2021-11-15T14:17:11-06:00 2020-12-31 161226221 FREED MAXICK CPAS PC 424 MAIN STREET SUITE 800 BUFFALO NY 142023508 990 2020-01-01 150524324 DELAWARE VALLEY HOSPITAL INC DELA 6078652197 1 TITUS PLACE WALTON NY 138561457 LUCINDA RIDER CFO 6078652197 2021-11-11 1 LUCINDA RIDER 999009999 MARY MADONIA P00405803 7168472651 2021-11-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROLLAND V BOJO JR 1 TITUS PLACE WALTON NY 138561457 30967896 0 X WWW.NYUHS.ORG X 1950 NY SEE SCHEDULE OTO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE,PRIMARY CARE AND WELLNESS SERVICES. 8 4 240 32 0 0 1208797 7270845 24990075 23357978 161825 195421 391936 143652 26752633 30967896 0 0 0 0 10341924 10449295 0 0 215085 14429311 14882202 24771235 25331497 1981398 5636399 23538078 30737711 5893763 7208593 17644315 23529118 X INPATIENT AND ACUTE SERVICES (SEE SCHEDULE O)AS A CRITICAL ACCESS HOSPITAL AND MEMBER OF THE UHS HEALTHCARE SYSTEM, UHS DELAWARE VALLEY HOSPITAL'S MISSION IS TO PROVIDE THE COMMUNITY WITH THE HIGH QUALITY, PATIENT-CENTERED SERVICES THAT ARE MOST OFTEN NEEDED; THEREBY IMPROVING ACCESS TO CARE AND REDUCING THE NEED TO TRAVEL LONG DISTANCES. WE DO THIS BY OFFERING EMERGENCY CARE, INPATIENT SHORT-TERM ACUTE CARE, PHYSICAL REHABILITATIVE CARE AND ADDICTION TREATMENT. IN ADDITION, WE PROVIDE HIGH QUALITY PRIMARY CARE; A WIDE RANGE OF DIAGNOSTIC AND TREATMENT SERVICES; ACCESS TO TOP LOCAL SPECIALTY CARE AND AN OUTPATIENT PHARMACY. UHS DELAWARE VALLEY HOSPITAL ALSO SERVES AS THE GATEWAY FOR PATIENTS TO ACCESS THE STATE-OF-THE-ART TECHNOLOGY AND HIGHLY QUALIFIED SPECIALISTS OF THE UHS SYSTEM, WHEN MORE SPECIALIZED CARE IS NEEDED. 0 0 5004806 4742868 INPATIENT AND ACUTE SERVICES (SEE SCHEDULE O) INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT ACUTE CARE, SWING BED AND ADDICTION TREATMENT SERVICES VIA ITS 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2020 WERE COMPRISED OF 89 ACUTE, 121 SWING BED, AND 72 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 254 PATIENT DAYS, IN ADDITION TO THE 2,177 PATIENT DAYS FOR SWING BED AND 1,116 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 5,654 LAB TESTS, 8,994 RESPIRATORY TREATMENTS, 111 X-RAYS, 11 ULTRASOUNDS, 58 CT AND 2 MRI EXAMS, 1,250 PHYSICAL THERAPY AND 716 OCCUPATIONAL THERAPY SESSIONS, AND 45 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED 6 ECHO EXAMS, AND 540 DIETARY CONSULTS. TO ENSURE OUR RURAL AREA RESIDENTS HAVE ACCESS TO HIGH QUALITY, EFFICIENT CARE IN A COMFORTABLE AND PRIVATE AREA, THE HOSPITAL'S IMAGING CENTER IS EQUIPPED WITH 3D MAMMOGRAPHY, ULTRASOUND, BONE DENSITY, X-RAY AND A 128-SLICE CT SUITE. MRI SERVICES ARE OFFERED ON SUNDAYS THROUGH AN AGREEMENT WITH A MOBILE VENDOR. 3326843 2157254 CLINICS (SEE SCHEDULE O) CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH ITS PRIMARY CARE CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE PRIMARY CARE CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. 2020 INCLUDED 10,276 VISITS IN WALTON, 425 IN ROSCOE, AND 1,740 IN DOWNSVILLE. 12465715 16457856 OUTPATIENT AND AMBULATORY SERVICES (SEE SCHEDULE O) OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC CARDIOPULMONARY, IMAGING, LAB AND TREATMENT SERVICES AT ITS WALTON CAMPUS. THESE INCLUDE A 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE PHYSICAL AND OCCUPATIONAL REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, CARDIAC AND PULMONARY REHABILITATION AND ACCESS TO SPECIALTY SERVICES. IN 2020 THE CARDIOLOGY SPECIALTY CLINIC HAD 568 VISITS, PAIN MANAGEMENT 405; TELE-MENTAL HEALTH AND TELE-DIABETES CONSULTS 890, WHILE GASTROENTEROLOGY HAD 72. THE HOSPITAL ALSO GENERALLY CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS, DIABETES EDUCATION AND CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS. GENERALLY, THESE PROGRAMS ARE CONDUCTED BEGINNING IN THE SPRING AND HELD AGAIN IN THE FALL. HOWEVER, DUE TO THE PANDEMIC GROUP EDUCATION PROGRAMS WERE NOT HELD. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION: 198 IN 2020. IN 2020 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 4,107 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 56,278 TESTS, AND 5,853 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,526 X-RAYS, CT SCANS, MRI'S, ULTRASOUNDS, BONE DENSITY TESTS AND MAMMOGRAPHY FOR OUTPATIENT SERVICES. OTHER OUTPATIENT SERVICES PERFORMED IN 2020 INCLUDED 198 AMBULATORY PROCEDURES, 49 ENDOSCOPIES, 1,614 OPIATE ADDICTION TREATMENT SESSIONS, AND 542 SERVICES ASSOCIATED WITH CARDIAC AND PULMONARY REHABILITATION. THE CARDIOPULMONARY DEPARTMENT PERFORMED 973 TESTS AND/OR TREATMENTS. 1,047 CARDIAC RELATED TESTS WERE PERFORMED: EKGS, ECHOCARDIOGRAMS, CARDIAC HOLTER AND EVENT MONITORS. THERE WERE 213 DIETARY CONSULTS. THE HOSPITAL'S OUTPATIENT RETAIL PHARMACY FILLED 58,260 PRESCRIPTIONS. 143652 143652 20797364 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 31 0 1 240 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 NY X ROLLAND BOJO 6078652197 DELAWARE VALLEY HOSPITAL 1 TITUS WALTON NY 138561457 HELEN JOHNSTON BOARD MEMBER/BOARD CHAIR 2.00 X X 0 0 0 JOHN CARRIGG BOARD MEMBER/VICE CHAIR 2.00 55.00 X X 0 3503410 1354855 LARRY LIGHT BOARD MEMBER 2.00 X 0 0 0 EDWARD SNOW BOARD MEMBER/SECRETARY 2.00 X X 0 0 0 ERIN NEALE BOARD MEMBER 2.00 X 0 0 0 AMANDA HALL BOARD MEMBER/TREASURER 2.00 X X 0 0 0 DR MICHAEL FREEMAN BOARD MEMBER/MEDICAL STAFF PRESIDENT 57.00 X X 236927 0 21741 DR JOHN GIANNONE CHIEF MEDICAL OFFICER 5.00 X 21938 0 0 DOTTIE KRUPPO V.P. COMMUNITY RELATIONS 55.00 X 99906 0 21951 DEBORAH HITT V.P. QUALITY/SUPPORT SVCS 55.00 X 28257 0 1222 VICTORIA CONKLING V.P. PATIENT CARE SERVICES 55.00 X 138635 0 7627 LUCINDA RIDER CFO 55.00 X 100489 0 19375 KATHLEEN ULMSCHNEIDER STAFF NURSE 55.00 X 113858 0 22490 TITO ENDAYA LAB MANAGER 55.00 X 110210 0 22868 PATRICIA SVOBODA CLINICAL LAB TECHNOLOGIST 55.00 X 104774 0 16581 PAUL SUMMERS FORMER BOARD MEMBER/PRES/CEO 6/30/20 57.00 X 239801 0 24966 1194795 3503410 1513676 7 1 1 1 SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH NY 13815 PHYSICAL/OCC. THERAPY 658807 GE HEALTHCARE SERVICE PO BOX 96483 CHICAGO IL 60693 HEALTH TREATMENT SERVICES 476886 MEDHOST OF TENNESSEE INC 2739 MOMENTUM PLACE CHICAGO IL 60689 MEDHOST PROGRAM MANAGEMENT/FINANCE 418765 AMN HEALTHCARE PO BOX 56157 LOS ANGELES CA 900746157 MEDICAL STAFFING SOLUTION 371483 EVANS MECHANICAL INC 314 MAPLE STREET ENDICOTT NY 13760 PLUMBING AND HEATING SOLUTIONS 156751 18 7263720 7125 7270845 OUTPATIENT SERVICES 621400 16457856 16457856 INPATIENT AND ACUTE SERVICES 621990 4742868 4742868 CLINICS 621110 2157254 2157254 23357978 191321 191321 4100 0 4100 4100 4100 DSRIP PROJECT REVENUE 900099 80656 80656 MISC REVENUE 900099 13328 13328 49668 49668 143652 30967896 23501630 0 195421 X 1232263 851751 258655 121857 7417940 6064241 1319123 34576 241800 200694 38688 2418 956339 754300 192476 9563 600953 463375 127463 10115 113297 113297 12317 12317 88226 88226 1735 1735 4708 4708 6443967 5236696 1207271 594 594 1433488 799495 621389 12604 107515 107515 199533 47790 151743 21030 13086 7613 331 30583 7121 435 23027 118469 87289 31180 930553 930553 124784 89570 35214 DRUGS 3934638 3934638 MEDICAL SUPPLIES 558067 558067 BAD DEBT EXPENSE 515228 515228 EQUIPMENT 174521 174521 68949 68949 25331497 20797364 4319048 215085 3628167 3734558 2176087 2608965 504567 382713 550450 780361 26636899 16298203 9919860 10338696 5046374 11408064 318209 318209 1394364 1166145 23538078 30737711 1535695 1103340 2148852 1831430 222663 166045 1516651 3456654 469902 651124 5893763 7208593 X 17308649 23192273 335666 336845 17644315 23529118 23538078 30737711 X 5636399 295317 -46913 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1735 1735 0 PART II-B, LINE 1: AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY (17.97%) AND IROQUOIS HEALTHCARE (39.70%). 335666 1179 336845 330416 5250 335666 328445 1971 330416 330360 9996 11911 328445 324669 5691 330360 0.94000 0.06000 1 0 51202 51202 13760390 6757140 7003250 11345386 9541063 1804323 1479921 1479921 10338696 DUE UNITED MED. ASSOC. 207576 DUE UHS HOSPITALS 445033 DUE TO UHS, INC. 592 DUE FROM UHSH SBO LOCKBOX -2077 651124 X 30701072 295317 -46913 248404 30452668 515228 515228 30967896 24816269 0 24816269 515228 515228 25331497 PART V, LINE 4: PURCHASE OF CAPITAL EQUIPMENT (MEDICAL) AND IMPROVEMENT OF FACILITIES. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2020 AND 2019, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2017 TO 2020. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. PART XI, LINE 2D - OTHER ADJUSTMENTS: INTEREST RATE SWAP -46,913. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 515,228. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 515,228. 1 1 X 1 X 0 1 1 0 1 1 152431 152431 0.00610 5511089 3847793 1663296 0.06700 74971 102218 0 0.00000 5738491 3950011 1815727 0.07310 258270 258270 0.01040 11799 11799 0.00050 13589225 10979327 2609898 0.10520 13859294 10979327 2879967 0.11610 19597785 14929338 4695694 0.18920 6262 6262 0.00030 11014 11014 0.00040 179 179 0.00000 17455 17455 0.00070 0 515228 296464 4787213 4759091 28122 X 1 1 1 1 DELAWARE VALLEY HOSPTITAL 1 TITUS PLACE WALTON NY 13856 X X X DELAWARE VALLEY HOSPTITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTP://WWW.NYUHS.ORG X 1 19 1 HTTP://WWW.NYUHS.ORG 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.NYUHS.ORG X HTTP://WWW.NYUHS.ORG X HTTP://WWW.NYUHS.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 5: DELAWARE VALLEY HOSPITAL HAS MEMBERSHIP IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY, AS WELL AS ON ITS WELLNESS COMMITTEE. A STAFF MEMBER ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR PARTICIPATES IN ALL DVH VOLUNTEER MEETINGS AND ACTIVELY SEEKS THEIR INPUT AND FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES INPUT AS TO WHAT THEY HEAR FROM COMMUNITY MEMBERS. PATIENT SATISFACTION SURVEYS ARE ALSO USED IN GAINING INPUT FROM OUR PATIENTS. DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6A: O'CONNOR HOSPITAL, DELHI, NYMARGARETVILLE COMMUNITY HOSPITAL, MARGARETVILLE, NY DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, DEPARTMENT OF SOCIAL SERVICES, SHERIFF'S DEPT, ALCOHOL AND DRUG ABUSE COUNCIL, PLANNING DEPARTMENT, EMERGENCY SERVICES, DRUG TREATMENT COURT, WATERSHED AFFAIRSHOSPITAL AND HEALTH SERVICES:UHS DELAWARE VALLEY HOSPITAL, BASSETT HEALTHCARE-O'CONNOR HOSPITAL AND CATSKILL AREA HOSPICEEDUCATION:ROXBURY CENTRAL SCHOOLNURSING HOMES:ROBINSON TERRACEALLIANCES:RURAL HEALTH NETWORK OF SOUTH CENTRAL NYOTHER HUMAN SERVICE AGENCIES:CORNELL COOPERATIVE EXTENSION, RURAL 3 FOR TOBACCO FREE COMMUNITIES, CANCER SERVICE PROGRAM OF DELAWARE, OTSEGO AND SCHOHARIE COUNTIES, DELAWARE OPPORTUNITIES, NY CONNECTS, FAMILY RESOURCE NETWORK, CATHOLIC CHARITIES DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 11: DELAWARE VALLEY HOSPITAL - 2020 UPDATEDELAWARE COUNTY 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS(EXCERPTED FROM COMMUNITY HEALTH NEEDS ASSESSMENT 2019-2021)CHALLENGES THE SHEER SIZE, TOPOGRAPHY AND PAROCHIAL NATURE OF THE COMMUNITIES WITHIN DELAWARE COUNTY POSE HUGE CHALLENGES IN THE DELIVERY OF HEALTH CARE. THERE ARE MANY CHALLENGES BUT FOR DELAWARE VALLEY'S PLAN, THE KEY FINDINGS ARE BELOW: KEY FINDINGS FROM THE ASSESSMENT 1. LACK OF TRANSPORTATION 2. AGING POPULATION 3. POVERTY 4. PREVALENCE OF CHRONIC DISEASE 5. PREVALENCE OF MENTAL HEALTH NEEDS ACCESSDVH HAS BEGUN TO ADDRESS MANY OF THESE ISSUES IN A VARIETY OF WAYS. THE HOSPITAL HAS EXPANDED THE HOURS THAT ITS PRIMARY CARE OFFICES ARE OPEN. BOTH THE DOWNSVILLE AND ROSCOE OFFICES ARE NOW OPEN 5 DAYS PER WEEK. THE WALTON OFFICE IS OPEN UNTIL 7 PM, MONDAYS THROUGH THURSDAYS AND UNTIL 5 PM ON FRIDAY. SATURDAY MORNING HOURS HAVE BEEN DISCONTINUED DUE TO THE INCREASED USE OF VIRTUAL VISITS SINCE THE COVID PANDEMIC BEGAN. THE HOSPITAL'S RETAIL PHARMACY IS OPEN 7 DAYS A WEEK. THE IMAGING AND LAB DEPARTMENTS OFFER EVENING AND WEEKEND APPOINTMENTS. THE HOSPITAL'S OUTPATIENT REHABILITATION DEPARTMENT OFFERS EARLY MORNING AND EVENING APPOINTMENTS. BY EXTENDING HOURS, PATIENTS HAVE THE OPPORTUNITY TO RECEIVE CARE WITHOUT HAVING TO TAKE TIME OFF FROM WORK. MANY AGING PATIENTS RELY ON THEIR CHILDREN OR NEIGHBORS/FRIENDS FOR TRANSPORTATION TO HEALTH CARE APPOINTMENTS. THIS ALLOWS THE CAREGIVERS THE ABILITY TO SCHEDULE THOSE APPOINTMENTS AT A MORE CONVENIENT TIME. SINCE THE PANDEMIC, MANY HOURS HAVE HAD TO BE ADJUSTED IN ORDER TO PROMOTE SOCIAL DISTANCING AND PATIENT AND STAFF SAFETY. MANY ACCOMMODATIONS HAVE BEEN MADE INCLUDING THE EXTENSIVE USE OF VIRTUAL VISITS AND TELEPHONIC VISITS. FOR PATIENTS, LIKE THE ELDERLY, WHO WOULD BE AT HIGH-RISK IF THEY WERE TO CONTRACT COVID, DVH PHLEBOTOMISTS WERE GOING OUT TO THEIR CAR TO DRAW BLOOD, RATHER THAN HAVE THEM ENTER THE HOSPITAL. ALL COVID-19 TESTING HAS BEEN DONE WHILE THE PATIENT REMAINS IN THEIR CAR. THE HOSPITAL BUILT A SMALL ADDITION TO THE HOSPITAL TO ACCOMMODATE TESTING SUPPLIES AND ALLOW STAFF PROTECTION FROM THE WEATHER. PATIENTS THEN DRIVE UNDER AN EXISTING OVERHANG TO HAVE THEIR TEST COMPLETED. TRANSPORTATION: DELAWARE VALLEY HAS A REPRESENTATIVE ON THE COUNTY'S TRANSPORTATION COMMITTEE, THROUGH THE OFFICE FOR THE AGING, BUT THERE WAS NO MEETING IN 2020. THE HOSPITAL MAINTAINED AN OFFICE FOR TWO REPRESENTATIVES FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY. THE ORGANIZATION SERVES DELAWARE COUNTY, YET HAS NO PHYSICAL PRESENCE IN THE AREA. THEIR OFFICE IS BASED APPROXIMATELY ONE HOUR AWAY: CENTRAL TO THEIR COVERAGE AREA BUT CHALLENGING WHEN TRYING TO REACH THE FAR CORNERS OF THEIR TERRITORY. BECAUSE THEY HAVE NO BUDGET FOR A SECOND OFFICE, DVH PROVIDES THE SPACE, PHONE, SUPPLIES AT NO CHARGE TO THE ORGANIZATION. THIS HELPS THEM PROVIDE DELAWARE COUNTY RESIDENTS WITH MANY REFERRALS, NAVIGATION, AND SOCIAL SERVICE-TYPE SUPPORTS. HOWEVER, DUE TO THE PANDEMIC, IN 2020, MOST OF THEIR WORK WAS DONE FROM HOME, WITH OCCASIONAL VISITS TO THE OFFICE. PREVALENCE OF CHRONIC DISEASE DVH HAD THREE STAFF MEMBERS WHO WERE CERTIFIED LEADERS OF THE STANFORD UNIVERSITY EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. THE PROGRAM IS GENERALLY OFFERED AT LEAST TWICE PER YEAR AND ALSO IS OFFERED BOTH DURING THE DAY AND IN THE EVENING FOR CONVENIENCE. HOWEVER, IN 2019, WE SAW DECLINING INTEREST. IN 2020, WE DID NOT OFFER THE PROGRAM, AS WE DID NOT HAVE A SPACE LARGE ENOUGH TO ACCOMMODATE SOCIAL DISTANCING. ONE OF THE THREE LEADERS LEFT DVH EMPLOY IN 2020. DVH ALSO HAS A CARE COORDINATOR RN WHO WORKS CLOSELY WITH THE PRIMARY CARE PROVIDERS TO HELP PATIENTS WHO ARE HIGH RISK FOR ADMISSION TO THE HOSPITAL DUE TO THEIR CHRONIC DISEASE. SHE OFFERS ONE- ON- ONE GUIDANCE AND SUPPORT BASED ON THEIR NEEDS. SHE ALSO WORKS VERY CLOSELY WITH THE CERTIFIED DIETITIAN/NUTRITIONIST WHO ALSO OFFERS INDIVIDUALIZED GUIDANCE. THE DIETITIAN ALSO WORKED WITH 30 SNAP RECIPIENTS IN 2020 IN CONJUNCTION WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S FRUIT AND VEGETABLE RX PROGRAM. THE PROVIDERS BEGAN TO TRACK, AND WILL CONTINUE TO TRACK VARIOUS METRICS REGARDING CHRONIC DISEASE THROUGHOUT THIS THREE-YEAR PLAN. SPECIFICS ARE OUTLINED LATER IN THIS DOCUMENT. AS DVH, ALONG WITH THE ENTIRE UHS SYSTEM, WAS PREPARING TO IMPLEMENT THE EPIC ELECTRONIC HEALTH RECORD IN APRIL 2020. IT IS BELIEVED THAT THE PROGRAM'S FEATURES WILL ENHANCE THE PROVIDERS' EFFORTS TO SERVE AS THE PATIENTS' MEDICAL HOME AND GUIDE THEIR CARE. DUE TO THE PANDEMIC, THE IMPLEMENTATION DID NOT TAKE PLACE UNTIL SEPTEMBER 2020. IT IS EXPECTED THAT IN 2021, THE PROVIDERS WOULD BE ABLE TO GUIDE THEIR CARE BETTER, GIVEN TIME TO WORK WITH THE NEW SYSTEM.TELE-ENDOCRINOLOGY WORKING WITH UHS, DVH OFFERS VIDEOCONFERENCING APPOINTMENTS WITH A UHS NURSE PRACTITIONER SPECIALIZING IN DIABETES CARE. THIS NOT ONLY PROVIDES FURTHER CARE FOR ITS DIABETIC PATIENTS BUT ALSO EASES THE ACCESS TO CARE. PREVALENCE OF MENTAL HEALTH NEEDS TELE-MENTAL HEALTH WORKING CLOSELY WITH THE DELAWARE COUNTY MENTAL HEALTH DEPARTMENT OVER SEVERAL YEARS, DELAWARE VALLEY INSTITUTED A TELE-MENTAL HEALTH PROGRAM TO HELP INCREASE ACCESS TO MENTAL HEALTH PROFESSIONALS. PATIENTS SEE PROVIDERS THROUGH VIDEOCONFERENCING AT THE HOSPITAL'S PRIMARY CARE OFFICE IN WALTON. DVH IS CURRENTLY IN THE PROCESS OF REQUESTING AN ADDITIONAL LCSW, AS THERE IS STILL UNMET NEED. THE STIGMA THAT SOME PATIENTS FEEL CAN BE REDUCED BECAUSE THEY ARE COMING TO A PRIMARY CARE FACILITY AS OPPOSED TO A MENTAL HEALTH FACILITY. THE HOSPITAL CONTRACTS WITH A VENDOR WHO SUPPLIES A PSYCHIATRIC NURSE PRACTITIONER AND TWO LICENSED CLINICAL SOCIAL WORKERS. IN 2020, ONE LCSW WENT ON MATERNITY LEAVE AND LEFT THE PROGRAM THEREAFTER. TWO ADDITIONAL LCSWS WERE CONTRACTED, BUT ALMOST IMMEDIATELY ONE OF THEM FOUND THAT THE MENTAL HEALTH NEEDS OF FIRST RESPONDERS AND RESIDENTS OF HER COMMUNITY WERE SO EXCESSIVE DUE TO THE PANDEMIC; SHE FELT COMPELLED TO CONCENTRATE ON HELPING THEM AND THEREFORE LEFT THE PROGRAM. ANOTHER LCSW WAS CONTRACTED TO REPLACE HER BUT IN OCTOBER ALSO HAD TO LEAVE AS HER PRIVATE PRACTICE WAS GROWING, ALSO DUE TO THE PANDEMIC. THE NPP REMAINED CONSTANT. CPEP IN ED WORKING WITH UHS' COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM (CPEP), DVH WAS ABLE TO INSTITUTE VIDEOCONFERENCING IN ITS ER SO THAT UHS' MENTAL HEALTH PROFESSIONALS CAN ACTUALLY SEE THE PATIENTS PRIOR TO THEM BEING SENT TO UHS (1 HOUR AWAY) ONLY TO FIND THEY ACTUALLY DON'T NEED HOSPITALIZATION. THIS WILL REDUCE THE UNNECESSARY USE OF RESOURCES: AMBULANCE AND CREW; A SECOND ER VISIT AND THE NEED TO FIND THE PATIENT A RIDE BACK HOME AFTER THE ASSESSMENT HAS TAKEN PLACE AT UHS. ALTHOUGH THIS SERVICE IS IN PLACE, IT IS NOT WELL-UTILIZED AS YET DUE TO THE SHORTAGE OF PROVIDERS AT THE CRISIS CENTER. RECRUITMENT FOR ALL HEALTHCARE PROFESSIONALS IN RURAL AREAS IS CHALLENGING BUT MENTAL HEALTH PROFESSIONALS ARE EVEN MORE DIFFICULT TO ATTRACT. ASSETS AND RESOURCES DELAWARE VALLEY HOSPITAL HAS CHOSEN TO FOCUS MUCH OF ITS WORK OVER THE NEXT FEW YEARS TO THE WALTON COMMUNITY. WALTON'S POPULATION CONSISTS OF 31.3% OF RESIDENTS AT AGE 65 AND OVER, COMPARED TO THE COUNTY'S 23%. 26% OF THE POPULATION IS DISABLED. OVER THE PAST 12 MONTHS, 25.8% OF ALL HOUSEHOLDS HAVE BEEN BELOW THE POVERTY LEVEL. 59% OF THE HOUSEHOLDS FIT THE DEFINITION OF POVERTY OR OF ALICE (ASSET LIMITED, INCOME CONSTRAINED, AND EMPLOYED). 45.3% OF THE POPULATION HAS PUBLIC INSURANCE COVERAGE AND 6.7% HAVE NO COVERAGE AT ALL.THE WALTON COMMUNITY HAS SUFFERED THROUGH TWO MAJOR FLOODS. ONE HAPPENED IN 1996 AND THE SECOND WAS IN 2006. TWO SMALLER EVENTS, CONSIDERED MODERATE FLOODING, TOOK PLACE IN 2010 AND 2011. THESE EVENTS LED TO A SENSE OF VICTIMIZATION THROUGHOUT THE COMMUNITY AND ITS RESIDENTS. ALL OF THESE FACTORS HAD LED DVH TO BELIEVE THAT TO REALLY MAKE AN IMPACT ON THE HEALTH OF ITS OWN COMMUNITY; IT NEEDS TO ADDRESS MANY OF THE SOCIAL DETERMINANTS OF HEALTH. HOWEVER, IT COULD NOT MAKE MUCH HEADWAY WITHOUT THE COOPERATION OF THE COMMUNITY'S ORGANIZATIONS, SCHOOLS, GOVERNMENT AND RESIDENTS. SOME NEW INITIATIVES FROM A LOCAL 4H CLUB TO BEAUTIFY THE COMMUNITY; THE FORMATION OF A NEW ART GROUP THAT SPONSORED AN ART WALK WITH ACTIVITIES AND A CREATED COMMUNITY MURAL ENTITLED, WALTON RISING; NEW YOUNGER RESIDENTS IN BOTH GOVERNMENT AND CHAMBER OF COMMERCE LEADERSHIP POSITIONS; AND A NEW FOUNDATION THAT WAS CREATED FROM THE ESTATE OF A COUPLE, WHO WERE LONG-STANDING MEMBERS OF THE COMMUNITY HAVE ALL COALESCED INTO A FORCE OF POSITIVITY. THE SCHOOL ADMINISTRATION IS ALSO COMPRISED OF YOUNGER RESIDENTS WHO HAVE GROWN UP IN WALTON AND WANT TO SEE IT THRIVE. THE HOSPITAL IS AN ACTIVE MEMBER OF THE CHAMBER AND THE COMMUNITY COMMITTEE OF THE SCHOOL. IT HAS ALSO ACTIVELY PARTICIPATED IN MANY OF THE ACTIVITIES THAT HAVE BEEN TAKING PLACE. DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE. PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN (CONTINUED) BASED ON ALL OF THE ACTIVITIES AND RENEWED SENSE OF COMMUNITY AND POSITIVITY AMONG THE RESIDENTS, DVH DISCUSSED THE POSSIBILITY OF PRESENTING A SERIES OF WORKSHOPS (FOR THE ENTIRE COUNTY) BASED ON THE AARP AGE-FRIENDLY COMMUNITIES PROGRAM, WHICH IS BASED ON THE WORLD HEALTH ORGANIZATION'S 8 DOMAINS OF LIVABILITY. THEY INCLUDE:OUTDOOR SPACES AND BUILDINGS TRANSPORTATION OPTIONS HOUSING- APPROPRIATELY DESIGNED OR MODIFIED AND AFFORDABLE SOCIAL PARTICIPATION RESPECT AND SOCIAL INCLUSION CIVIC PARTICIPATION AND EMPLOYMENT COMMUNICATION AND INFORMATION COMMUNITY AND HEALTH SERVICES DISCUSSION WAS HELD WITH THE CARE COMPASS NETWORK EAST REGIONAL PERFORMING UNIT, WHICH IS COMPRISED OF HOSPITALS AND ORGANIZATIONS AND AGENCIES FROM BOTH DELAWARE AND CHENANGO COUNTY. THE IDEA WAS WELL RECEIVED AND CARE COMPASS AGREED TO FUND THE PROGRAM. THE FIRST WORKSHOP WAS HELD ON JANUARY 30TH IN WALTON AND WAS PRESENTED BY ESTHER GREENHOUSE, NATIONALLY RENOWNED EXPERT ON BUILT ENVIRONMENTS. ORGANIZATIONS, AGENCIES AND HEALTHCARE PROVIDERS FROM ACROSS DELAWARE COUNTY, AND THOSE THAT SERVE DELAWARE COUNTY WILL BE INVITED TO ALL THE WORKSHOPS. HOWEVER, DVH AND ITS LOCAL PARTNERS INTEND TO FOCUS OUR EFFORTS TO THE WALTON COMMUNITY. MORE DETAILED INFORMATION REGARDING THIS PROGRAM IS OUTLINED IN SCHEDULE H- SUPPLEMENTAL INFORMATION. COMMUNITY SERVICE PLAN PREVENT CHRONIC DISEASE FOCUS AREA 4: PREVENTIVE CARE AND MANAGEMENT DISPARITY: UNLESS OTHERWISE NOTED THE DISPARITY FOR ALL OF THE FOLLOWING WILL BE: DVH PRIMARY CARE PATIENTS FITTING DEMOGRAPHICS AS DESCRIBED IN OBJECTIVES. INTERVENTIONS: UNLESS OTHERWISE NOTED THE INTERVENTIONS WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS REMINDERS THROUGH EHR ALERTS, MAILS, PHONE CALLS, EMAILS AND/OR E-CHART NOTIFICATIONS MEASURES: UNLESS OTHERWISE NOTED THE MEASURE WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: PERCENTAGE OF DVH PATIENTS, AS DESCRIBED, WHO COMPLY WITH SCREENING GUIDELINES. GOAL 4.1 INCREASE CANCER SCREENING RATES 4.1.1 OBJECTIVE: BY DECEMBER 31, 2021, THE PERCENTAGE OF ADULTS, AGE 50-75 YEARS OLD, RECEIVING A COLORECTAL SCREENING WILL INCREASE. INTERVENTIONS WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS' REMINDERS THROUGH ELECTRONIC HEALTH RECORD (EHR) ALERTS, MAILS, PHONE CALLS, EMAILS AND/OR E-CHART NOTIFICATIONS YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019, 64.4% OF DVH PATIENTS, WHO HAD AN INTERACTION WITH DVH WITHIN THE LAST TWO YEARS, AND ARE BETWEEN THE AGES OF 50 AND 75 HAD APPROPRIATE COLORECTAL SCREENING. 70% WAS THE GOAL FOR 2019. THE YEAR ENDED AT 67.2%, AN IMPROVEMENT FROM THE SEPTEMBER PERCENTAGE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 68%IN JUNE 2020 THE RESULT WAS AT 65.1% BUT FELL UNFORTUNATELY TO 47% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE. IN ADDITION, ALL PATIENTS WERE REQUIRED TO HAVE A COVID TEST PRIOR TO ANY PROCEDURE AND THIS REQUIREMENT RESULTED IN PEOPLE OPTING TO WAIT TO BE SCREENED.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.3 PROMOTE EVIDENCE-BASED CARE TO PREVENT AND MANAGE CHRONIC DISEASES INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES AND OBESITY 4.3.1 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 50-85 YEARS OLD, HAVING AN ANNUAL WELL CARE VISIT WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019, 36.5% OF DVH PATIENTS, BETWEEN THE AGES OF 50-85 HAD AN ANNUAL WELL CARE VISIT. 50% WAS THE GOAL FOR 2019. THE YEAR ENDED AT 38%, AN IMPROVEMENT SINCE THE SEPTEMBER MEASURE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 50%.IN JUNE 2020 THE RESULT WAS AT 39.1%, A SLIGHT IMPROVEMENT FROM YEAR-END 2019 BUT FELL UNFORTUNATELY TO 25.5% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE. YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.2 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-85 YEARS OLD, DIAGNOSED WITH HYPERTENSION WHO HAVE THEIR CONDITION ADEQUATELY CONTROLLED WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019 71.7% OF DVH PATIENTS, BETWEEN THE AGES OF 18-85 WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION, HAD THEIR BLOOD PRESSURE ADEQUATELY CONTROLLED (<140/90). THE TARGET FOR 2019 WAS 71%. THE YEAR ENDED AT 73.9%, WHICH EXCEEDED THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 72.5%THIS METRIC ACTUALLY DID IMPROVE OVER 2020 THE RESULT WAS 76%. THIS CAN MOST LIKELY BE BASED ON THE FACT THAT VISITS ARE NECESSARY IN ORDER TO CONTINUE RECEIVING BLOOD PRESSURE MEDICATION, SO COMPLIANCE IS HIGHER. YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.3 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-75, WITH DIABETES, WHO HAVE HAD HBA1C TESTING WITHIN A YEAR WITH A RESULT OF <8.0% WILL INCREASE. YEAR 1 AS OF SEPTEMBER 2019 AT LEAST 69.5% OF PATIENTS AGE 18-75 YEARS OF AGE, WITH DIABETES, WILL HAVE HAD HBA1C TESTING WITHIN A YEAR AND THE RESULT WILL BE <8.0%. GOAL WAS 67.2% FOR 2019. THE YEAR ENDED AT 68.3%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 67.2% IN JUNE 2020 THE RESULT WAS AT 65.3%, BUT FELL UNFORTUNATELY TO 24% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.4 OBJECTIVE: BY DECEMBER 31, 2021 MOST PRESCRIPTIONS FOR CHRONIC DISEASE MANAGEMENT WILL BE WRITTEN FOR 90 DAYS IN ORDER TO FOSTER BETTER PATIENT COMPLIANCE AND CONVENIENCE YEAR 1 AS OF SEPTEMBER 2019, 72.6% OF PRESCRIPTIONS, WRITTEN FOR THE CHRONIC CONDITIONS OF PATIENTS WHO HAVE HAD ANY INTERACTION WITH DVH WITHIN THE LAST 2 YEARS, WILL BE WRITTEN FOR A 90 DAY SUPPLY. MEDICATION TYPES INCLUDED IN THE MEASURE: ACE INHIBITOR/ARB MEDICATIONS, DIABETES, BETA-BLOCKER, HIGH AND MODERATE AND LOW INTENSITY STATIN MEDICATIONS. GOAL WAS 72% FOR 2019. THE YEAR ENDED AT 74.4%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 72%.IN JUNE 2020 THE RESULT WAS AT 74.1%, BUT FELL TO 70.7% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.4 IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES AND OBESITY 4.4.1 OBJECTIVE: A HEALTHCARE PROVIDER OR HUMAN SERVICE AGENCY WILL HAVE REFERRED MORE PARTICIPANTS TO THE CHRONIC DISEASE SELF- MANAGEMENT WORKSHOP. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE MEASURES: THE PERCENTAGE OF PARTICIPANTS REFERRED BY PRIMARY CARE PROVIDERS OR HUMAN SERVICE AGENCIES INTERVENTIONS: WORK WITH MARKETING STAFF, PRIMARY CARE PROVIDER OFFICES AND LOCAL HUMAN SERVICE AGENCIES TO PUT SYSTEMS IN PLACE TO ASSURE AWARENESS OF THE AVAILABILITY OF THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. YEAR 1 RECOGNIZED THAT MOST PARTICIPANTS ARE LEARNING OF THE PROGRAM THROUGH ONE SOLE PROVIDER OR THROUGH ADVERTISING. THERE IS A NEED TO CREATE MORE WIDELY-BASED KNOWLEDGE OF THE PROGRAM. YEAR 2 SYSTEMS WILL BE IN PLACE AND UTILIZED BY THE FALL OF 2020.NO ACTION TOOK PLACE ON THIS INITIATIVE. VIRTUALLY ALL THE TARGETED RESOURCES THAT WOULD HAVE WORKED ON THIS WERE OVERWHELMED DEALING WITH COVID-19. IN DVH'S CASE THE CLINICAL STAFF ALSO HAD TO FOCUS ON THE IMPLEMENTATION OF THE NEW EHR IN SEPTEMBER 2020. YEAR 3 AT LEAST 25% OF THE PARTICIPANTS WILL HAVE BEEN REFERRED FROM AN AGENCY OR PROVIDER. PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN (CONTINUED) 4.4.2 OBJECTIVE: ACCESS TO CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS WILL CONTINUE. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE MEASURE: NUMBER OF SERIES OF WORKSHOPS OFFERED INTERVENTIONS: HOLD CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS YEAR 1 DURING 2019, 2 SERIES OF WORKSHOPS WERE HELD IN THE SPRING. A FALL SERIES WAS OFFERED BUT THERE WERE NOT ENOUGH PARTICIPANTS TO ACTUALLY HOLD THE PROGRAM. YEAR 2 DURING 2020, AT LEAST TWO WORKSHOPS WILL BE HELDNO WORKSHOPS WERE OFFERED DUE TO THE PANDEMIC. YEAR 3 DURING 2021, AT LEAST TWO WORKSHOPS WILL BE HELD. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS FOCUS AREA 1: PROMOTE WELL-BEING GOAL 1.1: STRENGTHEN OPPORTUNITIES TO BUILD WELL-BEING AND RESILIENCE ACROSS THE LIFESPAN 1.1.1 OBJECTIVE: BY DECEMBER 31, 2020 AT LEAST ONE COMMUNITY WITHIN THE DVH SERVICE AREA WILL BE ACTIVELY WORKING TO BECOME AN AGE-FRIENDLY COMMUNITY. INTERVENTIONS: BUILD COMMUNITY WEALTH BY SERVING AS THE CATALYST TO CREATE INCLUSIVE, HEALTHY PUBLIC SPACES AND INTER-GENERATIONAL SOCIALIZATION OPPORTUNITIES MEASURES: IMPROVEMENT IN ACCESSIBILITY, SOCIALIZATION, AND WELL-BEING MEASURES YEAR 1: RESEARCHED BUILDING AGE FRIENDLY COMMUNITIES THROUGH AARP - DISCUSSED CONCEPT WITH POTENTIAL STAKEHOLDERS INCLUDING LOCAL OFFICIALS, ORGANIZATIONS, AGENCIES, SCHOOLS, POTENTIAL COMMUNITY PARTNERS AND GARNERED SUPPORT TO MOVE PROJECT FORWARD. REQUESTED AND SECURED FUNDING FROM CARE COMPASS NETWORK TO HOLD SERIES OF WORKSHOPS REGARDING AGE FRIENDLY COMMUNITIES - SET DATES, SECURED VENUE, CATERERS AND DEVELOPED INVITE LIST. YEAR 2: HOLD SERIES OF WORKSHOPS BASED ON A BLEND OF AARP'S ROAD TO LIVABILITY PROGRAM AND NY STATE'S LIVABLE NY PROGRAM WHICH INCORPORATES THE IMPORTANCE OF THE SOCIAL DETERMINANTS OF HEALTH. HOLD FOLLOW-UP MEETINGS WITH APPROPRIATE INTERESTED PARTIES FROM WALTON AREA TO CREATE A COALITION OF COMMUNITY MEMBERS TO PRIORITIZE POTENTIAL AGE FRIENDLY COMMUNITY INITIATIVES; IDENTIFY NEXT STEPS AND IDENTIFY POTENTIAL COMMITTEE MEMBERS TO ADDRESS EACH INITIATIVE. MEASURES: TWO COMMITTEES WILL BE FORMED OR EXISTING COMMITTEES, INTEGRATED INTO ADDRESSING AT LEAST TWO COMPONENTS OF THE AGE FRIENDLY COMMUNITY. RECRUIT AND FORM COMMITTEE(S) OF COMMUNITY RESIDENTS, WHICH IS REPRESENTATIVE OF THE POPULATION AND ALSO INCLUDES APPROPRIATE COMMUNITY BASED ORGANIZATIONS, AGENCIES AND GOVERNMENT ENTITIES TO DEVELOP AN ACTION PLAN AND TIMELINE TO ADDRESS AT LEAST TWO COMPONENTS OF BECOMING AN AGE FRIENDLY COMMUNITY.THE WALTON CONTINGENT, WHICH IS DELAWARE VALLEY HOSPITAL'S HOME TOWN, CONTINUED THE MOMENTUM, HOLDING A COMMUNITY FORUM ON MARCH 1 WITH REPRESENTATIVES FROM LOCAL ORGANIZATIONS WHICH WERE ABLE TO TELL ATTENDEES ABOUT THEIR PLANS. DELAWARE VALLEY HOSPITAL SPOKE SPECIFICALLY ABOUT ITS PLANS TO CONDUCT A SURVEY ABOUT HOW PEOPLE SOCIALIZE AND ITS PLAN TO WORK ON HELPING WALTON BECOME AN AGE-FRIENDLY COMMUNITY. SEVEN COMMUNITY MEMBERS VOLUNTEERED TO SERVE ON VARIOUS COMMITTEES TO BEGIN WORK ON BUILDING AN AGE-FRIENDLY COMMUNITY. UNFORTUNATELY, DUE TO THE PANDEMIC AND PEOPLE'S COMMITMENT TO THEIR JOBS, CARING FOR THEMSELVES, THEIR FAMILIES AND RE-STRUCTURING THEIR DAILY LIVES AROUND REMOTE WORK AND SCHOOL, SOME OF THIS WORK HAD TO BE SET ASIDE. HOWEVER, THE COMMUNITY RELATIONS DIRECTOR WROTE A GRANT APPLICATION TO HELP PAY FOR THE SURVEY EXPENSES, BUT WAS TURNED DOWN, AS ALL FUNDING WENT TO FOOD SECURITY. A SECOND APPLICATION WAS ALSO TURNED DOWN AS A BOARD MEMBER FELT THAT THE WORK COULD BE DONE IN CONJUNCTION WITH A BINGHAMTON UNIVERSITY INTERN. UNFORTUNATELY, THAT DID NOT COME TO FRUITION EITHER, AS THE CANDIDATES ALL DECIDED TO DO THEIR INTERNSHIP CLOSER TO THEIR HOMES. AS OF THIS WRITING THE DECISION HAS BEEN MADE TO CONDUCT THE SURVEY AND DVH WILL BE FUNDING THE INITIATIVE. A COMPONENT OF BECOMING AGE FRIENDLY IS TO CREATE SPACES WHERE PEOPLE CAN COME TOGETHER. WALTON HAS A RECLAIMED FLOOD PLAIN THAT BORDERS THE DELAWARE RIVER AND FOR YEARS PLANS HAVE BEEN DISCUSSED BUT NO ACTION HAD OCCURRED. IN 2020, THE FIRST PROJECT, A BOAT RAMP WAS INSTALLED. WITH THIS SPARK, THE DECISION WAS MADE TO APPLY FOR AN AARP GRANT TO CREATE A RIVER WALK AND PICNIC AREA. EXTENSIVE WORK HAD TO TAKE PLACE IN ORDER TO DESIGN THE WALK, THE PARKING AREAS, THE PICNIC AREA, AND DECIDING ON SPECIFIC TABLES ETC. WHILE KEEPING WITHIN THE SCOPE OF WHAT IS ALLOWABLE IN THE FLOOD PLAIN. THE GRANT WAS NOT SUCCESSFUL, HOWEVER ENOUGH WORK HAD BEEN DONE THAT MORE DETAILED DRAWINGS AND PLANS COULD BE MADE UP AND SEVERAL GRANTS ARE BEING WRITTEN IN 2021 FOR THE PROJECT. FUNDING HAD BEEN SECURED FOR PICNIC TABLES, SIGNAGE, CREATION OF NEW WALKING TRAIL MARKERS THAT HAD BEEN DESTROYED IN A FLOOD AND SIGNAGE FOR A BIKE TRAIL UNFORTUNATELY WAS RESCINDED BY THE STATE DUE TO PANDEMIC COSTS. MEASURES: COMMITTEE OBJECTIVES AND TIMELINES WILL BE DEVELOPED COMMITTEES WILL FORMULATE THEIR RESPECTIVE OBJECTIVES, BASED ON AGE FRIENDLY SERIES AND DEVELOP A WORK PLAN AND CREATE A TIMELINE TO ACHIEVE THOSE OBJECTIVES AND CHOOSE A REPRESENTATIVE TO SIT ON THE COMMUNITY COALITION. MEASURES: BEST PRACTICE, CORE MEASURES AND STAKEHOLDER ROLES WILL BE DETERMINED COMMITTEES WILL REACH CONSENSUS ON BEST PRACTICE INTERVENTIONS, CORE MEASURES AND ROLES OF STAKEHOLDERS YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.2 INCREASE ACCESSIBILITY OF PHYSICAL ENVIRONMENT BY 5% (BASELINE TO BE SET IN 2020) INTERVENTION: DEVELOP CONSENSUS ON DEVELOPMENT OF WATER STREET THROUGH FLOOD MITIGATION PROJECT AND OTHER FUNDING MEASURES: ACCESSIBILITY OF PHYSICAL ENVIRONMENT YEAR 1: HELD DISCUSSION WITH TOWN SUPERVISOR, VILLAGE MAYOR, AND PROJECT MANAGER FOR WATER STREET PROJECT, AND CHAMBER OF COMMERCE PRESIDENT TO ASSESS FEASIBILITY OF HAVING AN IMPACT ON WATER STREET USE AND DEVELOPMENT. YEAR 2: REVIEW PREVIOUS WALK AUDIT DONE BY RURAL HEALTH GROUP. COMPLETE WALK AUDIT OF WATER STREET AND DELAWARE STREET IN WALTON NY NO ACTION TOOK PLACE ON THIS DUE TO COVID. YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.3: BY DECEMBER 31, 2021 DECREASE THE % OF ADULTS WHO REPORT FEELING ANXIETY OR FEAR, DEPRESSION OR SADNESS, HELPLESS OR HOPELESS INTERVENTIONS: SURVEY COMMUNITY MEMBERS YEAR 1: DELAWARE COUNTY COMMUNITY SURVEY COMPLETED. QUESTION- IN THE PAST YEAR, HAVE YOU OR SOMEONE CLOSE TO YOU EXPERIENCED ANY OF THE FOLLOWING: RESULTS OF THESE MEASURES INCLUDED: ANXIETY OR FEAR 49.6% - DEPRESSION OR SADNESS 55.5% - FEELING HELPLESS OR HOPELESS 30.56% YEAR 2: FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEING BECAUSE THE SURVEY HAS BEEN DELAYED UNTIL LATE 2021, NO FURTHER WORK TOOK PLACE ON THIS INITIATIVE IN 2020.YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.4 BY DECEMBER 31, 2021 INCREASES THE % OF ADULTS WHO REPORT ONGOING PARTICIPATION IN AT LEAST ONE SOCIALIZATION OPPORTUNITY OTHER THAN WORK. (BASELINE TO BE SET IN 2020) INTERVENTIONS: SURVEY COMMUNITY MEMBERS MEASURES: NUMBER OF PEOPLE PARTICIPATING AT SOCIALIZATION OPPORTUNITIES. YEAR 1: DISCUSSIONS CENTERED ON CORRELATION OF ISOLATION AND FEELINGS YEAR 2: DEVELOP A SURVEY TO GET SENSE OF SOCIALIZATION ACTIVITIES AND PARTICIPATION THROUGHOUT THE COMMUNITY. FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEINGBECAUSE THE SURVEY HAS BEEN DELAYED UNTIL LATE 2021, NO FURTHER WORK TOOK PLACE ON THIS INITIATIVE IN 2020YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS DELAWARE VALLEY HOSPITAL STAFF WILL PLAY AN INTEGRAL ROLE, WITH CARE COMPASS NETWORK STAFF TO ENSURE APPROPRIATE STAKEHOLDERS FROM ACROSS THE COUNTY ARE INVITED TO THE VARIOUS AGE-FRIENDLY WORKSHOPS. DVH STAFF WILL ALSO SECURE THE VENUE AND CATERER FOR EACH WORKSHOP. DELAWARE VALLEY STAFF WILL BE THE CATALYST AND CHAMPION TO ENSURE WALTON COMMUNITY STAKEHOLDERS HOLD FOLLOW-UP MEETINGS AND FORMULATE COMMITTEES TO FOCUS ON SPECIFIC INTERVENTIONS, BASED ON THE CONSENSUS OF THE GROUP. DVH WILL MAINTAIN REPRESENTATION ON THE STEERING COMMITTEE AND ANY OTHER SUB-COMMITTEE THAT IS APPROPRIATE. DVH WILL WORK WITH DELAWARE COUNTY MENTAL HEALTH TO CREATE SURVEY OF SOCIALIZATION ACTIVITIES. IF NECESSARY, DVH WILL ASSIST IN PROVIDING SUPPORT IN WRITING ANY GRANT APPLICATIONS.THE DVH COMMUNITY RELATIONS DIRECTOR WROTE AN AARP GRANT FOR THE VILLAGE OF WALTON TO FUND THE CREATION OF A TRAIL ALONG THE RIVER. SHE ALSO WROTE 2 GRANTS FOR THE FUNDING OF THE SURVEY. UNFORTUNATELY, NONE OF THESE WERE SUCCESSFUL. IN ADDITION, DVH WILL CONTINUE TO MEET REGULARLY WITH DELAWARE COUNTY PUBLIC HEALTH STAFF AND STAFF FROM BOTH O'CONNOR HOSPITAL AND MARGARETVILLE HOSPITAL TO CONTINUE DIALOGUE REGARDING OUR ACTIVITIES SO WE CAN IDENTIFY OPPORTUNITIES TO WORK TOGETHER.ALTHOUGH, DVH HAD A LOT OF INTERACTION WITH DELAWARE COUNTY PUBLIC HEALTH THROUGHOUT 2020, IT WAS FOCUSED ON THE PANDEMIC AND NOT ON THE COMMUNITY SERVICE PLAN. 5 1 - WALTON FAMILY HEALTH CENTER 2 TITUS PLACE WALTON NY 13856 OUTPATIENT PHYSICIAN CLINIC 2 - DOWNSVILLE FAMILY HEALTH CENTER 28315 STATE HWY 206 DOWNSVILLE NY 13755 OUTPATIENT PHYSICIAN CLINIC 3 - ROSCOE FAMILY HEALTH CENTER 1982 OLD ROUTE 17 ROSCOE NY 12776 OUTPATIENT PHYSICIAN CLINIC 4 - PHYSICAL AND OCCUPATIONAL THERAPY 121 STOCKTON AVENUE WALTON NY 13856 REHABILITATION CLINIC 5 - DVH COMMUNITY PHARMACY 121 STOCKTON AVENUE WALTON NY 13856 COMMUNITY PHARMACY PART I, LINE 7: DELAWARE VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) AS DESIGNATED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. UNLIKE NON-CAH'S THAT ARE REIMBURSED BASED ON A PROSPECTIVE REIMBURSEMENT METHODOLOGY, CAH'S ARE REIMBURSED THEIR ALLOWABLE COSTS FOR MEDICARE PURPOSES. THE MEDICARE COST REPORT (CMS 2552) AND THE MEDICAID INSTITUTIONAL COST REPORT (ICR) WAS UTILIZED FOR PURPOSES OF IDENTIFYING COSTS AND NET REVENUE. ADDITIONALLY, THERE IS NO BAD DEBT EXPENSE IN ANY OF THE COSTS USED IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F. PART I, LN 7 COL(F): DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $515,228 IN PART IX, LINE 24C. THE AFOREMENTIONED BAD DEBT EXPENSE WAS SUBTRACTED IN THE CALCULATIONS OF SCHEDULE H, PART I, LINES 7A THRU 7K. PART II, COMMUNITY BUILDING ACTIVITIES: DELAWARE VALLEY HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH ITS MEMBERSHIP AND PARTICIPATION IN THE DELAWARE COUNTY RURAL HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY. THE COMMUNITY RELATIONS DIRECTOR ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. IN 2020, SHE SERVED ON THE SCHOOL'S RE-OPENING PLANNING COMMITTEE. DURING THESE MEETINGS, THE SCHOOL REPORTED IT HAD CHANGED OUT ALL THE WATER FOUNTAINS TO BOTTLE FILLING STATIONS. THE HOSPITAL OFFERED FREE WATER BOTTLES TO ALL STUDENTS. DVH THEN REACHED OUT TO THE SCHOOLS IN OTHER AREAS AND FOUND THEY ALSO HAD A NEED. 2,400 WATER BOTTLES WERE PROVIDED TO 5 SCHOOLS. BOTTLES WERE ORDERED IN EACH SCHOOL'S COLORS AND PRINTED WITH ITS MASCOT AND A PLACE FOR THE CHILDREN TO WRITE THEIR NAMES. THE HOSPITAL MAINTAINS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). HOWEVER, NO MEETINGS WERE HELD IN 2020 DUE TO THE PANDEMIC. WEEKLY NARCOTICS ANONYMOUS MEETINGS CONTINUED TO BE HELD AT THE HOSPITAL UNTIL MARCH 10, 2020. HOSPITAL STAFF PERFORMED DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG TREATMENT COURT FREE OF CHARGE UNTIL THE COURT CLOSED DUE TO COVID -19. IT DID NOT RE-OPEN IN 2020. THE DELAWARE COUNTY DRUG TREATMENT COURT'S MISSION IS TO HELP CHANGE THE BEHAVIORS OF ADULT NONVIOLENT DRUG AND ALCOHOL USERS THROUGH SUPERVISION AND TREATMENT RATHER THAN JUST SENDING THEM TO JAIL. THE OVERALL GOAL IS TO HELP ADDICTED INDIVIDUALS ACHIEVE LIFELONG RECOVERY AND BECOME RESPONSIBLE AND PRODUCTIVE MEMBERS OF THE COMMUNITY. DELAWARE COUNTY'S SOLID WASTE MANAGEMENT CENTER CONTINUES TO DISTRIBUTE THE BROCHURES, PRINTED COURTESY OF DVH, REGARDING SAFE NEEDLE DISPOSAL. WHEN PATIENTS BRING THEIR USED SHARPS TO THE HOSPITAL FOR DISPOSAL, THEY ARE GIVEN A FREE AND APPROPRIATELY SIZED SHARP DISPOSAL CONTAINER. THE HOSPITAL CONTINUES TO SUPPORT THE TOWN'S VETERAN'S CLUB, CHAMBER OF COMMERCE, THE LITTLE LEAGUE ORGANIZATION, THE LOCAL TOY BANK DRIVE AND TWO 5K RUNS. BECAUSE OF THE PANDEMIC, THE COMMUNITY'S ANNUAL HOLIDAY DINNER WAS NOT HELD AND THE MUSIC ON THE DELAWARE GROUP WAS NOT ACTIVE. THE HOSPITAL CHOSE TO REDIRECT ITS SUPPORT TO TWO LOCAL FOOD BANKS INSTEAD. THE PRESIDENT/CEO OF DELAWARE VALLEY IS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB. THE HOSPITAL CONTROLLER SERVES ON THE BOARD OF THE CULLMAN CENTER, A DAY CARE CENTER IN SIDNEY, NY. BEGINNING IN 2020, THE DIRECTOR OF SUPPORT SERVICES SERVES ON THE DELAWARE COUNTY CHAMBER OF COMMERCE BOARD, WHILE THE COMMUNITY RELATIONS DIRECTOR SITS ON THE WALTON CHAMBER OF COMMERCE BOARD. OVER THE COURSE OF EACH YEAR, DVH MEMORIALIZES PEOPLE BY DONATING TO NON-PROFIT ORGANIZATIONS RATHER THAN GETTING FLOWERS. IN 2015, THE WALTON MINISTERIAL ASSOCIATION BEGAN A HUNGER WALK TO RAISE MONEY FOR THE LOCAL FOOD BANK AND CHILDREN'S NUTRITION PROGRAMS. DELAWARE VALLEY CONTINUES TO BE THE LEADING SPONSOR OF THE EVENT AND STAFF SERVES ON THE PLANNING COMMITTEE. DVH CONTINUES TO SUPPLY OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE MOVED TO BINGHAMTON , NY, BUT STILL AT LEAST AN HOUR AWAY FROM DELAWARE COUNTY; ONE OF THEIR TARGET AREAS. BY PROVIDING THEM WITH FREE OFFICE SPACE, THEY HAVE A HOME BASE MORE CENTRALLY LOCATED TO THOSE WHO THEY ARE TRYING TO SERVE. THE ORGANIZATION OFFERS MANY NAVIGATION-TYPE PROGRAMS, MOST ESPECIALLY ACCESS TO TRANSPORTATION SERVICES. THE HOSPITAL ALSO PROVIDES PHONE AND OFFICE SUPPLIES TO THEM AT NO CHARGE. ALTHOUGH THE OFFICE IS STILL MAINTAINED, THE STAFF HAS BEEN WORKING REMOTELY, WITH ONLY OCCASIONAL OFFICE DAYS. DVH WAS MADE AWARE THAT AN ORGANIZATION, THE FAMILY RESOURCE NETWORK, WHICH SERVES FAMILIES DEALING WITH DISABILITIES, NEEDED A MORE LOCAL PRIVATE PLACE FOR MEETING WITH FAMILIES. THEIR MAIN OFFICE IS LOCATED 45 MINUTES AWAY FROM WALTON AND CLIENTS HAD DIFFICULTY GETTING THERE. DVH HAS AGREED TO LET THEM USE ITS WELLNESS ROOM FOR THOSE MEETINGS. WHILE WE STILL MAINTAIN THEIR SPOT ON THE CALENDAR, THEY DID NOT UTILIZE THE ROOM IN 2020. WHEN THE LOCAL EMERGENCY SQUAD NEEDS TO RE-STOCK ITS AMBULANCE, BUT HAS NOT BROUGHT THE PATIENT TO THE HOSPITAL'S ER, THE HOSPITAL RE-STOCKS THE AMBULANCE FREE OF CHARGE. THIS CAN HAPPEN WHEN THE AMBULANCE PERSONNEL HAVE CALLED FOR A HELICOPTER EVACUATION OF THE PATIENT(S) DIRECTLY FROM THE SCENE OF THE INCIDENT. A PATIENT AND FAMILY ADVISORY COMMITTEE STARTED IN 2018. THE GROUP PROVIDES DVH WITH INVALUABLE INSIGHT AS TO HOW A PATIENT INTERPRETS A MULTITUDE OF HEALTHCARE TOPICS. DVH IS ABLE TO PROVIDE THEM WITH INSIGHT TO SOME OF THE REASONS THAT THINGS ARE DONE THE WAY THEY ARE. DURING 2019, THE GROUP WAS INSTRUMENTAL IN HELPING THE HOSPITAL TO RE-TOOL ITS ADMISSION PACKET, HEALTH HISTORY FORM AND PATIENT EDUCATION MATERIALS. HOWEVER, THIS GROUP DID NOT MEET IN 2020 DUE TO THE PANDEMIC. WE ALSO BELIEVE IN ENCOURAGING FAMILY TOGETHERNESS AND ACTIVITIES. IN 2019, WE HELD OUR THIRD SANTA EVENT BUT THIS TIME WE ADDED A CRAFT ACTIVITY FOR EACH CHILD TO DO WITH HIS/HER PARENTS. APPROXIMATELY 80 KIDS CAME TO THE EVENT WITH THEIR PARENTS. PLANS AND ADVERTISING HAD BEEN DONE WITH EVERY INTENTION OF GOING FORWARD WITH THIS EVENT IN 2020 WITH SOCIAL DISTANCING ARRANGEMENTS. UNFORTUNATELY THE WEEK BEFORE THE EVENT, OUR TOWN EXPERIENCED A SURGE IN COVID-19 CASES AND WE FELT WE NEEDED TO BE PRUDENT AND CANCELLED THE EVENT. TO ENCOURAGE YOUNG CHILDREN TO BE SAFE AND NOT TO BE AFRAID OF HEALTHCARE PROVIDERS OR HOSPITALS, DVH GENERALLY HOSTS SECOND GRADERS FROM 5 AREA SCHOOLS AT ITS TEDDY BEAR CLINIC. THEY LEARN LESSONS ABOUT SAFETY HELMETS, SEAT BELTS AND POISON, ALSO HAVE HANDS-ON EXPERIENCE IN THE ER, RADIOLOGY, AND HELP CARE FOR OUR MANNEQUIN PATIENT (A BIKE ACCIDENT PATIENT WHO DID NOT WEAR A HELMET). THEY TOUR AN AMBULANCE, LOOK INSIDE THE MEDICAL HELICOPTER AND GET TO MEET AND LEARN ABOUT WHAT K9 OFFICERS AND THEIR DOGS DO. THE EVENT IS USUALLY HELD IN MAY, BUT HAD TO BE CANCELLED IN 2020.THE PEDIATRICIAN PARTICIPATES IN THE NATIONAL REACH OUT & READ PROGRAM, AND GIVES FREE AND AGE-APPROPRIATE BOOKS TO CHILDREN AT EACH WELLNESS VISIT, BEGINNING AT THE AGE OF 6 MONTHS. PART III, LINE 2: THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2020 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2020 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2020, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 52.3% OF THE TOTAL BAD DEBT WRITE-OFFS. PART III, LINE 4: AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. PLEASE REFER TO FOOTNOTE 1, PAGE 8 OF THE AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION. PART III, LINE 8: BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE HOSPITAL HAS A POLICY TO PROVIDE A COMMUNITY BENEFIT TO UNINSURED PATIENTS THAT CONSISTS OF FEE DISCOUNTS. CERTAIN PATIENTS THAT WERE PROVIDED FEE DISCOUNTS WOULD HAVE LIKELY QUALIFIED UNDER THE CHARITY CARE POLICY. DELAWARE VALLEY HOSPITAL USES THE COST TO CHARGE RATIO METHODOLOGY UTILIZING AMOUNTS FROM THE 2020 MEDICARE COST REPORT FOR ALL PERTINENT CALCULATIONS IN PART III, LINE 6. PART III, LINE 9B: UHS HOSPITALS POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.UHS HOSPITALS REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. UHS HOSPITALS PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. UHS HOSPITALS ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENCING LEGAL ACTION. PART VI, LINE 2: RECRUITMENT OF HEALTHCARE PROFESSIONALS IS ALWAYS A CHALLENGE, ESPECIALLY IN OUR RURAL AREA. DELAWARE VALLEY HOSPITAL (DVH) AND 2 OF ITS 3 PRIMARY CARE CENTERS MAINTAIN THEIR STANDING AS APPROVED SITES FOR PROFESSIONALS SEEKING ASSISTANCE THROUGH THE NATIONAL HEALTH SERVICE CORPS. HOWEVER, THE ROSCOE SITE HAD TO BE TEMPORARILY CLOSED ON 9/11/20 DUE TO THE LOSS OF THE PROVIDER AND THE INABILITY TO RECRUIT ANOTHER PRIOR TO THEIR DEPARTURE. DVH WAS ABLE TO RECRUIT A NEW NURSE PRACTITIONER AND THE OFFICE WAS RE-OPENED ON 4/26/21 AND IS IN THE PROCESS OF APPLYING FOR NHSC APPROVAL. THE HOSPITAL ALSO HOSTS BOTH RN AND CNA STUDENTS, FROM OUR LOCAL COLLEGE (SUNY DELHI) AND BOARD OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). DUE TO THE PANDEMIC, THE STUDENTS FROM BOTH SCHOOLS WERE ONLY ABLE TO DO THEIR CLINICALS FROM JANUARY TO MARCH 5, WHEN THE HOSPITAL CLOSED DOWN TO THEM. UNFORTUNATELY, THEY WERE UNABLE TO RETURN IN THE FALL. THE ANNUAL EDUCATION OF DIABETES THAT THE HOSPITAL'S DIETITIAN PROVIDES FOR THE NURSING STUDENTS DID NOT TAKE PLACE DUE TO THE PANDEMIC. TWO DVH RNS SERVED AS MENTORS TO SUNY DELHI RN AND BSN STUDENTS IN 2020. THE PANDEMIC ALSO MADE IT IMPOSSIBLE TO HOST THE ANNUAL MASH CAMP FOR HIGH SCHOOL STUDENTS WHERE THEY LEARN ABOUT HEALTHCARE CAREERS AND ENCOURAGE THEM TO PRACTICE IN OUR RURAL COMMUNITY. THE ANNUAL CAREER DAY AT THE AREA HIGH SCHOOL, WHICH IS ATTENDED EACH YEAR BY ONE OF THE HOSPITALS ER PHYSICIAN ASSISTANTS WAS ALSO CANCELLED. IN 2019, THE HOSPITAL CONTINUED TO WORK HAND IN HAND WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT, O'CONNOR HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL TO DEVELOP THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND OUR INDIVIDUAL COMMUNITY SERVICE PLANS. STAFF FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY AIDED US BY RESEARCHING AREA DEMOGRAPHICS AND COMPILING THE REPORT. THE NEW NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN ARE LOCATED AT HTTPS://WWW.NYUHS.ORG/WHY-CHOOSE-US/COMMUNITY-SERVICE-REPORTS. IN 2020, DVH RESOURCES WERE MORE FOCUSED ON DEVELOPING EVEN MORE STRINGENT SAFETY PROTOCOLS, GIVEN THE PANDEMIC. ACCESS TO THE HOSPITAL WAS DETOURED TO ONE ENTRANCE, WHERE A SCREENER WAS PUT IN PLACE TO ASSESS THE PATIENT/VISITOR/VENDOR FOR COVID-19 SYMPTOMS AND OTHER RISK FACTORS BEFORE HAVING THEM ENTER. ALL VISITORS/COMPANIONS WERE PROVIDED INFORMATION ABOUT PROPER WAY TO WEAR MASKS, SOCIAL DISTANCE AND THE IMPORTANCE OF SAFETY AND HAND HYGIENE. WAITING ROOMS WERE RECONFIGURED TO ALLOW SOCIAL DISTANCING. APPOINTMENTS WERE STAGGERED SO LESS PEOPLE WOULD BE IN ANY ONE WAITING ROOM AT A TIME. ALL STAFF WERE TRAINED IN THE USE OF TELEHEALTH SO THAT VIRTUAL APPOINTMENTS COULD TAKE PLACE. TELEPHONIC AND VIRTUAL APPOINTMENTS WERE USED WHEN APPROPRIATE, TO HELP REDUCE POTENTIAL EXPOSURE. A TEMPORARY DRIVE-THROUGH WAS CREATED TO ALLOW NURSING STAFF TO CONDUCT COVID TESTING WHILE THE PATIENTS REMAINED IN THEIR CARS. ALL STAFF WORE MASKS, AND APPROPRIATE LEVELS OF PERSONAL PROTECTIVE EQUIPMENT (PPE) WERE ORDERED. PROPER DONNING AND DOFFING TECHNIQUES WERE REVIEWED WITH STAFF. STAFF MEMBERS VOLUNTEERED TO CREATE FACE SHIELDS, WHEN THEY WERE NOT PROCURABLE. ALWAYS A FOCUS, HAND HYGIENE WAS EVEN MORE GREATLY EMPHASIZED. STAFF MEMBERS WERE RE-ASSIGNED TO SERVE AS SCREENERS FOR ANYONE WANTING TO COME INTO THE HOSPITAL. MAINTENANCE STAFF INSTALLED A BUZZER AND SPEAKER SYSTEM SO THAT SCREENERS COULD COMMUNICATE WITH PEOPLE WAITING OUTSIDE THE BUILDING TO BE SCREENED. EVENTUALLY, MAINTENANCE STAFF ALSO BUILT AN OFFICE FOR THE SCREENER TO WORK FROM. THEY ALSO BUILT A TEMPORARY WALL ON THE MEDICAL FLOOR, WHICH IN EFFECT, CREATED A SEPARATE COVID WARD. A SINK WAS INSTALLED IN THE HALLWAY SO STAFF COULD PERFORM HAND HYGIENE MORE EASILY AND EFFICIENTLY. THEY CREATED 5 ADDITIONAL NEGATIVE PRESSURE ROOMS ON THE MEDICAL FLOOR, USING PORTABLE HEPA FILTRATION UNITS AND PERMANENTLY INSTALLED A NEGATIVE AIR PRESSURE SYSTEM THROUGHOUT THE ER. PLEXIGLASS PARTITIONS WERE INSTALLED TO PLACE EXTRA PROTECTION BETWEEN STAFF AND PATIENTS. THE MANAGEMENT TEAM WORKED EXTENSIVELY ON A PLAN THAT WOULD ENABLE DVH TO ACCOMMODATE A 50% BED SURGE CAPACITY. THIS INCLUDED WAYS TO ACCOMMODATE EXTRA BEDS AND HOW TO ENSURE THE HOSPITAL WOULD BE ABLE TO STAFF THEM. LPNS FROM THE HOSPITAL'S PRIMARY CARE CENTERS STEPPED UP TO BE CROSS-TRAINED TO WORK ON THE MEDICAL FLOOR IF NEEDED. THE HOSPITAL PURCHASED 10 ADDITIONAL BEDS AND THE MAINTENANCE STAFF TRANSPORTED EXTRA BEDS FROM THE LOCAL BOCES CNA PROGRAM'S CLINICAL TRAINING AREA. AN EXISTING STORAGE AREA WAS EXTREMELY HUMID AND WITHOUT HEATING OR COOLING. THESE CONDITIONS WERE NOT CONDUCIVE FOR STORING EXTRA EQUIPMENT THAT WOULD BE NEEDED IN A SURGE. SO THE ENTIRE AREA WAS CLIMATE-CONTROLLED TO ASSURE THAT ANY STORED EQUIPMENT WILL NOT BE DAMAGED DUE TO EXTREMES IN THE ENVIRONMENT. BY THE END OF NOVEMBER, THE MAINTENANCE CREW ALSO INSTALLED A CUSTOM, PRE-FABRICATED ANNEX TO THE FRONT OF THE HOSPITAL, ADJACENT TO THE ER AMBULANCE FOYER. THE ANNEX IS USED TO STORE SUPPLIES AND PPE NEEDED TO CONDUCT COVID TESTING, CONTAINS A HANDWASHING STATION AND OFFERS PROTECTION FROM THE ELEMENTS FOR NURSING STAFF BETWEEN PATIENT TESTS. BY PLACING IT IN THAT LOCATION, THE PATIENTS CAN STILL REMAIN IN THEIR CAR, BUT ARE UNDERNEATH THE EXISTING OVERHANG AT THE ER. THE CREW ALSO WORKED WITH THE SAME VENDOR TO DEVELOP A CUSTOM SEMI-ENCLOSED METAL AND GLASS WALKWAY OVERHANG TO PROTECT PATIENTS/VISITORS/VENDORS FROM THE ELEMENTS WHILE WAITING TO BE SCREENED FOR ENTRY. SOME LANDSCAPING WAS REMOVED, TO ACCOMMODATE A WIDENED SIDEWALK SO BENCHES COULD BE PROVIDED WHILE MAINTAINING SOCIAL-DISTANCING GUIDELINES. THE FINAL OVERHANG WAS INSTALLED IN JANUARY 2021. THE ENVIRONMENTAL SERVICES DEPARTMENT, REVIEWED THEIR TERMINAL CLEANING PROTOCOLS, AND A MEMBER OF THE EVS STAFF WAS PUT ON CALL FOR AFTER HOUR TERMINAL CLEANING IF NEEDED BY THE ER, IN ORDER TO BE SURE A FULL COMPLEMENT OF ER BEDS WOULD BE AVAILABLE AT ALL TIMES. UV WANDS WERE PURCHASED TO DISINFECT ELECTRONIC AND OTHER EQUIPMENT THAT CANNOT BE SPRAYED. AIR IONIZERS WERE ALSO PURCHASED TO ADD ANOTHER LAYER OF PROTECTION AS WELL AS TO REDUCE THE TURNAROUND TIME TO PERFORM A TERMINAL CLEANING. THE AIR IONIZERS WORK TO CHANGE THE ELECTRICAL CHARGE OF THE GERM MOLECULES SO THEY ARE TAKEN OUT OF THE AIR AND FALL TO THE GROUND, ALLOWING THEM TO BE WIPED AWAY, ONCE THE VIREX FOG HAS BEEN DISPERSED. EVS STAFF ALSO ENHANCED THE CLEANING THROUGHOUT ALL FACILITIES OF HIGH-TOUCH AND HIGH-USE AREAS, INCLUDING HANDRAILS, DOOR KNOBS, SEATING, AND PUBLIC BATHROOMS. THEY ALSO INSURED THAT ALL DEPARTMENTS HAD ACCESS TO AN AMPLE SUPPLY OF HAND SANITIZER, AND VIREX FOR DISINFECTING SURFACES. SOCIAL DISTANCE MARKERS WERE PLACED ON THE FLOORS TO HELP PEOPLE MAINTAIN THE PROPER 6 FEET DISTANCE.THE FOOD SERVICE DEPARTMENT WAS RECONFIGURED FROM SELF-SERVE TO FULLY SERVED ITEMS. ALL CONTAINERS, CUPS ETC. ARE SINGLE-USE. THE CAFETERIA SEATING WAS REARRANGED TO ENSURE SOCIAL DISTANCING. EXTENSIVE SIGNAGE, BROCHURES, NEWS ARTICLES WERE DEVELOPED TO HELP THE PUBLIC UNDERSTAND WHAT WAS BEING DONE AND WHY. PHONE MESSAGES WERE DEVELOPED SO THEY COULD MORE EASILY ACCESS THE LATEST INFORMATION. GREAT ATTENTION WAS ALSO PAID TO THE WELL-BEING OF OUR STAFF. WEEKLY COMMUNICATION WAS DISTRIBUTED THROUGH A GROUP EMAIL. UPDATES ON VISITATION, WHAT SERVICES WERE OPENED OR CLOSED, INFO ABOUT DONATIONS BEING MADE TO THE STAFF, SUCH AS MASKS, GIFTS OF FOOD, PEOPLE MAKING HONOR SIGNS SO THEY WOULD KNOW THEIR EFFORTS WERE NOT GOING UNNOTICED. THERE WAS ALSO INFORMATION ON VARIOUS RESOURCES THAT HAD USEFUL INFORMATION FOR THEM AND THEIR FAMILIES. FINALLY, NON-COVID RELATED NEWS WAS ALSO INCLUDED TO HELP THEM REALIZE THERE WAS SOME NORMALITY WAS STILL OCCURRING. A NEW FOUNDATION WAS CREATED IN WALTON NY THAT FOCUSES ON HOSTING "RETREATS FOR GROUPS SEEKING RENEWAL, LEARNING, AND GROWTH." ITS RESTORATIVE CARE PROGRAMS AND OFFERINGS ARE MEANT FOR GROUPS WHOSE MISSION IS TO SERVE OTHERS, INCLUDING HEALTH CARE PROVIDERS, EDUCATORS, FIRST RESPONDERS AND SOCIAL SERVICE PROVIDERS. ONE OF THE FOUNDATION'S MAJOR INITIATIVES IS HAVING A SEVERAL ACRE GARDEN AND SHARING THE PRODUCE WITH THE COMMUNITY THROUGH DONATIONS TO THE FOOD BANK, CHURCHES AND A ROAD SIDE STAND. WORKING TOGETHER, IT WAS RECOGNIZED THAT MANY OF THE PEOPLE BENEFITING FROM THE BOUNTY, REALLY DID NOT KNOW HOW TO COOK THE VEGETABLES, WHEN THEY WOULD COME IN SEASON, OR HOW THEY WOULD TASTE. THE PANDEMIC MEANT WE COULD NOT COOK AT THE COMMUNITY'S FARMER'S MARKET SO TASTE TESTING COULD NOT BE OFFERED, BUT WE WORKED TOGETHER TO CREATE TWO-SIDED CARDS, EACH SIDE DISPLAYING A VEGETABLE. INFORMATION INCLUDED WHEN THE VEGETABLE IS GENERALLY HARVESTED, NUTRITIONAL INFORMATION AND THE VARIOUS WAYS THE VEGETABLE CAN BE USED AND COOKED. THE CARDS WERE TAKEN TO THE FARMER'S MARKET FOR DISTRIBUTION. SINCE THEN, THEY HAVE BEEN UTILIZED AT THE UHS SYSTEM LEVEL AS WELL. PART VI, LINE 3: DELAWARE VALLEY HOSPITAL IS COMMITTED TO PROVIDING OUR PATIENTS THE KNOWLEDGE THAT WE OFFER FINANCIAL ASSISTANCE. EACH PATIENT CARE REGISTRATION AREA HAS SIGNS TELLING THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO THEM. THERE ARE ALSO BROCHURES REGARDING THE PROGRAM THROUGHOUT THE HOSPITAL'S FACILITIES AND THE INFORMATION IS ALSO POSTED ON THE WEBSITE. IF NEEDED, TRANSLATION SERVICES ARE AVAILABLE. A FINANCIAL ASSISTANCE HELP LINE IS ALSO AVAILABLE AND ADVERTISED ON ALL BILLINGS. IN 2015, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CHANGED TO PROVIDE ALL SELF-PAY PATIENTS AN AUTOMATIC 35% DISCOUNT AT THE TIME OF SERVICE. IF FURTHER ASSISTANCE IS NEEDED, THE PATIENT APPLIES THROUGH THE FINANCIAL ASSISTANCE PROGRAM. DELAWARE VALLEY ALSO OFFERS PATIENTS EASY ACCESS TO A FIDELIS REPRESENTATIVE, BY PROVIDING A SITE FOR THEM TO INTERVIEW AND ENROLL RESIDENTS IN THEIR MEDICAID MANAGED CARE PRODUCT. FIDELIS IS THE ONLY PROVIDER OF THESE SERVICES FOR DELAWARE COUNTY. WHILE THE HOSPITAL MAINTAINED THE SPACE FOR THE FIDELIS REPRESENTATIVE TO COME IN 2020, MOST OF THE WORK WAS DONE REMOTELY. PART VI, LINE 4: DELAWARE VALLEY HOSPITAL'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY. USING PERCENTAGES, BASED ON THE NUMBERS OF UNIQUE PATIENTS UTILIZING OUR PRIMARY CARE SITES IN 2019, (AS THAT IS WHERE THE HIGHEST UTILIZATION OCCURS) THE PRIMARY SERVICE AREA ENCOMPASSES WALTON, DOWNSVILLE, ROSCOE, SIDNEY CENTER, DELHI, HAMDEN, EAST BRANCH AND HANCOCK. THE PRIMARY SERVICE AREA REFLECTS WHERE 42.02% OF OUR PATIENTS RESIDE. THE SECONDARY SERVICE AREA CONSISTS OF THE COMMUNITIES WHERE THE NEXT 5.32% OF OUR PATIENTS RESIDE. THOSE COMMUNITIES INCLUDE: SIDNEY, UNADILLA, DELANCEY, LIVINGSTON MANOR, FRANKLIN, BAINBRIDGE AND ONEONTA. DELAWARE COUNTY IS LOCATED ON THE WESTERN EDGE OF THE CATSKILL MOUNTAINS IN RURAL, UPSTATE NEW YORK. ENCOMPASSING 1446.37 SQUARE MILES, THE COUNTY'S SIZE APPROXIMATES THAT OF RHODE ISLAND AND IS THE FOURTH LARGEST OF NEW YORK STATE'S 62 COUNTIES. IN FACT, ITS SIZE IS SO GREAT THAT, SEVEN COUNTIES AND THE STATE OF PENNSYLVANIA BORDER DELAWARE COUNTY. IT ALSO RANKS AS THE SIXTH MOST RURAL COUNTY IN THE STATE WITH JUST 33 PERSONS PER SQUARE MILE. ITS TOPOGRAPHY IS CHARACTERIZED BY WINDING, AND TWISTING, TWO-LANE ROADS THAT TRANSVERSE A MOUNTAINOUS TERRAIN, MAKING TRAVEL CHALLENGING, ESPECIALLY DURING THE WINTER MONTHS. TRANSPORTATION IS AN EXTREMELY CHALLENGING BARRIER TO PROVIDING PATIENT CARE. THE AREA DOES NOT HAVE PUBLIC TRANSPORTATION AND WHILE RECENTLY SOME PRIVATE TRANSPORTATION SERVICES HAVE BEGUN, THEY ARE GENERALLY TOO COST PROHIBITIVE FOR MANY TO ACCESS. THE COUNTY IS HOME TO TWO OF THE STATE'S LARGEST RESERVOIRS IN THE NEW YORK CITY WATERSHED, WHICH HAS THE LARGEST UNFILTERED DRINKING WATER SUPPLY IN THE UNITED STATES. APPROXIMATELY 55% OF DELAWARE COUNTY'S POPULATION LIES WITHIN THE WATERSHED. NEW YORK CITY HAS WORKED TO PRESERVE AND SAFEGUARD THE WATERSHED FROM ENVIRONMENTAL DEGRADATION BY MEANS OF RESTRICTIONS AND REGULATIONS ON LAND USE WITHIN AND SURROUNDING THE WATERSHED. THE INITIAL IMPACT OF THE WATERSHED ON DELAWARE COUNTY HAS BEEN TO LIMIT ECONOMIC DEVELOPMENT WHICH PREVENTS EXPANSION OF THE TAX BASE. BECAUSE OF THE ENVIRONMENTAL ECOSYSTEM OF THE WATERSHED, THERE HAVE BEEN STRICT REGULATIONS PERTAINING TO AGRICULTURAL POLLUTION AND BUILDING CONSTRUCTION. MANY PROPERTIES HAVE BEEN PURCHASED BY NYC, TO FURTHER PROTECT ITS WATERSHED. LIMITING INFRASTRUCTURE GROWTH RESULTS IN DECREASED EMPLOYMENT OPPORTUNITIES. THESE UNIQUE CIRCUMSTANCES RESULT IN HEALTH CARE RELATED CHALLENGES FOR THE COUNTY RESIDENTS. THESE LIMITATIONS ALSO IMPACT THE LOCAL HEALTH AND SOCIAL SERVICE AGENCIES AND ORGANIZATIONS AND THE DELIVERY OF CARE AND SERVICES.THESE LIMITATIONS HAVE CAUSED RESIDENTS TO SEEK ALTERNATIVES TO STIMULATE ECONOMIC GROWTH. DELAWARE COUNTY FARMERS HAVE STARTED SPECIALTY INDUSTRIES. THIS IS REFLECTED IN THE INCREASED NUMBER OF SPECIALTY FARMS. OTHER ECONOMIC DEVELOPMENTS ARE TAKING THE FORM OF TOURISM (E.G. BED AND BREAKFAST), RECREATIONAL FACILITIES COMPATIBLE WITH THE ENVIRONMENT (E.G. GOLF, SKIING, HIKING, HUNTING AND FISHING), LOW POLLUTION FARMING, AND PROFESSIONAL/BUSINESS SERVICES COMPANIES.ACCORDING TO THE 2019 AMERICAN COMMUNITY SURVEY 5 YEAR ESTIMATES DATA PROFILES, THE POPULATION OF DELAWARE COUNTY NY IS 44,995. OF THOSE 3.9% ARE UNDER THE AGE OF 5, WHILE 24% ARE AGE 65 AND OVER. 94.7 % OF THE POPULATION IS CAUCASIAN, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN HOUSEHOLD INCOME IS $ 49,544 AND APPROXIMATELY 16.6% OF THE POPULATION LIVES IN POVERTY, WHICH IS AN INCREASE OF 2.5%. ACCORDING TO THE SAME SOURCE, THE PERCENTAGE OF RELATED CHILDREN UNDER THE AGE OF 18 LIVE BELOW THE POVERTY LEVEL 30.1% WHILE FOR CHILDREN UNDER THE AGE OF 5, THE RATE IS 33.1% IN DELAWARE COUNTY. PART VI, LINE 5: DELAWARE VALLEY HOSPITAL, A CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH OUR ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE WE SERVE. OUR INPATIENT SERVICES INCLUDE ACUTE CARE FOR THOSE PATIENTS REQUIRING 96 HOURS OR LESS OF HOSPITALIZATION; LONGER TERM REHABILITATIVE CARE FOR THOSE WHO NEED TIME TO GAIN STRENGTH AND STAMINA AFTER A DEBILITATING ILLNESS OR INJURY OR A SURGICAL PROCEDURE; AND INPATIENT ADDICTION TREATMENT. THE HOSPITAL ALSO PROVIDES 24-HOUR EMERGENCY CARE. DIAGNOSTIC SERVICES INCLUDE LABORATORY, CARDIOPULMONARY, AND IMAGING SERVICES. THE HOSPITAL HAS THE CAPABILITY OF PERFORMING PULMONARY FUNCTION TESTING, EKGS, CARDIAC STRESS TESTING, AND PLACING HOLTER AND EVENT MONITORS. IN THE IMAGING CENTER, X-RAY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS, AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE WEEKLY. OUR OUTPATIENT REHABILITATION DEPARTMENT OFFERS PHYSICAL AND OCCUPATIONAL THERAPY; AACVPR CERTIFIED CARDIAC AND PULMONARY REHABILITATION PROGRAMS ARE ALSO IN PLACE. THROUGH OUR THREE PRIMARY CARE OFFICES LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE NY, PATIENTS OF ALL AGES CAN RECEIVE ACUTE AND PREVENTIVE CARE, AS WELL AS CHRONIC DISEASE MANAGEMENT. ON SEPTEMBER 11, 2020, THE ROSCOE PRIMARY CARE SITE WAS TEMPORARILY CLOSED DUE TO THE LOSS OF ITS PROVIDER AND NURSE. THE TEMPORARY CLOSURE PLAN WAS FORMULATED AND APPROVED BY THE NYS DEPARTMENT OF HEALTH. THE CLOSURE WAS TO GIVE US A 6-MONTH WINDOW TO TRY AND RECRUIT NEW STAFF TO THIS LOCATION. WE WERE ABLE TO RE-OPEN THE SITE ON APRIL 26, 2021. OCCUPATIONAL HEALTH SERVICES INCLUDE PRE-EMPLOYMENT AND DOT PHYSICALS, IMMUNIZATIONS, DRUG TESTING, AND ANNUAL PHYSICALS FOR FIRE DEPARTMENT MEMBERS. VISITING SPECIALISTS INCLUDE A GASTROENTEROLOGIST, CARDIOLOGIST, PODIATRIST AND THREE PAIN MANAGEMENT PROVIDERS: A PHYSICIAN, PHYSICIAN ASSISTANT AND A CHIROPRACTOR. THE GENERAL SURGEON, WHO HAD BEEN COMING FOR CONSULTS AND TO PERFORM ENDOSCOPY PROCEDURES, RETIRED. DVH WAS ABLE TO RECRUIT A GASTROENTEROLOGIST FROM UHS TO CONTINUE PERFORMING THE ENDOSCOPIES AND HE ALSO RUNS A GI CLINIC WHILE HE IS AT DVH. THIS BRINGS A NEW SERVICE TO THE COMMUNITY. THE PAIN MANAGEMENT CLINIC BEGAN TO HELP PATIENTS UTILIZE ALTERNATIVE TREATMENT METHODS RATHER THAN USING OPIOIDS. THE CLINIC IS HELD THREE DAYS PER MONTH. DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST GENERALLY OFFERS A VARIETY OF PROGRAMS TO SEVERAL GROUPS. HOWEVER, THIS WAS NOT THE CASE IN 2020 DUE TO THE PANDEMIC. SHE AND OUR RN CARE COORDINATOR PARTNERED AGAIN WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY IN 2020, TO WORK WITH THEIR CLIENTS WHO WERE ELIGIBLE FOR THE FRUIT AND VEGGIE VOUCHER PROGRAM. THE DIETITIAN AND FOOD SERVICE MANAGER HELD A CELEBRATORY EVENT AT THE END OF THE YEAR, CREATING A BUDDHA BOWL DINNER FOR ALL OF THE PARTICIPANTS. SHE ALSO WAS EXTREMELY INSTRUMENTAL IN THE DEVELOPMENT OF THE VEGETABLE CARDS FOR THE LOCAL FARMER'S MARKET AUDIENCE. THE ANNUAL DELAWARE COUNTY FAIR WAS CANCELLED DUE TO COVID-19. HOWEVER, THE HOSPITAL LET THE FAIR, A NON-PROFIT GROUP, KEEP THE FUNDS THAT WE PAID FOR OUR BOOTH AS A DONATION. SEVERAL WELLNESS INITIATIVES ALSO SUFFERED DUE TO THE PANDEMIC. THE LACK OF FACILITATORS HAMPERED THE FRESH START SMOKING CESSATION PROGRAM, BUT NO CLASSES WOULD HAVE BEEN HELD IN PERSON ANYWAY. THE HOSPITAL PLANNED TO CONTINUE THE LUNG MATTERS GROUP FOR PATIENTS AND CAREGIVERS DEALING WITH LUNG CONDITIONS. THEY TOOK A HIATUS IN WINTER, BUT RETURNED IN MARCH. THE PROGRAM WAS ADVERTISED AND READY TO BE HELD WHEN DVH HAD TO SHUT DOWN TO VISITORS. IN 2020, THE HOSPITAL ALSO PLANNED TO OFFER CHAIR YOGA AGAIN, BUT IT HAD TO BE POSTPONED DUE TO THE PANDEMIC. THE STANFORD UNIVERSITY, EVIDENCED-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, MARKETED AS 'HAPPY HEALTHY AND WISE WORKSHOPS' WAS NOT OFFERED. FURTHER COMPLICATING THE ABILITY TO PRESENT THIS PROGRAM IS THAT A FACILITATOR HAS LEFT THE HOSPITAL'S EMPLOY. OTHER AVENUES OF POSSIBLY OFFERING THIS PROGRAM IN THE FUTURE ARE BEING EXPLORED. PART VI, LINE 6: DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT MEMBER OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UNITED HEALTH SERVICES IN 1981 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATIONS INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. DVH PARTICIPATES IN THE UNITED HEALTH SERVICES SYSTEM STRATEGIC PLANNING PROCESS. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSES ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND THREE OBJECTIVES: IMPROVE OUR CARE, MANAGE OUR COSTS, AND GROW OUR MARKET SHARE. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE AND DVH FURTHER DEVELOPS OBJECTIVES AS THEY RELATE TO THE HOSPITAL'S SERVICES AND THE NEEDS OF OUR PATIENTS. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES BOTH LOCALLY AND REGIONALLY. THE DVH COMMUNITY SERVICE REPORT IS INCLUDED WITH THE DELAWARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, ALONG WITH THE COMMUNITY SERVICE PLANS OF O'CONNOR HOSPITAL, TRI-TOWN REGIONAL HOSPITAL, AND MARGARETVILLE HOSPITAL, ALL IN ONE DOCUMENT. PART VI, LINE 7, REPORTS FILED WITH STATES NY PART VI, LINE 2 CONTINUED: MENTAL HEALTH AND SUBSTANCE USE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2020, MEETINGS WERE CONTINUED WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. THE DIRECTOR OF COMMUNITY RELATIONS SAT ON A SUB-COMMITTEE OF THE COUNTY'S COMMUNITY SERVICE DEPARTMENT, FOCUSED ON MENTAL HEALTH. IN SEPTEMBER, SHE WAS ASKED TO SIT ON THE COUNTY COMMUNITY SERVICES BOARD. THE MOST CHALLENGING BARRIER IN ACCESSING CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. IN 2017, DVH BEGAN A TELE PSYCHIATRY PROGRAM WITH A PRIVATE PRACTICE PSYCHIATRIST. UNFORTUNATELY, DUE TO THE PHYSICIAN'S LIMITED PARTICIPATION WITH INSURANCE CARRIERS, MANY PATIENTS IN NEED COULD NOT BE REFERRED. IN 2018, DVH WAS ABLE TO CONTRACT WITH AN OUTSIDE VENDOR TO BEGIN A TELE-MENTAL HEALTH PROGRAM. THE PROGRAM OFFICIALLY BEGAN IN JANUARY 2019. AN NPP AND LCSW ARE AVAILABLE TO SEE PATIENTS THROUGH THIS TECHNOLOGY. IN 2020, THE LCSW WENT ON MATERNITY LEAVE AND LEFT THE PROGRAM THEREAFTER. TWO ADDITIONAL LCSWS WERE CONTRACTED, BUT ALMOST IMMEDIATELY ONE OF THEM FOUND THAT THE MENTAL HEALTH NEEDS OF FIRST RESPONDERS AND RESIDENTS OF HER COMMUNITY WERE SO EXCESSIVE DUE TO THE PANDEMIC; SHE FELT COMPELLED TO CONCENTRATE ON HELPING THEM AND THEREFORE LEFT THE PROGRAM. ANOTHER LCSW WAS CONTRACTED TO REPLACE HER BUT IN OCTOBER, ALSO HAD TO LEAVE AS HER PRIVATE PRACTICE WAS GROWING, ALSO DUE TO THE PANDEMIC. THE NPP REMAINED CONSTANT. THE HOSPITAL CONTINUES TO SERVE AS THE COLLECTION SITE FOR URINE SPECIMENS FOR THE COUNTY'S DRUG COURT. IN 2020, SERVICES WERE PROVIDED FREE OF CHARGE UNTIL MARCH, WHEN THE DRUG COURT CLOSED AND DID NOT REOPEN UNTIL 2021. A SECOND NEED IS FOR CHRONIC DISEASE MANAGEMENT AND PREVENTION. IN 2020, THE HOSPITAL STAFF TRAINED TO PROVIDE THE CLASSES WAS REDUCED TO TWO; ONE LEFT FOR A POSITION OUTSIDE OF THE HEALTHCARE FIELD. HOWEVER, NO CLASSES WERE HELD IN 2020 DUE TO THE PANDEMIC. THE HOSPITAL PLANNED TO CONTINUE ITS LUNG MATTERS PROGRAM FOR PATIENTS DIAGNOSED WITH LUNG CONDITIONS. IN FACT, ITS MARCH SESSION HAD BEEN ADVERTISED, WHICH WAS ITS FIRST FOR 2020 AFTER A WINTER HIATUS, BUT IT ULTIMATELY HAD TO BE CANCELLED DUE TO COVID. DVH SPONSORED CHAIR YOGA FOR CARDIAC/PULMONARY REHABILITATION PATIENTS WAS ALSO NOT CONTINUED IN 2020 DUE TO THE PANDEMIC. BECAUSE NUTRITION PLAYS A HUGE ROLE IN THE HEALTH OF COMMUNITY MEMBERS, THE HOSPITAL'S DIETITIAN/NUTRITIONIST WORKED IN CONJUNCTION WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY TO PROVIDE 30 PATIENTS WITH COMPLIMENTARY ONE ON ONE DIETARY COUNSELING AS THEY PROGRESSED THROUGH THE COOPERATIVE EXTENSION'S FRUIT & VEGETABLE PROGRAM. A CELEBRATORY DINNER WAS HELD OUTDOORS IN EARLY OCTOBER FOR PARTICIPANTS IN THE PROGRAM TO RECOGNIZE THE GAINS THEY MADE. THE HOSPITAL ALSO ACTIVELY PARTICIPATED IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR WAS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS UNTIL THE FOCUS OF ITS PROGRAMS CHANGED TO COMMUNITY BASED ORGANIZATIONS. SHE CONTINUES TO SERVE IN AN AD-HOC CAPACITY WHEN APPROPRIATE.THE HOSPITAL RECOGNIZED THAT UNLESS IT IS ABLE TO ENGAGE THE COMMUNITY IN CONVERSATIONS ABOUT MANY OF THE SOCIAL DETERMINANTS OF HEALTH, A LOT OF PROGRESS CANNOT BE MADE IN THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS. RESEARCH LED TO THE AARP AGE FRIENDLY LIVABLE COMMUNITY PROGRAM, WHICH IS GEARED TO ALL AGES. WORKING WITH THE CARE COMPASS NETWORK, WHICH AGREED TO FUND AN EVENT, LEADERS FROM AROUND THE COUNTY WERE INVITED TO ATTEND A DAY-LONG PROGRAM FEATURING NATIONALLY RENOWNED SPEAKER, ESTHER GREENHOUSE, WHO IS CONSIDERED AN EXPERT ON AGING IN PLACE. KAT FISHER FROM THE REGIONAL AARP OFFICE SPOKE ABOUT AARP'S PROGRAM. INVITATIONS WERE SENT TO LEADERS IN VARIOUS GOVERNMENT AGENCIES, SERVICE ORGANIZATIONS, SCHOOLS, CHURCHES AND COMMUNITY MEMBERS. THE PROGRAM WAS SCHEDULED FOR LATE JANUARY, 2020. THIS FULL-DAY WORKSHOP TOOK PLACE ON 1/30/20, WITH 50 PEOPLE IN ATTENDANCE. PARTICIPANTS INCLUDED REPRESENTATION FROM ALL THREE HOSPITALS SERVING DELAWARE COUNTY, COMMUNITY BASED ORGANIZATIONS INCLUDING HOSPICE AND PALLIATIVE CARE, ALCOHOL AND DRUG ABUSE, REHABILITATIVE SUPPORT, FAMILY PLANNING, NAMI, RURAL HEALTH NETWORK OF SOUTH CENTRAL NY, COOPERATIVE EXTENSION, ACTION FOR OLDER PERSONS, WALTON CHAMBER OF COMMERCE AND WEST BRANCH ARTISTS. THREE SCHOOL DISTRICTS WERE REPRESENTED. TWO COMMUNITIES' LOCAL GOVERNMENT BOARD MEMBERS ATTENDED. DELAWARE OPPORTUNITIES, THE AREA'S LEAD AGENCY FOR MANY COMMUNITY PROGRAMS SUCH AS HEAD START, WIC, HOUSING, SENIOR DINING, TRANSPORTATION AND MORE, HAD THREE ATTENDEES. DEPARTMENT HEADS OF DELAWARE COUNTY WERE VERY WELL REPRESENTED; THESE INCLUDED OFFICE FOR THE AGING, PUBLIC HEALTH, COMMUNITY SERVICES (BEHAVIORAL AND ADDICTION SERVICES), PLANNING AND WATERSHED AFFAIRS, CHAMBER OF COMMERCE, AND SOIL AND WATER CONSERVATION. THE PRESENTERS WERE VERY IMPRESSED WITH NOT ONLY THE NUMBER OF ATTENDEES, ESPECIALLY IN SUCH A SMALL COMMUNITY, BUT ALSO THE WIDE RANGE AND SCOPE OF THE ATTENDEES. ALL PARTICIPANTS RECEIVED A SET OF THE AARP AGE FRIENDLY COMMUNITY GUIDES. X X X X 0 0 0 0 0 1 1 0 0 JOHN CARRIGG BOARD MEMBER/VICE CHAIR 0 823311 0 133369 0 2546730 0 1333289 0 21566 0 4858265 0 0 PAUL SUMMERS FORMER BOARD MEMBER/PRES/CEO 6/30/20 214777 0 25024 0 0 0 8334 0 16632 0 264767 0 0 0 DR MICHAEL FREEMAN BOARD MEMBER/MEDICAL STAFF PRESIDENT 234927 0 2000 0 0 0 12336 0 9405 0 258668 0 0 0 PART I, LINE 6 THE EXECUTIVE COMPENSATION INCENTIVE PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2020 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS. FORM 990, PART VII, SECTION A, LINE 5, UNRELATED PARTY DETAIL: INDIVIDUAL: MICHAEL FREEMAN, MEDICAL STAFF PRESIDENT COMPENSATION RECEIVED FROM UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES (UMA) COMPENSATION: WAGES & NON-TAXABLE BENEFITS $258,668. PAYMENT IN 2020 FROM A NON-QUALIFIED PLAN: JOHN CARRIGG $2,546,730 RE: SCHEDULE J, PART II, LINE 1, BIII - OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $2,536,832 INCLUDES THE TRIGGERING EVENT OF A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. "SERP" AMOUNTS INCLUDED AS COMPENSATION FOR MR. CARRIGG RELATED TO THE RECOGNITION OF THAT PLAN. EARLY SERP DISTRIBUTIONS WERE RELATED TO INCOME TAX PAYMENTS. THE REMAINING AMOUNTS ARE DEFERRED UNTIL SUBSEQUENT TRIGGERING EVENTS. THESE TAX RELATED PROCEEDS AND DEFERRALS WERE REPORTED BY UNITED HEALTH SERVICES HOSPITALS, INC, ONLY, A RELATED ORGANIZATION. RE: SCHEDULE J, PART II, LINE 1, C - RETIREMENT AND OTHER DEFERRED COMPENSATION IN THE AMOUNT OF $1,285,207 ALSO INCLUDES THE DEFFERRAL AMOUNT FOR THE SUPPLYMENTAL EXECUTIVE RETIREMENT PLAN NOTED IN BIII. A COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY 161137407 245867AA4 2007-06-29 5805000 CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE 0 0 0 A 5805000 250826 5554174 2008 0 0 1 1 A 0 0 0 0 1 0 1 A 1 1 0 0 0 0 A 1 MILA KATANIC-TUCKER STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS 32051 EMPLOYEE WAGES 0 NANCY VOLLKOMMER SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO 33909 EMPLOYEE WAGES 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A UHS, INC., THE ORGANIZATION'S SOLE CORPORATE MEMBER, APPOINTS THE VOTING BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE DELAWARE VALLEY HOSPITAL, INC. (DVH) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF FORM 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATIONAL PURPOSES. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMMITTEE. FORM 990, PART VI, SECTION B, LINE 15A PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY THE BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. THE COMMITTEE USES SULLIVAN-COTTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS THE BASIS FOR ESTABLISHING AN ACCEPTABLE COMPENSATION RANGE TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 5,236,696. MANAGEMENT AND GENERAL EXPENSES 1,207,271. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,443,967. FORM 990, PART XI, LINE 9: INTEREST RATE SWAP -46,913. FORM 990, PART XII, LINE 2C NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT HAS CHANGED DURING THE YEAR. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS. UNITED HEALTH SERVICES HOSPITALS INC 10-42 MITCHELL AVENUE BINGHAMTON NY 13903 161165049 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 PROFESSIONAL HOME CARE 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 161261977 HOME HEALTH CARE NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER 508 HIGH AVENUE ENDICOTT NY 13760 222902896 SENIOR LIVING CENTER NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER HOUSING 508 HIGH AVENUE ENDICOTT NY 13760 222902899 SENIOR HOUSING NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 CHENANGO MEMORIAL HOSPITAL 179 NORTH BROAD STREET NORWICH NY 13815 150532180 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 UNITED HEALTH SERVICES INC 20-40 MITCHELL AVENUE BINGHAMTON NY 13903 222682421 PARENT COMPANY NY 501(C)(3) 10 BOARD OF DIRECTORS UHS INC 0 TWIN TIER HOME HEALTH INC 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 222438211 HOME HEALTH CARE NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0