2025-11-13T11:36:37+00:00 2024-12-31 346565596 ERNST & YOUNG US LLP ONE MANHATTAN WEST NEW YORK NY 100018604 990 2024-01-01 150552726 Margaretville Memorial Hospital MARG 8459436084 42084 STATE ROUTE 28 MARGARETVILLE NY 12445 Elissa Waliszewski Chessari COO NORTHERN REGION 2025-11-13 true Yucen Zhong P01593150 2127733000 2025-11-13 2024 2025-03-06 01:10:19Z Elissa Waliszewski (Chessari) 105 Marys Avenue KINGSTON NY 12401 16401408 false X HTTPS://WWW.MARGARETVILLEHOSP.ORG/ X 1930 NY TO OPERATE A CRITICAL ACCESS HOSPITAL FOR QUALITY MEDICAL CARE AND DIAGNOSTIC SERVICES TO MEDICALLY UNDERSERVED COMMUNITIES IN THE AREA. 14 12 122 2 0 1431340 1461530 13581296 13444780 3397 2042 1528728 1486299 16544761 16394651 0 0 0 0 9875522 10629289 0 0 0 8653734 9463494 18529256 20092783 -1984495 -3698132 6610821 5998150 9722765 15343571 -3111944 -9345421 TO OPERATE A CRITICAL ACCESS HOSPITAL FOR QUALITY MEDICAL CARE AND DIAGNOSTIC SERVICES TO MEDICALLY UNDERSERVED COMMUNITIES IN THE AREA. false false 14982377 0 14736876 MARGARETVILLE MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE HEALTH CARE SERVICES TO RESIDENTS AND VISITORS TO THE COMMUNITIES SERVICED. MARGARETVILLE MEMORIAL HOSPITAL RECORDED 1,756 PATIENT DAYS, 3,616 EMERGENCY ROOM VISITS, 113 OUTPATIENT SURGERIES, 228 DISCHARGES AND 218 INFUSION THERAPIES IN 2024. 14982377 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false true true true false false true 16 0 true 122 true false false false false false false false false false false false false X 14 12 false false false false true true true true true false false false true true true true true true false false false false NY X ERIN NAGY 8459436084 105 MARYS AVENUE KINGSTON NY 12401 DAVE RAMA Vice Chair 1.0 1.0 X X 0 0 0 EMILY ADAMS CHAIR 1.0 2.0 X X 0 0 0 JOHN RIEDL SECRETARY 1.0 1.0 X X 0 0 0 JOSHUA RATNER CEO (THRU 11/2024) / TRUSTEE (EFF. 11/2024) 1.0 39.0 X X 0 1214669 86847 Arnold Schwartz Trustee 1.0 1.0 X 0 0 0 CATHERINE ALLEN MD TRUSTEE 1.0 39.0 X 0 439465 67307 COLLEEN MCDANIEL TRUSTEE 1.0 1.0 X 0 0 0 CONNIE JEFFERS TRUSTEE (resigned 5/2024) 1.0 1.0 X 0 0 0 CRAIG SICKLER TRUSTEE Ex Officio 1.0 4.0 X 0 0 0 DIANA MASON TRUSTEE 1.0 1.0 X 0 0 0 DIANE MUNRO TRUSTEE 1.0 1.0 X 0 0 0 FRED MARGUILES TRUSTEE 1.0 1.0 X 0 0 0 JAMES HOWIE TRUSTEE (resigned 12/31/24) 1.0 1.0 X 0 0 0 MICHAEL CIOFFI TRUSTEE 1.0 1.0 X 0 0 0 Richard Siegel Trustee (AS OF 1/2024) 1.0 1.0 X 0 0 0 STEVE FINCH TRUSTEE 1.0 1.0 X 0 0 0 JOHN EDWARDS FACILITY ADMINISTRATOR (RESIGNED 1/2024) 10.3 29.7 X 0 27649 3799 MICHAEL DOYLE MD CMO 2.0 38.0 X 0 590841 9189 Michael Hochman Executive Director (AS OF 7/2024) 19.5 20.5 X 0 174290 47231 ELISSA WALISZEWSKI CHESSARI Chief Operating Officer Northern Region 2.0 38.0 X 0 534090 31148 FRANCES DAVIS REGIONAL VICE PRESIDENT, NURSE EXECUTIVE 10.0 30.0 X 0 400996 69062 MEGHAN WEYGANT Vice President, Operations (resigned 11/16/24) 5.0 35.0 X 0 317190 33661 ALETA HUNTER DIRECTOR AMBULATORY SURGERY 40.0 0.0 X 129801 0 14425 AMY SMITH EDUCATION COORDINATOR 40.0 0.0 X 155474 0 34050 KIMBERLY COPPAGE DEPARTMENT HEAD 40.0 0.0 X 142706 0 29431 SUSAN SKOVSENDE LABORATORY TECHNOLOGIST 40.0 0.0 X 141078 0 12690 YELENA ZABIRKO PHARMACY SUPERVISOR 40.0 0.0 X 174340 0 17151 743399 3699190 455991 15 false true false CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 303844674 MANPOWER 1438224 NY MEDICAL PHYSICIANS ASSOCIATES 2100 POWELL STREET SUITE 400 EMERYVILLE CA 94608 PHYSICIANS 293295 SECO PHYSICAL & OCCUP THERAPY PC 26 CONKEY AVE SUITE 136 NORWICH CT 13815 CONTRACT LABOR 276247 RTG MEDICAL 22ND STREET FREEMONT NE 60825 CONTRACTED SERVICES 171238 CROTHALL HEALTHCARE INC 3028 COLLECTION CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING 168934 6 1461530 1461530 NET PATIENT SERVICE REVENUE 621300 13444780 13444780 0 0 0 0 13444780 2042 2042 97275 6757 90518 0 90518 90518 0 0 0 PHARMACY REVENUE 446110 1147706 1147706 0 0 AMBULANCE REVENUE 621300 85675 85675 0 0 AUXILIARY REVENUE 900099 58715 58715 0 0 103685 0 0 103685 1395781 16394651 14736876 0 196245 X 0 0 8331023 7238015 1093008 108255 81191 27064 1732352 1295986 436366 457659 343244 114415 106424 0 106424 3039 0 3039 2856261 2304012 552249 0 287064 109413 177651 259418 11153 248265 37867 0 37867 63810 0 63810 6379 0 6379 259699 259699 0 391551 0 391551 CONTRACTED SERVICES 1868648 325889 1542759 MEDICAL SUPPLIES 1825933 1822863 3070 PHYSICIAN AGREEMENTS 709107 686707 22400 EQUIPMENT SVC CONTRACTS 449780 380442 69338 338514 123763 214751 0 20092783 14982377 5110406 0 1544924 607616 496440 590879 1318566 1432366 0 0 0 0 651550 743387 369584 41520 24246754 22582610 1352940 1664144 0 0 876817 918238 6610821 5998150 4889161 4246519 128590 140142 0 0 0 25502 4705014 10931408 9722765 15343571 X -3111944 -9345421 -3111944 -9345421 6610821 5998150 X -3698132 -2535345 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3039 3039 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY MARAGARETVILLE HOSPITAL PAYS DUES TO IROQUOIS HEALTHCARE ALLIANCE AND HEALTHCARE ASSOCIATION OF NEW YORK STATE. IN ACCORDANCE WITH CODE SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY IROQUOIS HEALTHCARE ALLIANCE AND HEALTHCARE ASSOCIATION OF NEW YORK STATE, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE AMOUNT ATTRIBUTABLE TO LOBBYING ACTIVITIES APPLICABLE TO 2024 IROQUOIS HEALTHCARE ALLIANCE AND HEALTHCARE ASSOCIATION OF NEW YORK STATE WAS $3,039. 23127 23127 5123405 4484947 638458 0 0 0 18478500 17541962 936538 621722 555701 66021 1664144 OTHER RECEIVABLE 913880 ASSETS LIMITED AS TO USE 4358 918238 Federal Income Taxes OTHER NON-CURRENT LIABILITIES 269066 DUE TO RELATED PARTIES 10662342 10931408 0 0 0 0 0 0 0 0 0 0 0 0 true true X true X 400 true X 254674 254674 0.01267 4246124 1335113 2911011 0.14488 0 0.0 0 0 4500798 1335113 3165685 0.15755 34603 34603 0.00172 0 0.0 8913412 4671810 4241602 0.21110 0 0.0 0 0.0 0 0 8948015 4671810 4276205 0.21282 0 0 13448813 6006923 7441890 0.37038 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 571224 3618316 2243339 1374977 X true true 1 1 MARGARETVILLE MEMORIAL HOSPITAL 42084 STATE ROUTE 28 MARGARETVILLE NY 12455 WWW.HAHV.ORG 1226701C X X X X MARGARETVILLE MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 22 true true true true X The CHNA has been widely available to the public through the website at HTTPS://WWW.HAHV.ORG/COMMUNI X true 22 true Margaretville Hospital has adopted an implementation strategy that will address the significant comm false true X 400.0 400.0 X X X true true X X X true X https://www.hahv.org/financial-assistance X https://www.hahv.org/financial-assistance X https://www.hahv.org/financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THROUGH THE COLLABORATION AND PARTNERSHIP WITH DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT, MARGARETVILLE HOSPITAL, IN ACCORDANCE WITH NEW YORK STATE PREVENTION AGENDA MANDATE, HAS CHOSEN TO ALIGN WITH OUR COMMUNITY PARTNERS IN FOCUSING ON TWO PRIORITY AREAS: A. PREVENT CHRONIC DISEASES B. PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN MARGARETVILLE HOSPITAL INVOLVED KEY MEMBERS OF THE HOSPITAL TEAM IN THE ASSESSMENT AND SELECTION OF ITS HEALTH PRIORITIES. AFTER IDENTIFICATION OF THE CRITERIA FOR PRIORITY SELECTION, A WORK GROUP WAS CONVENED BY THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT WHICH INCLUDED MARGARETVILLE HOSPITAL AFFILIATED WITH HEALTH ALLIANCE OF THE HUDSON VALLEY AND WESTCHESTER MEDICAL CENTER HEALTH, DELAWARE VALLEY HOSPITAL AFFILIATED WITH UNITED HEALTH SERVICES, BASSETT HEALTHCARE NETWORK O'CONNOR HOSPITAL, AS WELL AS THE SOUTHERN TIER POPULATION HEALTH IMPROVEMENT PROGRAM ("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 2019-2024 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. THROUGH THE COLLABORATION DESCRIBED ABOVE WITH COUNTY PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS, MARGARETVILLE HOSPITAL ALIGNED TOGETHER TO SELECT TWO PREVENTION AGENDA PRIORITIES: A. PREVENT CHRONIC DISEASES B. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS BOTH OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) 2019 PRIORITIES ARE FROM THE NYS PREVENTION AGENDA 2019-2024. MARGARETVILLE HOSPITAL PARTICIPATED IN A WORKGROUP CONSISTING OF THE THREE LOCAL HEALTH SYSTEMS AND THE COUNTY PUBLIC HEALTH DEPARTMENT TO IDENTIFY FOCUS AREAS, AND OBJECTIVES FOR EACH OF THE AGENDA PRIORITIES JOINTLY IDENTIFIED BY THE HOSPITAL AND COLLABORATORS: THE NEW YORK STATE PREVENTION AGENDA OUTLINES THREE OTHER PRIORITY AREAS THAT WERE NOT SELECTED AS PRIORITIES FOR THE MARGARETVILLE HOSPITAL 2022-2024 COMMUNITY SERVICE PLAN: PROMOTE A HEALTHY AND SAFE ENVIRONMENT, PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN, AND PREVENT COMMUNICABLE DISEASES. ALTHOUGH ALL OF THESE MERIT FOCUS FOR IMPROVING POPULATION HEALTH, THEY WERE NOT SELECTED DUE TO THE LIMITED AMOUNT OF RESOURCES AVAILABLE TO ADDRESS THESE ISSUES AND THE RELATIVE SEVERITY OF NEED DEMONSTRATED FOR THE PRIORITY AREAS THAT WERE CHOSEN. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MARGARETVILLE MEMORIAL HOSPITAL. Margaretville Memorial Hospital (Margaretville Hospital), an affiliate of HealthAlliance of the Hudson Valley, a member of the Westchester Medical Center Health Network (WMCHealth) was an active member of a comprehensive Delaware County Community Health Assessment which includes 3 hospitals and the Delaware County Public Health Department. Primary data were collected and analyzed via two surveys, the Stakeholder and the Community Engagement surveys. Both surveys were electronically disseminated with the former sent to the county's health and human services providers to gain their perspectives on the NYS Prevention Agenda priorities and the related focus areas most in need of improvement. The latter was disseminated to community members to identify primary strengths and weaknesses of service provision, social determinants of health in need of addressing, and general quality of health and life in the county. Margaretville Hospital (MH), along with other hospitals' representatives, further facilitated survey distribution efforts to ensure all segments of the county's population were provided a chance to voice their health needs and concerns, especially those underserved and underrepresented. The hospital posted the Community Engagement survey link on its public facing webpage and publicized the survey opportunity through its social media platforms, including Instagram and Twitter. MH also disseminated the survey to all employees for their participation and input, conducted community outreach at community events, and promoted the survey link via a QR code for ease of participation. Through collaborative efforts, the survey was announced across Delaware County in late spring of 2022, from May 17 - June 23, receiving 442 responses. For the Stakeholder survey, MH shared the survey link via email to encourage participation among its provider partners. The data collection phase for the Stakeholder survey was completed in September, 2022 and yielded 16 responses, representing the education sector, emergency service providers, health care providers, law enforcement, social services, senior/elderly service providers, mental health providers, and substance use, prevention, treatment, and recovery service providers. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - MARGARETVILLE MEMORIAL HOSPITAL. The CHNA was conducted with Delaware Valley Hospital (DVH), an affiliate of United Health Services (UHS) system; Margaretville Hospital (MH), which is a part of the Health Alliance of the Hudson Valley and a member of the Westchester Medical Center Health Network; and O'Connor Hospital (OCH), of the Bassett Healthcare Network. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - MARGARETVILLE MEMORIAL HOSPITAL. MARGARETVILLE HOSPITAL WORKED VERY CLOSELY WITH DELAWARE COUNTY PUBLIC HEALTH. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MARGARETVILLE MEMORIAL HOSPITAL. Through the collaboration and partnership with Delaware County Public Health Department, Margaretville Hospital, in accordance with New York State Prevention Agenda mandate, has chosen to align with our community partners in focusing on two priority areas: I. Prevent Chronic Diseases Focus Area 4: Chronic Disease Preventive Care and Management II. Promote Well-Being and Prevent Mental and Substance Use Disorders Focus Area 2: Mental and Substance Use Disorders Prevention For Priority I, MH has planned to 1) promote evidence-based care to prevent and manage chronic lower respiratory diseases (CLRD), including asthma and chronic obstructive pulmonary disease (COPD) and 2) improve self-management skills for individuals with CLRD in the community setting. To achieve these goals by December 2024, MH will identify, track, and provide pulmonary screening and care coordination to 100 new CLRD patients, provide education and training to four cohorts of CLRD patients, and host community workshops and health fairs to increase the public knowledge in the prevention and self-management of CLRD conditions. As of July 2, 2024, Margaretville Hospital has registered 88 new CLRD patients. MH will also provide training to a minimum of 80% of all nursing and provider staff members to generate a well-informed workforce in the recognition and referral process for patients to be screened for CLRD at MH. For Priority II, by December 2024, MH's goals are to 1) prevent opioid overdose deaths by reducing overdose deaths by 7% and 2) reducing all emergency department visits for opioid overdose by 5%. MH will achieve these goals by increasing the availability of/access to overdose reversal (naloxone) trainings to prescribers, pharmacists and consumers, promoting and encouraging prescriber education and familiarity with opioid prescribing guidelines, establishing additional permanent safe disposal sites for prescription drugs and organizing take-back days, and integrating trauma-informed approaches in training staff. Margaretville Hospital directs the Catskills Rural Communities Opioid Response program (RCORP) Consortium, which features pre-pregnancy education, peer counseling, medication-assisted addictions treatment and other services. Since September 2021, the Catskills RCORP Consortium has trained nearly 10,000 people across three counties while also disseminating fentanyl testing devices. The NYS Prevention Agenda outlines three other priority areas that were not selected as priorities for the Margaretville hospital 2022-2024 CSP: Promote a Healthy and Safe Environment, Promote Healthy Women, Infants and Children, and Prevent Communicable Diseases, as a result of the public input and ranking system process. Within the selected priorities, Margaretville Hospital acknowledges the wide range of significant health needs that were identified but cannot be addressed by the hospital's focus areas due to the lack of resources, expertise, or level of priority. Presently there are various institutions, organizations, and programs in Delaware County that are actively working to advance the prevention of chronic diseases, such as cardiovascular disease and stroke. Two foundations in the area, the A. Lindsay and Olive B. O'Connor Foundation and the Robinson Broadhurst Foundation, focus on providing funding for quality-of-life programs which support obesity and chronic disease prevention efforts. AREAS OF FOCUS: Margaretville decided to address the county's health needs through the following implementation plan in guidance of NYS Prevention Agenda. NYS prevention agenda priority area: Prevent Chronic Diseases Focus Area 4: Chronic Disease Preventive Care and Management Prevention agenda goal 4.3: Promote evidence-based care to prevent and manage chronic diseases including asthma, arthritis, cardiovascular disease, diabetes and prediabetes and obesity Objective 4.3.1: Increase early detection of chronic lower respiratory disease (CLRD), which includes asthma and COPD (chronic obstructive pulmonary disease) by 100 new patients, based on 2022 baseline Evidence based intervention: Identify, track, and provide pulmonary screening and care coordination to CLRD patients Disparities Addressed: Low-income, racial/ethnic minorities, seniors and disadvantaged urban and rural communities NYS prevention agenda priority area: Prevent Chronic Diseases Focus Area 4: Chronic Disease Preventive Care and Management Prevention agenda goal 4.4: In the community setting, improve self-management skills for individuals with chronic diseases, including asthma, arthritis, cardiovascular disease, diabetes and prediabetes and obesity Objective 4.4.1: Increase the percentage of adults with chronic conditions (arthritis, asthma, CVD, diabetes, CKD, cancer) who have taken a course or class to learn how to manage their condition (70% of those diagnosed/screened positive for CLRD, starting in 2023) Evidence based intervention: * Provide education and training to CLRD patients to increase their knowledge in self-managing CLRD conditions * Provide training to nursing and provider staff members, including future staff, to generate a well-informed and confident provider workforce Disparities Addressed: Low-income, racial/ethnic minorities, seniors and disadvantaged urban and rural communities NYS prevention agenda priority area: Promote Well-Being and Prevent Mental and Substance Use Disorders Focus Area 2: Prevent Mental and Substance User Disorders Prevention agenda goal 2.2: Prevent opioid overdose deaths Objective 2.2.1: Reduce the age-adjusted overdose deaths involving any opioid by 7% using 2022 baseline Evidence based intervention: * Increase availability of/access to overdose reversal (Naloxone) trainings to prescribers, pharmacists and consumers * Disparities Addressed: Low-income, racial/ethnic minorities, and disadvantaged urban and rural communities NYS prevention agenda priority area: Promote Well-Being and Prevent Mental and Substance Use Disorders Focus Area 2: Prevent Mental and Substance User Disorders Prevention agenda goal 2.2: Prevent opioid overdose deaths Objective 2.2.4: Reduce all emergency department visits (including outpatients and admitted patients) involving any opioid overdose by 5%, using 2022 baseline Evidence based intervention: * Promote and encourage prescriber education and familiarity with opioid prescribing guidelines and limits as imposed by NYS statutes and regulations * Establish additional permanent safe disposal sites for prescription drugs and organized take-back days * Integrate trauma informed approached in training staff and implementing program and policy * Disparities Addressed: Low-income, racial/ethnic minorities, and disadvantaged urban and rural communities 0 Schedule H, Part I, Line 7 EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE Margaretville Memorial Hospital's costing methodology was based upon worksheet S-10 of the Medicare cost report. The cost-to-charge ratio was used for the various sub-line items of line # 7. Schedule H, Part I, Line 7 DESCRIBE SUBSIDIZED HEALTH SERVICE COSTS FROM PHYSICIAN CLINIC ON LINE 7G The costs on line 7G do not include any costs attributable to physician clinics. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount The amount reported on line 2 is equal to the provision for bad debt expense per the Audited Financial Statements. The explanation of the methodology used to estimate this amount can be found in footnote #2 on pages 19-20 of the attached Audited Financial Statements. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote that describes bad debt expense can be found on pages 19-20 of the attached Audited Financial Statements. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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 2024, Margaretville Memorial Hospital does not have a loss from Medicare therefore it is not considered a community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance 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 guarantor's gross monthly income. Schedule H, Part V, Section B, Line 16a FAP website - MARGARETVILLE MEMORIAL HOSPITAL: Line 16a URL: https://www.hahv.org/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - MARGARETVILLE MEMORIAL HOSPITAL: Line 16b URL: https://www.hahv.org/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MARGARETVILLE MEMORIAL HOSPITAL: Line 16c URL: https://www.hahv.org/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Process to maintain engagement, track progress, and make mid-course corrections For the community-based strategies, Margaretville hospital actively participates in a work group consisting of the public health department and three other local hospitals for the purposes of maintaining engagement with local partners throughout the 2022-2024 CHNA implementation period. Initially, meetings will be held quarterly; however, frequency will be revisited throughout the timeframe to ensure that the sessions suit all partners' needs. Progress will be tracked by the work group Margaretville Hospital is part of. Annually hospital leadership presents an update to the hospital's board of trustees noting specific achievements and barriers to implementation. Anecdotal feedback will be in work group meetings, meetings involving health and wellness groups such as the Suicide Prevention Network of Delaware County, and from patients and individuals participating in interventions, allowing continual review of the Community Service Plan tasks and mid-course corrections when required. Periodic public notices will be posted on the hospital website. Finally, as available, local, state and national health status indicators will be reviewed. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The hospital informs the patient of the availability of charity care several ways: 1. notice is on every patient bill with an application on the back of the bill 2. on the hospital website 3. all members of the patient accounting department are trained to screen patients for charity care when discussing bills and concerns regarding inability to pay 4. fliers are posted in registration areas of the hospital 5. registration clerks will identify patients without a pay source and refer the patient to a financial counselor and hand the patient a financial assistance form 6. financial counselors assist patients in securing Medicaid and screen for charity care 7. the collection agencies that HAHV engages with are aware of the charity care policy and assist patients in applying up to 180 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 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. Financial counselors and county Medicaid workers also provide guidance regarding the financial assistance program when necessary. Financial assistance is available on the back of every hospital bill as well as the hospital website at www.hahv.org. Financial counselors make affirmative efforts to help patients apply for public and private programs for which they may qualify and that may help them obtain and pay for healthcare services. The patient does not need to have an account with the hospital; they just have to be in a situation where they are in need of insurance coverage. Every effort is made to determine a patient's eligibility prior to or at the time of admission or service. However, determination for financial support can be made during any stage of the patient's 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 http://www.hahv.org/hahv/financial-assistance.aspx 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 receive in-service training regarding the financial assistance program. Patient accounting also receives information about the program and how to handle patients seeking financial assistance. Financial counselors receive in depth training to handle financial assistance requests, process applications, and manage outcomes. HealthAlliance provides several options for patients who either do not have insurance coverage or who have inadequate insurance coverage. Our many programs have been very successful and many have taken advantage of our offerings. Financial counseling offers a patient the opportunity to speak to a financial counselor to determine what assistance can be accessible based on family income. Patients often shop around for the most economical healthcare and we offer price quotes. This allows the patient to know their financial obligation up front and understand the competitive pricing being offered. Despite millions of dollars of charity care distributed to needy patients every year, a consistent challenge is patients not utilizing the programs we offer. Often, they don't want to provide the necessary financial information to initiate the financial aid process. Continual outreach and education is ongoing to minimize confusion and improve utilization. HealthAlliance is committed to providing the best possible healthcare and is very sensitive to low income patients' ability to pay. The call center offers the convenience of calling one telephone number for all billing inquiries regardless of which hospital the patient is calling about. Schedule H, Part VI, Line 4 Community information 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 Hospital's Mary's Avenue 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. Other community health services and resources available in Delaware County include 23 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 O'Connor Hospital affiliated with the Bassett Healthcare Network. Additionally, there are three 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 multiple locations within the county. Delaware County covers 1,442 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 31 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 county's land area and 11 of its 19 townships. Approximately 55% of Delaware County's population lies within the Watershed. Based on the 2020 Census, the population of Delaware County is 44,676, and is split evenly at 50% male and 50% female. This represents a 6.6% decrease in population from the 2010 census which had the population at 47,840. At the time of the 2020 Census the population age was comprised as follows: 20% of the people were less than 18, 80% were 18 and over and 41% were 65 and over, with a median average age of 48.3. Schedule H, 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 organization's hospital facilities work to further its exempt purposes by promoting the health of the community. In addition, the COVID-19 pandemic created a greater need and focus on community health care. Margaretville Hospital, HealthAlliance of the Hudson Valley, and the WMCHealth Network took a leading role in the Hudson Valley on the dissemination of information surrounding COVID-19, educating the community, providing community testing, and vaccination. In all of our efforts we focused on the hardest to reach individuals and communities. We coordinated closely on all of our COVID-19 messaging, outreach, and direct care with New York State Department of Health, Delaware County Department of Health, and Ulster County Department of Health. We provided detailed and ongoing information and messaging for community organizations, employers, and municipal governments. We participated at all levels of governments and with numerous community organizations on COVID-19 planning, preparedness, and response efforts. Additionally, Margaretville Hospital's clinical and community relations teams provide ongoing outreach, education and programming services to the communities it serves. MH participated in 64 community events in 2024 which included such things as: events promoting healthy/physical activity, pulmonary screenings, senior quality improvement programs, a food donation initiative, lending expertise to community meetings and roundtables on health care issues (i.e. substance abuse behavioral health care). Schedule H, Part VI, Line 6 Affiliated health care system Health Alliance is the parent company to affiliate members HA Mary's Avenue campus, Broadway campus, Margaretville Memorial Hospital, a rural critical access hospital; 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 its two Kingston hospitals in 2022, HAHV also committed to streamlining operations and improving care at the other affiliate locations. Schedule H, Part VI, Line 7 State filing of community benefit report NY false false false false false false false false false JOSHUA RATNER CEO (THRU 11/2024) / TRUSTEE (EFF. 11/2024) 0 1102541 0 89128 0 23000 0 48300 0 38547 0 1301516 0 0 CATHERINE ALLEN MD TRUSTEE 0 439465 0 0 0 0 0 36800 0 30507 0 506772 0 0 MICHAEL DOYLE MD CMO 0 535917 0 54388 0 536 0 8625 0 564 0 600030 0 0 Michael Hochman Executive Director (AS OF 7/2024) 0 174290 0 0 0 0 0 18170 0 29061 0 221521 0 0 MEGHAN WEYGANT Vice President, Operations (resigned 11/16/24) 0 306212 0 10862 0 116 0 4564 0 29097 0 350851 0 0 ELISSA WALISZEWSKI CHESSARI Chief Operating Officer Northern Region 0 481690 0 29400 0 23000 0 0 0 31148 0 565238 0 0 FRANCES DAVIS REGIONAL VICE PRESIDENT, NURSE EXECUTIVE 0 371685 0 29311 0 0 0 38000 0 31062 0 470058 0 0 AMY SMITH EDUCATION COORDINATOR 153787 0 1500 0 187 0 791 0 33259 0 189524 0 0 0 KIMBERLY COPPAGE DEPARTMENT HEAD 142190 0 0 0 516 0 3601 0 25830 0 172137 0 0 0 SUSAN SKOVSENDE LABORATORY TECHNOLOGIST 139495 0 0 0 1583 0 0 0 12690 0 153768 0 0 0 YELENA ZABIRKO PHARMACY SUPERVISOR 174160 0 0 0 180 0 4461 0 12690 0 191491 0 0 0 Schedule J, Part I, Line 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION The organization is subject to the compensation policies and process established by its sole member with respect to the system of related entities under its direction. Pursuant to that process, the Personnel and Compensation Committee of the sole member's Board of Directors sets the level of total compensation (base salary and incentive compensation) and benefits provided to senior executives. To set total compensation levels, the Committee works with a national independent compensation consulting firm to ensure that executive compensation levels are reasonable and appropriate relative to similar positions in comparable organizations, based on objective survey data. Executives' total compensation opportunities include incentive compensation arrangements based on each executive's achievement of specific performance goals set forth at the start of each calendar year, the achievement of which is measured at the end of each calendar year by the CEO or the Board of Directors (depending on the role). Leaders in roles below the senior executive tier are not subject to this Board process, but are subject to compensation and benefit arrangements under the established policies and programs of the sole member. Under those policies and programs, all compensation arrangements are administered in a manner intended to ensure competitive positioning and to permit effective recruitment and retention, while not exceeding reasonable, fair market levels. Form 990, Part VI, Line 6 Classes of members or stockholders HEALTHALLIANCE, INC. IS THE SOLE CORPORATE MEMBER OF MARGARETVILLE MEMORIAL HOSPITAL. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body 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 Decisions requiring approval by members or stockholders 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 Review of form 990 by governing body THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX ADVISORS WITH ASSISTANCE FROM THE ORGANIZATION'S FINANCE DEPARTMENT AND OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT AND THEN WAS PRESENTED TO THE FINANCE COMMITTEE OF THE SOLE MEMBER'S BOARD OF DIRECTORS FOR REVIEW AND APPROVAL FOR FILING; THE FINANCE COMMITTEE REPORTS OUT TO THE SOLE MEMBER'S FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy THE SOLE MEMBER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MEANS OF A SURVEY DEVELOPED AND APPROVED BY THE CHIEF COMPLIANCE OFFICER OF THE SOLE MEMBER. 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) FURTHER 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 4) REMOVAL OF THE INDIVIDUAL FROM THEIR POSITION Form 990, Part VI, Line 19 Required documents available to the public GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS - Total Revenue: 103685, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 103685; Form 990, Part IX, Line 11g Other Fees CONTRACTED SERVICES - Total Expense: 1348930, Program Service Expense: 1088515, Management and General Expenses: 260415, Fundraising Expenses: ; OTHER MANPOWER - Total Expense: 1485248, Program Service Expense: 1198935, Management and General Expenses: 286313, Fundraising Expenses: ; COLLECTION FEES - Total Expense: 22083, Program Service Expense: 16562, Management and General Expenses: 5521, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER TO HEALTHALLIANCE INC - -3027491; TRANSFER TO HA MARYS AVE CAMPUS - -2432832; TRANSFER TO MOUNTAINSIDE RCC - -3818831; TRANSFER FROM HEALTHALLIANCE INC - 884257; TRANSFER FROM HA MARYS AVE CAMPUS - 5612713; TRANSFER FROM MOUNTAINSIDE RCC - 246839; Total - -2535345; WMC HEALTH NETWORK - ROCKLAND INC 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 320467873 SUPPORTING NY 501(c)(3) Type I NA false WMC HEALTH NETWORK - ULSTER INC 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 320477183 SUPPORTING NY 501(c)(3) Type I WCHCC false WESTCHESTER COUNTY HEALTH CARE CORP 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 133964321 HEALTHCARE NY NA false WMC NEW YORK INC 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 134107894 FUNDRAISING NY 501(c)(3) Type I WCHCC false NORTH ROAD LHCSA INC 100 WOODS RD TAYLOR PAVILION M222 VALHALLA NY 10595 465293268 HOMECARE SVCS NY 501(c)(3) 10 WCHCC false MID-HUDSON VALLEY EARLY EDUCATION CENTER 100 WOODS RD TAYLOR PAVILION M222 VALHALLA NY 10595 465534882 PRESCHOOL NY 501(c)(3) 7 WCHCC false WESTCHESTER MEDICAL CENTER FOUNDATION 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 134095845 FUNDRAISING NY 501(c)(3) 7 WCHCC false HEALTHALLIANCE INC 105 MARYS AVENUE KINGSTON NY 12401 261850453 SUPPORTING NY 501(c)(3) Type I WCHCC false HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS 396 BROADWAY KINGSTON NY 12401 141349558 EXEMPT HOSP NY 501(c)(3) 3 HA INC false HEALTHALLIANCE HOSPITAL 105 MARYS AVENUE KINGSTON NY 12401 141338470 EXEMPT HOSP NY 501(c)(3) 3 HA INC false MARGARETVILLE HEALTH FOUNDATION 42084 STATE ROUTE 28 MARGARETVILLE NY 12455 261998454 SUPPORTING FDN NY 501(c)(3) Type I MMH true MARGARETVILLE NURSING HOME INC 42158 STATE HIGHWAY 28 MARGARETVILLE NY 12455 223143565 NURSING HOME NY 501(c)(3) 10 MMH 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 false BON SECOURS WARWICK HEALTH FOUNDATION 255 LAFAYETTE AVE SUFFERN NY 10901 141972807 SUPPORT FDN NY 501(c)(3) 7 BSCHSI false BON SECOURS CHARITY HEALTH SYSTEM INC 255 LAFAYETTE AVE SUFFERN NY 10901 912135195 SUPPORTING NY 501(c)(3) Type III-FI WMC Health Network-Rockland Inc false HEALTHALLIANCE FOUNDATION INC 105 MARYS AVENUE KINGSTON NY 12401 222511450 FUNDRAISING NY 501(c)(3) 7 HA INC false WMC ADVANCED PHYSICIAN SERVICES PC 100 WOODS RD TAYLOR PAVILION M222 VALHALLA NY 10595 264709927 HEALTHCARE NY 501(c)(3) 10 WCHCC false HUDSON RIVER WEST INSURANCE LIMITED 23 LIME TREE BAY AVE PO BOX 1051 GRAND CAYMAN CJ CAP INSURANCE CJ BSCHSI C Corporation false HUDSON RIVER NORTH INSURANCE LIMITED 23 LIME TREE BAY AVE PO BOX 1051 GRAND CAYMAN CJ CAP INSURANCE CJ HA INC C Corporation false NORTHEAST PROVIDER SOLUTIONS INC 100 WOODS RD TAYLOR PAVILLION M222 VALHALLA NY 10595 133991673 MSO & HEARING NY NA C Corporation false WCHCC (BERMUDA) LIMITED VICTORIA HALL 11 VICTORIA STREET HAMILTON BD CAP INSURANCE BD NA C Corporation false KINGSTON REGIONAL HEALTH CARE ENTERPRISE 105 Marys Avenue KINGSTON NY 12401 161514994 INVESTMENT NY HAH BWAY C Corporation false MID HUDSON PHYSICIANS PC 105 Marys Avenue KINGSTON NY 12401 203564769 MEDICAL SVCS NY NA C Corporation false BSCHS MEDICAL GROUP PC 10 FRANKLIN TURNPIKE MAHWAH NJ 07430 821632215 PHYSICIAN OFF NJ BSCHSI C Corporation false false false false false false false false false false true true false true false true false false true true 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.