2014-11-14T07:57:15-06:00 2013-12-31 990 2013-01-01 111631788 JAMAICA HOSPITAL MEDICAL CENTER JAMA 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 MOUNIR DOSS EXECUTIVE VP & CFO 7182066291 2014-11-13 1 P00851654 2122970400 2013 2015-11-30 17:44:51Z MOUNIR DOSS 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 542957085 0 X WWW.JAMAICAHOSPITAL.ORG X 1934 NY THE JAMAICA HOSPITAL IS AN ACUTE CARE FACILITY SERVING THE PUBLIC. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT REDUCED RATES. 11 9 3621 417 -655129 -655379 12603119 11826718 425850944 435046773 2609724 53721236 30872936 27786055 471936723 528380782 0 0 0 0 274562600 284408119 0 0 0 175022734 185104866 449585334 469512985 22351389 58867797 277691635 262173470 339549714 240574490 -61858079 21598980 X THE JAMAICA HOSPITAL IS AN ACUTE CARE FACILITY SERVING THE PUBLIC. ITS SERVICES INCLUDE ACUTE, MEDICAL REHABILITATION, TRAUMA BRAIN INJURY, AND PSYCHIATRIC CARE. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT DISCOUNTED AMOUNTS LESS THAN ESTABLISHED RATES. 0 0 436465842 462776292 JAMAICA HOSPITAL IS A 452-BEDS INCLUDING BASSINETS, FULLY ACCREDITED COMMUNITY TEACHING HOSPITAL WITH A LARGE NETWORK OF COMMUNITY-BASED AMBULATORY CARE CENTERS. JHMC OFFERS A FULL ARRAY OF ACUTE INPATIENT REHABILITATION AND MENTAL HEALTH SERVICES, THE LARGEST VOLUNTARY HOSPITAL AMBULANCE FLEET SERVING THE CITY'S 911 SYSTEM AND A LEVEL 1 TRAUMA CENTER. 436465842 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 843 5 1 3621 1 0 0 0 0 0 1 1 0 0 0 0 X 11 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MOUNIR DOSS 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 X ANTHONY DIMARIA MD SECRETARY 1.00 42.00 X X 0 228897 24890 ANTONIETTA MORISCO MD TRUSTEE 1.00 2.00 X 0 0 0 ARCHIE SPIGNER ASSISTANT SECRETARY 1.00 2.00 X X 0 0 0 DOUGLAS W SINGER TRUSTEE 1.00 2.00 X 0 0 0 GEOFFREY DOUGHLIN MD THIRD VICE PRESIDENT 40.00 2.00 X X 399018 0 26751 GERALDINE M CHAPEY PHD TRUSTEE 1.00 2.00 X 0 0 0 HON TIMOTHY J DUFFICY TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH FERRARA ASSISTANT TREASURER 1.00 2.00 X X 0 0 0 JOSEPH LIANA TRUSTEE 1.00 2.00 X 0 0 0 NEIL FOSTER PHILLIPS CHAIRMAN 1.00 3.00 X X 0 0 0 ROBERT W KOOP SECOND VICE CHAIRMAN/TREAS 1.00 3.00 X X 0 0 0 BRUCE FLANZ PRESIDENT & CEO 30.00 35.00 X 823499 548885 25590 MOUNIR DOSS VICE PRESIDENT & CFO 30.00 35.00 X 627755 346363 25590 WILLIAM LYNCH VICE PRESIDENT & COO 40.00 1.00 X 408903 0 25590 GIDEON YOELI RADIOLOGIST 40.00 X 422517 0 25750 ROBERT GREENBAUM MD RADIOLOGIST 40.00 X 416844 0 28090 ROBERT SOLOMON RADIOLOGIST 40.00 X 417616 0 25590 SABIHA RAOOF CHAIRPERSON RADIOLOGY 40.00 X 514100 0 25590 THOMAS SANTUCCI MD CHAIRMAN DEPT MEDICINE 40.00 X 463645 0 21362 4493897 1124145 254793 286 0 1 0 MARTIN CLEARWATER & BELL 220 E 42ND ST NEW YORK NY 10017 LEGAL SERVICE 1575216 PRICEWATERHOUSE COOPERS LLP PO BOX 7247-8001 PHILADELPHIA PA 19170 AUDIT FEES 531850 NY NEUROSCIENCE ASSOCIATE PC 30 WEST STREET SUITE 25F NEW YORK NY 10004 PHYSICIAN SERVICES 455000 ROYAL HEALTH CARE LLC 521 FITH AVENUE NEW YORK NY 10175 MANAGEMENT CONTRACTUAL SERVICES 429901 CLOCKNORSE REALTY 2001 MARCUS AVE SUITE W183 LAKE SUCCESS NY 11042 RENT 415853 23 324757 10944195 557766 11826718 NET PATIENT REVENUE 621400 369345965 369345965 CAPITATION REVENUE 621400 39832144 39832144 PROFESSIONAL COMPONENT 621400 23259523 23259523 TEACHING AND EDUCATION 611600 2609141 2609141 435046773 512134 512134 871448 871448 0 66686463 38310 13515671 0 53170792 38310 53209102 53209102 209845 324757 189184 20661 20661 REIMBURSMENT FOR SERVICES PROVIDE 900099 16388315 16388315 EARNINGS FROM JOINT VENTURES 523000 7120929 7811933 -691004 MANAGEMENT FEE 900099 3000000 3000000 1256150 1220275 35875 27765394 528380782 463467296 -655129 53741897 2362696 2196392 166304 210745669 195911807 14833862 13676946 12714260 962686 41908801 38958945 2949856 15714007 14607936 1106071 3933177 3656330 276847 397300 369335 27965 44146265 41038920 3107345 103487 96203 7284 1475957 1372068 103889 5439038 5056198 382840 9772978 9085082 687896 52568 48868 3700 2048804 1904594 144210 12796695 11895968 900727 10947234 10176686 770548 INCOME TAX EXPENSE 103408 96129 7279 BAD DEBT 40973252 38089247 2884005 MEDICAL SUPPLIES 34767578 32320375 2447203 COLLECTION AGENCY 3422791 3181869 240922 14724334 13688630 1035704 469512985 436465842 33047143 0 1523172 4900736 919898 27330167 65834376 56132528 3827394 3869391 6619050 9218034 264341598 210520699 55527086 53820899 18309788 0 51433325 53605208 73697546 53296507 277691635 262173470 98147784 96903048 1041055 2502963 26734280 0 624456 390463 213002139 140778016 339549714 240574490 X -61858079 21598980 -61858079 21598980 277691635 262173470 X 58867797 148620 24440642 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 1283 0 0 1283 0 PART II-B, LINE 1: JAMAICA HOSPITAL MEDICAL CENTER IS A MEMBER OF TWO ASSOCIATIONS OF WHICH SOME OF THEIR DUES ARE ALLOCATED TO GRASS ROOTS LOBBYING IN REGARD TO THEIR NEEDS IN SERVICING AND PROVIDING HEALTHCARE TO THE GENERAL PUBLIC. HEALTHCARE EDUCATION PROJECT $1,283 169319 2966 165657 6628 155261 200 17424 2808 759 169318 140528 687 17682 2973 663 155261 1018049 1018049 97168088 73676745 23491343 5993138 4911416 1081722 142867501 122834499 20033002 17294822 9098039 8196783 53820899 INVESTMENT IN NHP HOLDINGS 13031663 C JHMC HEALTHFIRST 40573545 C 53605208 DUE FROM THIRD PARTY PAYORS 10703556 DUE FROM RELATED PARTIES 4630159 INSURANCE RECOVERIES 24236656 DEFINED PENSION PLAN ASSETS 13726136 53296507 DUE TO THIRD PARTY 15250049 CAPITAL LEASE OBLIGATIONS 9685212 MALPRACTICE INSURANCE 115842755 140778016 X 617571280 148620 87981246 88129866 529441414 -1060632 -1060632 528380782 558554863 110079983 110079983 448474880 21038105 21038105 469512985 PART X, LINE 2: JAMAICA HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT -21,038,105. CAPITATION EXPENSE 109,019,351. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES MOVED FROM EXPENSES -189,184. RENTAL EXPENSES -871,448. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSES MOVED TO REVENUE 189,184. RENTAL EXPENSES 871,448. CAPITATION EXPENSE MOVED TO REVENUE 109,019,351. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT 21,038,105. GOLF OUTING 121791 41446 80345 3025 8501 74005 ANNUAL GALA 412811 283311 129500 97253 6400 534602 324757 209845 3025 8501 171258 6400 189184 20661 1 1 1 X 1 X 1 1 1 0 1 1 23809015 22851005 958010 0.00210 170802326 158378720 12423606 0.02770 194611341 181229725 13381616 0.02980 43332 6008647 4830281 1178366 0.00260 65874576 16351342 49523234 0.11040 70206836 59832974 10373862 0.02310 43332 142090059 81014597 61075462 0.13610 43332 336701400 262244322 74457078 0.16590 1 21038105 60106676 40940885 19165791 X 1 1 1 1 JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 X X X X JAMAICA HOSPITAL MEDICAL CENTER 1 1 X X X X X X X X 13 1 0 1 X WWW.JAMAICAHOSPITAL.ORG X X X X X 1 0 1 1 100.000000000000 1 300.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 JAMAICA HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 3: EXISTING, PUBLICALLY-AVAILABLE DATA RESOURCES WERE USED TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING:- CENSUS: THE U.S. CENSUS COUNTS EVERY RESIDENT IN THE UNITED STATES. IT TAKES PLACE EVERY 10 YEARS. THE CENSUS ASKS ABOUT RACE, ETHNICITY, AGE, SEX, HOME OWNERSHIP, AND THE NUMBER OF PEOPLE IN THE HOME.- AMERICAN COMMUNITY SURVEY: THE AMERICAN COMMUNITY SURVEY (ACS) IS AN ONGOING SURVEY THAT PROVIDES DATA EVERY YEAR. THE SURVEY ASKS A SAMPLE OF THE U.S. POPULATION ABOUT AGE, SEX, RACE, FAMILY AND RELATIONSHIPS, INCOME AND BENEFITS, HEALTH INSURANCE, EDUCATION, VETERAN STATUS, DISABILITIES, WORK, TRANSPORTATION, HOME, AND EXPENSES.- NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (DOHMH)'S COMMUNITY HEALTH SURVEY: THE NEW YORK CITY COMMUNITY HEALTH SURVEY (CHS) IS A TELEPHONE SURVEY CONDUCTED ANNUALLY BY THE DOHMH, DIVISION OF EPIDEMIOLOGY, BUREAU OF EPIDEMIOLOGY SERVICES. THE CHS PROVIDES ROBUST, SELF-REPORTED DATA ON THE HEALTH OF NEW YORKERS, INCLUDING NEIGHBORHOOD, BOROUGH, AND CITYWIDE ESTIMATES, ON A BROAD RANGE OF CHRONIC DISEASES AND BEHAVIORAL RISK FACTORS. THE CHS IS A CROSS-SECTIONAL SURVEY THAT SAMPLES APPROXIMATELY 10,000 ADULTS AGED 18 AND OLDER FROM ALL FIVE BOROUGHS OF NEW YORK CITY. A COMPUTER-ASSISTED TELEPHONE INTERVIEWING (CATI) SYSTEM IS USED TO COLLECT SURVEY DATA, AND INTERVIEWS ARE CONDUCTED IN A VARIETY OF DIFFERENT LANGUAGES. - NEW YORK STATE DEPARTMENT OF HEALTH, BUREAU OF VITAL STATISTICS: THE NEW YORK STATE DEPARTMENT OF HEALTH (NYS DOH) COLLECTS BIRTH AND CAUSE OF DEATH INFORMATION FOR ALL BIRTHS AND DEATHS THAT OCCUR IN NEW YORK STATE. CAUSES OF DEATH ARE ATTRIBUTED TO THE UNDERLYING CAUSES CLASSIFIED ACCORDING TO THE TENTH REVISION OF THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD, 10TH REVISION OR ICD-10 CODES). BIRTH-RELATED DATA AVAILABLE FOR REVIEW INCLUDE RACE/ETHNICITY OF MOTHER, LOW BIRTHWEIGHT/PREMATURE BIRTH EVENTS, PRIMARY FINANCIAL COVERAGE OF MOTHER DURING BIRTH, AND PERCENTAGE OF MOTHERS WHO RECEIVED EARLY/LATE/NO PRENATAL CARE.- NEW YORK STATE DEPARTMENT OF HEALTH, COMMUNITY HEALTH ASSESSMENT CLEARINGHOUSE (CHAC): THE CHAC CONTAINS SEVERAL DATA RESOURCES THAT WERE OF PARTICULAR RELEVANCE TO JAMAICA HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING COMMUNITY HEALTH INDICATORS, EPIQUERY, AS WELL AS LINKS TO SOCIODEMOGRAPHIC DATA SOURCES- NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE, OFFICE OF VITAL STATISTICS: THE NYC DOHMH'S OFFICE OF VITAL STATISTICS PRODUCES AN ANNUAL SUMMARY THAT PRESENTS DATA ON MANY IMPORTANT HEALTH INDICATORS SUCH AS LIFE EXPECTANCY, LEADING CAUSES OF DEATH AND THE INFANT MORTALITY RATE IN NYC. THE DOHMH USES THESE INDICATORS, WHICH ARE BROKEN DOWN BY ETHNIC GROUP, GENDER, AGE AND NEIGHBORHOODS, TO MONITOR PUBLIC HEALTH.- HEALTHY PEOPLE 2020: MAINTAINED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, HEALTHY PEOPLE IS AN INITIATIVE THAT PROVIDES SCIENCE-BASED, 10-YEAR NATIONAL OBJECTIVES FOR IMPROVING THE HEALTH OF ALL AMERICANS. THE MOST CURRENT OBJECTIVES ARE DESCRIBED AS TARGETS TO ACHIEVE BY 2020.- AIDSVU, EMORY UNIVERSITY ROLLINS SCHOOL OF PUBLIC HEALTH: IS AN INTERACTIVE, ONLINE MAP OF DATA, DELINEATING THE PREVALENCE OF HIV ACROSS THE U.S., AND PROVIDING DATA FOR COMPARISON AT THE LOCAL (ZIP CODE) LEVEL FOR NYC. ZIP CODE AND CENSUS TRACT DATA COME DIRECTLY FROM NYS, COUNTY AND NYC DOHMH HEALTH DEPARTMENTS, DEPENDING ON WHICH ENTITY IS RESPONSIBLE FOR HIV SURVEILLANCE IN A PARTICULAR GEOGRAPHIC AREA.- NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE, TAKE CARE NEW YORK 2016 BOROUGH-WIDE LISTENING SESSION (QUEENS): HELD ON MAY 14, 2013, THIS FEEDBACK SESSION SPONSORED BY THE NYC DOHMH PROVIDED AN OPPORTUNITY FOR COMMUNITY MEMBERS TO SHARE THEIR VIEWS ON WHAT COMMUNITY HEALTH NEEDS SHOULD BE PRIORITIZED TO IMPROVE HEALTH OUTCOMES. COMMUNITY-BASED ORGANIZATIONS, HEALTHCARE PROVIDERS, AND STAKEHOLDERS FROM THE GENERAL PUBLIC JOINED NYC DOHMH STAFF AND DISCUSSED HEALTHCARE/HEALTHY LIFESTYLE ISSUES AND STRATEGIES TO ADDRESS THEM. - NEW YORK CITY COMMUNITY AIR SURVEY (NYCCAS): THE NYC DOHMH AND QUEENS COLLEGE (QC-CUNY) CONDUCT THE NYCCAS TO EVALUATE HOW AIR QUALITY DIFFERS ACROSS VARIOUS PARTS OF NYC. DEVELOPED ALONG WITH NYC'S SUSTAINABILITY INITIATIVE, PLANYC, THE NYCCAS EXAMINES HOW POLLUTANTS EMANATING FROM TRAFFIC, BUILDINGS (E.G., BOILERS AND FURNACES) AND OTHER SOURCES CAN AFFECT AIR QUALITY DIFFERENTIALLY ACROSS NYC'S NEIGHBORHOODS. THE NYCCAS TRACKS POLLUTANTS, SUCH AS SULFUR DIOXIDE, OZONE, NITROGEN OXIDES, AND FINE PARTICLES THAT ARE KNOWN TO CAUSE/EXACERBATE HEALTH PROBLEMS. TO CAPTURE DATA, NYCCAS TAKES AIR POLLUTION MEASUREMENTS AT APPROXIMATELY 100 LOCATIONS THROUGHOUT NYC EACH SEASON.- NEW YORK STATE DEPARTMENT OF HEALTH, NEW YORK STATE STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS) COLLECTS PATIENT-LEVEL DETAILS ON PATIENT CHARACTERISTICS, DIAGNOSES AND TREATMENTS, SERVICES, AND CHARGES FOR EVERY HOSPITAL DISCHARGE, AMBULATORY SURGERY PATIENT, AND EMERGENCY DEPARTMENT ADMISSION IN NEW YORK STATE. THESE DE-IDENTIFIED HOSPITAL DISCHARGE DATA ARE PARTICULARLY RELEVANT TO HOSPITALS, AGENCIES, AND HEALTH CARE ORGANIZATIONS WHEN MAKING DECISIONS REGARDING FINANCIAL PLANNING AND MONITORING OF INPATIENT AND AMBULATORY SURGERY SERVICES AND COSTS.- NEW YORK CITY DEPARTMENT OF CITY PLANNING, COMMUNITY DISTRICT PROFILES: THESE PROFILES, WHICH CONTAIN INFORMATION ABOUT EACH OF NYC'S 59 COMMUNITY DISTRICTS, WERE LAST UPDATED IN JUNE 2013. PROFILES INCLUDE DATA ON TOPICS SUCH AS POPULATION SIZE, BIRTH, DEATH AND INFANT MORTALITY RATES, LAND USE, AND INCOME SUPPORT. ADDITIONALLY, THE PROFILES INCLUDE LISTINGS OF PROGRAM AND FACILITY SITES SUCH AS PRIVATE AND PUBLIC SCHOOLS, PARKS, PUBLIC SAFETY, HEALTH, MENTAL HEALTH, AND OTHER SOCIAL SERVICE FACILITIES. DATA FROM THE 2010 U.S. CENSUS AND NYC DOHMH VITAL STATISTICS ARE INCORPORATED INTO THE PROFILE INFORMATION. JAMAICA HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 20D: JHMC WOULD CHARGE 80% OF THE CURRENT MEDICAID RATE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 21,038,105. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIESJAMAICA HOSPITAL'S PROGRAMS SUPPORT TAKE CARE NEW YORK IN THE FOLLOWING WAYS:HAVE A REGULAR DOCTOR OR OTHER HEALTH CARE PROVIDER: JAMAICA'S AMBULATORY CARE SERVICES ARE DESIGNED TO PROMOTE CONTINUITY OF CARE BY ALLOWING PATIENTS TO CHOOSE A PHYSICIAN WHO WILL BE DESIGNATED AS THEIR PRIMARY CARE PROVIDER. IN ADDITION TO ON-CAMPUS AMBULATORY CARE SERVICES, THERE ARE TWELVE CENTERS CONVENIENTLY LOCATED THROUGHOUT JAMAICA'S SERVICE AREA. EVENING AND WEEKEND HOURS ALLOW RESIDENTS ACCESS FOR THOSE WHO FIND IT DIFFICULT TO SEEK CARE ON WEEKDAYS. THE DESIGNATED PROVIDER IS RESPONSIBLE FOR ENSURING THAT HIS/HER PATIENTS ARE GIVEN AGE APPROPRIATE SCREENING, IMMUNIZATION AND EDUCATION. THE HOSPITAL HAS IMPLEMENTED AN ELECTRONIC MEDICAL RECORD, HAS ENHANCED ITS HEALTH PROMOTION EFFORTS VIA AUTOMATIC REMINDERS TO PHYSICIANS WHEN A PATIENT IS DUE FOR A TEST OR PROCEDURE.BE TOBACCO-FREE: IN 2012 THE HOSPITAL JOINED THE NEW YORK CITY TOBACCO-FREE HOSPITALS CAMPAIGN, WHICH IS TARGETING STAFF AND PATIENTS, WITH A COMPREHENSIVE, EVIDENCE-BASED SERIES OF INITIATIVES.KNOW YOUR HIV STATUS: THE HOSPITAL PROVIDES HIV COUNSELING AND TESTING WITH STAFF THAT ROUTINELY PERFORMS THIS FUNCTION IN BOTH EMERGENCY DEPARTMENT AND CLINICS. THE HOSPITAL'S AMBULATORY CARE CENTER IS DESIGNATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH AS AN HIV PRIMARY MEDICAL CARE PROVIDER. PATIENTS WHO ARE HIV POSITIVE ARE CARED FOR IN THIS FACILITY AND REFERRED TO OTHER COMMUNITY SERVICE PROGRAMS FOR SUPPORTIVE SERVICES AS NECESSARY. THE HOSPITAL APPLIED AND WAS APPROVED FOR A GRANT IN THE SPRING 2010 FROM THE NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH) TO PROVIDE HIV/STI PREVENTION FOR WOMEN AND YOUNG PEOPLE.GET HELP FOR DEPRESSION: JAMAICA HOSPITAL'S MEDICAL PROVIDERS INCORPORATE DEPRESSION SCREENING DURING ROUTINE MEDICAL EXAMINATIONS AND ONGOING CARE. CHILDREN AND ADULTS NEEDING FURTHER SERVICES ARE REFERRED TO JAMAICA'S FULL SERVICE PSYCHIATRY DEPARTMENT OR OTHER COMMUNITY PROGRAMS. LIVE FREE OF DEPENDENCE ON ALCOHOL AND DRUGS: DURING ROUTINE MEDICAL EXAMINATIONS PATIENTS ARE SCREENED FOR ALCOHOL AND DRUG USE AND GIVEN PREVENTIVE COUNSELING AND, AS NECESSARY, TREATMENT OPTIONS ARE DISCUSSED, INCLUDING FLUSHING HOSPITAL, JAMAICA'S AFFILIATE, WHICH OFFERS BOTH IN-PATIENT AND OUT-PATIENT TREATMENT FOR CHEMICAL DEPENDENCY.GET CHECKED FOR CANCER: REFERRALS FOR OTHER CANCER SCREENINGS, SUCH AS BREAST CANCER, ARE PART OF THE HOSPITAL'S ROUTINE PROTOCOLS. THE HOSPITAL PARTICIPATES IN THE QUEENS HEALTHY LIVING PARTNERSHIP WHICH PROVIDES FREE CANCER SCREENING AND TREATMENTS FOR THE UNINSURED. THE HOSPITAL EMPLOYS A COLONOSCOPY SCREENING PATIENT NAVIGATOR TO DECREASE CANCELLATIONS DUE TO POOR PREPARATION AND NO SHOWS AND TO PROVIDE OUTREACH SERVICES TO INCREASE THE NUMBER OF PATIENTS RECEIVING COLONOSCOPY SCREENING.GET THE IMMUNIZATIONS YOU NEED: THE HOSPITAL PARTICIPATES IN THE NYC'S VACCINE FOR CHILDREN PROGRAM (VFC) PROVIDING IMMUNIZATIONS TO CHILDREN UP TO 19 YEARS OF AGE AGAINST CHILDHOOD DISEASES AND INFLUENZA TO ELIGIBLE CHILDREN INCLUDING THOSE WITHOUT HEALTH COVERAGE SEEN IN OUR AMBULATORY CARE NETWORK. INFLUENZA VACCINE IS OFFERED TO ADULTS DURING RECOMMENDED VACCINATION MONTHS. HAVE A SAFE AND HEALTHY HOME: ANTICIPATORY GUIDANCE ON SAFETY IN THE HOME IS PROVIDED BY THE HOSPITAL'S PEDIATRIC, FAMILY MEDICINE AND REHABILITATION PROFESSIONALS. AT HEALTH FAIRS IN THE COMMUNITY, FIRE, HOME AND AUTOMOTIVE SAFETY INFORMATION IS ROUTINELY MADE AVAILABLE TO ATTENDEES.HAVE A HEALTHY BABY: THE HOSPITAL FOLLOWS PRENATAL CARE GUIDELINES ADOPTED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THE HOSPITAL OPERATES A WOMEN, INFANT AND CHILDREN (WIC) PROGRAM FUNDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES FOOD VOUCHERS AND EDUCATION TO LOW INCOME PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE. THE HOSPITAL WILL BE IMPLEMENTING A CENTERING PREGNANCY PROGRAM WITH THE HELP OF A MARCH OF DIMES GRANT AND IS DEVELOPING AN AGGRESSIVE BREAST FEEDING PROMOTION PROGRAM IN CONCERT WITH THE NEW YORK CITY DEPARTMENT OF HEALTH & MENTAL HYGIENE.JAMAICA HOSPITAL'S PUBLIC HEALTH EFFORTS ARE CONSTANTLY CHANGING WITH THE NEEDS OF ITS COMMUNITY. THE ABOVE LISTING DOES NOT INCLUDE ALL PROGRAMS, SOME OF WHICH ARE FUNDED BY GRANTS SUCH AS THE SCHOOL HEALTH PROGRAM PRIMARILY FUNDED BY NEW YORK STATE DEPARTMENT OF HEALTH WHICH OPERATES IN TWO ELEMENTARY SCHOOLS AND A CAMPUS MAGNET SCHOOL CONSISTING OF FOUR HIGH SCHOOLS. IN ADDITION, CLINICAL DEPARTMENTS OFTEN INITIATE THEIR OWN PREVENTION ACTIVITIES WITH THEIR PATIENTS AND WITHIN THE COMMUNITY. LASTLY, THE HOSPITAL PROVIDES HUNDREDS OF FREE HEALTH SCREENINGS AND OUTREACH EFFORTS EACH YEAR FOR A VARIETY OF DISORDERS. PART III, LINE 4: FINANCIAL STATEMENTS BAD DEBT & CHARITY CARE FOOTNOTE:JAMAICA PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MATTER OF POLICY, JAMAICA PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED AS CHARITY CARE. JAMAICA PROVIDES CHARITY CARE FOR THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. SINCE PAYMENT OF THIS DIFFERENCE IS NOT SOUGHT, CHARITY CARE ALLOWANCES ARE NOT REPORTED AS REVENUE. REMAINING UNCOLLECTED BALANCES AFTER CHARITABLE ALLOWANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. THE ESTIMATED COSTS OF PROVIDING CHARITY SERVICES ARE BASED ON A CALCULATION WHICH APPLIES A RATIO OF COSTS TO CHARGES TO THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. JAMAICA'S FINANCIAL ASSISTANCE POLICY ENSURES THAT ANY PATIENT THAT HAS BEEN DEEMED TO BE UNINSURED THROUGH BASIC FINANCIAL SCREENING WILL BE ENTITLED TO A GLOBAL CHARITABLE DISCOUNT FOR EMERGENT (NEW YORK STATE ("NYS") RESIDENTS) AND/OR MEDICALLY NECESSARY SERVICES (RESIDES IN JAMAICA'S PRIMARY SERVICE AREA). THE GLOBAL CHARITABLE DISCOUNT WILL BE BASED ON THE CURRENT APPLICABLE MEDICAID OR MEDICARE RATE - DEPENDING ON THE SERVICE PROVIDED. THE GLOBAL DISCOUNTS FOR UNINSURED PATIENTS ARE BASED ON THE PREMISE THAT JAMAICA SERVES A LOW-INCOME, UNDER-INSURED POPULATION - AS SUPPORTED BY PUBLIC STATISTICS - AND THAT UNINSURED PATIENTS LIVING IN THIS COMMUNITY WILL GENERALLY NOT BE ABLE TO PAY THEIR BILL IN ITS ENTIRETY. AFTER THE GLOBAL CHARITABLE DISCOUNT IS APPLIED, PATIENTS DEMONSTRATING ADDITIONAL FINANCIAL NEED MAY BE EXTENDED SLIDING SCALE DISCOUNTS UNDER THE CHARITY CARE POLICY. ADDITIONALLY, FOR COVERED SERVICES THERE ARE NO LIMITS ON FINANCIAL ASSISTANCE BASED ON THE MEDICAL CONDITION OF THE APPLICANT.COSTING METHODOLOGY FOR CALCULATING LINES 2 & 3:BAD DEBT EXPENSE IS ESTIMATED BASE ON AGING OF THE ACCOUNTS RECEIVABLE AND GETS ADJUSTED BASE ON ACTUAL WRITE OFF. ACTUAL ACCOUNT WRITE OFF IS AS FOLLOW: PATIENTS WHO ARE ENTITLED TO FINANCIAL ASSISTANT ARE GIVEN DISCOUNT BASE ON OUR CHARITY CARE POLICY (MEDICAID RATE) IF THE PATIENT DOESN'T PAY THE BALANCE OF THEIR ACCOUNT AFTER RECEIVING 3 BILLS THEN THE ACCOUNT BALANCE GETS TRANSFER TO THE COLLECTION AGENCY. IF THE COLLECTION AGENCY CAN'T COLLECT AFTER EXHAUSTING THEIR EFFORT THEN THE ACCOUNT GETS RETURNED AS UNCOLLECTIBLE AND HOSPITAL WRITE OFF THE ACCOUNT AS BAD DEBT. BAD DEBT RELATED TO LINE 3: BAD DEBT EXPENSE IS ALLOCATED TO THE PATIENTS WHO ARE ENTITLED TO FINANCIAL AID BASE ON CHARITY CARE VOLUME PATIENTS. PART III, LINE 8: LINE 5 MEDICARE REVENUE AND LINE 6 MEDICARE ALLOWABLE COSTS ARE FROM HOSPITAL COST REPORT THAT GETS FILED WITH MEDICARE EVERY YEAR. COST METHODOLOGY THAT IS USED TO CALCULATE MEDICARE ALLOWABLE COST IS RATIO OF COST TO CHARGES BASE ON MEDICARE GUIDELINES. MEDICARE ALLOWABLE COST ON LINE 6 DOESN'T INCLUDE COST OF RESIDENCY PROGRAM AND SUPERVISORY PHYSICIAN COST WHICH IS OVER $60 MILLION . EXCLUSION OF THESE COSTS RESULTED IN THE SURPLUS ON LINE 7. PART III, LINE 9B: THE HOSPITAL OFFERS INSTALLMENT PLANS FOR THE PAYMENT OF OUTSTANDING BALANCES FOR PATIENTS APPROVED FOR FINANCIAL AID. THE HOSPITAL DOES NOT MANDATE THAT THE MONTHLY INSTALLMENT PAYMENT ARRANGEMENT EXCEED 10% OF THE APPLICANT'S GROSS MONTHLY INCOME OR AN INTEREST RATE THAT EXCEEDS THE RATE FOR A 90-DAY SECURITY ISSUED BY THE US DEPARTMENT OF TREASURY, PLUS 0.5%. THERE IS NO ACCELERATOR OR SIMILAR CLAUSE UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED WHEN A PATIENT MISSES MAKING A PAYMENT. THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTIONS AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTIONS AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING A LEGAL ACTION. PART VI, LINE 2: LOWER-INCOME, MINORITY ADULTS AND CHILDREN BEAR A DISPROPORTIONATE BURDEN OF CHRONIC DISEASE, USE EMERGENCY ROOM SERVICES MORE OFTEN FOR CARE, HAVE POORER HEALTH STATUS, AND HIGHER PREMATURE MORTALITY. ADDITIONALLY, LOWER-INCOME, MINORITY POPULATIONS ARE MORE LIKELY TO LACK ACCESS TO HEALTH CARE AND TO DEVELOP MENTAL HEALTH CONDITIONS (E.G., MOOD DISORDERS, DRUG OR ALCOHOL ABUSE) ASSOCIATED WITH HIGH PSYCHOSOCIAL STRESSORS (E.G., JOB LOSS, FINANCIAL STRAIN). GIVEN THE DEMOGRAPHICS OF ITS PRIMARY SERVICE AREA, JAMAICA HOSPITAL HAS IDENTIFIED CHIEF CONCERNS IN THE NEIGHBORHOODS IT SERVES, AND IS COMMITTED TO REDUCING DISPARITIES IN HEALTHCARE ACCESS SO THAT THE HEALTH STATUS OF ALL RESIDENTS IS IMPROVED. HERE, DEATH RATES AND DATA CAPTURING A FEATURE FROM EACH OF THE TEN PRIORITY AREAS IDENTIFIED BY NEW YORK CITY'S TAKE CARE NEW YORK (TCNY) 2016 (AND CORRESPONDING WITH THE NEW YORK STATE'S PREVENTION AGENDA 2013-2017'S FIVE PRIORITY ACTION PLANS) ARE DESCRIBED FOR JAMAICA HOSPITAL'S NEIGHBORHOODS AND COMPARED WITH QUEENS AND NYC.DEATH RATESDEATH RATES FOR HEART DISEASE AND CANCER TOP THE LIST OF RANKED CAUSES OF DEATH ACROSS JAMAICA HOSPITAL'S PRIMARY SERVICE AREA AS WELL AS QUEENS AND NYC. FLU/PNEUMONIA (HIGHEST IN JAMAICA) AND STROKE ARE ALSO CONSISTENTLY RANKED HIGHER AS MORTALITY CAUSES (EXCEPT IN ENY). THERE IS SOME FLUCTUATION WITH OTHER LEADING CAUSES OF DEATH. OF PARTICULAR NOTE ARE MORTALITIES DUE TO NON-DRUG OVERDOSE ACCIDENTS (HIGHEST IN SWQ) AND DIABETES (THE THIRD LEADING CAUSE OF DEATH IN ENY).TOBACCO-FREE LIVING (CORRESPONDS TO NYS'S PREVENT CHRONIC DISEASES): IN 2010, TOBACCO USE WAS MARKEDLY HIGHER IN NEIGHBORHOODS SERVED BY JAMAICA HOSPITAL, PARTICULARLY IN ENY, RELATIVE TO QUEENS AND NYC OVERALL. QUEENS' OVERALL AND JAMAICA'S 2011 RATES HOVERED AROUND THE HEALTHY PEOPLE 2020 TARGET OF 12%, WHILE SWQ'S RATE WAS LOWER. GENERALLY, SMOKING RATES DECLINED BETWEEN 2010 AND 2011 IN QUEENS AND JHMC'S SERVICE AREA. JAMAICA HOSPITAL'S EFFORTS TO REDUCE TOBACCO CONSUMPTION, PARTICULARLY SMOKING AMONG ADULTS, ARE DESCRIBED IN A LATER SECTION (SELECTION OF PUBLIC HEALTH PRIORITIES).HEALTHY EATING (CORRESPONDS TO NYS'S PREVENT CHRONIC DISEASES): WHILE OBESITY RATES HAVE IMPROVED IN JAMAICA OVER THE PAST THREE YEARS, THEY HAVE REMAINED THE SAME (IN NYC, QUEENS, AND ENY) OR INCREASED IN OTHER AREAS (SWQ). JAMAICA HOSPITAL'S SERVICES INCLUDE NUTRITIONISTS AND DIABETES EDUCATORS, WHO CAN ASSIST PATIENTS WITH DEVELOPING HEALTHY EATING HABITS AND REACHING WEIGHT MANAGEMENT GOALS. THE HOSPITAL'S PARTNERSHIP WITH NYC DOHMH ON THEIR ANTI-OBESITY CAMPAIGN AND HEALTHY HOSPITAL FOOD INITIATIVE WILL HELP THE JAMAICA COMMUNITY REACH THE NYS AND HEALTHY PEOPLE TARGETS.ACTIVE LIVING (CORRESPONDS TO NYS'S PREVENT CHRONIC DISEASES): THE PERCENTAGE OF ADULTS WHO EXERCISE HAS ONLY INCREASED SLIGHTLY OVER THE PAST FEW YEARS. JAMAICA HOSPITAL'S NEIGHBORHOODS ARE FAIRLY CONSISTENT WITH QUEENS AND NYC ON THIS MEASURE, AND REFLECT THE NEED TO ENGAGE RESIDENTS IN EXERCISE PROGRAMS TO PREVENT OBESITY AND ITS RELATED EFFECTS, INCLUDING HEART DISEASE, DIABETES, AND STROKE. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES INCLUDE INCREASING THE PERCENTAGE OF ADULTS AGES 18 YEARS AND OLDER WHO PARTICIPATE IN LEISURE-TIME PHYSICAL ACTIVITY FROM 73.7% TO 77.4%HEART HEALTH (CORRESPONDS TO NYS'S PREVENT CHRONIC DISEASES): RATES OF UNCONTROLLED HIGH BLOOD PRESSURE WERE RELATIVELY HIGHER IN SWQ AND ENY THAN JAMAICA AND ACROSS NYC/QUEENS. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES INCLUDE REDUCING THE AGE-ADJUSTED HEART ATTACK HOSPITALIZATION RATE (PER 10,000) FROM 14.4 (QUEENS) AND 15.5 (NYS) TO 14.0. JAMAICA HOSPITAL'S CARDIOLOGY DEPARTMENT AND PRIMARY CARE PHYSICIANS WORK TO HELP PATIENTS MONITOR AND MANAGE FACTORS RELATED TO HEART DISEASE, SUCH AS HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL, ULTIMATELY TO REDUCE PREMATURE DEATHS FROM HEART DISEASE. JAMAICA HOSPITAL IS PARTNERING WITH NYC DOHMH TO ENSURE ALL AMBULATORY CARE PATIENTS WITH HIGH BLOOD PRESSURE ARE BEING TRACKED, APPROPRIATELY CONTROLLED, AND THAT THE DATA IS BEING REPORTED. THE HOSPITAL IS ALSO PLANNING TO PARTNER WITH NYC BY PARTICIPATING IN THE NATIONAL DIABETES PREVENTION PROGRAM.HIV PREVENTION (CORRESPONDS TO NYS'S PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE, & OTHER HEALTHCARE ASSOCIATED INFECTIONS ACTION PLAN): HIV/AIDS REMAINS AN IMPORTANT HEALTH ISSUE IN THE COMMUNITIES THAT JHMC SERVES. IN 2011, THERE WERE MORE THAN 6,923 PEOPLE LIVING WITH HIV/AIDS IN THE SERVICE AREA, WHICH IS MORE THAN THE NUMBER OF PEOPLE LIVING WITH HIV/AIDS STATEWIDE IN 27 OF THE 50 STATES. AN IMPORTANT PART OF PREVENTING HIV IS TO ENCOURAGE EVERYONE TO RECEIVE ROUTINE HIV TESTING AND DEVELOP AWARENESS OF THEIR HIV STATUS. RATES OF HIV TESTING ARE GENERALLY LOWER ACROSS QUEENS AND IN THE QUEENS NEIGHBORHOOD OF SWQ THAN THEY ARE IN JAMAICA AND ACROSS NYC. RELEVANT HEALTHY PEOPLE 2020 HIV TESTING TARGETS ARE TO INCREASE THE PROPORTION OF PEOPLE LIVING WITH HIV WHO KNOW THEIR SEROSTATUS FROM 80.6% (2006) TO 90% AND TO INCREASE THE PROPORTION OF ADOLESCENTS AND ADULTS WHO HAVE BEEN TESTED FOR HIV IN THE PAST 12 MONTHS FROM 17.2% (2006-2010) TO 18.9%. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES INCLUDE REDUCING THE RATE OF NEWLY DIAGNOSED HIV CASES (PER 100,000) FROM 26.1 (QUEENS) AND 21.6 (NYS) TO 14.7. THE HOSPITAL'S AMBULATORY CARE CENTER IS DESIGNATED BY NYS DOH AS AN HIV PRIMARY MEDICAL CARE PROVIDER, AND OFFERS TESTING ANNUALLY TO PATIENTS AGES 13 - 64 IN BOTH THE EMERGENCY DEPARTMENT AND CLINICS. THE HOSPITAL HAS A NYS GRANT TO PROVIDE SCREENINGS, COUNSELING AND RISK-REDUCTION INTERVENTIONS TO AT-RISK WOMEN IN THE HOSPITAL CLINICS.PROMOTE MENTAL HEALTH (CORRESPONDS TO NYS'S PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE): DEPRESSION RATES WERE HIGHER ACROSS NYC THAN WITHIN JHMC'S NEIGHBORHOODS, DECREASING IN QUEENS, ENY, AND SWQ TO VARYING DEGREES, WHILE INCREASING SLIGHTLY IN JAMAICA BETWEEN 2009 AND 2010. RELEVANT HEALTHY PEOPLE 2020 TARGETS ARE TO REDUCE THE PROPORTION OF ADULTS (18+) WHO EXPERIENCE MAJOR DEPRESSIVE EPISODES FROM 6.4 % (IN 2008) TO 5.8% AND TO INCREASE THE PROPORTION OF PRIMARY CARE PHYSICIANS WHO SCREEN ADULTS (19+) FOR DEPRESSION DURING OFFICE VISITS FROM 2.2% (2007) TO 2.4%. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES ARE TO REDUCE THE PERCENTAGE OF ADULT NEW YORKERS REPORTING 14 OR MORE DAYS WITH POOR MENTAL HEALTH IN THE LAST MONTH BY 10% TO NO MORE THAN 10.1% (BASELINE: 11.1%, 2011 BRFSS) AND REDUCE THE AGE-ADJUSTED SUICIDE MORTALITY RATE BY 10% TO 5.9 PER 100,000 (BASELINE: 6.6 PER 100,000, BUREAU OF BIOMETRICS 2007-2009). JHMC'S MENTAL HEALTH SERVICES INCLUDE ITS LARGE AND RECENTLY RENOVATED MENTAL HEALTH OUTPATIENT CENTER (FUNDED BY A NYS HEAL GRANT), ITS AFFILIATED OUTPATIENT ADVANCED CENTER FOR PSYCHOTHERAPY, ITS PSYCHIATRIC EMERGENCY DEPARTMENT AND COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM (CPEP) PROGRAM, ITS INPATIENT PSYCHIATRY UNITS AND A CONSULTATION LIAISON SERVICE FOR OTHER INPATIENT UNITS. THESE VERTICALLY INTEGRATED SERVICES PROMOTE THE COORDINATION OF MENTAL HEALTH CARE, INCLUDING INCREASING DEPRESSION SCREENING RATES AND PROVIDING APPROPRIATE AND TIMELY TREATMENT.REDUCE ALCOHOL AND DRUG ABUSE (CORRESPONDS TO NYS'S PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE): CONSISTENT WITH NYC'S AND QUEENS' DATA, BINGE DRINKING RATES INCREASED BETWEEN 2009 AND 2010 IN JHMC'S PRIMARY SERVICE AREA BUT ARE LOWER THAN THE HEALTHY PEOPLE 2020 TARGET OF 24.4%. JAMAICA HOSPITAL REFERS ITS PATIENTS FOR CHEMICAL DEPENDENCY TREATMENT, BOTH IN-PATIENT AND OUT-PATIENT, TO ITS AFFILIATE, FLUSHING HOSPITAL, AND TO OTHER CHEMICAL DEPENDENCY SERVICES IN THE COMMUNITY.PREVENT & TREAT CANCER (CORRESPONDS TO NYS'S PREVENT HIV/STDS, VPDS, & OTHER HEALTHCARE ASSOCIATED INFECTIONS): COLONOSCOPY RATES (FIGURE 9) WERE CONSISTENT ACROSS NYC AND QUEENS, AS WELL AS JAMAICA, BUT VARIED SLIGHTLY IN SWQ. USED PRIMARILY TO SCREEN FOR COLORECTAL POLYPS OR CANCER, A COLONOSCOPY IS AN OUTPATIENT PROCEDURE THAT INVOLVES THE INSERTION OF A COLONSCOPE (SLENDER TUBE WITH A CAMERA ATTACHED) INSIDE OF THE LARGE INTESTINE (COLON AND RECTUM) TO EXAMINE AND REMOVE, IF WARRANTED, ANY ABNORMAL TISSUE. JAMAICA HOSPITAL HAS FOCUSED ON IMPROVING COLONOSCOPY RATES, INCLUDING EFFORTS TO RAISE COLON CANCER AWARENESS AND INCREASE THE NUMBER OF SCREENINGS USING A PATIENT NAVIGATOR. THE HOSPITAL IS PART OF THE QUEENS CANCER SERVICES PROGRAM, FUNDED BY NYS DOH TO INCREASE RATES AMONG UNDER- AND UNINSURED INDIVIDUALS FOR BREAST, CERVICAL, COLORECTAL AND PROSTATE CANCER. PART VI, LINE 3: CHARITY CARE POLICYPOLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO IDENTIFY METHODS BY WHICH PATIENTS AND/OR FAMILY MEMBERS ARE NOTIFIED OF THE JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL AID POLICY.PROCEDURE: NOTIFICATION TO PATIENTS:JAMAICA HOSPITAL MEDICAL CENTER DEVELOPED AND HAS PUBLICLY AVAILABLE A CLEAR AND UNDERSTANDABLE WRITTEN SUMMARY OF ITS FINANCIAL ASSISTANCE POLICIES AND ENSURES THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE POLICIES. THE HOSPITAL HAS A 24-HOUR EMERGENCY DEPARTMENT AND NOTIFIES PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE DURING THE INTAKE AND REGISTRATION PROCESS THROUGH THE POSTING OF CONSPICUOUS AND LANGUAGE APPROPRIATE INFORMATION, AND THROUGH INFORMATION ON ALL BILLS AND STATEMENTS SENT TO PATIENTS. IN ADDITION, THE HOSPITAL POSTS THE FINANCIAL ASSISTANCE SUMMARY ON ITS WEBSITE. THE SUMMARY OF POLICIES INCLUDES THE SPECIFIC INCOME LEVELS USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE, A DESCRIPTION OF THE PRIMARY SERVICE AREA OF THE HOSPITAL, AND INFORMATION ABOUT HOW PATIENTS CAN APPLY FOR ASSISTANCE.ADDITIONALLY, THE HOSPITAL REQUIRES CONTRACTED OUTSIDE COLLECTIONS AGENCIES TO, WHEN APPROPRIATE; PROVIDE INFORMATION TO PATIENTS ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE. CHANGES IMPACTING COMMUNITY HEALTH/PROVISION OF CHARITY CARE/ACCESS TO SERVICES:THE HOSPITAL CONTINUES TO FACE EXTRAORDINARY FINANCIAL CHALLENGES INCLUDING FEDERAL AND STATE BUDGET CUTS, INCREASES IN THE UNINSURED, AND DWINDLING THIRD-PARTY REIMBURSEMENT RATES. SIMULTANEOUSLY, THE HOSPITAL HAS HAD A DRAMATIC INCREASE IN ITS EMERGENCY AND INPATIENT LOAD DUE TO NEARBY HOSPITAL CLOSINGS. POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED. PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO DEFINE THEIR RESPONSIBILITY TO CONTRIBUTE TO THEIR CARE BASED ON THEIR ABILITY TO PAY. PROCEDURE: ELIGIBILITY:JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL ASSISTANCE POLICY ENSURES THAT ANY PATIENT THAT HAS BEEN DEEMED TO BE UNINSURED THROUGH BASIC FINANCIAL SCREENING WILL BE ENTITLED TO A GLOBAL CHARITABLE DISCOUNT FOR EMERGENT (NYS RESIDENTS) AND/OR MEDICALLY NECESSARY SERVICES (RESIDES IN HOSPITAL'S PRIMARY SERVICE AREA). THE GLOBAL CHARITABLE DISCOUNT WILL BE BASED ON THE CURRENT APPLICABLE MEDICAID RATE - DEPENDING ON THE SERVICE PROVIDED. ADDITIONALLY, FOR COVERED SERVICES THERE ARE NO LIMITS ON FINANCIAL ASSISTANCE BASED ON THE MEDICAL CONDITION OF THE APPLICANT. THE HOSPITAL ALSO PROVIDES ADDITIONAL FINANCIAL ASSISTANCE TO PATIENTS WITH INCOMES BELOW 300% FPL. TO BE POTENTIALLY ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE, A PATIENT MUST BE UNINSURED OR HAVE EXHAUSTED THEIR HEALTH INSURANCE BENEFITS AND MUST BE DEEMED INELIGIBLE FOR ANY OTHER GOVERNMENT ASSISTANCE PROGRAM BY THE FINANCIAL COUNSELING OFFICE OF THE HOSPITAL. THOSE PATIENTS WHO ARE POTENTIALLY ELIGIBLE AND PROVIDE PROOF THAT THEIR INCOME IS BELOW 300% FPL CAN QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE. THE LEVEL OF ADDITIONAL ASSISTANCE WOULD BE DEPENDENT ON HOW LOW THEIR INCOME IS. THERE IS NO RESOURCE TEST FOR FINANCIAL AID ELIGIBLE PATIENTS. PLEASE NOTE THAT CERTAIN ELECTIVE SERVICES ARE EXCLUDED FROM THIS PROGRAM SUCH AS NON-MEDICALLY NECESSARY COSMETIC SERVICES AND SELF-IMPROVEMENT SERVICES.CO-PAYS AND DEDUCTIBLES ARE NOT COVERED UNDER THE PROGRAM. PATIENTS WHO DO NOT HAVE INSURANCE, AND; CHOOSE NOT TO FILE FOR ADDITIONAL CHARITABLE ASSISTANCE; ARE UNCOOPERATIVE; OR WHO ARE UNABLE TO BE LOCATED WILL HAVE THE GLOBAL CHARITABLE DISCOUNT APPLIED TO THEIR ACCOUNT(S). NO FURTHER DISCOUNTING WILL BE MADE AVAILABLE TO PATIENTS IN THESE CATEGORIES UNLESS APPROVED VIA THE APPEALS PROCESS. ANCILLARIES ARE NOT INCLUDED IN DISCOUNTING EXTENDED TO THESE PATIENTS' ACCOUNTS.JAMAICA HOSPITAL MEDICAL CENTER ALLOWS FOR ALL RESIDENTS OF NEW YORK STATE TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR EMERGENCY HOSPITAL SERVICES. FOR ANY MEDICALLY NECESSARY, NON-EMERGENT MEDICAL CARE, THE POLICY ALLOWS FOR RESIDENTS OF THE HOSPITAL'S PRIMARY SERVICE (AS DEFINED BY THE COMMISSIONER OF THE DEPARTMENT OF HEALTH), TO BE ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED. PURPOSE: TO DEFINE WHAT SERVICES ARE COVERED UNDER THE JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL AID POLICY BASED ON NEW YORK STATE MANDATORY GUIDELINES. PROCEDURE: SERVICES COVERED: JAMAICA HOSPITAL MEDICAL CENTER PROVIDES FINANCIAL ASSISTANCE FOR ALL MEDICALLY NECESSARY AND THERAPEUTICALLY BENEFICIAL SERVICES AND PROCEDURES, AND ALL EMERGENCY HOSPITAL SERVICES INCLUDING EMERGENCY TRANSFERS PURSUANT TO THE FEDERAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA).POLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO DEFINE THEIR RESPONSIBILITY TO CONTRIBUTE TO THEIR CARE BASED ON THEIR ABILITY TO PAY. PROCEDURE: APPLICATION, APPROVAL, AND APPEAL:JAMAICA HOSPITAL MEDICAL CENTER FINANCIAL ASSISTANCE POLICY ALLOWS PATIENTS TO APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE UP TO 90 DAYS AFTER INPATIENT DISCHARGE OR RECEIPT OF OUTPATIENT SERVICES. THE HOSPITAL REQUIRES APPLICANTS TO SUBMIT FINANCIAL DOCUMENTS TO SUPPORT THEIR APPLICATION. THE POLICY ALLOWS 20 DAYS FOR PATIENTS TO SUBMIT ADDITIONAL DOCUMENTS AND INFORMATION NEEDED TO COMPLETE AN APPLICATION. FINANCIAL ASSISTANCE APPLICANTS ARE NOT REQUIRED TO PAY THEIR HOSPITAL BILL(S) WHILE THE APPLICATION FOR ASSISTANCE IS BEING CONSIDERED AND A DETERMINATION MADE. DESIGNATED HOSPITAL STAFF ASSISTS PATIENTS IN THE APPLICATION PROCESS, INCLUDING UNDERSTANDING THE POLICIES AND PROCEDURES. PATIENTS APPLYING FOR FINANCIAL ASSISTANCE ARE REQUIRED TO COOPERATE WITH THE REQUIREMENTS OF THE APPLICATION, SUCH AS PROVIDING INFORMATION AND DOCUMENTATION NECESSARY TO RENDER A DECISION ON THE APPLICATION. TO QUALIFY FOR ADDITIONAL FINANCIAL ASSISTANCE, HOSPITAL POLICY REQUIRES A PATIENT TO FIRST APPLY FOR MEDICAID OR ANOTHER INSURANCE PROGRAM, IF, IN THE JUDGMENT OF THE HOSPITAL, THE PATIENT MAY BE ELIGIBLE FOR MEDICAID OR ANOTHER HEALTH INSURANCE PROGRAM.THE HOSPITAL PROVIDES APPLICATION FORMS IN THE PRIMARY LANGUAGES OF PATIENTS SERVED BY THE HOSPITAL.DECISIONS REGARDING FINANCIAL ASSISTANCE APPLICATIONS ARE MADE BY THE HOSPITAL WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. WHENEVER A MEDICAID APPLICATION IS ALSO BEING SUBMITTED ON BEHALF OF THE FINANCIAL AID APPLICANT, A FINANCIAL AID DECISION WILL BE RENDERED WITHIN 30 DAYS OF A MEDICAID DENIAL. THE DECISION IS PROVIDED TO THE PATIENT IN WRITING AND INCLUDES THE METHOD BY WHICH THE PATIENT CAN APPEAL A DENIAL. THE FINANCIAL ASSISTANCE DENIAL LETTERS EXPLAINS THE APPEALS PROCESS TO RE-EVALUATE DENIED APPLICATIONS; IF, OR WHEN, AN APPEAL IS REQUESTED. PART VI, LINE 4: JAMAICA HOSPITAL'S PRIMARY SERVICE AREA WAS DETERMINED BY ANALYZING STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS) DISCHARGE DATA AT THE ZIP CODE LEVEL. THE HIGHEST VOLUME ZIP CODES WERE AGGREGATED INTO UNITED HOSPITAL FUND (UHF) NEIGHBORHOODS. THE TOTAL (PRIMARY AND SECONDARY) SERVICE AREA COLLECTIVELY ACCOUNTS FOR APPROXIMATELY 85% OF THE HOSPITAL'S TOTAL INPATIENT CASES. THE PRIMARY SERVICE AREA ACCOUNTS FOR 79% OF THE CASES.POPULATION, RACE, AND ETHNICITY: THE PRIMARY SERVICE AREA NEIGHBORHOODS SERVED BY JAMAICA HOSPITAL ACCOUNT FOR 79% OF THE HOSPITAL'S CASES. THIS AREA IS HOME TO ALMOST 720,000 PEOPLE (240,000 IN SOUTHWEST QUEENS (SWQ); 290,000 IN JAMAICA; 180,000 IN EAST NEW YORK (ENY), MOST OF WHOM IDENTIFY AS RACIAL/ETHNIC MINORITY RESIDENTS. ALMOST ONE IN THREE PEOPLE WHO LIVE IN THE SERVICE AREA IS UNDER 20 YEARS OF AGE. MORE THAN 52% OF THE POPULATION IN JAMAICA HOSPITAL'S SERVICE AREA IS FEMALE. A CONSIDERABLE PERCENTAGE OF PEOPLE LIVING IN THE JHMC SERVICE AREA IS FOREIGN BORN, RANGING FROM 31% (ZIP CODE 11207, ENY) TO 66.6% IN ZIP CODE 11419 (RICHMOND HILL AREA OF SWQ). ALMOST THREE-QUARTERS OF RICHMOND HILL'S FOREIGN-BORN POPULATION HAILS FROM LATIN AMERICA (DEFINED BY THE U.S. CENSUS AS INCLUDING MEXICO, CENTRAL AMERICA, THE CARIBBEAN, AND SOUTH AMERICA ), AND RECENT WAVES OF GUYANESE IMMIGRANTS OF INDIAN (SOUTH ASIAN) DESCENT ARE CONCENTRATING IN LARGE NUMBERS IN THIS AREA AND NEIGHBORING OZONE PARK (SWQ). TO BETTER MEET THE NEEDS OF THE SOUTH ASIAN COMMUNITY IT SERVES, TJH MEDICAL SERVICES, THE HOSPITAL'S AFFILIATED GROUP PRACTICE, IS DEVELOPING AN OFFICE FOR OBSTETRICS AND GYNECOLOGY TARGETED TO THIS POPULATION. CURRENTLY JAMAICA HOSPITAL MEDICAL CENTER EMPLOYS 1750 STAFF WHO SPEAK ENGLISH AND A SECOND LANGUAGE, INCLUDING 557 WHO SPEAK SPANISH, 241 WHO SPEAK TAGALOG, 219 WHO SPEAK FRENCH/CREOLE, AND 211 WHO SPEAK ANY INDIAN LANGUAGES (BENGALI, URDU, PUNJABI, HINDI).SOCIOECONOMIC AND HEALTH INSURANCE STATUS: JAMAICA HOSPITAL SERVES A RELATIVELY LOWER-INCOME POPULATION ($59,364 WEIGHTED MEAN HOUSEHOLD INCOME, RANGING FROM LOW MEAN OF $44,515 IN ZIP CODE 11208 - CYPRESS HILLS, ENY TO HIGH MEAN OF $79,561 IN ZIP CODE 11423 - HOLLIS, JAMAICA). MOST OF THE COMMUNITY DISTRICTS WITHIN JHMC'S SERVICE AREA [CD 9 (42.4%) & CD 12 (39.4%) IN QUEENS AND CD 5 (51.2%) IN BROOKLYN HAVE HIGHER PERCENTAGES OF RESIDENTS RECEIVING SOME FORM OF INCOME ASSISTANCE THAN THE PERCENTAGES OBSERVED IN QUEENS (35.4%) OR NYC (37.3%) OVERALL. IN THE JHMC SERVICE AREA, SOME RESIDENTS ARE MEDICAID (ENY: 23%; SWQ: 15%; JAMAICA: 21%) OR MEDICARE (ENY: 11%; SWQ: 14%: JAMAICA: 16%) ENROLLEES. AN ALMOST EQUAL PROPORTION OF RESIDENTS HAVE PRIVATE INSURANCE (ENY: 31%; SWQ: 48%; JAMAICA: 35%). ABOUT ONE-QUARTER OF PEOPLE LIVING IN JHMC'S NEIGHBORHOODS ARE UNINSURED (ENY: 28%; SWQ: 20%; JAMAICA: 22%) . IN QUEENS, HISPANIC RESIDENTS (34%) ARE MORE LIKELY TO BE UNINSURED THAN BLACK (20%) OR WHITE RESIDENTS (10%). MEN IN QUEENS (24%) ARE MORE LIKELY TO BE UNINSURED THAN WOMEN (18 %). OTHER HEALTHCARE RESOURCES IN SOUTHWEST QUEENS, JAMAICA, AND EAST NEW YORKIN ADDITION TO JHMC, THERE IS QUEENS HOSPITAL CENTER, WHICH SERVES A SIMILAR AREA, AND THERE ARE 31 HRSA-SUPPORTED FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) OR LOOK-ALIKES THAT PROVIDE SERVICES IN QUEENS COUNTY. THE FOLLOWING FACILITIES PROVIDE PRIMARY AND/OR SPECIALTY HEALTHCARE SERVICES TO THE COMMUNITIES WITHIN JAMAICA HOSPITAL'S PRIMARY SERVICE AREA:COMMUNITY HEALTHCARE NETWORK, INC. (FQHC)CARE FOR THE HOMELESS (FQHC)DAMIAN FAMILY CARE CENTERS (DOES BUSINESS AS PROJECT SAMARITAN HEALTH SERVICES) (FQHC)HOUSING WORKS HEALTH SERVICES (FQHC)JOSEPH P. ADDABBO FAMILY HEALTH CENTER (FQHC)SUNSET PARK HEALTH COUNCIL, INC, (FQHC)THE HOSPITAL HAS PARTNERSHIPS WITH SOME OF THESE PROVIDERS THROUGH SEVERAL GRANT-FUNDED PROGRAMS AND ITS OWNERSHIP OF QUEENS COORDINATED CARE PARTNERS (QCCP), A STATE-DESIGNATED HEALTH HOME. THE HOSPITAL WILL BE FORGING MORE PARTNERSHIPS AROUND ITS TWO PREVENTION AGENDA PRIORITIES, AS DESCRIBED IN THE THREE YEAR ACTION PLAN.PUBLIC PARTICIPATIONPARTICIPANTS IN THE DEVELOPMENT OF THE COMMUNITY SERVICE PLAN INCLUDED STAFF FROM PUBLIC AFFAIRS, ADMINISTRATION, AS WELL AS MEDICAL STAFF, THE HOSPITAL'S BOARD OF TRUSTEES, THE HOSPITAL'S COMMUNITY ADVISORY BOARD (CAB), AND THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC DOHMH).THE DEPARTMENT OF PUBLIC AFFAIRS RECENTLY CONDUCTED A SURVEY TO HELP IDENTIFY WHICH HEALTH RELATED ISSUES WERE MOST IMPORTANT TO THE COMMUNITY. EACH OF THE COMMUNITY ORGANIZATIONS THAT PARTICIPATED IN THE SURVEY PROCESS WERE PROVIDED WITH A LIST OF COMMON HEALTH ISSUES AND ASKED TO INDICATE WHICH ISSUES THEY FELT WERE THE THREE MOST IMPORTANT FACTORS FOR A HEALTHY COMMUNITY. THE SURVEYS REVEALED THAT COMMUNITY MEMBERS HAD MANY CONCERNS INCLUDING CHILDHOOD OBESITY, HYPERTENSION, NUTRITION, DIABETES, ASTHMA, SEXUALLY TRANSMITTED DISEASES, AS WELL AS TOBACCO USE AND BREASTFEEDING. JAMAICA HOSPITAL IS PARTNERING ON SEVERAL PREVENTION PROJECTS WITH COMMUNITY BASED ORGANIZATIONS AND WITH THE NYC DOHMH AS PART OF ITS TAKE CARE NEW YORK (TCNY) PROGRAM TO ADDRESS THESE PROBLEMS.PRIOR TO DISTRIBUTING THESE SURVEYS, A BRIEF INTRODUCTION AND EXPLANATION OF THE SURVEY WAS GIVEN TO THOSE IN ATTENDANCE EITHER BY THE LEADERSHIP OF THE HOST ORGANIZATION OR BY A MEMBER OF THE STAFF OF THE DEPARTMENT OF PUBLIC AFFAIRS. THE RESPONDENTS WERE TOLD THAT THE SURVEYS WERE ANONYMOUS AND WOULD BE USED BY THE STAFF OF THE HOSPITAL FOR PURPOSES OF BETTER UNDERSTANDING WHAT THEY FELT ARE IMPORTANT TOPICS TO BE ADDRESSED.THE ORGANIZATIONS SURVEYED WERE:09-09-13 JAMAICA HOSPITAL COMMUNITY ADVISORY BOARD - NUMBER OF RESPONSES 1309-09-13 COMMUNITY BOARD 10 - NUMBER OF RESPONSES 2309-10-13 LINDENWOOD ALLIANCE - NUMBER OF RESPONSES 1609-11-13 106TH PRECINCT COUNCIL - NUMBER OF RESPONSES 709-15-13 HEALTH FAIR AT PS 232 - NUMBER OF RESPONSES 3409-18-13 COMMUNITY BOARD 12 - NUMBER OF RESPONSES 1009-23-13 COMMUNITY BOARD 13 - NUMBER OF RESPONSES 2309-24-13 ROCKAWAY BLVD SENIOR CENTER - NUMBER OF RESPONSES 1709-26-13 RICHMOND HILL SOUTH CIVIC ASSOCIATION - NUMBER OF RESPONSES 2709-30-13 CLERGY RESPONSES - NUMBER OF RESPONSES 13TWO INITIATIVES THAT THE HOSPITAL HAS CHOSEN TO ADDRESS AS PART OF THE COMMUNITY SERVICE PLAN AND THE NUMBER OF PEOPLE WHO INDICATED THAT THESE INITIATIVES ARE IMPORTANT:SMOKING CESSATION 60EDUCATING AND ENCOURAGING MOTHERS TO BREAST FEED 15BETWEEN MARCH AND SEPTEMBER 2013 THE CAB HELD DISCUSSIONS OF THE SERVICE AREA'S HEALTH PROBLEMS, INCLUDING THE TWO PROBLEMS THAT WERE BEING CONSIDERED AS PREVENTION AGENDA PRIORITIES FOR THE HOSPITAL'S 2013 COMMUNITY SERVICE PLAN. CONSENSUS WAS REACHED THAT DECREASING TOBACCO USE AND INCREASING EXCLUSIVE BREASTFEEDING WERE PROBLEMS THAT THE HOSPITAL SHOULD ADDRESS, ESPECIALLY SINCE THEY HAVE SUCH A PROFOUND IMPACT ON HEALTH. PART VI, LINE 5: SELECTION OF PUBLIC HEALTH PRIORITIESJAMAICA HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES ARE IN LINE WITH THE PRIORITIES IDENTIFIED BY THE NYS PREVENTION AGENDA AS WELL AS TAKE CARE NEW YORK 2016. ALTHOUGH JHMC COULD HAVE ALSO SELECTED OTHER INITIATIVES, BASED UPON COMMUNITY HEALTH STATISTICS AND CONSUMER NEEDS/UTILIZATION SURVEYS, ITS RESOURCES AND CAPABILITIES ARE BEST SUITED TO FOCUS ON EFFORTS TO INCREASE TOBACCO CESSATION SUCCESS RATES WITHIN THE COMMUNITY AND INCREASE RATES OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN THE SERVICE AREA. THAT IS, JHMC ELECTED TO ADDRESS THESE TWO PARTICULAR HEALTH NEEDS TO MAKE THE MOST IMPACT AND CREATE SUSTAINABLE QUALITY OF LIFE IMPROVEMENTS. JAMAICA HOSPITAL IS ALREADY A PARTNER ON NYC'S TOBACCO-FREE HOSPITAL CAMPAIGN, HAVING EARNED A BRONZE STAR FOR ITS ACCOMPLISHMENTS, AS WELL AS BEING A PARTNER IN THE CITY'S LATCH ON NYC INITIATIVE. THE HOSPITAL IS ALSO PARTNERING WITH THE CITY DOHMH ON 12 OTHER HOSPITAL COMMUNITY HEALTH INTERVENTIONS AND IS, THEREFORE, AN OFFICIAL TAKE CARE NEW YORK PARTNER, IMPLEMENTING EVIDENCE-BASED INTERVENTIONS IN PARTNERING WITH THE CITY:1. SUPPORT THE DEVELOPMENT AND PLACEMENT OF ANTI-OBESITY EDUCATIONAL /MEDIA CAMPAIGNS.2. ADOPT HEALTHY HOSPITAL FOOD INITIATIVE.3. TRACK AND REPORT THE BLOOD PRESSURE CONTROL SCORES OF PATIENTS IN THE HOSPITAL AMBULATORY FOOTPRINT.4. SUPPORT AND PROMOTE THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP) FOR OVERWEIGHT AND OBESE ADULTS WITH PRE-DIABETES OR WOMEN WITH HISTORY OF GESTATIONAL DIABETES.5. ENSURE ROUTINE OFFERING OF HIV TESTING IN EMERGENCY DEPARTMENTS AND ALL OUTPATIENT CLINICS.6. REDUCE THE PERCENT OF HIV INFECTED PATIENTS WITH DETECTABLE VIRAL LOADS.7. PROMOTE COMMUNITY VIOLENCE REDUCTION BY CREATING OR JOINING ESTABLISHED CURE VIOLENCE (CEASE-FIRE) EFFORTS.8. IMPLEMENT HOME-BASED FALLS RISK ASSESSMENTS AND INTERVENTIONS IN THE HOMES OF OLDER ADULTS, DEPLOYING DOHMH TOOLS.9. PROMOTE APPROPRIATE AND JUDICIOUS PRESCRIBING OF OPIOID ANALGESICS.10. SUPPORT TRAINING AND CERTIFICATION OF PRIMARY CARE PRACTICES TO PRESCRIBE BUPRENORPHINE.11. ADOPT SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIET) FOR ALCOHOL AND DRUG USE IN OUTPATIENT AND EMERGENCY DEPARTMENT SETTINGS.12. ENGAGE PATIENTS WITH FIRST EPISODE PSYCHOSIS INTO QUALITY OUTPATIENT CARE.PREVENTION AGENDA PRIORITY #1: DECREASE TOBACCO USEJAMAICA HOSPITAL IS COMMITTED TO PROMOTING TOBACCO-FREE LIVING, ONE OF THE TOP TEN GOALS AS RATED BY TAKE CARE NEW YORK. DISPARITIES IN TOBACCO USE, BOTH RELATED TO SOCIOECONOMIC STATUS AND RACIAL/ETHNIC BACKGROUND ARE SEEN NATIONALLY AND IN NYS AND CAN BE OBSERVED TO SOME EXTENT IN QUEENS AS WELL. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES ARE TO REDUCE SMOKING AMONG ADULTS WITH INCOME LEVELS LESS THAN $25,000 FROM 27.8% (2011) TO 20.0% AND TO INCREASE THE UTILIZATION OF SMOKING CESSATION BENEFITS AMONG SMOKERS WHO ARE ENROLLED IN MEDICAID MANAGED CARE BY 141% FROM 17% (2011) TO 41%.ONE OF THE CONCERNS BROUGHT FORWARD DURING THE TCNY BOROUGH-WIDE LISTENING SESSION (QUEENS, MAY 14, 2013 ) CENTERED ON INCREASING SMOKE-FREE HOUSING. QUEENS'S STAKEHOLDERS IDENTIFIED THE NEED FOR SMOKE-FREE COUNSELING TRAINING FOR CASE MANAGERS WHO WORK IN PUBLIC HOUSING, WHICH SPEAKS TO INCOME-ASSOCIATED DISPARITIES IN TOBACCO CESSATION SUCCESS (AND RELATES TO NYS PREVENTION AGENDA 2013-2017 OBJECTIVE 2.3.2, TO INCREASE THE NUMBER OF LOCAL HOUSING AUTHORITIES THAT ADOPT A TOBACCO-FREE POLICY FOR ALL HOUSING UNITS FROM 3 (2012) TO 12). JAMAICA HOSPITAL'S PLANNED ACTIVITIES TO INCREASE SMOKING CESSATION INCLUDE EFFORTS TO ENGAGE THE COMMUNITY THROUGH OUTREACH (E.G., DEVELOPING AND DISTRIBUTING MULTILINGUAL INFORMATIONAL POSTERS/FLYERS), EDUCATION (WORKING WITH QUEENS QUITS, A PARTNERSHIP BETWEEN THE QUEENS HEALTH NETWORK, THE AMERICAN CANCER SOCIETY AND MEMORIAL SLOAN-KETTERING CANCER CENTER, TO TRAIN TOBACCO CESSATION LEADERS), AND AUGMENTING SCREENING, REFERRAL, AND COUNSELING.JAMAICA HOSPITAL HAS ACHIEVED BRONZE STAR STATUS FROM THE NYC TOBACCO-FREE HOSPITALS CAMPAIGN FOR THE COMPLETION OF ITS ENVIRONMENTAL AND EMPLOYEE CESSATION PROGRAM ASSESSMENTS. THROUGH ITS PARTNERSHIP IN THE CITY?S CAMPAIGN, THE HOSPITAL HAS WORKED WITH THE NORTH CAROLINA PREVENTION PARTNERS, A STATE AND NATIONAL LEADER IN THIS FIELD, TO ENHANCE ITS JHMC'S TOBACCO-FREE CAMPUS POLICIES AND COMPLIANCE STRATEGIES. JHMC ACTIVELY SEEKS TO HELP EMPLOYEES QUIT SMOKING BY OFFERING SMOKING CESSATION BENEFITS, COUNSELING, HOTLINES, AND EDUCATIONAL PROGRAMS. ONE INITIATIVE JAMAICA HOSPITAL IS FOCUSING ON TO MEET TCNY AND NYS TOBACCO CESSATION OBJECTIVES IS TO INCREASE THE NUMBER OF OUTPATIENTS AND INPATIENTS WHO ARE COUNSELED, REFERRED, TREATED AND TRACKED (VIA ELECTRONIC HEALTH RECORDS) FOR TOBACCO CESSATION SERVICES. THE HOSPITAL INTENDS TO SEEK NYC'S SILVER AND GOLD STAR STATUS FOR ITS EFFORTS TO HELP PATIENTS REDUCE OR ELIMINATE TOBACCO USE. IN ITS EFFORTS TO REDUCE TOBACCO USE IN THE COMMUNITY, PARTICULARLY CIGARETTE SMOKING BY ADULTS, JAMAICA HOSPITAL WILL DIRECTLY ADDRESS INCOME AND RACIAL/ETHNIC-RELATED DISPARITIES AND PROVIDE CESSATION SERVICES IN A CULTURALLY-COMPETENT MANNER.PREVENTION AGENDA PRIORITY #2: INCREASE EXCLUSIVE BREASTFEEDINGAS A FOCUS ON CHILDREN AND ADOLESCENT HEALTH IS AN INTEGRAL PART OF THE GOALS SET BY TAKE CARE NEW YORK, JAMAICA HOSPITAL HAS ELECTED TO DIRECT EFFORTS ON INCREASING BREASTFEEDING WITHIN THE COMMUNITIES IT SERVES. JHMC?S BREASTFEEDING PROMOTION INITIATIVES WILL WORK TO INCREASE THE NUMBER OF WOMEN WHO BREASTFEED EXCLUSIVELY IN THE HOSPITAL AFTER CHILDBIRTH AND, WILL IN TURN, HELP ADVANCE OTHER OBJECTIVES, SUCH AS THE REDUCTION OF CHILDHOOD OBESITY RATES AND THE PREVENTION OF CANCER, AS BREASTFEEDING HAS BEEN SHOWN TO PROVIDE PROTECTION AGAINST CHILDHOOD OBESITY AND THE DEVELOPMENT IN WOMEN OF SOME TYPES OF CANCERS (NAMELY BREAST AND OVARIAN). IN 2011, JAMAICA HOSPITAL RANKED LAST (LOWEST) AMONG ALL NYS HOSPITALS REPORTING DATA ON EXCLUSIVE BREASTFEEDING (FIGURE 14). ONLY 0.1% OF INFANTS BORN AT JAMAICA HOSPITAL WERE EXCLUSIVELY FED BREAST MILK, COMPARED WITH 27.5% ACROSS QUEENS (CRUDE RATE, 2008-2010 DATA), 32.4% ACROSS NEW YORK CITY (CRUDE RATE, 2008-2010 DATA) , AND 39.7% STATEWIDE . JAMAICA HOSPITAL'S, QUEENS', NYC'S AND NYS'S EXCLUSIVE BREASTFEEDING RATES ALL FELL FAR SHORT OF THE HEALTHY PEOPLE 2020 GOAL OF AT LEAST 70% OF INFANTS RECEIVING ONLY BREAST MILK . WHILE THE PERCENTAGE OF INFANTS FED ANY BREAST MILK AT JAMAICA HOSPITAL (95.7%) EXCEEDED THE STATEWIDE PERCENTAGE (82.7%), THE PROMOTION OF EXCLUSIVE BREASTFEEDING IS ENCOURAGED, PARTICULARLY AS IT MAY HAVE A STRONGER PROTECTIVE EFFECT AGAINST CHILDHOOD OBESITY THAN COMBINED BREASTFEEDING AND FORMULA FEEDING. BREASTFEEDING RATES FOR MOTHERS ACROSS ALL AGES IN SOUTHWEST QUEENS [COMMUNITY DISTRICTS 9 (WOODHAVEN) AND 10 (HOWARD BEACH)] WERE AMONG THE LOWEST IN QUEENS AND ALSO RANKED AMONG THE LOWEST OF ALL NYC COMMUNITY DISTRICTS FOR THE PERCENTAGE OF INFANTS FED BREAST MILK ONLY AT THE TIME OF BIRTH CERTIFICATE FILING (WITHIN FIRST FIVE DAYS OF LIFE). IN 2011, IT WAS REPORTED THAT ONLY 18.3% AND 19.8% OF INFANTS WERE EXCLUSIVELY FED BREAST MILK IN QUEENS COMMUNITY DISTRICTS 10 AND 9, RESPECTIVELY. AMONG TEENAGE MOTHERS (AGE < 20 YEARS), BREASTFEEDING RATES WERE HIGHER IN JAMAICA (COMMUNITY DISTRICT 12) THAN IN THE OTHER NEIGHBORHOODS SERVED BY JHMC, BUT ALL OF THE COMMUNITY DISTRICTS IN JHMC?S SERVICE AREA HAD LOWER PERCENTAGES OF TEENAGE MOTHERS BREASTFEEDING THAN THE STATE AVERAGE. PART VI, LINE 6: THE HOSPITAL IS AFFLIATED WITH MEDISYS HEALTH SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY PART II COMMUNITY BUILDING ACTIVITIES CONTINUED: HEALTHY INDOOR & OUTDOOR AIR (CORRESPONDS TO NYS'S PROMOTE A HEALTHY & SAFE ENVIRONMENT): OZONE LEVELS WERE CONSISTENT ACROSS JHMC'S NEIGHBORHOODS AND NYC. ASTHMA HOSPITALIZATION RATES WERE HIGHEST IN ENY, ALTHOUGH DEATHS FROM LUNG DISEASES WERE FAIRLY CONSISTENT AMONG JAMAICA HOSPITAL'S NEIGHBORHOODS. RELEVANT HEALTHY PEOPLE 2020 TARGETS ARE TO REDUCE HOSPITALIZATIONS FOR ASTHMA AMONG CHILDREN UNDER AGE 5 YEARS FROM 41.4/10,000 CHILDREN <5 YEARS (2007) TO 18.1 HOSPITALIZATIONS /10,000 CHILDREN <5 YEARS AND TO REDUCE HOSPITALIZATIONS FOR ASTHMA AMONG CHILDREN AND ADULTS AGE 5 TO 65 YEARS FROM 11.1 HOSPITALIZATIONS FOR ASTHMA PER 10,000 CHILDREN AND ADULTS AGED 5 TO 64 YEARS (2007) TO 8.6/10,000 (AGE ADJUSTED TO THE YEAR 2000 STANDARD POPULATION). RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES INCLUDE: INCREASING THE PERCENTAGE OF HOMES IN NYS'S HEALTHY NEIGHBORHOOD PROGRAM (HNP; PROGRAM PROVIDING IN-HOME ASSESSMENTS AND INTERVENTIONS FOR ASTHMA, TOBACCO CESSATION, INDOOR AIR QUALITY, LEAD, FIRE SAFETY, AND OTHER ENVIRONMENTAL HEALTH HAZARDS) THAT HAVE FEWER ASTHMA TRIGGERS DURING THE HOME REVISITS FROM 23.9% TO 20% AND REDUCING THE ANNUAL NUMBER OF DAYS WITH UNHEALTHY AIR AS MEASURED BY THE AIR QUALITY INDEX (AQI)>100 TO 0 (BASELINE: NYC ANNUAL AVERAGE IS 5 DAYS FOR OZONE AND 6 DAYS FOR PARTICULATE MATTER; 2005 - 2009 DEC MONITORING DATA COMPARED TO NATIONAL AMBIENT AIR QUALITY STANDARDS-NAAQS). JAMAICA HOSPITAL IS PART OF THE ASTHMA COALITION OF QUEENS (FORMED IN 2012), IN WHICH ORGANIZATIONS WORK TOGETHER TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE WITH ASTHMA BY ENGAGING PATIENTS, FAMILIES, HEALTHCARE PROVIDERS, INSTITUTIONS AND THE COMMUNITY. JHMC'S RESPIRATORY CARE DEPARTMENT HELPS WITH THE MANAGEMENT OF DISEASES (E.G., ASTHMA) THAT CAN BE TRIGGERED OR MADE WORSE BY AIR POLLUTANTS.QUALITY PREVENTIVE CARE (CORRESPONDS TO NYS'S PREVENT CHRONIC DISEASES): WHILE PERCENTAGES OF PATIENTS REPORTING THEY WERE UNABLE TO ACCESS CARE HAVE DECREASED SLIGHTLY ACROSS NYC AND QUEENS, THEY HAVE FLUCTUATED IN SWQ AND JAMAICA (FIGURE 11). THESE VARIATIONS MAY BE AFFECTED BY HOSPITAL CLOSINGS, SUCH AS THE FEBRUARY 2009 CLOSING OF MARY IMMACULATE AND ST. JOHN'S QUEENS HOSPITALS (CARITAS). JAMAICA HOSPITAL HAS EXPERIENCED SUBSTANTIAL INCREASES IN EMERGENCY ROOM VISITS AND HAS ACCORDINGLY INCREASED CAPACITY (RECEIVING $4 MILLION IN NYS DOH GRANTS EARMARKED TO IMPROVE CAPACITY AND ACCESS TO CARE). NYC, QUEENS, AND THE NEIGHBORHOODS SERVED BY JHMC HAVE HIGHER PERCENTAGES OF PEOPLE REPORTING THAT THEY WERE UNABLE TO RECEIVE CARE THAN THE HEALTHY PEOPLE 2020 TARGET. RELEVANT NYS PREVENTION AGENDA 2013-2017 OBJECTIVES INCLUDE INCREASING THE AGE-ADJUSTED PERCENTAGE OF ADULTS WHO HAVE A REGULAR HEALTH CARE PROVIDER FROM 85.9% (QUEENS) AND 83.0% (NYS) TO 90.8% AND REDUCING THE AGE-ADJUSTED PREVENTABLE HOSPITALIZATION RATE PER 10,000 FROM 136.9 (QUEENS) AND 155.0 (NYS) TO 133.3. JAMAICA HOSPITAL AND ITS AFFILIATED DIAGNOSTIC AND TREATMENT CENTER, WITH A LARGE ON-CAMPUS CENTER AND TEN COMMUNITY-BASED CENTERS, ARE DESIGNATED AS LEVEL 3 PRIMARY CARE MEDICAL HOMES. THEY PROVIDE CARE TO MANY UNDERSERVED AREAS OF SOUTHERN QUEENS AND BROOKLYN, IN PARTICULAR THE JAMAICA AND ENY (BROOKLYN) COMMUNITIES. JAMAICA HOSPITAL IS ALSO A FOUNDING OWNER OF QCCP, A STATE-DESIGNATED HEALTH HOME, WHICH PROVIDES CARE MANAGEMENT SERVICES TO MEDICAID BENEFICIARIES WITH CHRONIC DISEASES WHO HAVE VERY HIGH UTILIZATION. THE HOSPITAL, WHICH ALREADY CARES FOR THOUSANDS OF MEDICAID BENEFICIARIES THROUGH MANAGED CARE PLANS, HAS EXECUTED CONTRACTS WITH EIGHT PLANS PARTICIPATING IN THE STATE'S INSURANCE EXCHANGE, NEW YORK STATE OF HEALTH, AND ANTICIPATES THAT MANY UNINSURED PERSONS IN THE AREA WILL SIGN UP AND ACCESS DEFERRED PRIMARY AND PREVENTIVE CARE.PREVENTION QUALITY INDICATORS (PQI) ARE MEASUREMENTS OF THE QUALITY OF OUTPATIENT CARE FOR AMBULATORY CARE SENSITIVE CONDITIONS - CONDITIONS FOR WHICH GOOD OUTPATIENT CARE CAN TYPICALLY PREVENT THE NEED TO BE ADMITTED TO THE HOSPITAL. THE PQI RANKINGS FOR THE SERVICE AREA ARE BASED UPON HOSPITAL DISCHARGE RATES PER 100,000 PEOPLE. WHEN ABOVE 100%, THE PERCENT OF THE EXPECTED DISCHARGE RATE INDICATES HOW MUCH THE OBSERVED RATE EXCEEDED THE EXPECTED RATE. FOR EXAMPLE, THE DISCHARGE RATE FOR CIRCULATORY CONDITIONS FOR BLACK PATIENTS IN JHMC'S SERVICE AREA WAS ALMOST DOUBLE (200%) THE EXPECTED RATE. FOR EACH CONDITION CATEGORY, THE PERCENTAGE OF OBSERVED ADMISSIONS EXCEEDS THAT EXPECTED PERCENTAGE FOR BLACK RESIDENTS IN JHMC'S SERVICE AREA, HIGHLIGHTING RACIAL DISPARITIES IN HOSPITALIZATIONS FOR CONDITIONS THAT COULD BE ADDRESSED WITH PREVENTIVE CARE. REDUCING DISPARITIES IN PREVENTABLE HOSPITALIZATIONS IS ALSO A PRIORITY FOR THE NYS PREVENTION AGENDA 2013-2017, AS OBJECTIVES INCLUDE REDUCING THE RATIO OF AGE-ADJUSTED PREVENTABLE HOSPITALIZATIONS AMONG BLACK NON-HISPANICS TO WHITE NON-HISPANICS FROM 1.82 (QUEENS-WHICH ALREADY IS LOWER THAN THE NYS PREVENTION AGENDA 2013-2017 OBJECTIVE) AND 2.09 (NYS) TO 1.85 AND REDUCING THE RATIO OF AGE-ADJUSTED PREVENTABLE HOSPITALIZATIONS AMONG HISPANICS TO WHITE NON-HISPANICS FROM 0.85 (QUEENS-WHICH IS ALREADY LOWER THAN THE NYS PREVENTION AGENDA 2013-2017 OBJECTIVE) AND 1.47 (NYS) TO 1.38. AS NOTED JAMAICA HOSPITAL HAS TAKEN MANY STEPS TO IMPROVE AND EXPAND AMBULATORY CARE AND INSURANCE COVERAGE IN ITS SERVICE AREA.PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDRENMATERNAL AND INFANT HEALTH INDICATORS: LOW BIRTH WEIGHT (LBW) AND PRETERM BIRTHS ARE MORE LIKELY TO RESULT IN MEDICAL PROBLEMS, BOTH AS NEWBORNS [E.G., RESPIRATORY DISTRESS SYNDROME (BREATHING PROBLEM CAUSED BY LACK OF SURFACTANTS IN PREMATURE LUNGS); BLEEDING IN THE BRAIN; PATENT DUCTUS ARTERIOSUS (WHEN A CRUCIAL ARTERY FAILS TO CLOSE AFTER BIRTH AND CAN CAUSE HEART FAILURE] AND LATER IN LIFE (E.G., HIGH BLOOD PRESSURE, DIABETES, HEART DISEASE). IN JAMAICA HOSPITAL'S PRIMARY SERVICE AREA (TABLE 5), THE LOW BIRTH WEIGHT RATE IS MORE THAN 28% HIGHER THAN THE HEALTHY PEOPLE 2020 GOAL OF 7.8%. SIMILARLY, MORE THAN 14% OF THE BIRTHS IN THE TARGETED ZIP CODES WERE PRETERM. THE PRETERM BIRTH RATE IS MORE THAN 18% HIGHER THAN THE HEALTHY PEOPLE 2020 GOAL OF 11.4%. IN QUEENS, THERE IS A NOTABLE DISPARITY IN THE RATIOS OF PRETERM BIRTHS, WHERE THE RATE OF PRETERM BIRTHS IS HIGHER FOR BLACK NON-HISPANICS (RATIO IS 1.65) THAN WHITE NON-HISPANICS (ACROSS NYS, RATIO IS 1.61). THIS DISPARITY IS ALSO FOUND WHEN COMPARING PRETERM BIRTH RATES FOR HISPANIC AND WHITE NON-HISPANIC MOTHERS (RATIO IS 1.33 IN QUEENS, COMPARED WITH 1.25 IN NYS ). ADDITIONALLY, JHMC'S NEIGHBORHOODS REFLECT HIGH RATES OF RISK FACTORS FOR LOW BIRTH WEIGHT AND PRETERM BIRTHS, INCLUDING BIRTHS TO MEDICAID BENEFICIARIES, AFRICAN-AMERICAN AND LATINO WOMEN, AND LOW-INCOME WOMEN. THE HOSPITAL OPERATES A WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM FUNDED BY THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH PROVIDES FOOD VOUCHERS AND EDUCATION TO LOW INCOME PREGNANT WOMEN AND CHILDREN UP TO AGE FIVE, AND IS SEEKING BABY FRIENDLY DESIGNATION BY PROMOTING EXCLUSIVE BREASTFEEDING. THE HOSPITAL'S EFFORTS TO INCREASE EXCLUSIVE BREASTFEEDING ARE DESCRIBED IN A LATER SECTION (SELECTION OF PUBLIC HEALTH PRIORITIES).TEENAGE PREGNANCY: QUEENS' TEENAGE BIRTH RATES DEMONSTRATE RACIAL/ETHNIC DISPARITIES , AS THE RATIO OF THE BLACK NON-HISPANIC TEENAGE PREGNANCY RATE TO THE WHITE NON-HISPANICS TEENAGE PREGNANCY RATE IS 6.31 (5.74 IN NYS; THE NYS PREVENTION AGENDA 2013-2017 OBJECTIVE IS TO REDUCE THIS RATIO TO 4.90). SIMILARLY, THE RATIO OF THE HISPANIC TEENAGE PREGNANCY RATE TO THE WHITE NON-HISPANIC TEENAGE PREGNANCY RATE IS 5.67 IN QUEENS (5.16 FOR NYS; THE NYS PREVENTION AGENDA 2013-2017 OBJECTIVE IS TO REDUCE THIS RATIO TO 4.10). NEIGHBORHOODS SERVED BY JAMAICA HOSPITAL DISPLAYED PERCENTAGES OF LOW BIRTH WEIGHT EVENTS AMONG TEENAGE MOTHERS THAT WERE COMPARABLE TO THE PERCENTAGES ACROSS QUEENS AND NYC , HIGHLIGHTING THE NEED FOR QUALITY PRENATAL CARE FOR ALL MOTHERS-TO-BE IN THE COMMUNITY. X X X X 0 1 0 0 0 0 0 0 0 ANTHONY DIMARIA MD SECRETARY 0 216193 0 0 0 12704 0 5550 0 19340 0 253787 0 0 GEOFFREY DOUGHLIN MD THIRD VICE PRESIDENT 399018 0 0 0 0 0 6250 0 20501 0 425769 0 0 0 BRUCE FLANZ PRESIDENT & CEO 698623 548885 0 0 124876 0 6250 0 19340 0 849089 548885 0 0 MOUNIR DOSS VICE PRESIDENT & CFO 549896 346363 0 0 77859 0 6250 0 19340 0 653345 346363 0 0 WILLIAM LYNCH VICE PRESIDENT & COO 396981 0 0 0 11922 0 6250 0 19340 0 434493 0 0 0 GIDEON YOELI RADIOLOGIST 419001 0 0 0 3516 0 6250 0 19500 0 448267 0 0 0 ROBERT GREENBAUM MD RADIOLOGIST 413280 0 0 0 3564 0 6250 0 21840 0 444934 0 0 0 ROBERT SOLOMON RADIOLOGIST 415780 0 0 0 1836 0 6250 0 19340 0 443206 0 0 0 SABIHA RAOOF CHAIRPERSON RADIOLOGY 514100 0 0 0 0 0 6250 0 19340 0 539690 0 0 0 THOMAS SANTUCCI MD CHAIRMAN DEPT MEDICINE 431275 0 0 0 32370 0 6250 0 15112 0 485007 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED SERP PAYMENTS DURING 2013: BRUCE FLANZ - 24,898 FORM 990, PART VI, SECTION A, LINE 6 MEDISYS HEALTH NETWORK IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MEDISYS HEALTH NETWORK, AS SOLE MEMBER CAN APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION, IT IS FINALIZED AND SUBSEQUENTLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE COMPLIANCE OFFICERS REVIEW THE SUBMISSIONS FOR CONFLICTS AND REPORTS THEM TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION POLICY - THE BOARD OF MEDISYS HEALTH NETWORK HAS CREATED AN INDEPENDENT COMPENSATION COMMITTEE WHOSE CHARGE IS TO REVIEW AND APPROVE THE COMPENSATION OF ALL INDIVIDUALS WHO MEET THE REQUIREMENTS OF A DISQUALIFIED PERSON FOR INTERMEDIATE SANCTION. THIS COMMITTEE IS EMPOWERED TO APPROVE COMPENSATION FOR ALL ENTITIES WITHIN THE MEDISYS HEALTH NETWORK SYSTEM. THE COMMITTEE HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR EXECUTIVES. IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) OF EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTION REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE COMMITTEE SHALL APPROVE BASE SALARIES FOR EXECUTIVES AND ANY DISQUALIFIED INDIVIDUALS BASED UPON THE AMOUNTS PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE CEO SHALL RECOMMEND TO THE COMPENSATION COMMITTEE ANY ADJUSTMENTS TO THE BASE SALARIES OF EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, COLUMN C: MANAGEMENT HAS IN THE PREPARATION OF ITS FORM 990 REVIEWED PERSONNEL IN THE INSTITUTION TO SEE IF ANYONE MEETS THE CRITERIA ESTABLISHED TO BE CONSIDERED A "KEY EMPLOYEE" FOR IRS PURPOSES. IT IS THE CONTENTION OF MANAGEMENT THAT NO EMPLOYEE FULFILLS ANY OF THE SITUATIONS UNDER THE RESPONSIBILITY TEST ESTABLISHED BY THE IRS TO MEET TITLE OF KEY EMPLOYEE. THEREFORE, PART VII OF FORM 990 DOES NOT HAVE ANY INDIVIDUALS WHO WOULD BE CONSIDERED A "KEY EMPLOYEE". FORM 990, PART VII, SECTION A, LINE 1B: ANTHONY DIMARIA, M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL NURSING HOME WORKING ABOUT 40 HOURS PER WEEK. ANTHONY DIMARIA, M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMAICA HOSPITAL MEDICAL CENTER, MEDISYS HEALTH NETWORK, OR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. GEOFFREY DOUGHLIN M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL MEDICAL CENTER WORKING ABOUT 40 HOURS PER WEEK. GEOFFREY DOUGHLIN M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER OR MEDISYS HEALTH NETWORK FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. FOR BRUCE FLANZ, PRESIDENT & CEO, MOUNIR DOSS, EXECUTIVE VICE PRESIDENT & CFO, THE HOURS REPORTED BELOW REFLECT THE TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENTLY WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. ESTIMATED NUMBER OF HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS IS AS FOLLOWS: MEDISYS HEALTH NETWORK - 10 HOURS PER WEEK FLUSHING HOSPITAL MEDICAL CENTER - 15 HOURS PER WEEK JAMAICA HOSPITAL MEDICAL CENTER - 30 HOURS PER WEEK OTHER RELATED ENTITIES LISTED ON SCHEDULE R - 10.0 HOURS PER WEEK FORM 990, PART XI, LINE 9: PENSION ACTUARIAL GAINS 24,440,642. FORM 990, PART XII, LINE 2C: THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM THE PRIOR YEAR. 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