE OF CHARGE. ALL EMPLOYEES WHO IDENTIFIED THEMSELVES AS SMOKERS RECEIVED SMOKING CESSATION COUNSELING.OUTCOME OBJECTIVE - TRAIN ALL PATIENT NAVIGATORS IN SMOKING CESSATION.ACHIEVEMENTS YEAR TO DATE - ALL EIGHT PATIENT NAVIGATORS ARE TRAINED TO DELIVER ONE-ON-ONE ABBREVIATED QUIT PLANS. FOUR OF THE SEVEN PATIENT NAVIGATORS ARE TRAINED IN SMOKING CESSATION COUNSELING. PLANS ARE UNDERWAY TO SCHEDULE TRAININGS TO ENSURE THAT ALL NEWLY HIRED NAVIGATORS ARE FULLY TRAINED TO PROVIDE TOBACCO CESSATION COUNSELING.OUTCOME OBJECTIVE - ACHIEVE AND MAINTAIN STANDARDS FOR NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE GOLD STAR STATUS.ACHIEVEMENTS YEAR TO DATE - ALL STANDARDS HAVE BEEN UPHELD, INCLUDING EMPLOYEE POLICIES, AS WELL AS PROCEDURES FOR ASSESSMENT, COUNSELING AND MEDICATION ADMINISTRATION.GOAL 2: GENERAL MEDICAL/SURGICAL PATIENTS AGED 13 AND ABOVE INCREASE ASSESSMENTS, INTERVENTIONS, AND NUMBER OF QUITTERS.OUTCOME OBJECTIVE - DECREASE SMOKING PREVALENCE AMONG PATIENTS.NOTE: NYS SMOKING PREVALENCE TARGET OF 12.3% FOR ADULTS AND 20% AMONG LOW SES ADULTS (USING MEDICAID COVERAGE AS A PROXY).ACHIEVEMENTS AS OF OCTOBER 21, 2018 OUTPATIENT (OP) = 5%, SAME AS IN 2017INPATIENT (IP) = 20.8%, COMPARED TO 22.2% IN 2017MEDICAID OP = 4.2%MEDICAID IP = 23.7%OUTCOME OBJECTIVE - ACHIEVE 95% OR GREATER ASSESSMENT RATE FOR OUTPATIENTS AND INPATIENTS.ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 85%, COMPARED TO 80.2% IN 2017IP = 94.7% COMPARED TO 93.8% IN 2017 OUTCOME OBJECTIVE - INCREASE COUNSELING RATE FOR RETURNING OUTPATIENT SMOKERS TO 85% OR GREATER; 50% OR GREATER FOR INPATIENTS.NOTE: THE BASIC INTERVENTION IS COUNSELING. OTHER POSSIBLE INTERVENTIONS INCLUDE EDUCATIONAL MATERIALS, PRESCRIPTIONS FOR MEDICATIONS, AND/OR REFERRAL FOR SMOKING CESSATION CLASSES/SUPPORT.ACHIEVEMENTS AS OF OCTOBER 21, 2018 OP = 55.6%IP = 100% COMPARED TO 84% LAST YEARMEDICAID OP = 86% MEDICAID IP = 100%OUTCOME OBJECTIVE - INCREASE PRESCRIPTIONS FOR SMOKING CESSATION BENEFITS AMONG MEDICAID AND MEDICAID MANAGED CARE SMOKERS. NOTE: NYS BENEFIT USE TARGET OF 41% FOR MMC ENROLLEES.ACHIEVEMENTS AS OF OCTOBER 21, 2018 ALL OP = 10.5%ALL IP = 85.5%MEDICAID OP =7%MEDICAID IP = 85%OUTCOME OBJECTIVE - DOCUMENT AND TRACK USE OF NYS QUITLINE.ACHIEVEMENTS AS OF OCTOBER 21, 2018 APPROXIMATELY 74 REFERRALS WERE MADE TO THE NYS QUITLINE.GOAL 3: BEHAVIORAL HEALTH PATIENTS ABOVE AGED 13INCREASE ASSESSMENTS, INTERVENTIONS, AND NUMBER OF QUITTERS.OUTCOME OBJECTIVE - DECREASE SMOKING PREVALENCE AMONG BH PATIENTS. NOTE: NYS SMOKING PREVALENCE TARGET OF 24% AMONG ADULTS WHO REPORT POOR MENTAL HEALTH.ACHIEVEMENTS AS OF OCTOBER 21, 2018 - OP = 3.8%IP = 52.5%OUTCOME OBJECTIVE - ACHIEVE 65% OR GREATER ASSESSMENT RATE OF OUTPATIENTS AND 100% OR GREATER OF INPATIENTS.ACHIEVEMENTS AS OF OCTOBER 21, 2018 - OP = 27.6% IP = 100%OUTCOME OBJECTIVE - ACHIEVE 90% OR GREATER COUNSELING RATE FOR OUTPATIENTS AND INPATIENTS. NOTE: THE BASIC INTERVENTION IS COUNSELING. PRESCRIPTIONS FOR MEDICATION, FOLLOW-UP COUNSELING AND PROVISION OF EDUCATIONAL MATERIALS ARE OTHER POSSIBLE INTERVENTIONS.ACHIEVEMENTS AS OF OCTOBER 21, 2018 -OP = 60.7%IP = 100%OUTCOME OBJECTIVE - INCREASE PRESCRIPTIONS FOR SMOKING CESSATION AMONG BH MEDICAID AND MEDICAID MANAGED CARE PATIENTS.NOTE: NYS BENEFIT USE TARGET OF 41% FOR MEDICAID MANAGED CARE ENROLLEES.ACHIEVEMENTS AS OF OCTOBER 21, 2018 -MEDICAID OP = 100%MEDICAID IP = 75%GOAL 4: PROVIDE TOBACCO CESSATION EDUCATION TO COMMUNITY RESIDENTS AND PROVIDERSOUTCOME OBJECTIVE - INCREASE KNOWLEDGE OF COMMUNITY MEDICAL PROVIDERS ABOUT HOW TO PROMOTE TOBACCO CESSATION. ACHIEVEMENTS YEAR TO DATE - PLAN TO INTRODUCE INFORMATION ABOUT THE HOSPITAL'S SMOKING CESSATION RESOURCES TO ALL PHYSICIANS DURING THEIR APPLICATION FOR ADMITTING PRIVILEGES AND FOR BIANNUAL RENEWAL.OUTCOME OBJECTIVE - INCREASE THE NUMBER OF COMMUNITY EDUCATIONAL EVENTS THAT COVER TOBACCO CESSATION, IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS AND OFFER FFS CLASSES AND ABBREVIATED QUIT PROGRAMS IN AS MANY LANGUAGES AS POSSIBLE.ACHIEVEMENTS YEAR TO DATE - NINETEEN EDUCATIONAL OUTREACH EVENTS WERE CONDUCTED WITH STAFF WHO SPEAK ENGLISH, SPANISH AND CHINESE. EDUCATIONAL MATERIALS WERE DISTRIBUTED TO MORE THAN 800 PEOPLE AND SMOKERS WERE URGED TO SIGN UP FOR QUIT SMOKING PROGRAMS; 20 SMOKERS SIGNED UP FOR A HOSPITAL SMOKING CESSATION CLASS. THE HOSPITAL HELD TWO FFS CLASSES; THREE PEOPLE ATTENDED AND TWO COMPLETED. PLAN TO HOST A GREAT AMERICAN SMOKEOUT EVENT ON NOVEMBER 15, 2018. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CONTINUATION: PRIORITY 2: INCREASE RATES OF EXCLUSIVE BREASTFEEDING IN THE SERVICE AREA.SUCCESSES:- AS OF JULY 2018, WE ARE A BABY-FRIENDLY DESIGNATED HOSPITAL.- MADE GREAT STRIDES IN COMMUNITY EDUCATION ABOUT BREASTFEEDING AND NUTRITION IN GENERAL, ESPECIALLY TARGETING OUR LARGE IMMIGRANT COMMUNITY, OFFERING MANY CLASSES IN THEIR OWN LANGUAGES, INCORPORATING ETHNIC FOOD PREFERENCES AND PRACTICES. SINCE 2015 WHEN THE PROGRAM BEGAN AT OUR LOCAL LIBRARIES AND AT FACULTY PHYSICIAN OFFICES, WE HAVE REACHED MORE THAN 3,600 FAMILIES.- IN ADDITION, TOGETHER WITH THE HOSPITAL'S WIC PROGRAM, OVER 1,600 PREGNANT AND NEW MOTHERS ATTENDED CLASSES IN CHILD BIRTH, BREASTFEEDING, INFANT FEEDING AND CHILD CARE OVER THE 12 MONTHS ENDING IN SEPTEMBER.- LACTATION COUNSELORS FLUENT IN HINDI, BANGALI, URDU AND ENGLISH, ARE NOW AVAILABLE SEVEN DAYS A WEEK TO PROVIDE EDUCATION AND SUPPORT TO MOTHERS ON THE POST-PARTUM UNIT AND THE NUMBER OF REFERRALS HAS BEEN INCREASING STEADILY.- WE HAVE MAINTAINED AN INCREASE IN THE NUMBER OF BABIES WHO HAVE SKIN-TO-SKIN CONTACT TO 91% AFTER CESAREAN BIRTHS.- WE HAVE SPREAD THE WORD ABOUT THE SIGNIFICANT BENEFITS OF EXCLUSIVE BREASTFEEDING TO COMMUNITY PHYSICIANS WHO REFER THEIR PATIENTS TO FHMC FOR DELIVERY. OUR STAFF VISITS THREE LARGE SOUTHEAST ASIAN AND ASIAN PHYSICIAN PRACTICES EACH MONTH TO ENCOURAGE THE WOMEN TO COMMIT TO EXCLUSIVE BREASTFEEDING. THIS HAS ENABLED US TO PROVIDE MEANINGFUL EDUCATION TO APPROXIMATELY 40 PATIENTS PER MONTH.- WE HAVE HAD SUCCESS CONVINCING NEW MOTHERS WHO NEED TO SUPPLEMENT WITH FORMULA OR EXPRESSED BREASTMILK THAT IT IS BEST TO PROVIDE THE SUPPLEMENT USING A CUP, TEASPOON OR SYRINGE SO AS NOT TO CONFUSE THE BABY.CHALLENGES:- DATA FOR INFANT FEEDING PRACTICES WAS NOT BEING CAPTURED IN THE DATA FIELD DEVELOPED BY THE EMR BUILD TEAM SO SIGNIFICANT UNDERREPORTING OF THIS MEASURE TOOK PLACE. IT WAS DETERMINED THAT THE REVISED TEMPLATES WERE CUMBERSOME AND PROVIDERS CHOSE TO USE THEIR OWN FORMATS FOR DOCUMENTATION. A WORK GROUP WAS FORMED TO REDESIGN THE TEMPLATES AND RECOMMENDED CHANGES HAVE BEEN IMPLEMENTED IN THE EHR.- THE BELIEFS AND PRACTICES OF THE LARGE SOUTHEAST ASIAN AND ASIAN POPULATIONS IN THE HOSPITAL'S ETHNICALLY DIVERSE COMMUNITY ARE NOT SUPPORTIVE OF EXCLUSIVE BREASTFEEDING OR OF THE MOTHER ROOMING IN WITH THEIR NEWBORN FOR 24 HOURS. - ANOTHER BARRIER TO EXCLUSIVE BREASTFEEDING IS THE COMMON PRACTICE OF SENDING INFANTS BACK TO CHINA, BY ONE MONTH OF AGE, OR AS SOON AS THE BIRTH CERTIFICATE ARRIVES, TO BE TAKEN CARE OF BY FAMILY MEMBERS. THESE TRADITIONAL POSTPARTUM PRACTICES LEAD TO NEGATIVE PHYSICAL AND EMOTIONAL OUTCOMES. MATERNAL REPORTS OF DELAY IN LACTATION IS OFTEN CORRELATED WITH THE INFLUENCES OF ELDERS AND PAST PRACTICES THAT DO NOT SUPPORT BREASTFEEDING OR CARING FOR THE INFANT ON THEIR OWN. NEW YORK STATE PRIORITY AREA: PROMOTING HEALTH WOMEN, INFANTS AND CHILDRENFOCUS AREA 1: MATERNAL AND INFANT HEALTH INCREASE THE PROPORTION OF BABIES WHO ARE BREASTFEDGOAL #2: INCREASE EXCLUSIVE BREASTFEEDINGFHMC PRIORITY 2: INCREASING RATES OF EXCLUSIVE BREASTFEEDING IN THE SERVICE AREAGOAL 1: EXCLUSIVE BREASTFEEDING AT DISCHARGE FOR AS MANY PATIENTS AS CLINICALLY POSSIBLEOUTCOME OBJECTIVES - INCREASE EXCLUSIVE BF RATE AT DISCHARGE BY 2% PER YEAR.NOTE: NYS TARGET OF 48.1%.ACHIEVEMENTS AS OF SEPTEMBER 2018 - INCREASED TO AN AVERAGE OF 30 %, RANGING BETWEEN 20% AND 36% EACH MONTH, COMPARED TO 5% IN 2016.OUTCOME OBJECTIVES - REDUCE EXCLUSIVE BF DISPARITY BETWEEN MEDICAID AND NON-MEDICAID ENROLLEES.NOTE: NYS DISPARITY TARGET OF 0.66. (EQUALITY WOULD EQUAL 1.0).ACHIEVEMENTS AS OF SEPTEMBER 2018 - 0.92% DISPARITY RATE.OUTCOME OBJECTIVES - ACHIEVE "ROOMING IN" FOR 70% OF BIRTHS WITH NO CONTRAINDICATIONS.ACHIEVEMENTS AS OF SEPTEMBER 2018 - 65% "ROOMING IN".OUTCOME OBJECTIVES ACHIEVE 95% OR GREATER TRAINING RATE OF:- MEDICAL PROVIDERS IN RECOMMENDED BF EDUCATION.- MATERNAL/CHILD NURSES IN BF MANAGEMENT, AND NEW HIRES WITHIN 3 MONTHS.ACHIEVEMENTS AS OF SEPTEMBER 2018 - 99% TRAINING RATE.OUTCOME OBJECTIVES ENROLL 1,200 WOMEN IN THE HOSPITAL'S AND WIC'S BREASTFEEDING PROGRAMS, INCLUDING BREASTFEEDING SUPPORT GROUPS, PRENATAL NUTRITION CLASS, CHILD BIRTH CLASSES AND MOTHER-BABY CLASSES.ACHIEVEMENTS AS OF SEPTEMBER 2018 - THE HOSPITAL, IN CONJUNCTION WITH WIC, HAS ENROLLED MORE THAN 1,600 WOMEN IN ONE YEAR (2017-2018) IN THE INFANT NUTRITION CLASS, CHILD BIRTH CLASS AND BREASTFEEDING PROGRAMS.GOAL 2: BABY FRIENDLY DESIGNATIONOUTCOME OBJECTIVES - SUCCESSFUL SITE VISIT.ACHIEVEMENTS YEAR TO DATE - BABY FRIENDLY DESIGNATION OFFICIAL AS OF JULY 2018.GOAL 3: EXCLUSIVE BREASTFEEDING AT 3 AND 6 MONTHS FOR AS MANY PATIENTS AS CLINICALLY POSSIBLEOUTCOME OBJECTIVES - INCREASE EXCLUSIVE BF RATES AT 3 AND 6 MONTHS FOR HOSPITAL'S WELL BABIES.NOTE: HEALTHY PEOPLE 2020 TARGETS =46.2% AT 3 MONTHS 25.2% AT 6 MONTHSACHIEVEMENTS YEAR TO DATE - A MEASURABLE DATA FIELD WAS IMBEDDED IN EPIC PEDIATRIC WELL CHILD TEMPLATES SO PROVIDERS COULD EASILY DOCUMENT NUTRITION INFORMATION DURING WELL CHILD ENCOUNTERS. PEDIATRIC PROVIDERS WERE NOT USING THESE TEMPLATES, PREFERRING TO USE THEIR OWN FORMAT, SO THE DATA COULD NOT BE CAPTURED. A GROUP REVISED AND SIMPLIFIED THE TEMPLATES TO GAIN ACCEPTANCE OF ALL PROVIDERS.OUTCOME OBJECTIVES - ACHIEVE POSTPARTUM VISIT RATE OF 90% AMONG HOSPITAL AMBULATORY CARE CENTER PATIENTS. ACHIEVEMENTS YEAR TO DATE - ACHIEVED 93% FOR THE POSTPARTUM VISIT RATE.GOAL 4: INCREASE KNOWLEDGE OF COMMUNITY RESIDENTS AND PROVIDERS ABOUT THE BENEFITS OF BREASTFEEDINGOUTCOME OBJECTIVES - INCREASE ADOPTION OF BREASTFEEDING FRIENDLY PRACTICE (BFFP) STANDARDS BY COMMUNITY PROVIDERS.ACHIEVEMENTS YEAR TO DATE - PRESENTED BFFP INFORMATION TO THE THREE LARGE COMMUNITY PHYSICIAN PRACTICES WE VISIT EACH MONTH, ENCOURAGING THEM TO ADOPT THESE STANDARDS.OUTCOME OBJECTIVES - INCREASE PARTICIPATION OF COMMUNITY RESIDENTS IN BF AND GENERAL NUTRITION EDUCATION PROGRAMS.ACHIEVEMENTS YEAR TO DATE - SINCE 2015 WHEN THE PROGRAM BEGAN AT OUR LOCAL LIBRARIES AND AT FACULTY PHYSICIAN OFFICES, WE HAVE REACHED MORE THAN 3,600 FAMILIES. IN ADDITION, OVER 1,600 PREGNANT AND NEW MOTHERS HAVE ATTENDED CLASSES IN CHILD BIRTH, BREASTFEEDING, INFANT FEEDING AND CHILD CARE IN THE 12 MONTHS ENDING IN SEPTEMBER. 0 0 0 0 0 0 0 0 0 ANTHONY DIMARIA MPHD TRUSTEE 0 242516 0 0 0 9600 0 13024 0 31617 0 296757 0 0 GEOFFREY DOUGHLIN MD TRUSTEE 0 470318 0 0 0 0 0 13750 0 31617 0 515685 0 0 BRUCE J FLANZ PRESIDENT & CEO 0 1469711 0 0 0 145683 0 13750 0 30232 0 1659376 0 0 MOUNIR F DOSS EXEC VP & CFO 0 1063402 0 0 0 33711 0 13750 0 30232 0 1141095 0 0 ROBERT LEVINE EXEC VP & COO 397496 0 0 0 3564 0 13750 0 30198 0 445008 0 0 0 ESSA MEHKRI DIRECTOR MD 357726 0 0 0 1117 0 13750 0 23941 0 396534 0 0 0 GAGAN GULATI DIRECTOR MD 310201 0 0 0 1191 0 13750 0 29389 0 354531 0 0 0 JAMES GIGLIO CHAIRPERSON 485954 0 0 0 2322 0 13750 0 33246 0 535272 0 0 0 NAGESWARA MANDAVA CHAIRPERSON 495566 0 0 0 3564 0 13750 0 30258 0 543138 0 0 0 OSCAR MARCILLA DIRECTOR MD 458733 0 0 0 1253 0 13750 0 12103 0 485839 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 MEDISYS HEALTH NETWORK IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A MEDISYS HEALTH NETWORK, AS SOLE MEMBER CAN APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION, IT IS FINALIZED AND SUBSEQUENTLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE COMPLIANCE OFFICERS REVIEW THE SUBMISSIONS FOR CONFLICTS AND REPORTS THEM TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, COLUMN C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII, SECTION A, LINE 1B: ANTHONY DIMARIA, M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL NURSING HOME WORKING ABOUT 40 HOURS PER WEEK. ANTHONY DIMARIA, M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMAICA HOSPITAL MEDICAL CENTER, MEDISYS HEALTH NETWORK, OR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. GEOFFREY DOUGHLIN M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL MEDICAL CENTER AS THE CHAIRMAN OF EMERGENCY MEDICINE WORKING ABOUT 40 HOURS PER WEEK. GEOFFREY DOUGHLIN M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMIACA HOSPITAL MEDICAL CENTER, THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER OR MEDISYS HEALTH NETWORK FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. FOR BRUCE FLANZ, PRESIDENT & CEO, MOUNIR DOSS, EXECUTIVE VICE PRESIDENT & CFO, THE HOURS REPORTED BELOW REFLECT THE TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENTLY WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. ESTIMATED NUMBER OF HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS IS AS FOLLOWS: MEDISYS HEALTH NETWORK - 10 HOURS PER WEEK FLUSHING HOSPITAL MEDICAL CENTER - 15 HOURS PER WEEK JAMAICA HOSPITAL MEDICAL CENTER - 30 HOURS PER WEEK OTHER RELATED ENTITIES LISTED ON SCHEDULE R - 10 HOURS PER WEEK FORM 990, PART VII, COLUMN C: MANAGEMENT HAS IN THE PREPARATION OF ITS FORM 990 REVIEWED PERSONNEL IN THE INSTITUTION TO SEE IF ANYONE MEETS THE CRITERIA ESTABLISHED TO BE CONSIDERED A "KEY EMPLOYEE" FOR IRS PURPOSES OF FORM 990. IT IS THE CONTENTION OF MANAGEMENT THAT NO EMPLOYEE FULFILLS ANY OF THE SITUATIONS UNDER THE RESPONSIBILITY TEST IN THE FORM 990 INSTRUCTIONS TO BE CONSIDERED A "KEY EMPLOYEE". THEREFORE, PART VII OF FORM 990 DOES NOT REPORT THE COMPENSATION OF ANY INDIVIDUALS WHO WOULD BE CONSIDERED A "KEY EMPLOYEE". ADVANCED CENTER FOR PSYCHOTHERAPY 89-06 135TH STREET JAMAICA NY 11418 111864871 HEALTHCARE NY 501(C)(3) LINE 10 MEDISYS HEALTH NETWORK 0 ALLIED HEALTH FOUNDATION OF QUEENS INC 4500 PARSONS BLVD FLUSHING NY 11355 112813535 INACTIVE NY 501(C)(3) LINE 10 MEDISYS HEALTH NETWORK 0 INTERNATIONAL ASSOCIATION OF MEDICAL BIKE UNITS INC 8900 VAN WYCK EXPY JAMAICA NY 11418 113483140 INACTIVE NY 501(C)(3) LINE 10 MEDISYS HEALTH NETWORK 0 JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPY JAMAICA NY 11418 237216197 HOSPITAL NY 501(C)(3) LINE 10 MEDISYS HEALTH NETWORK 0 JAMAICA HOSPITAL NURSING HOME 90-28 VAN WYCK EXPY JAMAICA NY 11418 237216197 HEALTHCARE NY 501(C)(3) LINE 3 MEDISYS HEALTH NETWORK 0 MEDISYS AMBULANCE SERVICE 8900 VAN WYCK EXPY JAMAICA NY 11418 542124788 HEALTHCARE NY 501(C)(3) LINE 10 MEDISYS HEALTH NETWORK 0 MEDISYS HEALTH NETWORK 8900 VAN WYCK EXPY JAMAICA NY 11418 113316802 ADMIN NY 501(C)(3) LINE 12A, I N/A 0 THE JAMAICA HOSPITAL DIAG AND TREAT CTR 8900 VAN WYCK EXPY JAMAICA NY 11418 113340969 HEALTHCARE NY 501(C)(3) LINE 3 MEDISYS HEALTH NETWORK 0 VWE PROPERTIES CORPORATION 8900 VAN WYCK EXPY JAMAICA NY 11418 113485165 PARKING GARAGE NY 501(C)(3) LINE 12A, I MEDISYS HEALTH NETWORK 0 NHP HOLDINGS LLC 521 FIFTH AVE 3RD FLOOR NEW YORK NY 10175 203418837 HOLDING COMPANY NY N/A FRR RECOVERY SERVICES 80 MARCUS DRIVE MELVILLE NY 11747 113454555 COLLECTION AGENCY NY N/A C 0 HI TECH MEDICAL EQUIPMENT 103-51 101 ST OZONE PARK NY 11416 113313334 DURABLE MEDICAL EQUIPMENT COMPANY/INACTIVE NY N/A C 0 JAMAICA RX 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 205292781 RETAIL PHARMACY NY N/A C 0 LCSC HOLDINGS 101-01 AVENUE D BROOKLYN NY 11236 113357198 HOLDING COMPANY NY N/A C 0 MEDISYS HOME CARE SERVICE INC 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 030474027 HOME CARE STAFFING/INACTIVE NY N/A C 0 MEDISYS IPA 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113452476 PHYSICIAN CONTRACTING/INACTIVE NY N/A C 0 MEDISYS SERVICE CORPORATION 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113479920 HOLDING COMPANY NY N/A C 0 MEDISYS VENTURES 111 STEWART AVE HICKSVILLE NY 11801 113431792 HOLDING COMPANY NY N/A C 0 MHN REALTY 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113458286 REAL ESTATE/INACTIVE NY N/A C 0 SECOND CENTURY SERVICE CORPORATION 4500 PARSONS BLVD FLUSHING NY 11355 112843101 RETAIL PHARMACY NY N/A C 0 1 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 1 0 0 FRR RECOVERY Q 801748 COST SECOND CENTURY SERVICE CORPORATION Q 1520000 COST