2019-11-05T14:14:54-06:00 2018-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2018-01-01 150552726 MARGARETVILLE MEMORIAL HOSPITAL % ERIN NAGY MARG 8459436084 42084 STATE ROUTE 28 MARGARETVILLE NY 12445 ROBERT ROSS exec. vice president 8459436024 2019-11-05 true LAURA KIELCZEWSKI P00740769 2127733000 164.57.159.253 26308520193095000015 2019-11-05 P 770194AAF055F9EA87E64CA02E08FE540289067F 42D26865FF540D3EA6F803EEB3CCA5BB79F92251 2018 2020-03-31 21:24:44Z robert ross 396 broadway kingston NY 12401 14327419 false X https://www.margaretvillehosp.org/ X 1930 NY TO PROVIDE IMMEDIATE ACCESS TO HIGH QUALITY MEDICAL CARE AND DIAGNOSTIC TESTING SERVICES TO MEDICALLY UNDERSERVED COMMUNITIES IN THE AREA. 18 14 141 14 0 0 2079901 1731638 9440021 10522404 1285 2395 1524237 2049061 13045444 14305498 0 0 0 0 7440097 8570991 0 0 0 6071697 6186385 13511794 14757376 -466350 -451878 6058032 5391412 4389069 4174327 1668963 1217085 TO PROVIDE IMMEDIATE ACCESS TO HIGH QUALITY MEDICAL CARE AND DIAGNOSTIC TESTING SERVICES TO MEDICALLY UNDERSERVED COMMUNITIES IN THE AREA. false false 11588223 0 10597329 MARGARETVILLE MEMORIAL HOSPITAL PROVIDES ACUTE HEALTH CARE SERVICES TO RESIDENTS AND VISITORS TO THE CATSKILL REGION. MARGARETVILLE MEMORIAL HOSPITAL RECORDED 1,566 PATIENT DAYS, 3,901 EMERGENCY ROOM VISITS, 128 OUTPATIENT SURGERIES, 245 DISCHARGES AND 274 INFUSION THERAPIES IN 2018. 11588223 true true false true false false false false false false true false false true true false false true false false false false false false true false true true false false true false false false false false false false true false false false false false true true true false false true 27 0 true 141 true false false false false false false false false false false false false X 18 14 false false false false true true true true true false false true true true true true true false false false NY X ERIN NAGY 8459436084 741 GRANT AVENUE LAKE KATRINE NY 12449 Carey Wagner CHAIR 1.0 4.0 X 0 0 0 JANE Piasek Trustee 1.0 1.0 X 0 0 0 Fred Marguiles Secretary 1.0 1.0 X 0 0 0 Arthur Martello Trustee 1.0 1.0 X 0 0 0 Jenny Morrill-Liddle Vice Chair 1.0 1.0 X 0 0 0 Thomas O'Brien Trustee 1.0 1.0 X 0 0 0 David Riordan Trustee 1.0 1.0 X 0 0 0 Nancy Slauson Trustee 1.0 1.0 X 0 0 0 David Scarpino CEO/Trustee 2.0 38.0 X X 0 530999 50301 Kent Garrett Trustee 1.0 1.0 X 0 0 0 Thomas Collins EX-OFFICIO TRUSTEE 1.0 4.25 X 0 0 0 James Howie Trustee 1.0 1.0 X 0 0 0 Paul Llobet MD TRUSTEE 1.0 39.0 X 0 313996 6750 MARK POHAR EXEC DIR/ex-officio trustee 20.0 20.0 X X 0 226326 28461 CHRISTOPHER ESOLA trustee 1.0 39.0 X 0 107416 3257 KRISTIN FLACHS TRUSTEE 1.0 1.0 X 0 0 0 KAREN KOLAR TRUSTEE (effective 1/2018) 1.0 1.0 X 0 0 0 ARNIE SCHWARTZ TRUSTEE 1.0 1.0 X 0 0 0 ROBERT ROSS EXECUTIVE VICE PRESIDENT 1.0 39.0 X 0 322361 93462 Eileen King CLINICAL COORDINATOR 40.0 0.0 X 238509 0 24218 Joseph Marsicovete Chief Operating Officer 1.0 39.0 X 0 315251 15316 GENE EPSTEIN NURSE PRACTITIONER 40.0 0.0 X 205578 0 9082 NANETTE TREADWELL PHYSICIAN ASSISTANT 40.0 0.0 X 235696 0 19068 JANE ULRICH SR. VP OF NURSING 2.0 38.0 X 0 192299 21799 679783 2008648 271714 11 false true false Laboratory Corp of America PO Box 12140 BURLINGTON NC 27216 Laboratory Services 599016 Seco Physical Occupational Therap Eaton Center 26 Conkey Ave Suite NORWICH NY 13815 CONSULTING 231258 Llobet Medical PO Box 1020 MARGARETVILLE NY 12455 Medical 181569 MEDICAL STAFFING NETWORK PO Box 840292 DALLAS TX 75284 STAFFING AGENCY 177649 Fusion Medical Staffing LLC PO Box 82674 LINCOLN NE 68501 LAB STAFFING AGENCY 125542 5 15000 1690022 26616 1731638 NET PATIENT SERVICE REVENUE 621300 10522404 10522404 10522404 2395 2395 0 0 73096 8444 64652 0 64652 64652 0 37300 13477 23823 23823 0 0 0 0 0 0 PHARMACY REVENUE 446110 1454469 1454469 AMBULANCE REVENUE 621300 74925 74925 PROCEEDS FROM LIABILITY INSURANCE CONV. 524298 282578 282578 148614 148614 1960586 14305498 10597329 1976531 X 0 0 0 0 732150 732150 0 5813657 4448075 1365582 15852 11889 3963 1587905 1190929 396976 421427 316070 105357 0 3007 3007 90920 90920 1620 1620 0 0 1930620 1668428 262192 0 1706 1706 477301 256950 220351 0 0 177644 8225 169419 23328 23328 0 25835 21736 4099 5417 5417 0 499650 499650 147615 147615 MEDICAL SUPPLIES 1389207 1379675 9532 0 EQUIPMENT SVC CONTRACTS 969063 932237 36826 0 CONTRACTED SERVICES 272418 272418 0 INPATIENT ALLOWANCES 106458 106458 0 0 64576 15751 48825 14757376 11588223 3169153 0 707407 250785 0 0 90278 613541 1122876 1277479 0 0 0 0 0 0 316628 332443 118218 74915 22268614 20555451 1954664 1713163 0 0 0 0 0 0 0 0 1747961 1129086 6058032 5391412 2757450 2589907 0 0 570729 141188 0 0 0 0 0 0 36761 0 0 0 1024129 1443232 4389069 4174327 X 1668963 1217085 0 0 0 0 1668963 1217085 6058032 5391412 -451878 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1620 1620 false false SCHEDULE C, PART II-B, LINE 1I MARGARETVILLE MEMORIAL HOSPITAL PAYS DUES TO THE IROQUOIS HEALTHCARE ALLIANCE OF NEW YORK STATE (IHA). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY IHA, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2018 IHA ANNUAL DUES WERE $1,620. 23128 23128 4701478 3918929 782549 17050521 16231403 819118 493487 405119 88368 1713163 DUE FROM RELATED PARTIES 435320 INTEREST IN MH FOUNDATION 361973 OTHER RECEIVABLE 327435 ASSETS LIMITED AS TO USE 4358 1129086 0 OTHER NON-CURRENT LIABILITIES 1443232 1443232 harvest moon 28198 28198 5760 800 4533 flea market 9101 9101 100 1583 400 300 0 37299 37299 100 7343 1200 4833 13476 23823 true true X true X true X true true false true true 141852 23025 118827 0.00810 2225643 1569109 656534 0.04450 2367495 1592134 775361 0.05260 18831 18831 0.00130 4559189 2933799 1625390 0.11010 4578020 2933799 1644221 0.11140 6945515 4525933 2419582 0.16400 true 694582 4045508 3476313 569195 X true true 1 1 MARGARETVILLE MEMORIAL HOSPITAL 42084 STATE ROUTE 28 MARGARETVILLE NY 12455 HTTPs://WWW.HAHV.ORG/HAHV/HOME.ASPX 1226701c X X X X MARGARETVILLE MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X SEE SECTION C X true 16 true SEE SECTION C false true X 150. 300. X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X true X false X X true X false false Part V, Section B, Line 5: IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) OF 2010 AND THE NEW YORK STATE (NYS) HEALTH IMPROVEMENT PLANS PREVENTION AGENDA REQUIREMENTS, HEALTHALLIANCE OF THE HUDSON VALLEY (HEALTHALLIANCE), A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK (WMCHEALTH), PARTICIPATED WITH OTHER AREA HOSPITALS (UHS DELAWARE VALLEY HOSPITAL, OCONNOR HOSPITAL AND TRI-TOWN REGIONAL HOSPITAL), PUBLIC AND GOVERNMENT AGENCIES, COMMUNITY PARTNERS AND THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT TO PARTICIPATE IN A COMMUNITY HEALTH ASSESSMENT AND DEVELOP A LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN. A WORK GROUP CONSISTING OF THE SOUTHERN TIER HEALTH ACTIONS PRIORITIES NETWORK (HAPN), DELAWARE COUNTY PUBLIC HEALTH, THE REGIONAL POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) AND LOCAL AREA HOSPITALS MET REGULARLY BEGINNING IN FEBRUARY 2016 TO PRIORITIZE PREVIOUSLY IDENTIFIED COMMUNITY HEALTH NEEDS. THE IDENTIFIED COMMUNITY HEALTH NEEDS WERE BASED ON A VARIETY OF DATA SOURCES, INCLUDING STAKEHOLDER INTERVIEWS AND CONSUMER FOCUS GROUPS CONDUCTED BY HAPN, REGIONAL ASSESSMENTS COVERING DELAWARE COUNTY CONDUCTED BY THE PERFORMING PROVIDER SYSTEMS (PPS) AND DATA FROM THE NYS DEPARTMENT OF HEALTH (NYSDOH) PREVENTION AGENDA DASHBOARD. PARTNERS MET ON A MONTHLY BASIS TO ANALYZE DATA SETS AND COMMUNITY STRENGTHS. THE COMMUNITY PARTICIPATED IN THE PROCESS BY MEANS OF FOCUS GROUPS AND STAKEHOLDER INTERVIEWS CONDUCTED FROM JANUARY TO MARCH OF 2016 BY POPULATION HEALTH COORDINATORS. HEALTHALLIANCES CONTINUING PROGRESS AND MONITORING OF GOALS IDENTIFIED IN THIS ASSESSMENT IS MANAGED BY HEALTHALLIANCE COMMUNITY HEALTH LEADERSHIP, MARGARETVILLE HOSPITALS EXECUTIVE DIRECTOR, AND THE MARGARETVILLE HOSPITAL WELLNESS COMMITTEE. CURRENT AND NEW OUTREACH STRATEGIES WILL BE MODIFIED, IF NEEDED, AND DEVELOPED DURING THE CURRENT TERM OF THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). PART V, SECTION B, LINE 6A: the chna was conducted with the following other hospital facilities: UHS Delaware Valley Hospital, O'Connor Hospital and Tri-town Regional Hospital. PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING OTHER NON-HOSPITAL FACILITIES: DELAWARE COUNTY PUBLIC HEALTH AND HEALTHLINK NY COMMUNITY NETWORK. PART V, SECTION B, LINE 7: THE HOSPITAL'S CHNA REPORT IS WIDELY AVAILABLE TO THE PUBLIC AT THE BELOW WEBSITE URL: https://www.margaretvillehosp.org/Uploads/Public/Documents/HealthAlliance% 20PDFs/CHSP_NEW/Margaretville%20Hospital-Community%20Health%20Needs%20Asse ssment%20and%20Implementation%202016-2018.pdf PART V, SECTION B, LINE 10: THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS POSTED AT THE BELOW WEBSITE URL: https://www.margaretvillehosp.org/Uploads/Public/Documents/HealthAlliance% 20PDFs/CHSP_NEW/Margaretville%20Hospital-Community%20Health%20Needs%20Asse ssment%20and%20Implementation%202016-2018.pdf PART V, SECTION B, LINE 11 HEALTH NEEDS ADDRESSED BY HEALTHALLIANCE THE HEALTH NEEDS WERE IDENTIFIED THROUGH AN EXTENSIVE PROCESS THAT INCLUDED A REVIEW OF EXISTING DATA SETS FROM STATE AND NATIONAL SOURCES, REGIONAL COMMUNITY NEEDS ASSESSMENTS AND EXTENSIVE COLLABORATION WITH LOCAL FOCUS GROUPS AND HEALTH PROFESSIONALS. THROUGH COLLABORATION WITH COUNTY PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS, MARGARETVILLE HOSPITAL ALIGNED TOGETHER WITH OTHER AREA HOSPITALS AND THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT TO SELECT THE TWO PREVENTION AGENDA PRIORITIES OF PREVENT CHRONIC DISEASE AND PROMOTE MENTAL HEALTH/PREVENT SUBSTANCE ABUSE. PRIORITY AREA 1: PREVENT CHRONIC DISEASES FOCUS AREA 1: REDUCE OBESITY IN CHILDREN AND ADULTS. GOAL 1: CREATE COMMUNITY ENVIRONMENTS THAT PROMOTE AND SUPPORT HEALTH FOOD AND BEVERAGE CHOICES, AND PHYSICAL ACTIVITY. OUTCOME OBJECTIVE: REDUCE THE PERCENTAGE OF ADULTS AGES 18 AND OLDER WHO ARE OBESE FROM 24.5% TO 23.2% BY THE END OF 2018. MARGARETVILLE HOSPITAL WORKED WITH THE COMMUNITIES IN THEIR SERVICE AREA TO INCREASE RETAIL AVAILABILITY OF AFFORDABLE HEALTHY FOODS THAT MET THE NEEDS OF COMMUNITIES, ESPECIALLY THOSE WITH LIMITED ACCESS TO NUTRITIOUS FOODS. THE MARGARETVILLE HOSPITAL WELLNESS COMMITTEE RECOMMENDED HEALTHY VENDING GUIDELINES THAT WILL BE ADOPTED BY THE HOSPITAL AND IMPACT EMPLOYEES, PATIENTS AND VISITORS AT THE MARGARETVILLE HOSPITAL AND MOUNTAINSIDE RESIDENTIAL CARE CENTER. CURRENTLY UNDER REVIEW ARE VENDING POLICIES IMPLEMENTED IN OTHER LOCALES. ULSTER COUNTY AND THE CITY OF KINGSTON, THE PRIMARY HOME OF HEALTHALLIANCE, HAVE ADOPTED A HEALTHY VENDING POLICY. THROUGH THIS ACTION, MARGARETVILLE HOSPITAL EXPECTS THAT THE PERCENTAGE OF ADULTS WHO ARE OBESE, AGES 18 YEARS AND OLDER, WILL HAVE THE OPTION TO SELECT LOWER CALORIE FOODS WHEN DINING AT MARGARETVILLE HOSPITAL AND MOUNTAINSIDE RESIDENTIAL CARE CENTER. THIS STRATEGY WILL HELP TO DRIVE A REDUCTION IN OBESITY STATISTICS. MARGARETVILLE HOSPITAL STAFF WILL ASSESS THE FOOD THAT IS BEING OFFERED TO ENSURE ADHERENCE WITH NEWLY ADOPTED NUTRITION VENDING STANDARDS. GOAL 2: EXPAND THE ROLE OF PUBLIC AND PRIVATE EMPLOYERS IN OBESITY PREVENTION. OUTCOME OBJECTIVE: INCREASE THE PERCENTAGE OF SMALL AND MEDIUM WORKSITES THAT OFFER A COMPREHENSIVE WORKSITE WELLNESS PROGRAM FOR ALL EMPLOYEES. THE HOSPITAL HAS IMPLEMENTED AN EVIDENCE-BASED WELLNESS PROGRAM FOR ALL ITS EMPLOYEES IN COOPERATION WITH THE PARTICIPATING HEALTH PLAN AND COMMUNITY PARTNERSHIPS THAT INCLUDE BUT ARE NOT LIMITED TO INCREASED OPPORTUNITIES FOR PHYSICAL ACTIVITY; ACCESS TO AND PROMOTION OF HEALTHFUL FOODS AND BEVERAGES, AND HEALTH BENEFIT COVERAGE AND/OR INCENTIVES FOR OBESITY PREVENTION. THE HOSPITAL WILL IMPLEMENT NUTRITION AND BEVERAGE STANDARDS IN PUBLIC INSTITUTIONS, WORKSITES AND OTHER KEY LOCATIONS SUCH AS MARGARETVILLE HOSPITAL AND MOUNTAINSIDE NURSING HOME. AS A ROLE MODEL, HEALTHALLIANCE HAS IMPLEMENTED SYSTEM-WIDE CHANGES THAT INCENTIVIZE EMPLOYEE PARTICIPATION IN A PERSONAL HEALTH ASSESSMENT (PHA), ANNUAL PHYSICAL AND THE ADOPTION OF AT LEAST ONE HEALTHY BEHAVIOR BY STRUCTURING HEALTH INSURANCE RATES FAVORABLY FOR THOSE THAT PARTICIPATE IN WELLNESS ACTIVITIES. THIS MAY SERVE AS A TEMPLATE FOR OTHER COMMUNITY ORGANIZATIONS THAT ARE INTERESTED IN CREATING WORKSITE WELLNESS PROGRAMS. THE HEALTHALLIANCE ADMINISTRATION WILL REVIEW AND REPORT DATA AGGREGATED BY THE PARTICIPATING HEALTH PLAN ON EMPLOYEE PARTICIPATION AND SUCCESS. IN PARTNERSHIP WITH THE HEALTHALLIANCE EMPLOYEE WELLNESS COMMITTEE, HEALTHALLIANCE WILL OFFER HEALTHY EATING CLASSES AND GYM MEMBERSHIPS AT REDUCED RATES. PRIORITY AREA 4: PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE. FOCUS AREA 3: STRENGTHEN INFRASTRUCTURE ACROSS SYSTEMS. GOAL 1: STRENGTHEN INFRASTRUCTURE FOR MENTAL EMOTIONAL BEHAVIOR ("MEB") HEALTH PROMOTION AND MEB DISORDER PREVENTION. OUTCOME OBJECTIVE: ENHANCE TELEMEDICINE AND REFERRAL SYSTEMS TO BUILD INFRASTRUCTURE OF PSYCHIATRIC SERVICES. FOCUS AREA 2: PREVENT SUBSTANCE ABUSE AND OTHER MENTAL EMOTIONAL BEHAVIORAL DISORDERS. GOAL 2: PREVENT SUICIDES AMONG YOUTH AND ADULTS. OUTCOME OBJECTIVE: DECREASE AGE-ADJUSTED SUICIDE RATES. OUTCOME OBJECTIVE: DECREASE THE NUMBER OF SUICIDE ATTEMPTS. MARGARETVILLE HOSPITAL CONTINUES TO WORK WITH THE FOLLOWING ENTITIES TO ACHIEVE THE GOAL OF PREVENTING SUICIDE AMONG YOUTH AND ADULTS DELAWARE COUNTY PUBLIC HEALTH, OCONNOR HOSPITAL, TRI-TOWN REGIONAL HOSPITAL AND DELAWARE VALLEY HOSPITAL. THESE ENTITIES SHARE DATA ON SUICIDES, ATTEMPTED SUICIDES AND SUICIDAL IDEATION. MARGARETVILLE HOSPITAL WILL ESTABLISH TELEMEDICINE CAPABILITIES WITH INPUT FROM WMCHEALTH TO BRING PSYCHIATRIC SERVICES TO THE DELAWARE COUNTY COMMUNITY. UTILIZING RESOURCES FROM HEALTHALLIANCE AND WMCHEALTH AND WITH REFERRALS PROVIDED TO THE MARGARETVILLE AND ROXBURY SCHOOLS, MARGARETVILLE HOSPITAL FORESEES HIGH VALUE AND POTENTIAL IN MEETING THE NEEDS OF THE IDENTIFIED DISPARATE POPULATION. IN REGARDS TO SUICIDE PREVENTION, THE ENTITIES DESCRIBED ABOVE WILL TAKE RESPONSIBILITY FOR THE FOLLOWING: 1. DELAWARE COUNTY PUBLIC HEALTH WILL SHARE DATA ON GENDER, AGE AND MEANS OF SUICIDE DEATHS WITH THE DELAWARE COUNTY SUICIDE PREVENTION NETWORK; 2. OCONNOR HOSPITAL WILL COLLECT THE NUMBERS OF SUICIDE ATTEMPTS AND IDEATION STATISTICS FROM ALL EMERGENCY DEPARTMENTS IN DELAWARE COUNTY. THIS DATA WILL ALSO BE REPORTED TO THE DELAWARE COUNTY SUICIDE PREVENTION NETWORK; AND 3. MARGARETVILLE HOSPITAL, TRI-TOWN REGIONAL MEDICAL CENTER AND DELAWARE VALLEY HOSPITAL WILL REPORT THE NUMBER OF SUICIDE ATTEMPTS AND SUICIDE IDEATION TO OCONNOR HOSPITAL, WHERE THE COMPLETE DATA WILL BE AGGREGATED. THE INTENDED IMPACT BEHIND THE COLLABORATION OF RESOURCES WILL BE TO DECREASE THE AGE-ADJUSTED SUICIDE RATE IN DELAWARE COUNTY BY 10% (FROM 17.2 TO 15.5) PER 100,000, AND TO DECREASE THE NUMBER OF SUICIDE ATTEMPTS IN DELAWARE COUNTY BY DECEMBER 31, 2018. TO STRENGTHEN INFRASTRUCTURE FOR MEB HEALTH PROMOTION AND MEB BEHAVIOR PREVENTION, MARGARETVILLE HOSPITAL WILL PARTNER WITH COMMUNITY ORGANIZATIONS AND COALITIONS, AS WELL AS THE MARGARETVILLE HOSPITAL WELLNESS COMMITTEE, WESTCHESTER MEDICAL CENTER PSYCHIATRY AND PSYCHOLOGY DEPARTMENTS, THE MARGARETVILLE AND ROXBURY SCHOOLS AND POTENTIALLY OTHER SCHOOL DISTRICTS. ALSO INCLUDED IN THIS PARTNERSHIP WILL BE DELAWARE COUNTY PUBLIC HEALTH AND MENTAL HEALTH. TELEMEDICINE EQUIPMENT WILL BE OPERATIONAL, AND A SYSTEM FOR GATHERING REFERRALS FROM THE DELAWARE COUNTY COMMUNITY WILL BE IN PLACE. A STAFF PERSON AT MARGARETVILLE HOSPITAL WILL BE DEDICATED TO THIS WORK. 2018 Progress Update PRIORITY AREA 1: PREVENT CHRONIC DISEASES FOCUS AREA 1: REDUCE OBESITY IN CHILDREN AND ADULTS. GOAL 1: CREATE COMMUNITY ENVIRONMENTS THAT PROMOTE AND SUPPORT HEALTHY FOOD AND BEVERAGE CHOICES, AND PHYSICAL ACTIVITY. OUTCOME OBJECTIVE: REDUCE THE PERCENTAGE OF ADULTS AGES 18 AND OLDER WHO ARE OBESE FROM 24.5% TO 23.2% BY THE END OF 2018. - THERE ARE NO UPDATES OUTSIDE OF WHAT WAS TAKING PLACE IN 2017. WE CONTINUE TO INTRODUCE HEALTHY SNACKS IN VENDING MACHINES INCLUDING IN BOTH MARGARETVILLE HOSPITAL AND MOUNTAINSIDE RESIDENTIAL CARE CENTER. GOAL 2: EXPAND THE ROLE OF PUBLIC AND PRIVATE EMPLOYERS IN OBESITY PREVENTION. OUTCOME OBJECTIVE: INCREASE THE PERCENTAGE OF SMALL AND MEDIUM WORKSITES THAT OFFER A COMPREHENSIVE WORKSITE WELLNESS PROGRAM FOR ALL EMPLOYEES. - DUE TO THE COMPLEXITIES OF A TRANSITION FROM A FULL-INSURED TO A NEW SELF-INSURED HEALTH INSURANCE PROGRAM IN 2018, WE WERE UNABLE TO PROCEED WITH A WELLNESS PROGRAM FOR OUR EMPLOYEES. HEALTHALLIANCE WILL RESUME AN EMPLOYEE WELLNESS INITIATIVE IN 2019. PRIORITY AREA 4: PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE. FOCUS AREA 3: STRENGTHEN INFRASTRUCTURE ACROSS SYSTEMS. GOAL 1: STRENGTHEN INFRASTRUCTURE FOR MENTAL EMOTIONAL BEHAVIOR ("MEB") HEALTH PROMOTION AND MEB DISORDER PREVENTION. OUTCOME OBJECTIVE: ENHANCE TELEMEDICINE AND REFERRAL SYSTEMS TO BUILD INFRASTRUCTURE OF PSYCHIATRIC SERVICES. - THE EXISTING DISPARITY FOR THE 2016-2018 COMMUNITY HEALTH IMPROVEMENT PLAN IS "LOW INCOME RESIDENTS IN RURAL AREAS IN DELAWARE COUNTY." THIS CAN BENEFIT A LARGE PORTION OF THE MARGARETVILLE HOSPITAL SERVICE AREA, AS THE AVERAGE WEEKLY WAGE RATE FOR DELAWARE COUNTY IS $775 (2015), WHICH IS 34% BELOW THE NYS RATE OF $1,180. TELEHEALTH SERVICES AVAILABLE IN 4 SCHOOL SYSTEMS IN DELAWARE COUNTY. COORDINATION EXISTS BETWEEN PSYCHOLOGIST AND LCSW ASSESSMENTS, EVALUATIONS AND INTERVENTIONS COLLABORATED WITH THE BEHAVIORAL HEALTH TEAM IN THE SCHOOLS AND A PSYCHIATRIST VIA TELE-PSYCHIATRY. THIRD LCSW/RN HIRED TO SUPPORT THE GROWING NEEDS OF THE PROGRAM. TOTAL VISITS - SCHEDULED 1214 - SEEN 1020 (84%) - CANCELLED 119 (9%) - NO-SHOW 85 (7%) FACE-TO-FACE VISITS (WITH SOCIAL WORKER OR PSYCHOLOGIST) - SCHEDULED 1113 - SEEN 928 (83%) - CANCELLED 116 (10%) - NO SHOW 79 (7%) TELEPSYCHIATRY VISITS (WITH PSYCHIATRIST) - SCHEDULED 101 - SEEN 92 (91%) - CANCELLED 3 (3%) - NO SHOW 6 (6%) HEALTH NEEDS NOT ADDRESSED BY HEALTHALLIANCE AFTER A REVIEW OF THE COMMUNITY NEEDS ASSESSMENT DON PART V, SECTION B, LINE 16A, B AND C: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ("FAP") AND FAP APPLICATION ARE AVAILABLE AT THE FOLLOWING WEBSITE: https://www.hahv.org/Uploads/Public/Documents/HealthAlliance%20PDFs/Health Alliance%20Financial%20Assistance%20Policy_3.2018.pdf PART I, LINE 7 MARGARETVILLE MEMORIAL HOSPITALS COSTING METHODOLOGY WAS BASED ON WORKSHEET S-10 OF THE MEDICARE COST REPORT. THE COST-TO-CHARGE RATIO WAS USED FOR THE VARIOUS SUB-LINE ITEMS OF LINE #7. PART I, LINE 7B: COLUMN D - MEDICAID IN 2018, MARGARETVILLE MEMORIAL HOSPITAL RECEIVED $1.2M IN VITAL ACCESS PROVIDER AND SAFETY NET PROGRAM PROJECT (VAP) FUNDING WHILE IN 2017 MARGARETVILLE ONLY RECEIVED $600K IN THIS FUNDING. THIS INCREASE IN FUNDING WAS OFFSET SLIGHTLY BY THE FACT THAT IN 2017 MARGARETVILLE MEMORIAL HOSPITAL RECEIVED $262K FROM THE DEPARTMENT OF HEALTH. THE STATE FISCAL YEAR 2017/18 ENACTED BUDGET APPROPRIATED $20M FOR CRITICAL ACCESS HOSPITALS (CAHS). THERE WERE NO RESTRICTIONS ON THIS FUNDING AND THIS WAS NEW FUNDING FOR THE HOSPITAL IN 2017 WITH NO SIMILAR FUNDING IN 2018. THIS ADDITIONAL VAP FUNDING HAS CAUSED THE DIRECT OFFSETTING REVENUE TO INCREASE IN PART I, LINE 7B, COLUMN D. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES THE COSTS ON LINE 7G INCLUDE no COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. Part III, Line 2: Methodology Used to Estimate Amount of Bad Debt Expense THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS (AFS). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE THIS AMOUNT CAN BE FOUND IN FOOTNOTE #2 ON PAGES 18-19 OF THE ATTACHED Audited Financial Statements. Part III, Line 4: Description of Bad Debt Expense THE TEXT OF THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 18-19 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. Part III, Line 8: Costing Methodology SINCE MARGARETVILLE MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL, THE HOSPITAL RECEIVES 101% OF ITS COST FOR MOST OF ITS SERVICES; THEREFORE MARGARETVILLE SHOULD ALWAYS HAVE A SURPLUS FROM MEDICARE. THE AMOUNT REPORTED ON LINE 6 WAS DERIVED BY USING THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE MEDICARE COST REPORT AND THE APPLICABLE ADJUSTMENTS FROM WORKSHEET A. FOR 2018, MARGARETVILLE MEMORIAL HOSPITAL DOES NOT HAVE A LOSS FROM MEDICARE THEREFORE IT IS NOT CONSIDERED A COMMUNITY BENEFIT. PART III LINE 9B: Collection Practices THE CREDIT AND COLLECTION POLICY FOR SELF-PAY BALANCES PROVIDES THAT, IN SOME CASES, NON-INSURED PATIENTS THAT DO NOT QUALIFY FOR MEDICAID QUALIFY FOR CHARITY CARE. IN THOSE INSTANCES, THE CREDIT AND COLLECTION DEPARTMENT WILL FOLLOW THE GUIDELINES AS SET FORTH IN THE CHARITY CARE POLICY. THE CHARITY CARE POLICY PROVIDES THAT THE FINANCIAL COUNSELOR EVALUATES THE INFORMATION PROVIDED IN PATIENTS CHARITY CARE APPLICATIONS IN CONJUNCTION WITH FEDERAL INCOME POVERTY GUIDELINES TO DETERMINE THE WRITE-OFF PERCENTAGE. IF THE PATIENT/GUARANTOR QUALIFIES FOR CHARITY CARE BASED ON THE SLIDING SCALE, THE PATIENT WILL BE REQUIRED TO PAY THE OUTSTANDING AMOUNT. A PAYMENT PLAN IS ESTABLISHED NOT TO EXCEED 10% OF THE GUARANTORS GROSS MONTHLY INCOME. PART VI, LINE 2: NEEDS ASSESSMENT THE COMMUNITY SERVICE PLAN HAS TAKEN INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY MARGARETVILLE HOSPITAL. THROUGH COLLABORATION WITH DELAWARE COUNTY PUBLIC HEALTH, THE THREE OTHER HOSPITALS REPRESENTING DELAWARE COUNTY, AND THE SOUTHERN TIER POPULATION HEALTH IMPROVEMENT PROGRAM, MARGARETVILLE HOSPITAL ALIGNED TOGETHER TO ADDRESS TWO PREVENTION AGENDA PRIORITIES. THE PRIMARY PROACTIVE MEANS FOR RECEIVING COMMUNITY INPUT WAS THROUGH THE REGIONAL ASSESSMENT CONDUCTED BY THE SOUTHERN TIER POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP). IN THE SOUTHERN TIER, PHIP COVERS FIVE COUNTIES INCLUDING DELAWARE COUNTY. IN ORDER TO INFORM THE DIRECTION OF THE SOUTHERN TIER PHIP, ALSO KNOWN AS HEALTH ACTION PRIORITIES NETWORK (HAPN), THE TEAM CONDUCTED A REGIONAL HEALTH ASSESSMENT UTILIZING STAKEHOLDER INTERVIEWS AND CONSUMER FOCUS GROUPS. THE INFORMATION FROM THIS ASSESSMENT THAT SPECIFICALLY REFERS TO DELAWARE COUNTY WAS UTILIZED TO DIRECT THE SELECTION OF THE PUBLIC HEALTH PRIORITIES FOR MARGARETVILLE HOSPITAL. AFTER IDENTIFICATION OF THE CRITERIA FOR PRIORITY SELECTION, A WORK GROUP WAS CONVENED BY THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT WHICH INCLUDED MARGARETVILLE HOSPITAL, DELAWARE VALLEY HOSPITAL, OCONNOR HOSPITAL AND TRI-TOWN REGIONAL HOSPITAL, AS WELL AS THE SOUTHERN TIER PHIP. THROUGH THIS WORK GROUP, THE DATA FROM THE COMMUNITY ENGAGEMENT SESSIONS, AS WELL AS THE HOSPITAL AND COUNTY HEALTH DEPARTMENT COMMUNITY HEALTH ASSESSMENTS, WERE ALIGNED WITH THE PRIORITIES OUTLINED BY THE NYS 2014-2016 PREVENTION AGENDA. ADDITIONALLY, THE RATIONALE FOR CHOICE OF PRIORITIES WAS BASED ON AVAILABLE RESOURCES AND CAPACITY TO ADDRESS THE PRIORITY. OPPORTUNITY FOR DEVELOPMENT OF COLLABORATIVE INTERVENTIONS BY MARGARETVILLE HOSPITAL, THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS, WAS ALSO CONSIDERED. METHODOLOGY AND PROCESS FROM JUNE 2015 THROUGH JANUARY 2016, NUMEROUS ONE-ON-ONE STRUCTURED INTERVIEWS IN DELAWARE COUNTY WERE CONDUCTED WITH PROFESSIONALS WORKING IN DIVERSE FIELDS SUCH AS HEALTH CARE, EDUCATION, TRANSPORTATION, ECONOMIC DEVELOPMENT, MENTAL HEALTH, LAW ENFORCEMENT AND ELECTED OFFICIALS, AMONG OTHERS. THE INTERVIEW QUESTIONS, 10 KEY QUESTIONS AND FIVE SECONDARY QUESTIONS CENTERED ON HEALTH DISPARITIES, KEY BARRIERS TO ADDRESSING THEM, AND GAPS IN SERVICE PROVISION. CONSUMERS INPUT WAS SOUGHT THROUGH FOCUS GROUPS WHICH WERE CONDUCTED FROM JANUARY THROUGH MARCH OF 2016. POPULATION HEALTH COORDINATORS MET WITH PRE-EXISTING GROUPS INCLUDING SUPPORT GROUPS, SERVICE CLUBS, PARENT GROUPS AND SENIOR MEALS. HAPN/PHIP SOUTHERN TIER CONDUCTED FIVE FOCUS GROUPS WITH 37 PARTICIPANTS IN DELAWARE COUNTY. THEY WERE ASKED ABOUT THEIR EXPERIENCES WITH HEALTH AND HEALTH CARE DELIVERY. RESPONSES FROM THE FOCUS GROUPS WERE COLLECTED BY NOTE-TAKERS AND SUMMARIZED QUALITATIVELY BY THE POPULATION HEALTH COORDINATORS. IN ADDITION, MARGARETVILLE HOSPITAL IS AN ACTIVE PARTICIPANT IN DELAWARE COUNTYS COMMUNITY HEALTH IMPROVEMENT PLAN PROCESS. THIS PROCESS INCLUDED INPUT AND SUGGESTIONS FROM DELAWARE COUNTY PUBLIC HEALTH, DELAWARE VALLEY HOSPITAL, MARGARETVILLE HOSPITAL, OCONNOR HOSPITAL, AND THE SOUTHERN TIER PHIP. FOLLOWING THE PUBLIC PARTICIPATION AND INPUT PERIOD, THE HEALTH PRIORITIES WERE CHOSEN BASED UPON THE APPLICATION OF THE FOLLOWING FIVE CRITERIA: 1. THE PRIORITY AREA WAS IDENTIFIED BY AT LEAST TWO OF THREE PRIMARY INFORMATION SOURCES: MARGARETVILLE HOSPITAL COMMUNITY SERVICE PLAN, DELAWARE COUNTYS COMMUNITY HEALTH ASSESSMENTS OR THE WESTCHESTER MEDICAL CENTER PERFORMING PROVIDER SYSTEM COMMUNITY NEEDS ASSESSMENT; 2. THE PRIORITY AREA WAS CONSISTENT WITH THE CURRENT NYS DEPARTMENT OF HEALTH PREVENTION AGENDA AREAS; 3. THE PRIORITY AREA WAS SUPPORTED BY DATA SHOWING HEALTH STATUS INDICATORS OR HEALTH NEEDS WERE EITHER BELOW THE AVERAGES FOR NEW YORK STATE OR FOR THE MARGARETVILLE SERVICE AREA BASED ON THE WESTCHESTER PPS COMMUNITY NEEDS ASSESSMENT; 4. THE DEGREE OF ABERRATION FROM NATIONAL HEALTHY PEOPLE 2020 GOALS AND/OR FROM NYS PREVENTION AGENDA OBJECTIVES; AND 5. THE PRIORITY AREA WAS IDENTIFIED/ RECOMMENDED DURING THE PUBLIC INPUT PROCESS. PART VI, LINE 3: THE HOSPITAL INFORMS THE PATIENT OF THE AVAILABILITY OF CHARITY CARE SEVERAL WAYS: 1. NOTICE IS ON EVERY PATIENT BILL WITH AN APPLICATION ON THE BACK OF THE BILL 2. ON THE HOSPITAL WEBSITE 3. ALL MEMBERS OF THE PATIENT ACCOUNTING DEPARTMENT ARE TRAINED TO SCREEN PATIENTS FOR CHARITY CARE WHEN DISCUSSING BILLS AND CONCERNS REGARDING INABILITY TO PAY 4. FLIERS ARE POSTED IN REGISTRATION AREAS OF THE HOSPITAL 5. REGISTRATION CLERKS WILL IDENTIFY PATIENTS WITHOUT A PAY SOURCE AND REFER THE PATIENT TO A FINANCIAL COUNSELOR AND HAND THE PATIENT A FINANCIAL ASSISTANCE FORM 6. FINANCIAL COUNSELORS ASSIST PATIENTS IN SECURING MEDICAID AND SCREEN FOR CHARITY CARE 7. THE COLLECTION AGENCIES THAT HAHV ENGAGES WITH ARE AWARE OF THE CHARITY CARE POLICY AND ASSIST PATIENTS IN APPLYING UP TO 180 POST-PLACEMENT WITH THEM HEALTHALLIANCE IS COMMITTED TO: - PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES. - CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. - ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE. - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITY. IN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION (AHA) RECOMMENDATIONS, HEALTHALLIANCE ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS - MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS - OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS - IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER - IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONS HEALTHALLIANCE EFFECTIVELY COMMUNICATES WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATION AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND IN RESPONSE TO PATIENTS SEEKING FINANCIAL ASSISTANCE. INFORMATION REGARDING THE FINANCIAL ASSISTANCE IS ALSO PROVIDED BY THE ONSITE FINANCIAL COUNSELING STAFF IN BOTH INPATIENT AND OUTPATIENT AREAS. PATIENT ACCOUNTING ALSO SUPPORTS THE FINANCIAL COUNSELING PROGRAM BY PROVIDING PATIENTS WITH INFORMATION AND APPLICATIONS WHILE HANDLING CUSTOMER SERVICE CALLS. OUR FINANCIAL COUNSELORS AND COUNTY MEDICAID WORKERS ALSO PROVIDE GUIDANCE REGARDING THE FINANCIAL ASSISTANCE PROGRAM WHEN NECESSARY. FINANCIAL ASSISTANCE IS AVAILABLE ON THE BACK OF EVERY HOSPITAL BILL AS WELL AS THE HOSPITAL WEBSITE AT HTTPS://WWW.HAHV.ORG/FINANCIAL-ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. THE PATIENT DOES NOT NEED TO HAVE AN ACCOUNT WITH THE HOSPITAL; THEY JUST HAVE TO BE IN A SITUATION WHERE THEY ARE IN NEED OF INSURANCE COVERAGE. EVERY EFFORT IS MADE TO DETERMINE A PATIENTS ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENTS STAY AFTER STABILIZATION OR COLLECTION CYCLE. HEALTHALLIANCE OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH THE HOSPITAL WEBSITE, HOSPITAL POSTERS AND FLYERS, FINANCIAL ASSISTANCE APPLICATIONS AND HOSPITAL STATEMENTS. THE FINANCIAL ASSISTANCE POLICY (FAP) AND APPLICATION ARE AVAILABLE ON OUR WEBSITE AT HTTPS://WWW.HAHV.ORG/FINANCIAL-ASSISTANCE AND ARE SUPPLIED IN BOTH ENGLISH AND SPANISH AS WELL AS PLAIN LANGUAGE SUMMARY FORMAT. IF ADDITIONAL ASSISTANCE IS NEEDED, HEALTHALLIANCE OFFERS TRANSLATION SERVICES FOR PATIENTS. HEALTHALLIANCE HAS AN ESTABLISHED WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. THE ORGANIZATION MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. EDUCATED STAFF MEMBERS WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. ALL PATIENT REGISTRATION STAFF RECEIVES IN-SERVICE TRAINING REGARDING THE FINANCIAL ASSISTANCE PROGRAM. PATIENT ACCOUNTING ALSO RECEIVES INFORMATION ABOUT THE PROGRAM AND HOW TO HANDLE PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS RECEIVE IN DEPTH TRAINING TO HANDLE FINANCIAL ASSISTANCE REQUESTS, PROCESS APPLICATIONS, AND MANAGE OUTCOMES. HEALTHALLIANCE PROVIDES SEVERAL OPTIONS FOR PATIENTS WHO EITHER DO NOT HAVE INSURANCE COVERAGE OR WHO HAVE INADEQUATE INSURANCE COVERAGE. OUR MANY PROGRAMS HAVE BEEN VERY SUCCESSFUL AND MANY HAVE TAKEN ADVANTAGE OF OUR OFFERINGS. OFTEN UTILIZED, FINANCIAL COUNSELING OFFERS A PATIENT THE OPPORTUNITY TO SPEAK TO A FINANCIAL COUNSELOR TO DETERMINE WHAT ASSISTANCE CAN BE ACCESSIBLE BASED ON FAMILY INCOME. PATIENTS OFTEN SHOP AROUND FOR THE MOST ECONOMICAL HEALTHCARE AND WE OFFER PRICE QUOTES. THIS ALLOWS THE PATIENT TO KNOW THEIR FINANCIAL OBLIGATION UP FRONT AND UNDERSTAND THE COMPETITIVE PRICING BEING OFFERED. HEALTHALLIANCE IS COMMITTED TO PROVIDING THE BEST POSSIBLE HEALTHCARE AND IS VERY SENSITIVE TO LOW INCOME PATIENTS ABILITY TO PAY. OUR CALL CENTER OFFERS THE CONVENIENCE OF CALLING ONE TELEPHONE NUMBER FOR ALL BILLING INQUIRIES REGARDLESS OF WHICH HOSPITAL THE PATIENT IS CALLING ABOUT. PART VI, LINE 4: Community Description MARGARETVILLE MEMORIAL HOSPITAL (MARGARETVILLE HOSPITAL), A MEMBER OF HEALTHALLIANCE OF THE HUDSON VALLEY AND THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK (WMCHEALTH) IS A RURAL CRITICAL ACCESS HOSPITAL WHOSE MISSION IS TO PROVIDE IMMEDIATE ACCESS TO HIGH QUALITY MEDICAL CARE AND DIAGNOSTIC TESTING SERVICES TO MEDICALLY UNDERSERVED AREAS IN THE CATSKILL MOUNTAINS. MARGARETVILLE HOSPITAL PROVIDES LINKAGES TO HIGH TECH AND SPECIALTY MEDICAL CARE THROUGH AN ACTIVE RELATIONSHIP WITH HEALTHALLIANCE AND WMCHEALTH. MARGARETVILLE HOSPITAL IS THE DELAWARE COUNTY AFFILIATE OF HEALTHALLIANCE OF THE HUDSON VALLEY (HEALTHALLIANCE), A MULTI-CAMPUS HEALTH CARE SYSTEM CONSISTING OF HEALTHALLIANCE HOSPITALS MARYS AVE. AND BROADWAY CAMPUSES IN KINGSTON, NY, AND MARGARETVILLE HOSPITAL, WHICH IS CO-LOCATED ON A SINGLE CAMPUS IN MARGARETVILLE, NY (DELAWARE COUNTY), WITH THE MOUNTAINSIDE RESIDENTIAL CARE CENTER, A SKILLED NURSING FACILITY. HEALTHALLIANCE DEFINES ITS PRIMARY SERVICE AREA BY A FEDERAL DEFINITION THAT CONSISTS OF THE TOP 75% OF HOSPITAL DISCHARGES FROM THE LOWEST NUMBER OF CONTIGUOUS ZIP CODES. MARGARETVILLE HOSPITAL SERVES THE COMMUNITIES OF MARGARETVILLE, ARKVILLE, ANDES, FLEISCHMANNS, ROXBURY, HALCOTT CENTER, HALCOTTSVILLE, AND NEW KINGSTON. DUE TO THE GEOGRAPHICAL LOCATION OF ACUTE CARE HOSPITALS AFFILIATED WITH HEALTHALLIANCE, THERE ARE TWO DISTINCT PRIMARY SERVICES AREAS WITHIN ULSTER AND DELAWARE COUNTIES, THOUGH NOT ENCOMPASSING ALL OF EACH COUNTY. FOR OPERATIONAL AND COMMUNITY NEEDS DEVELOPMENT, HEALTHALLIANCE REGARDS THESE TWO SERVICE AREAS AS A SINGLE PRIMARY SERVICE AREA WITH THE PREDOMINANT POPULATION IN ULSTER COUNTY. HOWEVER, FOR THE PURPOSES OF THIS DOCUMENT, WHICH WILL ALIGN WITH THE DELAWARE COUNTY COMMUNITY HEALTH ASSESSMENT AND THE COMMUNITY HEALTH IMPROVEMENT PLAN, WE WILL PRESENT THE INFORMATION PERTAINING TO THE MARGARETVILLE HOSPITAL SERVICE AREA, LOCATED IN DELAWARE COUNTY AND DESCRIBED IN THE BEGINNING OF THIS SECTION. MARGARETVILLE HOSPITAL SERVICE AREA OTHER COMMUNITY HEALTH SERVICES AND RESOURCES AVAILABLE IN DELAWARE COUNTY INCLUDES AMBULANCE SERVICES, MOSTLY CONSISTING OF VOLUNTEER MEMBERSHIP. IN ADDITION TO MARGARETVILLE HOSPITAL, THERE ARE THREE OTHER HOSPITALS, OPERATED BY TWO OTHER HEALTHCARE SYSTEMS: DELAWARE VALLEY HOSPITAL AFFILIATED WITH UNITED HEALTH SERVICES, AS WELL AS OCONNOR HOSPITAL AND TRI-TOWN HOSPITAL, BOTH AFFILIATED WITH THE BASSETT HEALTHCARE NETWORK. ADDITIONALLY, THERE ARE TWO NURSING HOMES IN THE COUNTY, 15 PRIMARY CARE OFFICES INCLUDING HEALTH CENTERS AND PRIVATE PHYSICIAN OFFICES, 15 LOCATIONS AND 9 FULL-TIME EQUIVALENT DENTISTS, AND TWO MENTAL HEALTH CLINICS WITH FOUR LOCATIONS WITHIN THE COUNTY. DELAWARE COUNTY COVERS 1,446 SQUARE MILES IN UPSTATE NEW YORK, BELONGING TO BOTH THE SOUTHERN TIER REGION AND THE CATSKILL MOUNTAIN RANGE. DELAWARE COUNTY IS THE FOURTH LARGEST COUNTY IN NEW YORK BY AREA AND IS THE SIXTH MOST RURAL WITH A POPULATION DENSITY OF 32.3 PERSONS PER SQUARE MILE. THE COUNTY INCLUDES THE CATSKILL/DELAWARE WATERSHED, WHICH IS THE LARGEST UNFILTERED DRINKING WATER SUPPLY IN THE UNITED STATES. THE WATERSHED REGION ENCOMPASSES THE CENTRAL AND EASTERN SECTIONS OF DELAWARE COUNTY AND INCLUDES ROUGHLY 65% OF THE COUNTYS LAND AREA AND 11 OF ITS 19 TOWNSHIPS. APPROXIMATELY 55% OF DELAWARE COUNTYS POPULATION LIES WITHIN THE WATERSHED. BASED ON THE MOST RECENT CENSUS (2010), THE POPULATION OF DELAWARE COUNTY IS 47,963, 50.2% MALE AND 49.8% FEMALE. IN 2018, THE POPULATION DECREASED TO 44,527, REPRESENTING A 7.2% REDUCTION IN POPULATION. AT THE TIME OF THE 2018 CENSUS, 16.5% OF THE POPULATION IS UNDER 18 YEARS WITH 24.5% WERE 65 AND OVER. A MAJORITY OF DELAWARE COUNTY RESIDENTS OVER THE AGE OF 15 ARE MARRIED (72.5%), FOLLOWED BY NEVER MARRIED (42%); SEPARATED (2.8%), WIDOWED (2%), AND DIVORCED (1.8%) MAKE UP A SMALLER PORTION OF THE POPULATION. DELAWARE COUNTYS POPULATION IS 95% WHITE, 1.9% AFRICAN-AMERICAN, 0.2% AMERICAN INDIAN/ESKIMO, 0.8% ASIAN, AND 3.4% OF HISPANIC ORIGIN (U.S. CENSUS BUREAU, 2010-2014 AMERICAN COMMUNITY SURVEY). THE MEDIAN FAMILY INCOME IN DELAWARE COUNTY FOR 2018 WAS $47,921, OBVIOUSLY LESS THAN NEW YORK STATE. ACCORDING TO THE NYS POVERTY REPORT RELEASED IN MARCH 2019, THE POPULATION BELOW THE POVERTY LINE WAS 16.5%, HIGHER THAN THE RATE OF 15.1% FOR NEW YORK. NOTABLY, THE PERCENTAGE OF CHILDREN LIVING BELOW THE POVERTY LINE HAS INCREASED TO 30.7%. IN ADDITION, 9.4% OF EMPLOYED INDIVIDUALS HAD NO HEALTH INSURANCE COMPARED TO 14.4% FOR THOSE UNEMPLOYED. PART VI, LINE 5: Promotion of Community Health PLEASE SEE NARRATIVE FOR SCHEDULE H, PART V, SECTION B, LINE 11 FOR A COMPLETE DESCRIPTION OF HOW THE ORGANIZATIONS HOSPITAL FACILITIES FURTHER ITS EXEMPT PURPOSES BY PROMOTING THE HEALTH OF THE COMMUNITY. PART VI, LINE 6: Affiliated Health Care System HAHV IS THE PARENT COMPANY TO AFFILIATE MEMBERS HeAlthalliance MARYS AVENUE CAMPUS, BROADWAY CAMPUS, MARGARETVILLE MEMORIAL HOSPITAL, A RURAL CRITICAL ACCESS HOSPITAL AND MOUNTAINSIDE RESIDENTIAL CARE CENTER, A SKILLED NURSING FACILITY. THIS INTEGRATED HEALTHCARE SYSTEM IS COMMITTED TO PROVIDING QUALITY AND COMPASSIONATE MEDICAL CARE FOR OUR PATIENTS, THEIR FAMILIES AND OUR COMMUNITY. IN ADDITION TO SERVICE CONSOLIDATION BETWEEN THE TWO KINGSTON HOSPITALS, HAHV ALSO COMMITTED TO STREAMLINING OPERATIONS AND IMPROVING CARE AT THE OTHER AFFILIATE LOCATIONS. DESPITE SIGNIFICANT OPERATIONAL IMPROVEMENT AND AT THE SUGGESTION OF NYS DEPARTMENT OF HEALTH, HAHV JOINED WITH THE WESTCHESTER MEDICAL HEALTH PERFORMING PROVIDER SYSTEM IN THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) AGAIN SEEKING TO TRANSFORM HEALTHCARE DELIVERY TO A MORE EFFECTIVE AND EFFICIENT MODEL THAT WILL BENEFIT ULSTER COUNTY ON MANY LEVELS. WESTCHESTER COUNTY HEALTHCARE CORP, THROUGH ITS WHOLLY OWNED SUBSIDIARY, WMCHEALTH ULSTER, INC. (WMCHEALTH-ULSTER), IS THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE, INC. HEALTHALLIANCE REMAINS AN ACTIVE PARTICIPANT IN THE WMCHEALTH PERFORMING PROVIDER SYSTEM (PPS) WITHIN THE NEW YORK STATE DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP). WMCHEALTH-ULSTER OVERSEES OPERATIONS AT THE HEALTHALLIANCE CAMPUSES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT NEW YORK false false false false false false false false false David Scarpino CEO/Trustee 0 525005 0 0 0 5994 0 26704 0 23597 0 581300 0 0 Eileen King CLINICAL COORDINATOR 237717 0 0 0 792 0 240 0 23978 0 262727 0 0 0 Joseph Marsicovete Chief Operating Officer 0 307472 0 0 0 7779 0 6750 0 8566 0 330567 0 0 Paul Llobet MD TRUSTEE 0 308999 0 0 0 4997 0 6750 0 0 0 320746 0 0 MARK POHAR EXEC DIR/ex-officio trustee 0 207237 0 0 0 19089 0 5316 0 23145 0 254787 0 0 GENE EPSTEIN NURSE PRACTITIONER 204786 0 0 0 792 0 240 0 8842 0 214660 0 0 0 NANETTE TREADWELL PHYSICIAN ASSISTANT 234904 0 0 0 792 0 240 0 18828 0 254764 0 0 0 ROBERT ROSS EXECUTIVE VICE PRESIDENT 0 322361 0 0 0 0 0 50750 0 42712 0 415823 0 0 JANE ULRICH SR. VP OF NURSING 0 184164 0 0 0 8135 0 3434 0 18365 0 214098 0 0 Schedule J, Part I, line 3 The organization's top management official (CEO & Executive Director) received compensation from a related organization. In order to establish compensation payments, the related organization typically completes a compensation study or engages an independent consultant. The results of said study orconsultant's findings are INCORPORATED into a written employment contract. All actions above are approved by the Board of directors/compensation committee prior to finalization. LLOBET MEDICAL 35% OR GREATER THAN OWNERSHIP BY THE trustee of MMH 181569 Physician on Call Payments false FORM 990, PART VI, LINE 6 healthalliance, inc. is the sole corporate member of margaretville memorial hospital. FORM 990, PART VI, LINE 7A HEALTHALLIANCE, INC., THE SOLE CORPORATE MEMBER OF MARGARETVILLE MEMORIAL HOSPITAL, HAS THE POWER TO ELECT ONE OR MORE MEMBERS OF THE LOCAL GOVERNING BODY OF THE HOSPITAL. FORM 990, PART VI, LINE 7B ALL DECISIONS MADE AT THE LOCAL BOARD LEVEL OF MARGARETVILLE MEMORIAL HOSPITAL, OTHER THAN THOSE RELATED TO QUALITY ASSURANCE AND BUILDING AND GROUNDS, ARE SUBJECT TO APPROVAL BY MEMBERS OF HEALTHALLIANCE, INC. BOARD OF TRUSTEES. THESE DECISIONS INCLUDE ELECTION AND REMOVAL OF MEMBERS OF THE LOCAL LEVEL GOVERNING BODY, APPOINTMENT/REMOVAL OF CORPORATE OFFICERS, APPROVAL OF BYLAW AMENDMENTS, REVIEW OF ANNUAL CAPITAL AND OPERATING BUDGETS, REVIEW AND/OR MODIFICATIONS OF ANY CERTIFICATE OF NEED APPLICATIONS, REVIEW INCURRENCE OF DEBT AND DEVELOP AND IMPLEMENT JOINT MEDICAL STAFF APPOINTMENTS. FORM 990, PART VI, LINE 11B THE FORM 990 WAS PREPARED BY THE ORGANIZATIONS TAX ADVISORS WITH ASSISTANCE FROM THE ORGANIZATIONS FINANCE DEPARTMENT AND OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PROVIDED TO THE BOARD OF THE ORGANIZATION FOR APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MEANS OF A SURVEY DEVELOPED AND APPROVED BY THE CHIEF COMPLIANCE OFFICER. THE SURVEY IS SENT TO ALL TRUSTEES, OFFICERS, AND KEY EXECUTIVES FOR COMPLETION. ALL SURVEY RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS IDENTIFIED IN THE RESPONSES ARE DISCUSSED WITH SENIOR MANAGEMENT AND/OR REFERRED TO THE WMCHEALTH CONFLICTS OF INTEREST COMMITTEE FOR DISCUSSION. POTENTIAL ACTIONS TO BE TAKEN IN RESPONSE TO A CONFLICT CAN BE ONE OR MORE OF THE FOLLOWING: 1) DISCLOSURE OF THE CONFLICT, 2) INDIVIDUAL RECUSAL FROM DECISIONS FOR TRANSACTIONS WHERE THAT INDIVIDUAL MAY HAVE A CONFLICT, 3) REQUEST IN WRITING THE INDIVIDUAL ALLEVIATES THE CONFLICT, OR 4) REMOVAL OF THE INDIVIDUAL FROM EMPLOYMENT. FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:1095883 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MANPOWER TOTAL FEES:407919 FORM 990 PART IX LINE 11G DESCRIPTION:BIOMEDICAL SERVICES TOTAL FEES:57204 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:33864 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING & MGT TOTAL FEES:23297 FORM 990 PART IX LINE 11G DESCRIPTION:WASTE DISPOSAL TOTAL FEES:18810 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:293643 WMC HEALTH NETWORK - ROCKLAND INC 100 WOODS ROAD VALHALLA NY 10595 320467873 SUPPORTING NY 501(C)(3) 12A NA false WMC HEALTH NETWORK - ULSTER INC 100 WOODS ROAD VALHALLA NY 10595 320477183 SUPPORTING NY 501(C)(3) 12A WCHCC false WESTCHESTER COUNTY HEALTH CARE CORP 100 WOODS ROAD VALHALLA NY 10595 133964321 HEALTHCARE NY 115 N/A NA false WMC NEW YORK INC 100 WOODS ROAD VALHALLA NY 10595 134107894 FUNDRAISING NY 501(C)(3) 12A WCHCC false NORTH ROAD LHCSA INC 100 WOODS ROAD VALHALLA NY 10595 465293268 HOMECARE SVCS NY 501(C)(3) 10 WCHCC false MID-HUDSON VALLEY EARLY EDUCATION CENTER 100 WOODS ROAD VALHALLA NY 10595 465534882 PRESCHOOL NY 501(C)(3) 7 WCHCC false WESTCHESTER MEDICAL CENTER FOUNDATION 100 WOODS ROAD VALHALLA NY 10595 134095845 FUNDRAISING NY 501(C)(3) 7 WCHCC false HEALTHALLIANCE INC 741 GRANT AVENUE LAKE KATRINE NY 12449 261850453 SUPPORTING NY 501(C)(3) 12A WCHCC false HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS 396 BROADWAY KINGSTON NY 12401 141349558 EXEMPT HOSP NY 501(C)(3) 3 HA INC true HEALTHALLIANCE HOSP MARY'S AVE CAMPUS 105 MARYS AVENUE KINGSTON NY 12401 141338470 EXEMPT HOSP NY 501(C)(3) 3 HA INC true MARGARETVILLE NURSING HOME INC 42158 STATE HIGHWAY 28 MARGARETVILLE NY 12455 223143565 NURSING HOME NY 501(C)(3) 10 MMH true MARGARETVILLE HEALTH FOUNDATION 42084 STATE HIGHWAY 28 MARGARETVILLE NY 12455 261998454 SUPPORT FDN NY 501(C)(3) 12A MMH true FASC FOUNDATION 741 GRANT AVENUE LAKE KATRINE NY 12449 264201295 SUPPORT FDN NY 501(C)(3) 7 HAH BWAY true GOOD SAMARITAN FDN FOR BETTER HEALTH 255 LAFAYETTE AVE SUFFERN NY 10901 133400353 SUPPORT FDN NY 501(C)(3) 7 BSCHSI false BON SECOURS COMMUNITY HOSPITAL FDN 255 LAFAYETTE AVE SUFFERN NY 10901 810667395 SUPPORT FDN NY 501(C)(3) 7 BSCHSI true BON SECOURS WARWICK HEALTH FOUNDATION 255 LAFAYETTE AVE SUFFERN NY 10901 141972807 SUPPORT FDN NY 501(C)(3) 7 BSCHSI true BON SECOURS CHARITY HEALTH SYSTEM INC 255 LAFAYETTE AVE SUFFERN NY 10901 912135195 SUPPORTING NY 501(C)(3) 12C, III-FI WCHCC false HealthAlliance Foundation Inc 741 GRANT AVENUE LAKE KATRINE NY 12449 222511450 FUNDRAISING NY 501(C)(3) 7 HA INC false HUDSON RIVER WEST INSURANCE (BARBADOS) 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB BSCHSI C CORP true KINGSTON INSURANCE (BARBADOS) LIMITED 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB HEALTHALLIANCE C CORP true NORTHEAST PROVIDER SOLUTIONS INC 100 WOODS ROAD VALHALLA NY 10595 133991673 MSO & HEARING NY NA c corp true WMC ADVANCED PHYSICIAN SERVICES PC 19 BRADHURST AVENUE HAWTHORNE NY 10595 264709927 PHYSICIAN OFFices NY NA c corp true WESTCHESTER MEDICAL REGIONAL PHYS SVCS 241 NORTH ROAD POUGHKEEPSIE NY 10532 465522536 PHYSICIAN OFFices NY NA c corp true WCHCC (BERMUDA) LIMITED VICTORIA HALL 11 VICTORIA STREET HAMILTON BD CAP INSURANCE BD NA c corp true KINGSTON REGIONAL HEALTH CARE ENTERPRISE 396 BROADWAY KINGSTON NY 12401 161514994 INVESTMENT NY HAH BWAY c corp true MID HUDSON PHYSICIANS PC 396 BROADWAY KINGSTON NY 12401 203564769 MEDICAL SVCS NY na c corp true bschs medical group pc 10 franklin turnpike mahwah NJ 07430 821632215 physician offices NJ bschs c corp true false false false false false false false false false true true false true false true true false false false MARGARETVILLE NURSING HOME INC o 905117 COST MARGARETVILLE NURSING HOME INC p 262965 COST SCHEDULE R, PART II, Bon Secours Charity Health System, Inc. (BSCHS) Margaretville Memorial Hospital has a brother-sister relationship with BSCHS's six subordinates in a group exemption within BSCHS.