2019-11-04T18:25:37-06:00 2018-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2018-01-01 452964467 BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP % MAUREEN BURKE BONS 8453685000 255 Lafayette Avenue Suffern NY 10901 MARY LEAHY MD CEO - BSCHS 8453685305 2019-11-04 true Laura Kielczewski P00740769 2127733000 164.57.159.254 26308520193085000024 2019-11-04 P 47CCE9F19DA6832300AFC0DC75FEB109EC0143B4 047C777BBD395ADD529156C75D94AFF56594489C 2018 2020-01-14 16:20:31Z MARY LEAHY MD 255 Lafayette Avenue Suffern NY 10901 579482499 true true 5747 X www.bschs.org X NY TO OPERATE SEVERAL ACUTE CARE HOSPITALS, LONG-TERM CARE FACILITIES AND OTHER HEALTHCARE SERVICES FOR THE RESIDENTS OF THE COMMUNITIES SERVED. 16 8 3915 305 0 99776 1027633 1770316 517742377 561673680 2251790 993900 14360521 14470259 535382321 578908155 24296 11979 0 0 297676318 315109192 0 0 0 235343705 260306428 533044319 575427599 2338002 3480556 205936249 201981458 222453400 208803296 -16517151 -6821838 THE MISSION IS TO MAKE VISIBLE GOD'S LOVE AND TO BE GOOD HELP TO THOSE IN NEED, ESPECIALLY THOSE WHO ARE POOR, VULNERABLE AND DYING. AS A SYSTEM OF CAREGIVERS, WE COMMIT OURSELVES TO HELP BRING PEOPLE AND COMMUNITIES TO HEALTH AND WHOLENESS AS PART OF THE HEALING MINISTRY OF JESUS CHRIST AND THE CATHOLIC CHURCH. false false 497871842 11979 574888932 BON SECOURS CHARITY HEALTH SYSTEM AFFILIATED GROUP IS COMPOSED OF THREE ACUTE CARE HOSPITALS, A PRIMARY AND SPECIALTY MEDICAL CARE PRACTICE AND TWO LONG-TERM CARE AND RESIDENTIAL FACILITIES: GOOD SAMARITAN HOSPITAL OF SUFFERN, NY; BON SECOURS COMMUNITY HOSPITAL; ST. ANTHONY COMMUNITY HOSPITAL; BON SECOURS CHARITY HEALTH SYSTEM MEDICAL GROUP, PC; ST. FRANCIS CENTER AT THE KNOLLS (DBA MOUNT ALVERNO CENTER); AND VILLAS FRANCIS AT THE KNOLLS (DBA SCHERVIER PAVILION). GOOD SAMARITAN HOSPITAL (GSH) OPERATES A 286-BED HOSPITAL LOCATED IN SUFFERN, NEW YORK THAT PROVIDES EMERGENCY, MEDICAL, SURGICAL, OBSTETRICAL/GYNECOLOGICAL AND ACUTE CARE SERVICES TO ROCKLAND AND ORANGE COUNTIES, NEW YORK AND NORTHERN BERGEN COUNTY, NEW JERSEY. GSH HAS A LEVEL II TRAUMA CENTER, A DESIGNATED STROKE CENTER AND ACUTE MYOCARDIAL INFARCTION (AMI) PROGRAM, AND A REGIONAL CARDIOVASCULAR PROGRAM, PROVIDING OPEN HEART SURGERY, A CARDIAC CATHETERIZATION LABORATORY, EMERGENCY ANGIOPLASTY, ELECTROPHYSIOLOGY STUDIES AND A PACEMAKER CLINIC. GSH IS THE ONLY FACILITY IN THE REGION WITH AN ANGIOGRAPHY SUITE TO TREAT VASCULAR DISEASE WITH NEW 3D DIAGNOSTIC EQUIPMENT WHICH PROVIDES IMAGE GUIDED THERAPY TO EVALUTE ARTERIES AND VEINS TO IDENTIFY BLOCKAGES MORE PRECISELY. GSH IS THE ONLY HOSPITAL IN ORANGE AND ROCKLAND COUNTIES, AS WELL AS NORTHERN NEW JERSEY, TO RECEIVE THE 2018 AND 2019 FIVE STAR RATING FOR CORONARY INTERVENTION, ALONG WITH THE CORONARY INTERVENTION EXCELLENCE AWARD FROM HEALTHGRADES. GSH HAS RECEIVED MANY AWARDS AND IN 2014 WAS NAMED ONE OF THE NATION'S 50 TOP CARDIOVASCULAR HOSPITALS BY TRUVEN HEALTH ANALYTICS. GSH OFFERS A COMPREHENSIVE WOMEN'S BREAST CENTER, WOUND AND HYPERBARIC CENTER, SLEEP STUDY CENTER AND MATERNAL/CHILD SERVICES, INCLUDING A LEVEL II NEONATAL INTENSIVE CARE UNIT SUPPORTED BY PEDIATRIC SUBSPECIALISTS FROM WESTCHESTER MEDICAL CENTER (WMC). BREAST CENTER AT GSH IS THE ONLY FACILITY IN THE AREA THAT OFFERS A HIGH RISK SCREENING PROGRAM TO IDENTIFY WOMEN WHO MEET CRITERIA FOR HIGH RISK, DURING THEIR ROUTINE SCREENINGS. GSH'S SURGICAL WEIGHT LOSS INSTITUTE PROVIDES PRE-OPERATIVE, SURGICAL CARE AND OUTPATIENT POST-OPERATIVE BARIATRIC SUPPORT. GSH PROVIDES KIDNEY DIALYSIS, PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES AND A RANGE OF SOCIAL SUPPORT SERVICES, EDUCATION AND POPULATION HEALTH SERVICES. THE OB EMERGENCY DEPARTMENT IN COLLABORATION WITH THE OB HOSPITALIST PROGRAM PROVIDES EMERGENCY OBSTETRICAL SERVICES IN THE OB EMERGENCY DEPARTMENT. THE OB-GYN DEPARTMENT RECEIVED THE HEALTHGRADES FIVE STAR AWARD FOR VAGINAL DELIVERY FOR THE 4TH CONSECUTIVE YEAR BY HEALTHGRADES, AS WELL AS THE 2018 OBSTETRICS AND GYNECOLOGY EXCELLENCE AWARD. THE CAMPUS ALSO INCLUDES A MEDICAL OFFICE BUILDING HOUSING A STATE-OF-THE-ART AMBULATORY SURGERY CENTER, AND PRIMARY CARE AND SPECIALTY PHYSICIANS. GSH'S CERTIFIED HOME CARE AGENCY PROVIDES HOME HEALTH SERVICES TO THE RESIDENTS OF ROCKLAND AND ORANGE COUNTIES, NEW YORK. THIS PROGRAM IS FOR PATIENTS WHO HAVE ACUTE NEEDS AND REQUIRE HOME CARE FOR A RELATIVELY SHORT PERIOD OF TIME AND WILL BE DISCHARGED WHEN THEY ARE STABILIZED OR RETURNED TO A PRE-ILLNESS LEVEL OF FUNCTIONING. ADDITIONAL SERVICES INCLUDE WOUND AND OSTOMY ASSESSMENTS, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH PATHOLOGY, MEDICAL SOCIAL WORK, NUTRITION AND HOME HEALTH AIDES. THE HOME HEALTH AGENCY IS CERTIFIED FOR EXPANSION INTO MANHATTAN AND WESTCHESTER COUNTY, NEW YORK. BON SECOURS COMMUNITY HOSPITAL (BSCH) OPERATES A 122-BED ACUTE CARE HOSPITAL LOCATED IN PORT JERVIS, NEW YORK THAT PROVIDES COMMUNITY-BASED CARE TO RESIDENTS IN THE PORT JERVIS, NEW YORK AND SURROUNDING AREAS (ORANGE AND SULLIVAN COUNTIES IN NEW YORK, SUSSEX COUNTY IN NEW JERSEY AND PIKE COUNTY IN PENNSYLVANIA). BSCH PROVIDES EMERGENCY CARE, LABORATORY AND IMAGING SERVICES, MEDICAL AND SURGICAL SERVICES, AND INTENSIVE CARE UNIT, INPATIENT DIALYSIS, CARDIOPULMONARY CARE, INFUSION THERAPY AND OUTPATIENT WOUND CARE AND DIABETES PROGRAMS. BSCH ALSO OFFERS INPATIENT PSYCHIATRIC SERVICES AND A CHEMICAL DEPENDENCY PROGRAM. A MEDICAL OFFICE BUILDING WITH PRIMARY CARE AND DIAGNOSTIC SERVICES IS LOCATED ACROSS THE STREET FROM BSCH. BSCH ALSO OFFERS A WIDE RANGE OF HEALTH EDUCATION AND POPULATION HEALTH SUPPORT SERVICES FOR THE COMMUNITY. ST. JOSEPH'S PLACE IS A 46-BED NURSING CARE CENTER LOCATED ON THE FIRST FLOOR OF BSCH THAT PROVIDES 24-HOUR NURSING CARE, LONG- AND SHORT-TERM REHABILITATION, TRACHEOTOMY CARE, HEAD TRAUMA CARE, RESPIRATORY CARE AND PSYCHOLOGICAL SERVICES. ST. ANTHONY'S COMMUNITY HOSPITAL (SACH) OPERATES A 60-BED HOSPITAL THAT IS LOCATED IN WARWICK, NEW YORK SERVING THE RESIDENTS OF ORANGE COUNTY, NEW YORK, AND SUSSEX AND PASSAIC COUNTIES, NEW JERSEY. SACH PROVIDES EMERGENCY CARE, MEDICAL AND SURGICAL SERVICES, LABORATORY AND IMAGING SERVICES, OBSTETRICAL, AND GYNECOLOGICAL AND ORTHOPEDICS. THE SACH AMBULATORY SERVICES CENTER PROVIDES VARIOUS CONVENIENT SERVICES, INCLUDING ADMITTING, PRE-ADMISSION SCREENING, ENDOSCOPY, MINOR SURGERY AND SAME-DAY SURGERY. AN INFUSION CENTER PROVIDES LONG-TERM INTRAVENOUS ANTIBIOTICS, BLOOD TRANSFUSIONS, IRON THERAPY, CHEMOTHERAPY AND LONG-TERM CATHETER INSERTION AND MAINTENANCE. SACH EDUCATION AND OUTREACH SERVICES INCLUDE A DIABETES EDUCATION PROGRAM AND POPULATION HEALTH IMPROVEMENT PROGRAMS. BON SECOURS CHARITY HEALTH SYSTEM MEDICAL GROUP, PC (MEDPC) PROVIDES MEDICAL SERVICES TO SUFFERN, NEW YORK AND SURROUNDING COMMUNITIES. THEIR SERVICES INCLUDE PRIMARY CARE AND VARIOUS SPECIALTY PROFESSIONAL SERVICES. THE ORGANIZATION SEEKS TO LOCATE ITS PHYSICIAN PRACTICE SITES IN AREAS THAT MOST EFFECTIVELY MEET THE NEEDS OF THE COMMUNITY. VILLA FRANCIS AT THE KNOLLS, INC. D/B/A SCHERVIER PAVILION (SCHERVIER) IS A 122-BED, SKILLED NURSING FACILITY LOCATED IN WARWICK, NEW YORK. SCHERVIER PROVIDES THERAPEUTIC AND SOCIAL ACTIVITIES DESIGNED TO ENHANCE THE PHYSICAL AND MENTAL CAPABILITIES TO HELP RESIDENTS MAINTAIN AND OPTIMIZE THEIR LEVEL OF DAILY INDEPENDENCE. SCHERVIER IS PART OF THE 27-ACRE WARWICK CAMPUS THAT INCLUDES MOUNT ALVERNO CENTER AND SACH. LOCATED IN SCHERVIER IS A FULL-SERVICE ADULT DAY CARE PROGRAM KNOWN AS DAY-AT-A-TIME. IT PROVIDES HEALTH CARE, RECREATIONAL AND THERAPEUTIC ACTIVITIES FROM TWO TO FIVE DAYS PER WEEK FOR THE COGNITIVELY IMPAIRED AND PHYSICALLY FRAIL. THE PROGRAM PROVIDES AN ALTERNATIVE TO NURSING HOME PLACEMENT AND HOME HEALTH CARE. ST. FRANCIS CENTER AT THE KNOLLS, INC. D/B/A MOUNT AVERNO CENTER (MOUNT ALVERNO) IS AN ADULT HOME LOCATED ON THE SACH CAMPUS WITH AN ASSISTED LIVING PROGRAM SERVING 85 RESIDENTS BY PROVIDING INDIVIDUALIZED CARE PLANS DESIGNED TO HELP RESIDENTS REACH AND MAINTAIN A MAXIMUM LEVEL OF INDEPENDENCE. 497871842 true true false true false false false false true false true false false false true false false true false false false false false false false false true true false true true false false false false false false false false false false false false false true true true false false true 308 0 true 3915 true true true false false false false false false false false false false false X 16 8 false false false false true true true true true false false true true true true true true true true false NY X MAUREEN BURKE 8453685305 255 LAFAYETTE AVENUE Suffern NY 10901 MARY LEAHY MD PRESIDENT & CEO 36.0 4.0 X X 0 916194 91847 JOHN WALLENHORST PHD BOARD MEMBER - SPONSOR REP 1.0 39.0 X X 0 700238 27573 MARK NANTZ CHAIR 1.0 39.0 X X 0 2460201 137158 MICHAEL ISRAEL VICE CHAIR 1.0 39.0 X X 0 2466869 167424 JOHN HEIMERDINGER SECRETARY 1.0 7.0 X X 0 0 0 SUSAN GEVERTZ BOARD MEMBER 1.0 2.0 X 0 0 0 RENEE GARRICK MD BOARD MEMBER 1.0 39.0 X 0 521838 25512 GARY BRUDNICKI BOARD MEMBER 1.0 39.0 X 0 1650080 150650 RICHARD WISHNIE 1ST VICE CHAIR 1.0 5.0 X X 0 0 0 JULIE SWITZER BOARD MEMBER 1.0 39.0 X 0 877350 125589 STEPHEN DORMER BOARD MEMBER 1.0 1.0 X 0 0 0 TAMER EL-RAYESS BOARD MEMBER & TREASURER 1.0 1.0 X X 0 0 0 SANDRA GRANNUM BOARD MEMBER 1.0 1.0 X 0 0 0 MARK FERSKO BOARD MEMBER 1.0 39.0 X 0 987545 120518 SRELISE GITTRICH BOARD MEMBER-SPONSOR REP 1.0 1.0 X X 0 0 0 STEVEN KENT BOARD MEMBER (EFFECT. 1/1/18) 1.0 1.0 X 0 0 0 MARTIN EVERS MD PRESIDENT - MEDPC 40.0 0.0 X 339462 0 48328 PETER KENNIFF CFO 39.0 1.0 X 413305 0 47870 CARY HIRSCH MD PHYSICIAN 40.0 0.0 X 1058386 0 20898 SETH HURWITZ MD CARDIOLOGIST 40.0 0.0 X 690137 0 47210 ARVIND K AGARWAL PHYSICIAN 40.0 0.0 X 775162 0 36723 PERMINDER S GREWAL PHYSICIAN 40.0 0.0 X 704394 0 52008 AMALA P CHIRUMAMILLA PHYSICIAN 40.0 0.0 X 671169 0 27298 4652015 10580315 1126606 605 false true false CROTHALL HEALTHCARE INC 13028 COLLECTIONS CTR CHICAGO IL 60693 ENGINEERING 7421335 MORRISON MGT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 6057758 ACCESS REHABILITATION SERVICES 16 MAYBROOK RD STE H CAMPBELL HALL NY 10916 REHAB THERAPY 5578343 HOSPITAL ATTENDING PHYSICIANS 484 TEMPLE HILL RD STE 102 NEW WINDSOR NY 12553 PHYSICIAN SERVICES 3049167 INTEGRATED MEDICAL PROFESSIONALS LL 532 BROADHOLLOW RD STE 142 MELVILLE NY 11747 PHYSICIAN SERVICES 2027214 108 283810 1321266 165240 1770316 NET PATIENT SERVICE REVENUE 623000 558655817 558655817 CAPITATION REVENUE 623000 948358 948358 SHARED SAVINGS REVENUE 900099 2069505 2069505 561673680 976657 976657 0 0 949566 574344 375222 0 375222 375222 17243 0 17243 17243 17243 0 0 0 0 0 0 0 0 0 INCENTIVES, REBATES & REFUNDS 900099 899140 899140 NYS VBP-QIP REVENUE 900099 8108072 8108072 NYS DELIVERY SYSTEM REFORM INCENTIVE PYMT 900099 2277457 2277457 2810368 1930583 879785 14095037 578908155 574888932 2248907 0 11979 11979 0 0 1022830 102283 920547 0 238088863 224387550 13701313 7952100 6246812 1705288 51121047 48940816 2180231 16924352 16064787 859565 0 1299838 8091 1291747 620527 620527 143901 143901 0 0 22259500 21938685 320815 1234268 49970 1184298 8803874 4542601 4261273 1863522 1248002 615520 0 14777381 9895718 4881663 923132 828027 95105 0 162615 65868 96747 7567086 7567086 0 25159642 24992113 167529 9425889 7017838 2408051 MEDICAL SUPPLIES 70610114 70610114 PURCHASED SERVICES 41328925 25317998 16010927 CORPORATE DUES 41707376 16699260 25008116 OTHER EXPENSES 12418838 11336244 1082594 575427599 497871842 77555757 0 412111 785306 281238 281238 0 0 60039910 62706272 0 0 0 0 0 0 9079707 9934971 2780006 3524060 384425047 262761596 128402187 121663451 281133 30086 0 0 0 0 0 0 4659957 3056074 205936249 201981458 65680574 59667150 0 0 1318785 1004534 0 0 168073 185439 0 0 123100041 124152435 0 0 32185927 23793738 222453400 208803296 X -17353380 -7658067 836229 836229 0 0 -16517151 -6821838 205936249 201981458 X 3480556 6214757 X false true X true false X 0 0 0 0 0 0 2800331 2430784 1923266 1781088 1650443 10585912 0 0 0 2800331 2430784 1923266 1781088 1650443 10585912 0 0 0 10585912 0 0 0 0 120377 224288 122030 99086 102789 668570 2920708 2655072 2045296 1880174 1753232 11254482 0.94059 0.94504 0.00000 0.00000 X false false false false false 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schedule A, Part I One subordinate (ST. FRANCIS CENTER OF THE KNOLLS D/B/A MOUNT ALVERO ASSISTED LIVING CENTER) included in this return has public charity status as an organization described in section 509(a)(2). Schedule A, Part III is completed to report this entity's activities. false false false false false false false false true 143901 143901 false Part II-B, Line 1, Lobbying Activities The filing organization maintains memberships IN various professional healthcare associations. Portions of the membership dues are used for lobbying activities. The lobbying portion of such dues, AS PROVIDED BY THE MEMBERSHIP ORGANIZATION, is included on PART IX, line 11D. false true X 4895988 4895988 147949892 95559287 52390605 1945308 1923825 21483 215014300 157577672 57436628 14619560 7700813 6918747 121663451 0 DUE TO THIRD PARTIES 10912910 LONG TERM ASBESTOS LIABILITY 2938711 CAPITAL LEASE LT LIABILITY 3726686 ARCHDIOCESE LT PENSION LIABILITY 4794435 DUE TO AFFILIATES 1420996 OTHER L/T LIABILITIES 0 23793738 Part IV, Line 2B CERTAIN FACILITIES HOLD, SAFEGUARD, MANAGE AND ACCOUNT FOR THE PERSONAL FUNDS OF RESIDENTS WHO HAVE AUTHORIZED THE FACILITIES IN WRITING TO MANAGE PERSONAL FUNDS. FUND REQUESTS LESS THAN $50 ARE AVAILABLE FOR IMMEDIATE DISTRIBUTION TO RESIDENTS AND WRITTEN REQUESTS FOR $50 OR MORE ARE HONORED, BY CHECK, WITHIN A REASONABLE TIME FRAME. GENERALLY, ALL CUSTODIAL FUNDS IN EXCESS OF $50 ARE HELD IN INTEREST BEARING ACCOUNTS SEPARATE FROM THAT OF THE FACILITIES. true true X true X 250. true X 500. true true true false true true 2111848 96285 2015563 0.00350 95890357 70341065 25549292 0.04440 98002205 70437350 27564855 0.04790 90134 3991869 3991869 0.00690 1750 5050688 5050688 0.00880 10755224 10755224 0.01870 1702 13416 13416 93586 19811197 19811197 0.03440 93586 117813402 70437350 47376052 0.08230 6751 353736 353736 0.00060 105 7703 7703 257 455644 455644 0.00080 78 866790 866790 0.00150 7191 1683873 1683873 0.00290 true 50646754 140723316 167788097 -27064781 X true true 3 1 ST ANTHONY COMMUNITY HOSPITAL 15 MAPLE AVENUE WARWICK NY 10990 STANTHONYCOMMUNITYHOSP.ORG 3529000H/14-134010 X X X A 2 BON SECOURS COMMUNITY HOSPITAL 160 EAST MAIN STREET PORT JERVIS NY 12771 BONSECOURSCOMMUNITYHOSP.ORG 3535001H/14-134771 X X X A 3 GOOD SAMARITAN HOSPITAL OF SUFFERNNY 255 LAFAYETTE AVE SUFFERN NY 10901 GOODSAMHOSP.ORG 4329000H/13-174010 X X X A Facility Reporting Group - A 123 false false true X X X X X X X X X 16 true true false true X See Part V X X true 16 true See Part V false true X 250. 500. X X X true true X X X X true X See Part V X See Part V X See Part V X X X X X X X true X false X X X X true X false false Part V, section B FACILITY REPORTING GROUP A CONSISTS OF: FACILITY 1: ST. ANTHONY COMMUNITY HOSPITAL (SACH) FACILITY 2: BON SECOURS COMMUNITY HOSPITAL (BSCH) FACILITY 3: GOOD SAMARITAN HOSPITAL OF SUFFERN, NY (GSH) Part V, Line 5 STAFF FROM BON SECOURS CHARITY HEALTH SYSTEM (BSCHS) REPRESENTS THE HEALTH SYSTEM ON NUMEROUS COMMUNITY BOARDS AND AGENCIES THROUGHOUT THE YEAR. SOME OF THESE BOARDS AND AGENCIES INCLUDE THE FOLLOWING: CATHOLIC CHARITIES COMMUNITY SERVICES OF ROCKLAND COUNTY; ROCKLAND BUSINESS ASSOCIATION; ROCKLAND ECONOMIC DEVELOPMENT CORPORATION; WARWICK CHAMBER OF COMMERCE; WESTERN RAMAPO COLLABORATIVE; SUFFERN ROTARY CLUB; AND THE PORT JERVIS ROTARY CLUB. IN ADDITION, BSCHS STAFF PARTICIPATED AND TOOK INTO ACCOUNT INPUT FROM THE FOLLOWING BOARDS AND AGENCIES: ROCKLAND COUNTY DEPT. OF HEALTH (DOH). PUBLIC HEALTH PRIORITIES STEERING COMMITTEE ON WHICH WE DISCUSS THE COMMUNITY NEEDS ASSESSMENT AND WORK WITH DOH LEADERSHIP AND OTHER AGENCIES TO COORDINATE COMMUNITY ACTIVITIES TO ADDRESS/IMPACT IDENTIFIED NEEDS; ORANGE COUNTY CHAMBER OF COMMERCE HEALTHCARE COMMITTEE THROUGH WHICH WE COORDINATE EFFORTS WITH HEALTHCARE PROVIDERS TO ADDRESS COMMUNITY HEALTH NEEDS; ORANGE COUNTY CITIZEN'S FOUNDATION HEALTHCARE COMMITTEE ON WHICH WE SHARE INFORMATION, IDENTIFY POTENTIAL PARTNERS AND PROGRAMS FOR COLLABORATION; AND PORT JERVIS PRIDE (LOCAL DRUG TASK FORCE) THROUGH WHICH WE COLLABORATED AND SHARED INFORMATION TO IDENTIFY COMMUNITY ISSUES RELATED TO DRUGS AND OPIOD ABUSE. THE BSCHS FACILITIES HAVE CURRENT CHNAS FOR CALENDAR YEARS 2016 THROUGH 2018. THE CHNAS WERE DEVELOPED FROM DATA COLLECTED AS PART OF WESTCHESTER MEDICAL CENTER'S PLANNING FOR THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM PROJECTS. THE DSRIP PROGRAM IS A STATEWIDE INITIATIVE TO IMPROVE HEALTHCARE SERVICES THROUGHOUT THE STATE WHICH INCLUDES PROJECTS TO REDUCE AVOIDABLE HOSPITAL ADMISSIONS IN COLLABORATION WITH COMMUNITY BASED PROVIDERS AND ORGANIZATIONS. GSH AND BSCH ARE BOTH INVOLVED IN VARIOUS PROJECTS TO IMPROVE POPULATION HEALTH, A FEW OF WHICH INCLUDE MANAGEMENT OF DIABETES AND ASTHMA, REDUCING 30 DAY RE-ADMISSIONS, CANCER SCREENING, AND CO-LOCATING BEHAVIORAL HEALTH AND PRIMARY CARE SERVICES. THE WESTCHESTER MEDICAL CENTER PPS ("WMC PPS") LED A COMPREHENSIVE, COLLABORATIVE CHNA RECOGNIZING THE INTEGRAL ROLE THAT A CHNA PLAYS IN SUPPORTING THE DELIVERY OF PATIENT-CENTERED, POPULATION-BASED HEALTH CARE. THIS EIGHT COUNTY CHNA WAS UNDERTAKEN IN COLLABORATION WITH WESTCHESTER MEDICAL CENTER, THE MONTEFIORE HUDSON VALLEY COLLABORATIVE, REFUAH HEALTH CENTER, AND HEALTH ALLIANCE OF THE HUDSON VALLEY. THE CHNA LEADERSHIP OF THE PPS IN THE HUDSON VALLEY REGION PARTNERED TO UNDERTAKE AN EXTENSIVE REGIONAL ASSESSMENT OF COMMUNITY NEEDS. THE LEADERSHIP RECOGNIZED THE INTEGRAL ROLE THAT A COMMUNITY NEEDS ASSESSMENT PLAYS IN SUPPORTING THE DELIVERY OF PATIENT-CENTERED, POPULATION-BASED HEALTH CARE AND WAS GUIDED BY THE CENTER FOR DISEASE CONTROL AND PREVENTION'S (CDC) COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION CHANGE TOOLKIT. THE NEEDS AND OPINIONS OF COMMUNITY STAKEHOLDERS ACROSS SECTORS WERE GATHERED IN A SYSTEMATIC WAY THAT INCLUDED COMPILATIONS OF DATA INTO WORKBOOKS, CHART BOOKS, AND MAP BOOKS; SURVEYS; FOCUS GROUPS, KEY INFORMANT INTERVIEWS; AND A PUBLIC COMMENT PERIOD. RIGOROUS ANALYSIS OF EXTANT HEALTH, SOCIO-DEMOGRAPHICS, AND BUILT ENVIRONMENT DATA ENHANCED OUR ABILITY TO IDENTIFY DSRIP PROJECTS THAT FOCUSED INTERVENTIONS ON INDIVIDUALS AND COMMUNITIES MOST IN NEED. THE CHNA UTILIZED THE POWER OF GEOSPATIAL DATA ANALYSIS TO ASSIST IN PROJECT SELECTION AND PLANNING. THE NEEDS ASSESSMENT WAS DESIGNED WITHIN A GEOGRAPHIC INFORMATION SCIENCE (GISC) FRAMEWORK. GISC AND SPATIAL ANALYSES WERE USED TO IDENTIFY PARTICULAR POPULATION-BASED HEALTH ISSUES. FOR EXAMPLE, ACCESS TO CARE AT CLINICS OR HOSPITALS, SOCIO-ECONOMIC DATA AND PATTERNS OF DISEASE BURDEN BY POPULATION AND REGION WERE ASSESSED UTILIZING THIS FRAMEWORK. DETAILED-LEVEL STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS) DATA PROVIDED BY ACADEMIC COLLEAGUES AT IONA COLLEGE, ALONG WITH MEDICAID CLAIMS DATA ACCESSED THROUGH THE HEALTH.NY.GOV DASHBOARD, COMBINED WITH CENSUS INFORMATION, WERE MAPPED TO IDENTIFY COMMUNITY NEEDS BY PREVALENCE INDICATORS FOR MAJOR DIAGNOSTIC CATEGORIES. SPARCS DATA WAS USED TO IDENTIFY PATIENTS' EMERGENCY ROOM VISITS, HOSPITALIZATIONS AND READMISSIONS AND ANALYZE TRENDS OVER THE PAST THREE YEARS TO IDENTIFY NEGATIVE QUALITY INDICATORS. PPS PARTNERS IN OUR REGION AND COUNTY HEALTH DEPARTMENT TEAMS WORKED TOGETHER TO COORDINATE LOCAL SURVEYS ABOUT CAPABILITIES (E.G., HEALTH IT, COMMUNITY RESOURCES, HEALTHCARE RESOURCES, CONSUMER SURVEY, FOCUS GROUPS) TO SUPPLEMENT WHAT WAS AVAILABLE ON SECONDARY WEBSITES. CONFORMING TO THE GOAL OF IMPROVING POPULATION HEALTH, "HOT AND COLD SPOTS" (I.E., STATISTICAL CLUSTERS OF ZIP CODES WITH VALUES HIGHER OR LOWER THAN WOULD BE EXPECTED) WERE ISOLATED. THIS APPROACH WAS EXPANDED TO INCLUDE VARIABLES FROM A RANGE OF OTHER SOURCES (E.G., AMERICAN COMMUNITY SURVEY, VITAL STATISTICS, DSRIP DASHBOARDS) RELATED TO OUTCOMES AND SOCIODEMOGRAPHIC DETERMINANTS (E.G., POVERTY, ENGLISH-SPEAKING ABILITY, RACE/ETHNICITY, EMPLOYMENT, PHYSICAL ACTIVITY). SELECT NARRATIVE AND COMMUNITY PROFILES WERE DEVELOPED FOR HOT SPOT ZIP CODES SO THAT COMMUNITY "STORIES" COULD MORE EASILY BE SHARED WITH STAKEHOLDERS. TO ENSURE BROAD REPRESENTATION ACROSS ALL COMMUNITY SECTORS, COLLABORATION AND INPUT FROM LOCAL TEAMS WAS ESTABLISHED BY EACH COUNTY DEPARTMENT OF HEALTH. ALL DATA ANALYSES AND CHART, MAP AND WORKBOOKS WERE SHARED AS THEY WERE DEVELOPED WITH PROVIDERS AND STAKEHOLDERS ACROSS THE REGION THROUGH PUBLIC MEETINGS WITH COUNTY HEALTH COMMISSIONERS AND PROJECT TEAM MEETINGS CONDUCTED BY THE PPS IN THE REGION. AS PART OF THE CHNA, THE PPS CONDUCTED A SURVEY OF HUDSON VALLEY CONSUMERS TO GATHER INFORMATION AND FEEDBACK ABOUT DEMOGRAPHICS AND COMMUNITY HEALTH NEEDS. THE SURVEY WAS DRAFTED AT A SIXTH GRADE READING LEVEL AND REVIEWED AND APPROVED BY HEALTH LITERACY EXPERTS AND WAS MADE AVAILABLE ONLINE AND IN PAPER FORM IN THE FIVE LANGUAGES PREVALENT IN THE HUDSON VALLEY: ENGLISH, SPANISH, PORTUGUESE, FRENCH CREOLE, AND YIDDISH. THE SURVEY RECEIVED ALMOST 5,000 RESPONSES FROM RESPONDENTS LIVING IN 303 ZIP CODES ACROSS THE EIGHT COUNTIES AND RESPONDENT DEMOGRAPHICS WERE REPRESENTATIVE OF THE OVERALL REGION. Part V, Line 6a The following hospitals within Bon Secours Charity Health System conducted a joint Community Health Needs Assessment (CHNA): Good Samaritan Hospital of Suffern, NY (GSH); St. Anthony Community Hospital (SACH); Bon Secours Community Hospital (BSCH). THE CHNA WAS UNDERTAKEN IN COLLABORATION WITH WESTCHESTER MEDICAL CENTER, MONTEFIORE MEDICAL CENTER, REFUAH HEALTH CENTER, AND HEALTH ALLIANCE OF THE HUDSON VALLEY. Part V, Line 7 The CHNA is widely available to the public. The CHNA is easily accessible on the BSCHS Website: https://www.bschs.org/community-health-needs-assessment1 Part V, Line 7d The CHNA for each hospital was distributed at various community events. copies were provided to various community members and groups. Additionally, the CHNAs and the New York State Community Service Plans are posted on the BSCHS website. Part V, Line 10 The BSCHS implementation strategy plan was adopted in 2016 and is posted on the website: http://www.charity.bonsecours.com/bschs/community-health-needs-assessment1 .aspx Part V, Line 11 BASED ON DATA FROM THE CHNA AND THE NYS PREVENTION AGENDA PRIORITIES, THE MOST SIGNIFICANT HEALTH NEEDS OF THE SERVICE AREA ARE AS FOLLOWS: - CHRONIC DISEASE PREVENTION; - HEALTHY AND SAFE ENVIRONMENTS; - HEALTHY WOMEN, INFANTS AND CHILDREN; - MENTAL HEALTH AND SUBSTANCE ABUSE; AND - COMMUNICABLE DISEASES. CHRONIC DISEASE PREVENTION: BSCHS IS ADDRESSING THE CHRONIC DISEASE PREVENTION NEEDS LISTED ABOVE BY FOCUSING ON OBESITY AND DIABETES. BSCHS SUPPORTS THE FOLLOWING ORGANIZATIONS, COMMUNITY RESOURCES, AND PROGRAMS TO ADDRESS THE REMAINING IDENTIFIED HEALTH NEEDS AS FOLLOWS: HEALTHY AND SAFE ENVIRONMENTS: HEALTHY AND SAFE ENVIRONMENTS ENCOMPASSES AIR AND WATER QUALITY ISSUES, ACCESS TO HEALTHY FOODS, ASSAULT-RELATED HOSPITALIZATIONS, AND HOSPITALIZATIONS/EMERGENCY DEPARTMENT VISITS RELATED TO FALLS. BSCHS HAS PARTNERED WITH THE ROCKLAND AND ORANGE COUNTY DEPARTMENTS OF HEALTH AND SUPPORTS THEIR EFFORTS TO ADDRESS THESE AREAS. HEALTHY WOMEN, INFANTS AND CHILDREN: IN ADDITION TO BSCHS MATERNAL AND INFANT HOSPITAL-BASED SERVICES, THE LOWER HUDSON VALLEY PERINATAL NETWORK (LHVPN) HAS EXPERTISE AND RESOURCES AVAILABLE TO ADDRESS THESE HEALTH NEEDS. BSCHS SUPPORTS LHVPN'S MISSION TO ENHANCE MATERNAL, CHILD AND FAMILY HEALTH SERVICES IN DUTCHESS, PUTNAM, ORANGE, ROCKLAND & WESTCHESTER COUNTIES. IN ROCKLAND COUNTY, GSH IS WORKING WITH THE "BETTER BABY CARE" COALITION TO PROMOTE COMMUNITY AWARENESS OF FREE LOCAL PARENT SUPPORT SERVICES. MENTAL HEALTH AND SUBSTANCE ABUSE: THE OUTPATIENT PROGRAM AT THE MONSIGNOR PATRICK J. FRAWLEY PSYCHIATRIC UNIT AT GOOD SAMARITAN HOSPITAL IS DESIGNED TO TREAT EMOTIONAL AND PSYCHIATRIC DISORDERS IN ADOLESCENTS, ADULTS AND GERIATRIC PATIENTS. IN ADDITION TO PROVIDING DIRECT CARE FOR INDIVIDUALS, THE MENTAL HEALTH OUTPATIENT CLINIC OFFERS MENTAL HEALTH CONSULTATION AND OUTREACH SERVICES TO COMMUNITY ORGANIZATIONS. IN 2018, THE CHEMICAL DEPENDENCY PROGRAM OUTREACH COORDINATOR ATTENDED SEVERAL COMMUNITY AWARENESS EVENTS ON THE OPIOID CRISIS. THE ROCKLAND COUNTY DEPARTMENT OF MENTAL HEALTH OVERSEES AND SUPPORTS THE DELIVERY OF HIGH QUALITY, COMPREHENSIVE, PATIENT-CENTERED AND RECOVERY ORIENTED MENTAL HEALTH SERVICES, DEVELOPMENTAL DISABILITY SERVICES AND CHEMICAL DEPENDENCY SERVICES AT GSH. BON SECOURS COMMUNITY HOSPITAL PROVIDES PSYCHIATRIC AND CHEMICAL DEPENDENCY SERVICES IN A SUPPORTIVE ENVIRONMENT. THE NEW DIRECTIONS PROGRAM UTILIZES A MULTIDISCIPLINARY TREATMENT TEAM CONSISTING OF PSYCHIATRISTS, NURSES, CASE MANAGERS, SOCIAL WORKERS, AND CREDENTIALED ALCOHOL AND SUBSTANCE ABUSE COUNSELORS (CASAC). THE ADULT INPATIENT PROGRAM AT BON SECOURS COMMUNITY HOSPITAL IS DESIGNED TO PROVIDE A PATIENT-CENTERED AND COMPREHENSIVE TREATMENT PROGRAM FOR ADULTS AGES 18 AND OLDER WHO ARE STRUGGLING WITH AN ACUTE PHASE OF MENTAL ILLNESS. IN ADDITION, BSCH STAFF PARTICIPATED IN THE PORT JERVIS NATIONAL NIGHT OUT DRUG AWARENESS EVENT AS WELL AS ORANGE COUNTY'S ALCOHOL AND DRUG ADDICTION COALITION'S ANNUAL AWARENESS DAY. BSCH ALSO PROVIDES SPACE FOR THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) OF SULLIVAN COUNTY FRIENDS AND FAMILY SUPPORT GROUP. THE ORANGE COUNTY DEPARTMENT OF MENTAL HEALTH ENSURES THAT QUALITY MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND CHEMICAL DEPENDENCY SERVICES ARE ACCESSIBLE TO ALL THE PEOPLE OF ORANGE COUNTY, THEY ENSURE THAT SUCH SERVICES ARE DELIVERED IN A COST EFFECTIVE, TIMELY AND CULTURALLY SENSITIVE MANNER UNDER THE JURISDICTION OF THE MENTAL HYGIENE LAW OF NEW YORK STATE AND PROVIDED WITHIN THE RULES, REGULATIONS, POLICIES AND PROCEDURES OF THE LICENSING AUTHORITY OF APPROPRIATE STATE OFFICES. ADDITIONAL MENTAL HEALTH AND SUBSTANCE ABUSE RESOURCES ARE AVAILABLE AT ORANGE REGIONAL MEDICAL CENTER. IN PORT JERVIS, THE ED NAVIGATOR CONTINUED THE WORK OF THE NYS MAX SERIES PROJECT TO IMPROVE CARE FOR HIGH UTILIZERS AND SUSTAIN CHANGE. THE ED NAVIGATOR CONTINUED TO COLLABORATE AND PARTNER WITH COMMUNITY BASED ORGANIZATIONS, INCLUDING THE ORANGE COUNTY DEPARTMENT OF MENTAL HEALTH ON THIS INITIATIVE TO ADDRESS THE DIVERSE MEDICAL, BEHAVIORAL, AND SOCIAL NEEDS OF HIGH UTILIZERS. IN ORANGE COUNTY, BSCH IS WORKING WITH CBHS, INC. AND INDEPENDENT LIVING, INC. TO PROVIDE PATIENTS WITH TRANSITIONS OF CARE UPON DISCHARGE FROM THE BEHAVIORAL HEALTH INPATIENT UNIT. THIS PILOT PROGRAM IS CONNECTING PATIENTS WITH PEER SERVICES TO PROVIDE SUPPORT, TRANSPORTATION, AND LINK TO SERVICES FOR 30 DAYS POST DISCHARGE. COMMUNICABLE DISEASES: IN ADDITION TO THE COMMUNICABLE DISEASES THAT BSCHS ADDRESSES THROUGH IMMUNIZATION CLINICS AND PATIENT VACCINATION, BSCHS ALSO SUPPORTS REFUAH HEALTH CENTER, HUDSON RIVER HEALTHCARE, MIDDLETOWN COMMUNITY HEALTH CENTER, THE ROCKLAND AND ORANGE COUNTY HEALTH DEPARTMENTS AND THE NYS DEPT. OF HEALTH IN THEIR EFFORTS TO COMBAT COMMUNICABLE DISEASES. Part V, Line 13h Patients above the 500% Federal Poverty Guidelines are eligible for the lower of the 60% discount on total charges or the Medicare FFS rate, after they have paid the required out of pocket expense of 20% of family income. Part V, Line 15e BSCHS provides upfront financial assistance outreach services to all patients who do not have insurance. The service provider explains the options for federal and state financial assistance and provides assistance in filling out all required applications, including an application for Charity Care. The service provider reaches out to all patients who do not have insurance, either by meeting with patients who are still at the Hospital OR reaching out to those discharged. contact information is also provided on the FINANCIAL ASSISTANCE POLICY summary and on our Charity Care application for patient convenience. Part V, Lines 16a and 16b The financial assistance policy (FAP), application and plain language summary can be found at the following websites: http://bschs.bonsecours.com/bsch/billing-insurance-and-financial-assistanc e.aspx http://bschs.bonsecours.com/gsh/billing-insurance-and-financial-assistance .aspx http://bschs.bonsecours.com/sach/billing-insurance-and-financial-assistanc e.aspx Part V, Line 16J In addition to the methods reported on lines 16a through 16i, brochures are available at the time of registration, and onsite counselors and hospital paid eligibility vendor staff are available to assist patients. All billing statements also include information regarding the FAP and the eligibility vendor contacts all uninsured patients to determine the patient's eligibility for all Federal and State financial assistance programs including Charity Care. 52 THE AMBULATORY SURGERY CENTER 257 LAFAYETTE AVENUE SUFFERN NY 10901 AMBULATORY SURGERY CENTER GOSHEN MEDICAL ASSOCIATES 70 HATFIELD LANE SUITE 101 GOSHEN NY 10924 INTERNAL MEDICINE ROCKLAND PULMONARY & MEDICAL ASSOC 2 CROSFIELD AVENUE WEST NYACK NY 10994 PULMONOLOGY GOOD SAMARITAN HOME CARE 90 CRYSTAL RUN ROAD WALLKILL NY 10941 HOME CARE GOOD SAMARITAN HOME CARE 1 CROSFIELD AVENUE SUITE 202 WEST NYACK NY 10994 HOME CARE CARDIOLOGY CONSULTANTS-STONY POINT 12 LIBERTY SQUARE MALL STONY POINT NY 10980 CARDIOLOGY METRO CARDIOLOGY CONSULTANTS SUFFERN 257 LAFAYETTE AVENUE SUFFERN NY 10901 CARDIOLOGY BON SECOURS NEUROLOGY 100 ROUTE 59 SUFFERN NY 10901 NEUROLOGY RAMAPO VALLEY SURGICAL ASSOCIATES 257 LAFAYETTE AVENUE SUFFERN NY 10901 OUTPATIENT AMBULATORY SURGERY HUDSON VALLEY MEDICAL ASSOCIATES 26 FIREMANS MEMORIAL DRIVE PAMONA NY 10970 INTERNAL MEDICINE CENTER FOR PHYSICAL REHABILITATION 70 HATFIELD LANE GOSHEN NY 10924 OUTPATIENT PHYSICAL THERAPY CENTER FOR PHYSICAL REHABILITATION 153 SOUTH ROUTE 94 WARWICK NY 10990 OUTPATIENT REHAB UROLOGY 257 LAFAYETTE AVENUE SUFFERN NY 10901 UROLOGY METRO CARDIOLOGY CONSULTANTS GOSHEN 30 HATFIELD LANE GOSHEN NY 10924 CARDIOLOGY WOMEN'S IMAGING CENTER 55 RONALD REAGAN BOULEVARD WARWICK NY 10990 OUTPATIENT WOMEN'S IMAGING CENTER ROCKLAND PULMONARY & MEDICAL ASSOC 257 LAFAYETTE AVENUE SUFFERN NY 10901 PULMONOLOGY ROCKLAND HEART & VASCULAR ASSOCIATES 972 ROUTE 45 SUITE 103 PAMONA NY 10970 CARDIOLOGY ST ANTHONY SLEEP DISORDER INSTITUTE 74 NORTH MAIN STREET FLORIDA NY 10921 SLEEP LAB MONROE INTERNAL MEDICINE 505 ROUTE 208 MONROE NY 10950 INTERNAL MEDICINE MOB PORT JERVIS PRIMARY 161 EAST MAIN STREET PORT JERVIS NY 12771 PRIMARY CARE MAHWAH MEDICAL 10 FRANKLIN TURNPIKE MAHWAH NJ 07430 INTERNAL MEDICINE MSGR PATRICK J FRAWLEY MENTAL HEALTH 3 CAMPBELL AVENUE SUFFERN NY 10901 MENTAL HEALTH CARDIOLOGY CONSULTANTS-WEST NYACK 1 CROSFIELD AVENUE STE 407 WEST NYACK NY 10994 CARDIOLOGY BON SECOURS MEDICAL GROUP 2 EXECUTIVE BOULEVARD SUITE 406 SUFFERN NY 10901 PRIMARY CARE GOSHEN PRIMARY CARE PHYSICIANS 1 HATFIELD LANE GOSHEN NY 10924 PRIMARY CARE PORT JERVIS GASTROENTEROLOGY 39 EAST MAIN STREET PORT JERVIS NY 12771 GASTROENTEROLOGY BON SECOURS MEDICAL GROUP 15 MAPLE AVENUE WARWICK NY 10990 GASTROENTEROLOGY MEHTA PULMONARY 55 OLD NYACK TURNPIKE NANUET NY 10954 PULMONOLOGY ROCKLAND HEART & VASCULAR ASSOCIATES 2 EXECUTIVE BOULEVARD SUITE 406 SUFFERN NY 10901 CARDIOLOGY BON SECOURS MEDICAL GROUP 104 BENNETT AVENUE MILFORD PA 18337 INTERNAL MEDICINE GOPAL SHAH MD 33 DELAWARE STREET PORT JERVIS NY 12771 PRIMARY CARE PRIMARY MEDICAL CARE ROCKLAND 124 EAST RAMAPO ROAD SUITE 4 GARNERVILLE NY 10923 PRIMARY CARE ALAM PCP 906 PENNSYLVANIA AVENUE MATAMORAS PA 18336 PRIMARY CARE LUTWAK CARDIOLOGY 505 ROUTE 208 MONROE NY 10950 CARDIOLOGY LUTWAK CARDIOLOGY 4 SOUTH AIRMONT ROAD SUFFERN NY 10901 CARDIOLOGY ROCKLAND HEART & VASCULAR ASSOCIATES 79 ROUTE 59 SUITE 5 SUFFERN NY 10901 CARDIOLOGY GOOD SAMARITAN HOME CARE 120 WHITE PLAINS ROAD 4TH FL TARRYTOWN NY 10591 HOME CARE LAFAYETTE MEDICAL-GASPARE POLIZZI 599 STATE ROUTE 32 HIGHLAND MILLS NY 10930 PRIMARY CARE MONROE PRIMARY CARE 745 ROUTE 17M MONROE NY 10950 PRIMARY CARE GEORGE COX MD 257 LAFAYETTE AVENUE SUFFERN NY 10901 PRIMARY CARE BYADGI PRIMARY CARE 601 BROAD STREET MILFORD PA 18337 PRIMARY CARE NORTH ROCKLAND MEDICAL ASSOCIATES 71 SOUTH ROUTE 9W WEST HAVERSTRAW NY 10993 PRIMARY CARE YACOV TENDLER MD 257 LAFAYETTE AVENUE SUFFERN NY 10901 PRIMARY CARE BON SECOURS COMM SLEEP DISORDER INST 30 CANAL ST STE 2 PORT JERVIS NY 12771 SLEEP LAB BON SECOURS MEDICAL GROUP 500 NEW HEMPSTEAD ROAD NEW CITY NY 10956 INTERNAL MEDICINE BON SECOURS MEDICAL GROUP 5 SKINNER STREET PORT JERVIS NY 12771 CARDIOLOGY ROCKLAND PULMONARY & MEDICAL ASSOC 27 LIBERTY SQUARE MALL STONY POINT NY 10980 PULMONOLOGY PORT JERVIS INTERNAL 32 CANAL ST PORT JERVIS NY 12771 INTERNAL MEDICINE RAMAPO VALLEY SURGICAL ASSOCIATES 10 LIBERTY SQUARE MALL STONY POINT NY 10980 OUTPATIENT AMBULATORY SURGERY RALPH BOWMAN MD 170 EAST MAIN STREET PORT JERVIS NY 12771 PRIMARY CARE CARDIOLOGY CONSULTANTS-RAMSEY 27 SOUTH FRANKLIN TURNPIKE RAMSEY NJ 07446 CARDIOLOGY WARWICK PALLIATIVE CARE 22 VAN DUZER PLACE WARWICK NY 10990 PALLIATIVE CARE PART I, LINE 7A CHARITY CARE AT COST IS COMPUTED BY APPLYING THE COST-TO-CHARGE RATIO TO THE AGGREGATE CHARITY ADJUSTMENTS. PART I, LINE 7B UNREIMBURSED MEDICAID IS COMPUTED BY DETERMINING THE COST OF MEDICAID SERVICES LESS PAYMENTS RECEIVED FOR THESE SERVICES. TO DETERMINE THE COST OF MEDICAID SERVICES PROVIDED, A COST-TO-CHARGE RATIO IS APPLIED TO TRADITIONAL AND MANAGED MEDICAID GROSS CHARGES. PAYMENTS INCLUDE PAYMENTS FOR INDIVIDUAL CLAIMS, PAYMENTS FROM THE MEDICAID PROGRAM PAID OUTSIDE THE CLAIM PROCESS (SUCH AS MEDICAL EDUCATION PAYMENTS) AND EXPECTED OR ACTUAL COST REPORT SETTLEMENTS. PART I, LINE 7C UNREIMBURSED COSTS FROM OTHER MEANS-TESTED GOVERNMENT PROGRAMS ARE COMPUTED BY APPLYING A COST-TO-CHARGE RATIO TO THE TOTAL CHARGES TO PATIENTS COVERED UNDER THESE PROGRAMS. THE CHARGES ARE IDENTIFIED BY THE FINANCIAL CLASS ASSIGNED TO THE PATIENT. PART I, LINE 7 A-C COMPUTATIONS THE COST-TO-CHARGE RATIO IS DERIVED USING THE SUGGESTED COMPUTATION IN WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OPERATING EXPENSES AND GROSS PATIENT CHARGES ARE TAKEN FROM THE GENERAL LEDGER, EXPENSES FOR NONPATIENT CARE ACTIVITIES RECORDED IN OPERATING EXPENSES ARE APPROXIMATED AS DIRECTLY EQUALING OTHER OPERATING REVENUE. PART I, LINE 7E COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ARE ACCUMULATED THROUGHOUT THE YEAR AND REPORTED AT ACTUAL COST IN A SOFTWARE PROGRAM THAT SPECIFICALLY ADDRESSES THIS PURPOSE. PART I, LINE 7F HEALTH PROFESSIONS EDUCATION COST IS DETERMINED AS THE DIRECT AND INDIRECT COST OF QUALIFYING EDUCATION ACTIVITIES AS TRADITIONALLY REPORTED IN COLUMNS 21-24 ON WORKSHEET B OF THE MEDICARE COST REPORT AS A MEDICAL EDUCATION PROGRAM OR OTHER ALLIED HEALTH PROGRAM. PART I, LINE 7 THE FOLLOWING CHARITY CARE PECENTAGES HAVE BEEN DERIVED BY ONLY INCLUDING HOSPITAL EXPENSES: Percent of total expense Line 7a: 0.44 Line 7b: 5.56 Line 7d: 6.00 Line 7e: 0.87 Line 7f: 1.10 LINE 7G: 2.34 Line 7i: 0.00 Line 7j: 1.97 Line 7k: 7.97 Part II, Community Building Activities BSCHS WAS ACTIVELY ENGAGED IN COMMUNITY BUILDING ACTIVITIES WHICH PROMOTED THE HEALTH OF THE COMMUNITIES THROUGHOUT ITS SERVICE AREA. BSCHS HAS A DEDICATED COMMUNITY ENGAGEMENT DEPARTMENT WHICH EVALUATES, PLANS, AND IMPLEMENTS COMMUNITY HEALTH AND EDUCATION PROGRAMS, BASED ON COMMUNITY NEED AS WELL AS REQUESTS FOR PROGRAMS ON SPECIFIC TOPICS. IN 2018, OVER 20 SUPPORT GROUPS MET MONTHLY IN THE BSCHS FACILITIES AND AN ADDITIONAL GROUP, SPONSORED BY BSCHS, MET AT AN OFF-SITE LOCATION. THE COMMUNITY ENGAGEMENT DEPARTMENT MANAGED THE BSCHS HEALTHCARE SPEAKERS' BUREAU WHICH CONNECTED OUR BSCHS MEDICAL PROFESSIONALS DIRECTLY WITH THE COMMUNITY ON BROAD TOPICS SUCH AS CARDIAC HEALTH, ORTHOPEDICS, WOMEN'S HEALTH, OBESITY, STROKE, DIABETES, WOUND CARE, SAFETY, ASTHMA, SENIOR SERVICES, MEN'S HEALTH, NUTRITION, MEDICATION MANAGEMENT, ETC. BSCHS'S OUTREACH EVENTS WERE HELD AT VARIOUS LOCATIONS, INCLUDING LIBRARIES AND WORK-SITES. AT THESE PRESENTATIONS, BSCHS PROVIDED EDUCATIONAL BOOKLETS IN ENGLISH AND SPANISH. IN ADDITION TO THIS, THE OUTREACH DEPARTMENT HELPED COORDINATE SERVICE LINE SPECIFIC PROGRAMS SUCH AS BREAST AND CERVICAL CANCER SCREENINGS, HEARING TESTING, SLEEP DISTURBANCES SEMINARS, AS WELL AS OTHER PROGRAMS BENEFITTING THE COMMUNITY. IN 2018, BSCHS EMPLOYEES WORKED 3,355 HOURS TO PROVIDE COMMUNITY HEALTH IMPROVEMENT PROGRAMS. IN PORT JERVIS, ORANGE COUNTY, BSHCS TRANSFORMED THE DELIVERY OF HEALTHCARE THROUGH ITS BUILDING HEALTHY COMMUNITIES INITIATIVES AND EXPECTS TO CONTINUE THROUGH 2021. BON SECOURS COMMUNITY HOSPITAL ("BSCH") APPLIED FOR A CERTIFICATE OF NEED WITH THE NYSDOH TO UNDERTAKE A PHYSICAL PLANT MODERNIZATION AND RENOVATION PROJECT THAT WILL PROVIDE SIGNIFICANT AND NEEDED IMPROVEMENTS IN ORDER TO IMPLEMENT BSCH'S INNOVATIVE DSRIP-RELATED PROJECT TO INCREASE THE BREADTH OF THE OUTPATIENT DELIVERY SYSTEM IN WESTERN ORANGE COUNTY THROUGH THE CREATION OF A MEDICAL VILLAGE. BSCH WAS AWARDED $24.5 MILLION IN CAPITAL RESTRUCTURING FINANCING PROGRAM ("CRFP") GRANT FUNDS TO UNDERTAKE THIS MAJOR PROJECT, WHICH INCLUDED SEVERAL OF THE DSRIP PROJECTS, INCLUDING CARE TRANSITIONS INTERVENTION TO REDUCE 30 DAY READMISSIONS FOR CHRONIC HEALTH CONDITIONS, INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH, COMMUNITY CRISIS STABILIZATION SERVICES, IMPLEMENTATION OF EVIDENCE-BASED STRATEGIES IN THE COMMUNITY TO ADDRESS CHRONIC DISEASE, SUCH AS DIABETES AND ASTHMA. IMPLEMENTATION OF THESE PROJECTS IS ACHIEVED THROUGH INCREASED ACCESS TO PRIMARY CARE, OUTPATIENT SERVICES, PHARMACY AND AN EXPANSION OF COMMUNITY SERVICES. THE TOTAL ANTICIPATED PROJECT COST FOR THIS PROJECT IS $41.5 MILLION WHICH WILL BE FUNDED IN PART BY CAPITAL RESTRUCTURING FINANCE PROGRAM (CRFP) GRANT FUNDS ($24.5 MILLION). PLANNING AND COLLABORATION FOR BSCH'S MEDICAL VILLAGE HAS BEEN ONGOING WITH MEETINGS WITH CONSTITUENTS, STAKEHOLDERS, AND COMMUNITY ORGANIZATIONS. KEY PARTNERS INCLUDE WESTCHESTER MEDICAL CENTER, CORNERSTONE FAMILY HEALTHCARE, BON SECOURS MEDICAL GROUP, CATHOLIC CHARITIES, EASTER SEALS, THE MATERNAL-INFANT SERVICES NETWORK, SHOPRITE SUPER MARKET, NEW YORK STATE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, ORANGE COUNTY DEPARTMENT OF HEALTH, ORANGE COUNTY DEPARTMENT OF MENTAL HEALTH, PORT JERVIS COMMUNITY GARDEN, EMPOWERING PORT JERVIS, PORT JERVIS LIBRARY, THE SALVATION ARMY, SUNY COMMUNITY COLLEGES, AND 1199SEIU WORKFORCE. THE PARTICIPATORY, COLLABORATIVE DEVELOPMENT PROCESS RESULTED IN A PLAN THAT INCLUDED A STRATEGY TO REDUCE 25 STAFFED BEDS AND DECERTIFY 36 LICENSED BEDS THAT PRESERVES CRITICAL SAFETY-NET CAPACITY AND CREATES NEW SPACE FOR A RANGE OF AMBULATORY CARE AND SOCIAL SERVICES INCLUDING: (1) EXPANDED ACCESS TO PRIMARY CARE, DENTAL, AND PHARMACY SERVICES, (2) A NEW OBSERVATION UNIT AND EMERGENCY ROOM DIVERSION PROGRAM, (3) ENHANCED CARE COORDINATION BY SUPPORTING PRACTICES THAT MEET THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE PATIENT-CENTERED MEDICAL HOME LEVEL 3 ACCREDITATION, (4) CO-LOCATED BEHAVIORAL HEALTH PROVIDERS AND COMMUNITY BASED ORGANIZATIONS TO DELIVER VITAL DISEASE MANAGEMENT, PREVENTION, NUTRITION, AND WELLNESS SERVICES, AND (5) CONNECTING BSCHS TO HEALTHLINKNY, WHICH OFFERS ELECTRONIC ACCESS TO PATIENTS' COMMUNITY-WIDE HEALTH RECORDS AND SERVES AS THE REGION'S ACCESS POINT TO THE STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK (SHIN-NY), SUPPORTING COLLABORATION BETWEEN HEALTHCARE PROVIDERS ACROSS THE STATE. BUILDING UPON BSCH'S IN-PATIENT REDUCTION AND RECONFIGURATION EXPERIENCE THROUGH THE HEAL-NY PROGRAM AND LEVERAGING VALUE-BASED PURCHASING EFFORTS, THE MEDICAL VILLAGE WILL IMPROVE THE QUALITY, SAFETY, EFFECTIVENESS AND EFFICIENCY OF CARE DELIVERY TO THE MORE THAN 80,000 MEDICAID BENEFICIARIES IN ORANGE COUNTY AND ENSURE THAT BSCH IS ON A SUSTAINABLE PATH. PART III, LINE 2 BAD DEBT EXPENSE INCLUDES: 1) ACTUAL WRITE OFFS OF DISCOUNTED GROSS CHARGES WHERE IT IS DETERMINED THAT AN UNINSURED PATIENT CAN PAY AND DOES NOT PAY; AND 2) THE ESTIMATED WRITE OFFS FOR UNINSURED PATIENT ACCOUNTS WITH OUTSTANDING BALANCES AFTER DISCOUNT. ESTIMATES ARE BASED ON HISTORICAL COLLECTION RATES. PART III, LINE 3 THE ORGANIZATION DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THE ORGANIZATION TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED, THE ORGANIZATION MUST ASSUME THE PATIENT DOES NOT QUALIFY. PART III, LINE 4 PLEASE SEE FOOTNOTE 2 "PATIENT ACCOUNTS RECEIVABLE, NET" ON PAGE 19 IN THE ATTACHED BSCHS CONSOLIDATED AUDITED FINANCIAL STATEMENTS ("AFS"), ALLOWANCE FOR DOUBTFUL ACCOUNTS IS DISCUSSED IN THE SECOND PARAGRAPH OF THE FOOTNOTE. Part III, Line 8 THE MEDICARE SHORTFALL IS A COMMUNITY BENEFIT. THE ORGANIZATION IS ASSUMING A GOVERNMENT BURDEN BY PROVIDING CARE in excess of the revenue. the MEDICARE ALLOWABLE COSTS REFLECTED IN PART III ARE REFLECTED IN the FACILITY'S MEDICARE COST REPORT. THE COST REPORT SEGREGATES THE TOTAL FACILITY ACTUAL EXPENSES INTO COSTS FOR SUPPORT DEPARTMENTS, CLINICAL DEPARTMENTS (ROUTINE AND ANCILLARY) AND NONREIMBURSEABLE DEPARTMENTS. THE COST REPORT USES APPROPRIATE STATISTICAL BASES TO "STEP DOWN" SUPPORT COSTS TO ALLOWABLE CLINICAL AND NONREIMBURSEABLE DEPARTMENTS. THE CHARGES FOR CLINICAL DEPARTMENTS ARE MATCHED TO THE TOTAL COST FOR THESE DEPARTMENTS FOR A COST-TO-CHARGE RATIO. Part III, Line 9B THE ORGANIZATION HAS A WRITTEN POLICY THAT DESCRIBES COLLECTION PRACTICES APPLYING TO PATIENTS THAT QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR FULL ASSISTANCE, NO COLLECTION EFFORTS ARE PURSUED ON THAT PATIENT'S ACCOUNT(S). IF PARTIAL ASSISTANCE IS PROVIDED, THE PATIENT IS RESPONSIBLE FOR THE ADJUSTED ACCOUNT BALANCE AND COLLECTION EFFORTS WILL FOLLOW THE ESTABLISHED PRACTICES FOR ALL PATIENTS WHERE A SELF-PAY BALANCE EXISTS. COLLECTION EFFORTS ARE NOT PURSUED ON ANY PENDING FINANCIAL ASSISTANCE PROGRAM ACCOUNT. SPECIFIC CRITERIA EXIST FOR HOW MUCH FINANCIAL ASSISTANCE, PARTIAL OR TOTAL, WILL BE PROVIDED TO THE PATIENT BASED ON THE ASSESSED NEED. CRITERIA IS BASED ON FEDERAL POVERTY GUIDELINES AND IS REVIEWED AND UPDATED ANNUALLY. ONCE A PATIENT HAS BEEN DEEMED ELIGIBLE FOR THE PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP), THE PATIENT IS NOTIFIED BY LETTER WITHIN 60 DAYS AFTER RECEIPT OF THE APPLICATION AND SUPPORTING DOCUMENTATION. THE PATIENT RETAINS ELIGIBILITY FOR A PERIOD OF TWELVE MONTHS FROM THE DATE OF THE APPLICATION. NOTICE OF THIS ELIGIBILITY IS PROVIDED TO HOSPITAL ADMISSIONS, BILLING AND COLLECTION STAFF BY THE ASSIGNMENT OF A SPECIFIC FINANCIAL CLASS WITH ACCOMPANYING ELIGIBILITY DATES. AT THE END OF THE TWELVE MONTH PERIOD, THE PATIENT IS RESPONSIBLE FOR REAPPLYING FOR FAP ELIGIBILITY. BSCHS's collection policy contains provisions on collection practices which all facilities follow for patients known to qualify for financial assistance. The Charity Care Policy specifically provides the following collection practices: a. Any firm contracted with the hospital for collection purposes shall also provide information to BSCHS patients on how to apply for financial assistance, in accordance with all provisions of this policy. b. Accounts will not be sent to an external collection agency without the patient or his/her designee having an opportunity and adequate time to develop an alternative payment arrangement. Accounts will not be referred for collection while an application for financial assistance is pending. c. All patients will receive a minimum of thirty (30) days written notice on data mailers/billing statements that their account is subject to referral to a collection agency. d. BSCHS will not commence collection activity on any account for which financial assistance has been approved. The application for charity care will include a statement that the patient will not be responsible for any bills until such time that a decision on the application has been made. e. All legal firms and collection agencies with whom BSCHS may contract for collection services will conduct all collection activities in accordance with THE ORGANIZATION'S policies and procedures. Further, such firms shall not commence any legal proceedings on an account without the prior written consent of BSCHS. f. BSCHS will make best efforts to work with the patient to determine an equitable payment schedule/installment plan for any out-of-pocket expenses, considering the patient's financial and medical circumstances. The monthly payments on any installment plan will not exceed 10% of the patient's gross monthly income and there will be no interest charges on an approved installment plan. g. BSCHS, including any law firm or collection agency with which it contracts, will not force the sale or foreclose of a patient's primary residence to collect an outstanding bill. h. BSCHS will not pursue collections against any patient who was eligible for Medicaid at the time services were rendered. Part VI, Line 2 In addition to the CHNA, BSCHS continually assesses the health care needs of the community throughout the year. After every Community Outreach event, the System Director of Community ENGAGEMENT meets with various people who were involved in the event as well as participants and assesses and evaluates all aspects of the event. The assessment includes questions such as: did this event serve the needs of the community; which members of the community did we serve and who did we miss; how can we improve this event; do we need to invest more resources; and should this event be continued or expanded? BSCHS STAFF ALSO ACTIVELY PARTICIPATED IN THE FOLLOWING ACTIVITIES AND PROGRAMS BENEFITING THE COMMUNITY: CONDUCTED LGBT FOCUS GROUP TO IDENTIFY BARRIERS IN ACCESSING HEALTHCARE AND TO UNDERSTAND SPECIFIC HEALTH NEEDS; SPONSORED AND PARTICIPATED IN THE TRI-STATE CHAMBER 10K RACE; SPONSORED, PARTICIPATED AND COORDINATED TRI-STATE CHAMBER ANNUAL BUSINESS DINNER; COORINDATED TRI-STATE CHAMBER BUSINESS BREAKFAST SERIES WHICH PROVIDED INFORMATION ON OPIOD ABUSE IN THE COMMUNITY; PARTNERED WITH TRI-STATE CHAMBER TO DESIGN AND COORDINATE DISTRIBUTION OF OVER 146 PAIRS OF SHOES TO CHILDREN IN NEED; STAFF PARTICIPATED IN THE CHAMBER MATTERS RADIO SHOW AND DISCUSSED DIABETES MANAGEMENT AND PREVENTION; PROVIDED EDUCATION TO THE CENTER FOR DEVELOPMENTAL DISABILITIES STAFF ON INFECTION CONTROL AND MEDICATION ADMINISTRATION; SPONSORED THE PORT JERVIS ROTARY CLUB BREAKFAST TO BENEFIT LOCAL HIGH SCHOOL STUDENTS THROUGH SCHOLARSHIPS; PARTICIPATED, EVERY MONTH, IN THE PROJECT DISCOVERY COMMUNITY OUTREACH PROGRAM TO PROVIDE HOUSEHOLD NECESSITIES, FOOD AND CLOTHING TO THOSE IN NEED IN THE COMMUNITY; PROVIDED NUTRITIONIST AND PHYSICAL THERAPIST WHO CONDUCTED EDUCATIONAL PROGRAMMING FOR THE MAHWAH REGIONAL CHAMBER OF COMMERCE; AND WORKED WITH THE HEALTHY ORANGE COMMITTEE OF THE ORANGE COUNTY DEPT. OF HEALTH THROUGH WHICH WE RECEIVED A GRANT FOR THE GET FIT PORT JERVIS AND YOGA PROGRAMS. BY ACTIVELY PARTICIPATING AND COLLABORATING WITH THESE AGENCIES, ORGANIZATIONS, AND THE COMMUNITY, BSCHS IS ABLE TO OBTAIN INPUT AND INSIGHT ON THE HEALTH NEEDS AND CONCERNS OF THE COMMUNITIES SERVED. ADDITIONALLY, BSCHS EMPLOYEES WORK TOGETHER WITH COMMUNITY LIAISONS WHO WORK CLOSELY WITH AREA EMPLOYERS AND SPECIFIC GEOGRAPHICAL AND RELIGIOUS GROUPS TO IDENTIFY PERSONAL HEALTH RELATED NEEDS. BASED ON THESE NEEDS, BSCHS CLINICAL STAFF AND PHYSICIANS PROVIDED 90 HOURS OF EDUCATION ON PREVENTIVE HEALTH INTERVENTIONS TO A TOTAL OF ABOUT 1,570 EMPLOYEES AT THE FOLLOWING WORKSITES: AVON, CLARKSTOWN CENTRAL SCHOOL DISTRICT, DOMINICAN COLLEGE, EAST RAMAPO SCHOOL DISTRICT, EASTWICK COLLEGE, JAWONIO, JCC OF ROCKLAND, NORTH ROCKLAND SCHOOL DISTRICT, ORANGE-ULSTER BOCES, PFIZER INC., PEARL RIVER SCHOOL DISTRICT, RAMAPO COLLEGE, ROCKLAND BOCES, ROCKLAND COMMUNITY COLLEGE, SALVATION ARMY, ST. DOMINIC HOME, ST. THOMAS AQUINAS COLLEGE, SOUTH ORANGETOWN SCHOOL DISTRICT, TD BANK, TOWN OF HAVERSTRAW, TOWN OF ORANGETOWN, TOWN OF RAMAPO, UNEEDA ENTERPRIZES, INC., FARLEY ELEMENTARY SCHOOL, M&T BANK, AND THE VILLAGE OF SUFFERN. PREVENTIVE HEALTH TOPICS WERE PRESENTED AT EACH WORK SITE: BACK HEALTH AND ERGONOMICS, BENEFITS OF WALKING, BETTER HEARING, BREAST HEALTH, CARDIAC HEALTH & STROKE AWARENESS, CONCUSSION MANAGEMENT, EMERGENCY CARE, FALL PREVENTION, MANAGING STRESS, MANAGING MEDICATIONS, NUTRITION (FOOD LABELING, HEALHTY DINING OUT), SLEEP HEALTHY, VITAMINS/SUPPLEMENTS, AND WOMEN'S HEART HEALTH. Part VI, Line 3 Patient financial assistance policy is communicated to patients upon scheduling, registration, THROUGH visible postings of the policy in common areas throughout the hospital, brochures at registration and on the Bon Secours website. In addition, patient statements request that patients apply for financial assistance if needed, once any patient financial obligation is determined. BSCHS is committed to ensuring access to health care services for all. As a health care provider, BSCHS treats all patients, whether insured, underinsured or uninsured, with dignity, respect and compassion throughout admission, delivery of services, discharge and billing and collection processes. BSCHS addresses the needs of the uninsured by providing free or reduced fees FOR hospital services and Is ACTIVELY ENGAGED IN community outreach efforts to assist with enrollment in Medicaid and other medical coverage programs, including free community-based preventive and primary care services. BSCHS proactively screens to identify individuals and their families who may qualify for federal, state or local health insurance programs or the BSCHS Patient Financial Assistance Program ("FAP") and assists potential eligible patients through the qualification process. Potentially eligible patients that do not qualify for a federal or state health insurance program are referred to the Financial Assistance Coordinator located in Patient Financial Services for assistance in completing the documentation required to establish FAP eligibility. Patients are responsible for providing the information necessary to complete the documentation. The FAP aids uninsured and underinsured patients who do not qualify for government-sponsored health insurance and who communicate their inability to pay for their medical care. The FAP provides 100% financial assistance to uninsured patients with annual family incomes at or below 250% of the Federal Poverty Guidelines ("FPG"). INCOMES UP TO 500% ARE ALSO DISCOUNTED AT THE LOWER PERCENTAGES as indicated in the chart included in the FAP or the AMOUNTS GENERALLY BILLED ("AGB"). BSCHS offers 100% charity care to its patients with income up to 250% of the FPG. Patients with income between 251% - 350% of the FPL are offered the lower of a 50% reduction of total charges or the APG (the Medicare FFS rate). Patients with income between 351% - 500% of the FPL are offered the lower of a 30% reduction of total charges or the APG (the Medicare FFS rate). BSCHS is dedicated to meeting the needs of non-English speaking patients by having on-site Spanish translators, and other language translation services. In addition, BSCHS employs a telephone language service which assists in meeting any language needs that arise. The translation services are offered to non-English speaking patients from admission to discharge, including through the financial ASSISTANCE process. Patient financial assistance policy is communicated to patients upon scheduling, registration, THROUGH visible postings of the policy in common areas throughout the hospital, brochures at registration and on Bon Secours website. In addition, patient statements request that patients apply for financial assistance if needed, once any patient financial obligation is determined. Part VI, Line 4 BSCHS facilities operate and serve populations of lower New York State, principally Rockland and Orange counties. Rockland County is located approximately 30 miles north of Manhattan on the West side of the Hudson River. The County is a popular residence for people who commute to work in nearby Westchester and Bergen Counties, as well as Manhattan. The County comprises approximately 115,000 acres and contains more than 35,000 acres of preserved open space and park land. Rockland continues to experience steady population growth in its five towns and 19 villages. The most recent Census Department estimates indicate that Rockland County grew 8.7% from 2000 to 2010, and now includes 311,687 residents. In Rockland County, there was substantial growth in all age cohorts 65 and older, a consistent trend nationally. Gender among the age groups is roughly equal from the early age cohorts through the 40s, but after age 65, women continue to outnumber men. Population projections - Preliminary population projections through 2035 show that Rockland County's older population may double in size in the next three decades, while those ages 30 to 44 may shrink in size. While projections are based on historical data and do not always predict accurate trends, the dramatic possible increase in the elderly population is a trend that should be of importance to County service providers and planners. Orange County is located in the Hudson River Valley, bordering New Jersey. The County comprises approximately 816 square miles. Orange County continues to experience steady population growth, with the 2010 Census indicating that Orange County grew 9.2% from 2000 to 2010, and now includes 372,813 residents. Based on 2010 U.S. Census population estimates, the median age in Orange County has increased by more than 2 years since 2007, to 36.6 years. the largest cohort of residents is age 45-49. The number of residents ages 65-69 is forecasted to more than double from 2000-2020 primarily due to the entry of 'baby boomers' into these age ranges. Twenty-one percent of Rockland County's population was estimated to be foreign-born in 2010. Among the 63,058 Rockland county residents estimated to be foreign born in 2007, the largest group was born in Latin America and the Caribbean (48%). One quarter of foreign-born residents (25%) originated from Asia. Approximately another quarter (23%) came from Europe and 3% from Africa. Countywide, 32.9% of persons over age 5 speak a language other than English at home. According to the U.S. Census, 11.1% of residents in Orange County were foreign born, with 22.3% of persons over the age of five speaking a language other than English at home. Rockland County's rate of poverty for children under 18 increased to 16.9% in 2009 when compared to 15% in 2000. Poverty rates in Orange County vary greatly based on municipality. Poverty rates exceeding 25% for families with related children under 18 are found in Orange County's three cities (Middletown, Newburgh, and Port Jervis), as well as in the town of Monroe, largely due to the impact of the village of Kiryas Joel, where the poverty rate is more than 4 times the county average. Part VI, Line 5 BSCHS FACILITIES PROMOTED THE HEALTH OF THE COMMUNITY TO FURTHER ITS EXEMPT PURPOSE THROUGH VARIOUS PROGRAMS AND INITIATIVES THROUGHOUT THE YEAR. BSCHS'S COMMUNITY ENGAGEMENT DEPARTMENT PROVIDED EDUCATIONAL PRESENTATIONS AT VARIOUS COMMUNITY LOCATIONS ON BROAD TOPICS SUCH AS CARDIAC HEALTH, ORTHOPEDICS, WOMEN'S HEALTH, OBESITY, STROKE, DIABETES, WOUND CARE, SAFETY, ASTHMA, SENIOR SERVICES, ETC. THE OUTREACH DEPARTMENT ALSO HELD SERVICE LINE SPECIFIC PROGRAMS SUCH AS BREAST AND CERVICAL CANCER SCREENINGS, HEARING TESTING, SLEEP DISTURBANCE SEMINARS, AS WELL AS OTHER PROGRAMS BENEFITING THE COMMUNITY. BSCHS EXPECTS TO CONTINUE PROVIDING THESE PROGRAMS AND SERVICES THROUGH 2019. BSCHS CONTINUED ITS COMMITMENT TO BEING ACCESSIBLE AND PROVIDING FOR THE HEALTH CARE NEEDS OF THE COMMUNITIES IN ITS SERVICE AREA. AS EVIDENCED BY BSCHS'S ACTIVE PARTICIPATION IN THE VARIOUS DSRIP PROJECTS, BSCHS PROVIDED IMPROVED ACCESS TO HEALTH CARE SERVICES, ESPECIALLY TO THE UNDERSERVED POPULATION, AS WELL AS PROVIDED VARIOUS OPPORTUNITIES TO ENROLL IN GOVERNMENTAL AND/OR COMMUNITY HEALTH PLANS. AMBULATORY CARE MANAGERS AND PCMH STAFF WORKED OVER 27,300 HOURS TO PROVIDE CARE MANAGEMENT AND PREVENTATIVE HEALTHCARE SERVICES TO OUR PATIENTS AND THEIR FAMILIES. SOME OF THE OUTREACH SERVICES PROVIDED BY OUR AMBULATORY CARE MANAGERS INCLUDE THE FOLLOWING: COORDINATION OF REFERRALS AND TRANSITIONS OF CARE FROM ONE PROVIDER TO ANOTHER OR FROM ONE CARE SETTING TO ANOTHER; ASSISTANCE WITH MEDICATION RECONCILIATION AND ADHERENCE; FACILITATION WITH PROCURING TIMELY ACCESS TO APPOINTMENTS AND SERVICES; EDUCATION TO PATIENTS AND FAMILY/CAREGIVER. IN PORT JERVIS, THROUGH A MISSION GRANT, BSCHS PROVIDED TRANSPORTATION SERVICES TO UNINSURED AND MEDICAID PATIENTS TO COORDINATE CARE. ALL THREE BSCHS HOSPITALS PARTNERED WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) TO INCREASE PUBLIC AWARENESS OF THE AVAILABLE SERVICES THAT WERE EITHER FREE OF CHARGE OR BASED ON A SLIDING SCALE PAYMENT. IN FURTHERANCE OF THIS COMMITMENT, ALL BSCHS FACILITIES PROVIDED SPACE EACH MONTH, FREE OF CHARGE, TO INSURANCE SPECIALISTS TO MEET WITH PATIENTS TO REGISTER FOR HEALTH INSURANCE BENEFITS. IN RESPONSE TO THE GROWING COMMUNITY NEEDS OF ITS SERVICE AREA, BSCHS CONTINUED TO RECRUIT AND HIRE MORE EMPLOYED PHYSICIANS, WHO ACCEPT MEDICAID AND PARTICIPATE IN PROGRAMS TO PROVIDE CHARITY CARE, IN ALIGNMENT WITH THE BSCHS MISSION. BSCHS ALSO CONTINUED TO ADDRESS THE COMMUNITY NEED FOR CHRONIC DISEASE PREVENTION AT ALL OF ITS FACILITIES. THE FOLLOWING PROGRAMS AND INITIATIVES WERE PROVIDED, WHICH ARE EXPECTED TO CONTINUE: BSCHS HOSTED/ PARTICIPATED IN FREE CARDIAC AWARENESS AND PREVENTION PROGRAMS THAT WERE ATTENDED BY 2,957 PEOPLE. SOME OF THE PROGRAMS OFFERED INCLUDE THE FOLLOWING: HEART DISEASE PREVENTION, SIGNS AND SYMPTOMS, BLOOD PRESSURE SCREENINGS, OBESITY AND WOMEN AND HEART DISEASE. IN ADDITION, BSCHS ALSO PARTICIPATED IN THE AMERICAN HEART WALK WHICH WAS ATTENDED BY OVER 1,000 PEOPLE. THE LOWER HUDSON VALLEY MENDED HEARTS CHAPTER #368, WHICH MET EIGHT TIMES LAST YEAR AT A LOCAL COMMUNITY CENTER, WAS SUPPORTED BY BSCHS'S COMMUNITY ENGAGEMENT DEPARTMENT BUDGET. BSCHS TRAINED THE MENDED HEARTS VOLUNTEERS TO VISIT CARDIAC PATIENTS AND THEIR FAMILY MEMBERS IN THE HOSPITAL TO OFFER HOPE AND SUPPORT. THE VOLUNTEERS, WHO ARE FORMER HEART SURGERY PATIENTS, ALSO VISITED PATIENTS POST-SURGERY TO PROVIDE SUPPORT. IN 2018, VOLUNTEERS MADE 196 VISITS TO CARDIAC PATIENTS AT GSH. BSCHS PROVIDED THE COMMUNITY IN ITS SERVICE AREA WITH AMPLE CANCER TREATMENT AND SUPPORT OPTIONS. BSCHS ALSO ENGAGED THE COMMUNITY TO INCREASE AWARENESS OF RISK FACTORS AND PREVENTION. BSCHS HOSTED NUMEROUS CANCER AWARENESS, EARLY DETECTION, PREVENTION, AND SUPPORT PROGRAMS THAT REACHED 4,607 PEOPLE. THE PROGRAMS FOCUSED ON DIFFERENT CANCER RELATED ILLNESSES AND PROVIDED THE COMMUNITY WITH ACCESS TO MEET ONCOLOGY SPECIALISTS ON A ONE-TO-ONE BASE. THE CANCER PROGRAM AT GSH WAS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS AND THE RADIATION ONCOLOGY PROGRAM AT GSH WAS ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY. THE CENTER OF BREAST HEALTH AT GSH WAS ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS. BSCHS LEADERSHIP AND CANCER PROGRAM STAFF WORKED DILIGENTLY TO MAINTAIN THESE ACCREDITATIONS TO ENSURE THAT THE COMMUNITY IS RECEIVING THE BEST CARE AVAILABLE. THESE ACCREDITATIONS ARE EXPECTED TO CONTINUE THROUGH 2019. ADDITIONALLY, PARTNERSHIPS WITH THE AMERICAN CANCER SOCIETY AND THE CANCER SERVICES PROGRAM OF NYS HELPED DEVELOP NEW COMMUNITY SCREENING PROGRAMS AND IMPROVED PATIENT SUPPORT OFFERINGS, WHICH ARE EXPECTED TO CONTINUE. GSH PARTNERED WITH THE CANCER SERVICES PROGRAM OF ROCKLAND COUNTY TO PROVIDE ONGOING BREAST AND CERVICAL CANCER SCREENINGS FOR UNINSURED AND UNDERINSURED COMMUNITY MEMBERS. THROUGH THIS PARTNERSHIP, 10 FREE SCREENINGS WERE HELD IN 2018 AND 151 PEOPLE RECEIVED EARLY DETECTION SERVICES. IN FURTHERANCE OF ITS EXEMPT PURPOSE, GSH WORKED WITH CANCER SERVICES PROGRAM TO PROVIDE ALL NECESSARY FOLLOW UP TREATMENT, INCLUDING SURGERY, CHEMOTHERAPY, AND RADIATION FOR PATIENTS WHO HAD A POSITIVE FINDING FROM ANY OF THE FREE SCREENINGS. BSCHS EMPLOYED A BOARD CERTIFIED BREAST SURGEON AND A BOARD CERTIFIED COLORECTAL SURGEON AS WELL AS TWO PATIENT NAVIGATORS TO ASSIST BREAST CANCER PATIENTS TO COORDINATE THEIR CARE AND ACCESS AVAILABLE SERVICES. BSCHS CONTINUED TO FINANCIALLY SUPPORT THE AMERICAN CANCER SOCIETY'S MAKING STRIDES AGAINST BREAST CANCER WALK AND, IN 2018, THE WALK WAS ATTENDED BY 1,100 PEOPLE. THIS SPONSORSHIP HELPED SUPPORT AND PROVIDE PREVENTION AND EARLY DETECTION EDUCATIONAL MATERIALS TO THE COMMUNITIES WE SERVE. BSCHS ALSO WORKED TOWARDS PROMOTING HEALTH IN THE COMMUNITY BY PREVENTING OBESITY WHICH INCREASES A PERSON'S LIKELIHOOD OF DEVELOPING MANY CHRONIC DISEASES. BSCHS OFFERED SEVERAL SERVICES TO OFFSET THE DAMAGE THAT OBESITY CAN CREATE. IN ALIGNMENT WITH THE NYS PREVENTION AGENDA, BOTH GSH AND SACH PROVIDED BOARD CERTIFIED LACTATION CONSULTANT SERVICES TO NEW MOTHERS, AS RESEARCH HAS SHOWN THAT BREASTFEEDING CAN POSITIVELY AFFECT A PERSON'S FUTURE LIKELIHOOD OF NOT DEVELOPING OBESITY. ADDITIONALLY, SACH OFFERED A BI-WEEKLY BREASTFEEDING SUPPORT GROUP WHICH WAS ATTENDED BY OVER 163 PARTICIPANTS. IN PORT JERVIS, BSCH CONTINUED THE "GET FIT, PORT JERVIS" PROGRAM, IN PARTNERSHIP WITH ACCESS PT, WHICH OFFERED THE COMMUNITY ACCESS TO FREE GROUP WALKS AND YOGA CLASSES. IN 2018, 394 PEOPLE PARTICIPATED IN THE GROUP WALKS AND 793 PEOPLE PARTICIPATED IN FREE YOGA CLASSES. BSCH PROVIDED THE FOLLOWING HOSPITAL BASED PROGRAMS TO ADDRESS CHRONIC DISEASE PREVENTION AND PROMOTE WELLNESS; BSCH BMI AND BLOOD PRESSURE MONITORING PROGRAM; DIABETES SUPPORT GROUP FOR CHILDREN AND FAMILIES AND DIABETES PREVENTION CLASSES; SHARING AND CARING FAMILY SUPPORT GROUP FOR THOSE CARING FOR LOVED ONES LIVING WITH MENTAL ILLNESS; AND HEALTHY EATING PROGRAMS FOR CHILDREN AND SENIORS IN PARTNERSHIP WITH MORRISON HEALTH CARE. BSCHS PROVIDED DIABETES PREVENTION, EDUCATION, AND SUPPORT SERVICES AT ALL ITS FACILITIES. THESE FREE CLASSES WERE LED BY CERTIFIED DIABETES EDUCATORS WHO WERE ALSO REGISTERED NURSES AND REGISTERED DIETICIANS. GSH AND BSCH ALSO PROVIDED BARIATRIC SURGERY PROGRAMS AS BARIATRIC SURGERY CAN OFTEN REVERSE A DIABETES DIAGNOSIS. GSH DONATED A 3000-SQUARE FOOT FACILITY ON THE HOSPITAL CAMPUS THAT HOUSES THE "SPIRIT OF ROCKLAND" SPECIAL VICTIMS CENTER THAT PROVIDES CARE AND SUPPORT TO CRIME VICTIMS WITH SPECIAL NEEDS. IN 2018, THE DONATED VALUE OF THE BUILDING, INCLUDING UTILITIES AND UPKEEP, TOTALED $108,000. GSH IS EXPECTED TO CONTINUE THIS COMMUNITY INITIATIVE. GSH WAS ALSO A MEMBER OF THE ROCKLAND COUNTY PUBLIC HEALTH PRIORITIES STEERING COMMITTEE, WHICH IS A PRIVATE-PUBLIC PARTNERSHIP THAT WAS FORMED IN MAY 1997 AND INCLUDES MORE THAN TWENTY REPRESENTATIVES OF EDUCATIONAL INSTITUTIONS, HEALTH CARE PROVIDERS, HEALTH-RELATED ORGANIZATIONS, COMMUNITY SERVICE ORGANIZATIONS, GOVERNMENTAL AGENCIES, FAITH-BASED ORGANIZATIONS, CONSUMERS, AND THE BUSINESS COMMUNITY. THE COMMITTEE WAS CHAIRED AND COORDINATED BY THE ROCKLAND COUNTY DEPARTMENT OF HEALTH. ITS MISSION IS THE COORDINATION AND COLLABORATION OF RESOURCES TO ADDRESS LOCAL UNMET PUBLIC HEALTH NEEDS IN ORDER TO PROMOTE HEALTH, IMPROVE ACCESS TO HEALTH CARE AND PREVENT DISEASE AND DISABILITY IN ROCKLAND COUNTY. GSH COLLABORATED AND WORKED WITH THIS COMMITTEE IN FURTHERANCE OF ITS EXEMPT PURPOSE AND TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES AND EXPECTS TO CONTINUE ITS WORK WITH THIS COMMITTEE. SACH WORKED WITH VILLAGE OF WARWICK TO PASS A COMPLETE STREET POLICY AND DEVELOPED A DESIGNATED MUNICIPAL WALKING PATH TO PROMOTE HEALTH AND WELLNESS. SACH HOSTED A RIBBON CUTTING CEREMONY TO HELP PROMOTE THE WALKING PATH. BSCHS'S POPULATION HEALTH DEPARTMENT STAFF FURTHERED THE ORGANIZATION'S EXEMPT PURPOSES BY PROMOTING THE HEALTH OF THE COMMUNITY IN BOTH ROCKLAND AND ORANGE COUNTY. STAFF HAVE BEEN INVOLVED IN MANAGING PREVENTIVE AND CHRONIC Part VI, Line 6 BSCHS is a not-for-profit, non-stock membership corporation that is the sole member of five LEGAL ENTITIES that operate hospitals, nursing homes, and other healthcare-related facilities in the State of New York. Bon Secours Health System, Inc. ("BSHSI") a Maryland not-for-profit, non-stock membership corporation, is a member of BSCHS with a forty percent(40%) economic interest in BSCHS. Sisters of Charity ("SOC"), a New Jersey not-for-profit corporation, IS a member of BSCHS without any economic interest. BSCHS, a Catholic health system, is canonically co-sponsored by Bon Secours Ministries ("BSM"), an affiliate of BSHSI and SOCSE. BSHSI is a not-for-profit, non-stock membership corporation, and the sole member of which is Bon Secours, Inc. ("BSI"). BSHSI is a corporation formed to participate in the charitable healthcare system now sponsored by BSM throughout the United States of America through which the healthcare mission of the Sisters of Bon Secours, USA, the founding participating entity of BSM, is furthered. The Ministry of BSHSI aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to the following: acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of Bon Secours Health System, Inc. (BSHSI), this organization and its related entities are called to continue the healing ministry of Jesus. THEY exist to benefit the people living in the communities we serve. Through all of the services offered to the community, the mission is "to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church." This organization and related organizations share the BSHSI Vision. Inspired by the healing ministry of Jesus Christ and the charism of Bon Secours, Bon Secours Health System will be recognized for its leadership in justice, transforming the communities in which we serve and work into places of health and hope, and being a prophetic voice for systemic US health reform and a more humane world. Westchester County Healthcare Corporation was created in 1997 as a New York public benefit corporation and owns and operates a number of healthcare facilities including Westchester Medical Center located in Valhalla, New York. In May, 2015, WMC and BSHSI ENTERED INTO a transaction (the "Affiliation") under which WMC, or its subsidiary, became a majority co-member in BSCHS and manages the day to day operations of BSCHS and its subsidiaries and facilities pursuant to a management agreement approved by the New York State Department of Health; BSCHS and its subsidiaries remain a Catholic healthcare ministry subject to the Ethical and Religious Directives for Catholic Healthcare Services. WMC appoints at least sixty percent (60%) of the members of the BSCHS Board of Directors, while BSHSI and SOCSE jointly appoint approximately 40% of the BSCHS Board, and each member of BSCHS holds certain reserve powers. Please see Schedule R for listings of the related organizations and Schedule H for the hospitals included in this return. Part VI, Line 7 List of States Receiving Community Benefit Report: NY false TRANSPORTATION FOR INDIGENT PATIENTS 102 11979 false true false false false false false false false MARY LEAHY MD PRESIDENT & CEO 0 693405 0 222789 0 0 0 38500 0 53347 0 1008041 0 0 JOHN WALLENHORST PHD BOARD MEMBER - SPONSOR REP 0 334352 0 107234 0 258652 0 16500 0 11073 0 727811 0 0 MARTIN EVERS MD PRESIDENT - MEDPC 142377 0 196299 0 786 0 20898 0 27430 0 387790 0 0 0 MARK NANTZ CHAIR 0 723712 0 219430 0 1517059 0 109945 0 27213 0 2597359 0 81973 MICHAEL ISRAEL VICE CHAIR 0 1566869 0 900000 0 0 0 68500 0 98924 0 2634293 0 0 RENEE GARRICK MD BOARD MEMBER 0 446838 0 75000 0 0 0 10425 0 15087 0 547350 0 0 GARY BRUDNICKI BOARD MEMBER 0 1152946 0 497134 0 0 0 68500 0 82150 0 1800730 0 0 JULIE SWITZER BOARD MEMBER 0 655675 0 221675 0 0 0 62500 0 63089 0 1002939 0 0 PETER KENNIFF CFO 303803 0 65774 0 43728 0 20898 0 26972 0 461175 0 0 0 CARY HIRSCH MD PHYSICIAN 1000004 0 0 0 58382 0 20898 0 0 0 1079284 0 0 0 SETH HURWITZ MD CARDIOLOGIST 341789 0 347988 0 360 0 18308 0 28902 0 737347 0 0 0 MARK FERSKO BOARD MEMBER 0 738695 0 248850 0 0 0 68500 0 52018 0 1108063 0 0 ARVIND K AGARWAL PHYSICIAN 669618 0 100000 0 5544 0 20898 0 15825 0 811885 0 0 0 PERMINDER S GREWAL PHYSICIAN 539642 0 160000 0 4752 0 20898 0 31110 0 756402 0 0 0 AMALA P CHIRUMAMILLA PHYSICIAN 344191 0 326618 0 360 0 20898 0 6400 0 698467 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J PART I LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION AS DESCRIBED BELOW: THE BOARD OF DIRECTORS PERSONNEL AND COMPENSATION COMMITTEE SETS THE LEVEL OF TOTAL COMPENSATION (BASE SALARY AND INCENTIVE COMPENSATION) AND THE BENEFITS PROVIDED TO THE ORGANIZATION'S SENIOR EXECUTIVES. IN ORDER TO SET BASE SALARY AND INCENTIVE COMPENSATION LEVELS, THE COMMITTEE WORKS WITH A NATIONAL INDEPENDENT COMPENSATION CONSULTING FIRM. THE CONSULTING FIRM ASSISTS THE COMMITTEE WITH ITS DECISION-MAKING PROCESSES TO ENSURE THAT (I) EXECUTIVE COMPENSATION LEVELS ARE REASONABLE AND APPROPRIATE RELATIVE TO THOSE OF OTHER SIMILAR ORGANIZATIONS, AS WELL AS (II) SUCH LEVELS MEET THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" STANDARD COMPENSATION LEVELS ARE DETERMINED BASED ON COMPETITIVE MARKET DATA FOR COMPARABLE POSITIONS IN SIMILAR SIZED AND TYPE OF ORGANIZATIONS AND EACH EXECUTIVE'S SCOPE OF RESPONSIBILITIES. IN ADDITION, INCENTIVE COMPENSATION ARRANGEMENTS ARE BASED ON EACH EXECUTIVE'S ACHIEVEMENT OF SPECIFIC PERFORMANCE GOALS SET FORTH AT THE BEGINNING OF EACH CALENDAR YEAR, THE ACHIEVEMENT OF WHICH IS MEASURED AT THE END OF EACH CALENDAR YEAR BY THE CEO OR THE BOARD OF DIRECTORS DEPENDING ON THE EXECUTIVE. PART I, LINE 4B THE FILING ORGANIZATION PARTICIPATES IN A BON SECOURS HEALTH SYSTEM, INC. ("BSHSI") supplemental executive retirement plan THAT ALLOWS FOR DEPOSITS INTO ADDITIONAL RETIREMENT PLANS AND IS AVAILABLE ONLY TO OFFICERS AND CERTAIN OTHER EMPLOYEES. THE 457(F) PLAN IS A NON-QUALIFIED PLAN AND IS SUBJECT TO A MINIMUM THREE-YEAR SERVICE REQUIREMENT BEFORE VESTING ON DEPOSITS MADE INTO THIS PLAN. ONE INDIVIDUAL RECEIVED A DISTRIBUTION: MARK NANTZ, $85,799. Form 990, Part VI, Line 6 Members or stockholders: the members of BSCHS are as follows: WMC - Rockland, Inc. - 60% BSHSI, together with SISTERS OF CHARITY - 40% Pursuant to New York State Law, as an organization engaged in the profession of medicine, Bon Secours Charity Health System Medical Group, P.C. (MedPC) was the sole shareholder of the organization who is engaged in the practice of medicine and licensed to practice in the State of New York AND THE STATE OF NEW JERSEY. Form 990, Part VI, Line 7a Power to elect or appoint members: The governing bodY of the members within the Group, with the exception of MedPC, are appointed by its members, WMC-Rockland, BSHSI and SOC and are subject to the approval of its members. Form 990, Part VI, Line 7b Decisions reserved to members or stockholders: Certain authorities of the members of the Group, with the exception of Bon Secours Charity Health System Medical Group, PC, are jointly reserved to WMC-Rockland, BSHSI and SOC, certain authorities are reserved to BSHSI and WMC-Rockland, and certain authorities are reserved solely to BSHSI. Form 990, Part VI, Line 11b Process used to review the Form 990: THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT WITH ASSISTANCE FROM VARIOUS DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY INTERNAL LEADERSHIP AND OUR EXTERNAL TAX ADVISORS. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PROVIDED TO THE BOARD OF THE ORGANIZATION FOR APPROVAL PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: The organization monitors and enforces compliance with the Conflict of Interest policy by means of a survey developed and approved by the Chief Compliance Officer. The survey is sent to all trustees, officers, and key executives for completion. All survey responses are reviewed by the Chief Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or referred to the WMCHealth Conflicts of Interest Committee for discussion. Potential actions to be taken in response to a conflict can be one or more of the following: 1) disclosure of the conflict, 2) individual recusal from decisions for transactions where that individual may have a conflict, 3) request in writing THAT the individual alleviates the conflict, or 4) removal of the individual from employment. FORM 990, PART VI, LINE 15 process for determining compensation: The organization has a comprehensive process for the oversight and management of remuneration for the CEO and other senior executives. Compensation for such key employees is set by reviewing and relying on objective market data to ensure they receive compensation that is in full compliance with the IRS' rebuttable presumption of reasonableness. The organization maintains a compensation philosophy, reviews pay practices against LOCAL, REGIONAL AND NATIONAL healthcare organizations and approves all remunerative decisions for this group of individuals. Further, the organization ensures that all levels of pay within the organization are reasonable based on performance and validates that incentives payments, if any, are adequately supported. Such decisions are documented in Board and other relevant Committee minutes. Form 990, Part VI, Line 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets: Transfers to Affiliates $6,214,757 WMC HEALTH NETWORK - ROCKLAND INC 100 WOODS ROAD VALHALLA NY 10595 320467873 SUPPORTING NY 501(C)(3) 12A NA false WMC HEALTH NETWORK - ULSTER INC 100 WOODS ROAD VALHALLA NY 10595 320477183 SUPPORTING NY 501(C)(3) 12A WCHCC false WESTCHESTER COUNTY HEALTH CARE CORP 100 WOODS ROAD VALHALLA NY 10595 133964321 HEALTHCARE NY 115 N/A NA false WMC NEW YORK INC 100 WOODS ROAD VALHALLA NY 10595 134107894 FUNDRAISING NY 501(C)(3) 12A WCHCC false NORTH ROAD LHCSA INC 241 NORTH ROAD POUGHKEEPSIE NY 12601 465293268 HOMECARE SVCS NY 501(C)(3) 10 WCHCC false MID-HUDSON VALLEY EARLY EDUCATION CENTER 100 WOODS RD TAYLOR PAVILION VALHALLA NY 10595 465534882 PRESCHOOL NY 501(C)(3) 7 WCHCC false WESTCHESTER MEDICAL CENTER FOUNDATION 100 WOODS ROAD VALHALLA NY 10595 134095845 FUNDRAISING NY 501(C)(3) 7 WCHCC false HEALTHALLIANCE INC 741 GRANT AVENUE LAKE KATRINE NY 12449 261850453 SUPPORTING NY 501(C)(3) 12A WCHCC true HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS 396 BROADWAY KINGSTON NY 12401 141349558 EXEMPT HOSP NY 501(C)(3) 3 HA INC true HEALTHALLIANCE HOSP MARY'S AVE CAMPUS 105 MARYS AVENUE KINGSTON NY 12401 141338470 EXEMPT HOSP NY 501(C)(3) 3 HA INC true MARGARETVILLE MEMORIAL HOSPITAL 42084 STATE ROUTE 28 MARGARETVILLE NY 12455 150552726 EXEMPT HOSP NY 501(C)(3) 3 HA INC true MARGARETVILLE NURSING HOME INC 42158 STATE HIGHWAY 28 MARGARETVILLE NY 12455 223143565 NURSING HOME NY 501(C)(3) 10 MMH true MARGARETVILLE HEALTH FOUNDATION 42084 STATE HIGHWAY 28 MARGARETVILLE NY 12455 261998454 SUPPORT FDN NY 501(C)(3) 12A MMH true FASC FOUNDATION 741 GRANT AVENUE LAKE KATRINE NY 12449 264201295 SUPPORT FDN NY 501(C)(3) 7 HAH BWAY true GOOD SAMARITAN FDN FOR BETTER HEALTH 255 LAFAYETTE AVE SUFFERN NY 10901 133400353 SUPPORT FDN NY 501(C)(3) 7 BSCHS false BON SECOURS COMMUNITY HOSPITAL FDN 255 LAFAYETTE AVE SUFFERN NY 10901 810667395 SUPPORT FDN NY 501(C)(3) 7 BSCHS true BON SECOURS WARWICK HEALTH FOUNDATION 255 LAFAYETTE AVE SUFFERN NY 10901 141972807 SUPPORT FDN NY 501(C)(3) 7 BSCHS true BON SECOURS CHARITY HEALTH SYSTEM INC 255 LAFAYETTE AVE SUFFERN NY 10901 912135195 SUPPORTING NY 501(C)(3) 12C, III-FI WCHCC false HealthAlliance Foundation Inc 741 GRANT AVENUE LAKE KATRINE NY 12449 222511450 FUNDRAISING NY 501(C)(3) 7 HA INC false HUDSON RIVER WEST INSURANCE (BARBADOS) 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB BSCHS C CORP true KINGSTON INSURANCE (BARBADOS) LIMITED 38 PINE ROAD BELLEVILLE ST MICHAEL BB CAP INSURANCE BB HEALTHALLIANCE C CORP true NORTHEAST PROVIDER SOLUTIONS INC 100 WOODS ROAD VALHALLA NY 10595 133991673 MSO & HEARING AID NY NA C CORP true WMC ADVANCED PHYSICIAN SERVICES PC 19 BRADHURST AVENUE HAWTHORNE NY 10595 264709927 PHYSICIAN OFFICES NY NA C CORP true WESTCHESTER MEDICAL REGIONAL PHYS SVCS 241 NORTH ROAD POUGHKEEPSIE NY 10532 465522536 PHYSICIAN OFFICES NY NA C CORP true WCHCC (BERMUDA) LIMITED VICTORIA HALL 11 VICTORIA STREET HAMILTON BD CAP INSURANCE BD NA C CORP true KINGSTON REGIONAL HEALTH CARE ENTERPRISE 396 BROADWAY KINGSTON NY 12401 161514994 INVESTMENT NY HAH BWAY C CORP true MID HUDSON PHYSICIANS PC 396 BROADWAY KINGSTON NY 12401 203564769 MEDICAL SVCS NY NA C CORP true BSCHS MEDICAL GROUP PC 10 FRANKLIN TURNPIKE MAHWAH NJ 07430 821632215 PHYSICIAN OFFICES NJ BSCHS C CORP true false false true false false false false false false false false false false true true true true true BON SECOURS CHARITY HEALTH SYSTEM INC R 278968267 FMV BON SECOURS CHARITY HEALTH SYSTEM INC S 282677802 FMV ST ANTHONY COMMUNITY HOSPITAL O 27398477 FMV BON SECOURS COMMUNITY HOSPITAL O 42336897 FMV VILLA FRANCES AT THE KNOLLS INC O 6892877 FMV ST FRANCIS AT THE KNOLLS INC O 2415230 FMV BON SECOURS CHARITY HLTH SYSTEM MED GROUP PC O 51589176 FMV GOOD SAMARITAN HOSPITAL OF SUFFERN NY O 81045629 FMV GOOD SAMARITAN HOSPITAL OF SUFFERN NY P 16368658 FMV ST ANTHONY COMMUNITY HOSPITAL P 31356961 FMV BON SECOURS COMMUNITY HOSPITAL P 27183398 FMV BON SECOURS COMMUNITY FOUNDATION C 283810 FMV VILLA FRANCES AT THE KNOLLS INC P 7194159 FMV ST FRANCIS AT THE KNOLLS INC P 2636468 FMV BON SECOURS CHARITY HLTH SYSTEM MED GROUP PC P 19775558 FMV BON SECOURS CHARITY HLTH SYSTEM MED GROUP PC Q 19322041 FMV GOOD SAMARITAN HOSPITAL OF SUFFERN NY Q 85762078 FMV