DELAWARE VALLEY HOSPITAL INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DELAWARE VALLEY HOSPITAL INC (EIN 15-0524324)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-09
IRS object ID
201733139349303573
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-09T16:10:10-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13214ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150524324EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELAWARE VALLEY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDELABusinessNameControlTxt
Phone6078652197PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 TITUS PLACEAddressLine1Txt
CityWALTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP138561457ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL SUMMERSPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone6078652160PhoneNum
Signature2017-10-23SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA M FRANCOPreparerPersonNm
PTINP00589741PTIN
Phone3154463600PhoneNum
Preparation2017-10-23PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.39.85.114IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-10-23IPDt
IP Tm09:15:53IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id9ED0318F8F0D15647C4BFB992883BD7B1D0B79ECAtSubmissionCreationDeviceId
At Submission Filing Device Id315614A2A569D91B0F4A84342C1D145A8997199DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPAUL SUMMERSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 TITUS PLACEAddressLine1Txt
CityWALTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP138561457ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,532,288GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UHS.NET/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1950FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE,PRIMARY CARE AND WELLNESS SERVICES.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee215TotalEmployeeCnt
Total Volunteers28TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$491,375PYContributionsGrantsAmt
CY Contributions Grants$1,281,516CYContributionsGrantsAmt
PY Program Service Revenue$20,803,358PYProgramServiceRevenueAmt
CY Program Service Revenue$21,976,456CYProgramServiceRevenueAmt
PY Investment Income$43,318PYInvestmentIncomeAmt
CY Investment Income-$24,738CYInvestmentIncomeAmt
PY Other Revenue$288,254PYOtherRevenueAmt
CY Other Revenue$224,273CYOtherRevenueAmt
PY Total Revenue$21,626,305PYTotalRevenueAmt
CY Total Revenue$23,457,507CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,465,037PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,904,417CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$194,205CYTotalFundraisingExpenseAmt
PY Other Expenses$12,175,307PYOtherExpensesAmt
CY Other Expenses$12,825,965CYOtherExpensesAmt
PY Total Expenses$20,640,344PYTotalExpensesAmt
CY Total Expenses$21,730,382CYTotalExpensesAmt
PY Revenues Less Expenses$985,961PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,727,125CYRevenuesLessExpensesAmt
Total Assets BOY$17,094,367TotalAssetsBOYAmt
Total Assets EOY$18,857,786TotalAssetsEOYAmt
Total Liabilities BOY$7,451,663TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,426,972TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,642,704NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,430,814NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,481,905ExpenseAmt
Revenue$9,638,938RevenueAmt
DescINPATIENT 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 ACUTECARE, 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 2016 WERE COMPRISED OF 262 ACUTE, 153 SWING BED, AND 110 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 798 PATIENT DAYS, IN ADDITION TO THE 1,616 PATIENT DAYS FOR SWING BED AND 1,701 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 6,017 LAB TESTS, 13,828 RESPIRATORY TREATMENTS, 283 X-RAYS, 718 PHYSICAL THERAPY SESSIONS, AND 151 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED OCCUPATIONAL AND SPEECH THERAPY, ENDOSCOPY, ECHO EXAMS, ULTRASOUNDS, CT EXAMS AND MAMMOGRAPHY. 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 A 16-SLICE CT SUITE. MRI SERVICES ARE OFFERED ON SUNDAYS AND WEDNESDAYS THROUGH AN AGREEMENT WITH A MOBILE VENDOR.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,403,071ExpenseAmt
Revenue$4,621,162RevenueAmt
DescCLINICS: 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. 2016 INCLUDED 13,710 VISITS IN WALTON, 1,140 IN ROSCOE, AND 1,595 IN DOWNSVILLE. THE CLINICS HAVE BECOME KEY TO THE IMPROVEMENT OF CHILDHOOD IMMUNIZATION LEVELS IN COORDINATION WITH DELAWARE COUNTY'S PUBLIC HEALTH NURSING SERVICES AND OTHER AREA HEALTHCARE PROVIDERS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$10,121,168ExpenseAmt
Revenue$7,716,356RevenueAmt
DescOUTPATIENT 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. THE HOSPITAL ALSO CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS AND DIABETES EDUCATION. THE HOSPITAL'S COMMUNITY PHARMACY OFFERS FREE MAIL ORDER FOR THOSE PATIENTS WHO WOULD HAVE DIFFICULTY ACCESSING THE PHARMACY. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION. IN 2016 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,404 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 66,548 TESTS, AND 6,432 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,874 X-RAYS, CT SCANS, MRI'S AND MAMMOGRAPHIES FOR OUTPATIENT SERVICES. OUTPATIENT SERVICES WERE ALSO PERFORMED IN 2016 FOR 160 AMBULATORY PROCEDURES, 1,264 OPIATED ADDICTION SESSIONS, AND 721 SERVICES ASSOCIATED WITH CARDIOPULMONARY REHABILITATION.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Revenue$90,505RevenueAmt
DescOTHER PROGRAM SERVICE REVENUE CONSISTS OF VARIOUS OTHER PHYSICIAN SERVICE REVENUE INCLUDING MEDICAL RECORD AND TRANSCRIPTION FEES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Revenue$90,505TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$18,006,144TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee215EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Taxable Distributions0TaxableDistributionsInd
Distribution To Donor0DistributionToDonorInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAUL SUMMERSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6078652197PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1DELAWARE VALLEY HOSPITAL 1 TITUSAddressLine1Txt
CityWALTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP138561457ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
HELEN JOHNSTON
BOARD CHAIR1.00Yes (X)Yes (X)$0$0$0
JOHN CARRIGG
2ND VICE CHAIR1.00Yes (X)Yes (X)$0$575,657$34,83055.00
LARRY LIGHT
TREASURER1.00Yes (X)Yes (X)$0$0$0
EDWARD SNOW
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ERIN NEALE
TRUSTEE1.00Yes (X)$0$0$0
AMANDA HALL
TRUSTEE1.00Yes (X)$0$0$0
DR MICHAEL FREEMAN
MEDICAL STAFF PRESIDENT56.00Yes (X)Yes (X)$240,072$0$38,265
PAUL SUMMERS
PRESIDENT/CEO56.00Yes (X)Yes (X)$225,080$0$16,302
DR JOHN GIANNONE
CHIEF MEDICAL OFFICER5.00Yes (X)$32,236$0$0
JOAN GUARNIERI
V.P. ANCILLARY SVCS55.00Yes (X)$102,248$0$13,608
DOTTIE KRUPPO
V.P. COMMUNITY RELATIONS55.00Yes (X)$79,340$0$17,516
DEBORAH HITT
V.P. QUALITY/SUPPORT SVCS55.00Yes (X)$88,853$0$18,487
VICTORIA CONKLING
V.P. NURSING/CNO55.00Yes (X)$108,130$0$6,055
KATHLEEN ULMSCHNEIDER
STAFF NURSE55.00$109,460$0$19,221Yes (X)
DR RAJESH DAVE
FORMER 2ND VICE CHAIR0.00$0$656,443$33,48455.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$985,419TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,232,100TotReportableCompRltdOrgAmt
Total Other Compensation$197,768TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MCKESSON
12748 COLLECTIONS CENTER DRCHICAGOIL60693PHARMACEUTICAL$3,262,576
SECO PHYSICALOCCUPATIONAL THERAPY
26 CONKY AVENORWICHNY13815PHYSICAL/OCC. THERAPY$395,662
MEDHOST OF TENNESSEE
2739 MOMENTUM PLACECHICAGOIL60689INFORMATION TECHNOLOGY$350,966
ALLIANCE HEALTHCARE SYSTEMS
PO BOX 96485CHICAGOIL60693MEDICAL SUPPORT$291,774
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216LAB TESTING SERVICE$218,089
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Government Grants$1,159,138GovernmentGrantsAmt
All Other Contributions$122,378AllOtherContributionsAmt
Total Contributions$1,281,516TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business900099BusinessCd
Total Revenue Column$21,976,456TotalRevenueColumnAmt
Related Or Exempt Func Income$21,976,456RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$21,976,456TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,043TotalRevenueColumnAmt
Exclusion$50,043ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$74,781OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$74,781OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$74,781TotalRevenueColumnAmt
Exclusion-$74,781ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INTEREST RATE SWAP900099$133,768$133,768
PHYSICIAN OTHER REVENUE621498$33,794$33,794
MEDICAL RECORD FEES900099$6,945$6,945

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$49,766TotalRevenueColumnAmt
Related Or Exempt Func Income$49,766RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$224,273OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,457,507TotalRevenueColumnAmt
Related Or Exempt Func Income$22,066,961RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$109,030ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$675,618TotalAmt
Program Services$386,938ProgramServicesAmt
Management And General$191,824ManagementAndGeneralAmt
Fundraising$96,856FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,595,108TotalAmt
Program Services$5,120,110ProgramServicesAmt
Management And General$1,474,998ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$173,353TotalAmt
Program Services$138,332ProgramServicesAmt
Management And General$35,021ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$940,902TotalAmt
Program Services$750,821ProgramServicesAmt
Management And General$190,081ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$519,436TotalAmt
Program Services$406,189ProgramServicesAmt
Management And General$113,247ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$22,947TotalAmt
Management And General$22,947ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$7,152TotalAmt
Management And General$7,152ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$100,349TotalAmt
Management And General$100,349ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$5,063TotalAmt
Management And General$5,063ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,429TotalAmt
Management And General$7,429ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,438,508TotalAmt
Program Services$4,831,408ProgramServicesAmt
Management And General$583,449ManagementAndGeneralAmt
Fundraising$23,651FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,421,977TotalAmt
Program Services$947,336ProgramServicesAmt
Management And General$445,343ManagementAndGeneralAmt
Fundraising$29,298FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$66,719TotalAmt
Management And General$66,719ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$226,467TotalAmt
Program Services$55,427ProgramServicesAmt
Management And General$171,040ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$32,239TotalAmt
Program Services$25,632ProgramServicesAmt
Management And General$5,172ManagementAndGeneralAmt
Fundraising$1,435FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$57,850TotalAmt
Program Services$12,985ProgramServicesAmt
Management And General$1,900ManagementAndGeneralAmt
Fundraising$42,965FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$220,963TotalAmt
Program Services$151,285ProgramServicesAmt
Management And General$69,678ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$835,450TotalAmt
Program Services$835,450ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$97,676TotalAmt
Program Services$81,382ProgramServicesAmt
Management And General$16,294ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS$3,171,523$3,171,523
BAD DEBT EXPENSE$619,554$619,554
MEDICAL SUPPLIES$387,780$387,780

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$106,319TotalAmt
Program Services$83,992ProgramServicesAmt
Management And General$22,327ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,730,382TotalAmt
Program Services$18,006,144ProgramServicesAmt
Management And General$3,530,033ManagementAndGeneralAmt
Fundraising$194,205FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,554,440BOYAmt
EOY$4,014,103EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,357,318BOYAmt
EOY$1,370,438EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,153,339BOYAmt
EOY$1,994,226EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$523,224BOYAmt
EOY$587,536EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$464,907BOYAmt
EOY$493,679EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,067,981LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,913,604LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,002,831BOYAmt
EOY$7,154,377EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,017,387BOYAmt
EOY$1,100,629EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,955,921BOYAmt
EOY$2,077,798EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$65,000BOYAmt
EOY$65,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,094,367BOYAmt
EOY$18,857,786EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$971,189BOYAmt
EOY$1,233,964EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,814,257BOYAmt
EOY$3,220,060EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$527,784BOYAmt
EOY$441,081EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,663,573BOYAmt
EOY$2,046,868EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$474,860BOYAmt
EOY$484,999EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,451,663BOYAmt
EOY$7,426,972EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,318,035BOYAmt
EOY$11,100,454EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,460BOYAmt
EOY$12,150EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$318,209BOYAmt
EOY$318,210EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,642,704BOYAmt
EOY$11,430,814EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,094,367BOYAmt
EOY$18,857,786EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,727,125ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$60,985NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,063OtherActivitiesAmt
Total Lobbying Expenditures$5,063TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationAMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY AND IROQUOIS HEALTHCARE.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$324,669BeginningYearBalanceAmt
Contributions$5,691ContributionsAmt
End Year Balance$330,360EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$361,539BeginningYearBalanceAmt
Contributions$5,286ContributionsAmt
Other Expenditures$42,156OtherExpendituresAmt
End Year Balance$324,669EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$348,578BeginningYearBalanceAmt
Contributions$12,961ContributionsAmt
End Year Balance$361,539EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$379,742BeginningYearBalanceAmt
Contributions$1,700ContributionsAmt
Other Expenditures$32,864OtherExpendituresAmt
End Year Balance$348,578EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$381,035BeginningYearBalanceAmt
Contributions-$1,293ContributionsAmt
End Year Balance$379,742EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.96000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.04000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,202OtherCostOrOtherBasisAmt
Book Value$51,202BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,175,831OtherCostOrOtherBasisAmt
Depreciation$5,355,651DepreciationAmt
Book Value$4,820,180BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,915,869OtherCostOrOtherBasisAmt
Depreciation$9,557,953DepreciationAmt
Book Value$1,357,916BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$925,079OtherCostOrOtherBasisAmt
Book Value$925,079BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,154,377TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
WELLS FARGO-PRIN. PYMTS ON BONDS$162,763F
TEMP.RESTRICTED DONATIONS$19,851F
CAPITAL CONST(FUNDED DEPR)$1,895,184F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$2,077,798TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE UNITED MED. ASSOC.$216,229
DUE UHS HOSPITALS$203,770
MALPRACTICE INSURANCE RESERVE$65,000
FieldValueIRS element (for citing)
Total Liability$484,999TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$23,339,838TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$23,339,838RevenueSubtotalAmt
Other Revenues Not Included$117,669OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$117,669RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$23,457,507TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$21,730,382TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$21,730,382ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,730,382TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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, 2016 AND 2015, 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 2013 TO 2016. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS FOR PURCHASE OF EQUIPMENT 117,669.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,088,627TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,868,847DirectOffsettingRevenueAmt
Net Community Benefit Expns$219,780NetCommunityBenefitExpnsAmt
Total Expense0.01040TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$147,274TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,485DirectOffsettingRevenueAmt
Net Community Benefit Expns$126,789NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,235,901TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,889,332DirectOffsettingRevenueAmt
Net Community Benefit Expns$346,569NetCommunityBenefitExpnsAmt
Total Expense0.01640TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$195,209TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$195,209NetCommunityBenefitExpnsAmt
Total Expense0.00920TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,869TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$44,869NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,227,206TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,319,226DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,907,980NetCommunityBenefitExpnsAmt
Total Expense0.13770TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,467,284TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,319,226DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,148,058NetCommunityBenefitExpnsAmt
Total Expense0.14900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,703,185TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,208,558DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,494,627NetCommunityBenefitExpnsAmt
Total Expense0.16540TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,087TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,087NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,994TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,994NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,548TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,548NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,629TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,629NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$619,554BadDebtExpenseAmt
Bad Debt Expense Attributable$278,799BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,291,509ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,220,788CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$70,721MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DELAWARE VALLEY HOSPTITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 TITUS PLACEAddressLine1Txt
CityWALTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13856ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1DELAWARE VALLEY HOSPTITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.UHS.NETOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.UHS.NETStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.UHS.NETFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.UHS.NETFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.UHS.NETFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DELAWARE VALLEY HOSPTITALPART 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 HOSPTITALPART V, SECTION B, LINE 6A: O'CONNOR HOSPITAL, DELHI, NYTRI-TOWN REGIONAL HOSPITAL, SIDNEY, NYMARGARETVILLE COMMUNITY HOSPITAL, MARGARETVILLE, NY
DELAWARE VALLEY HOSPTITALPART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, DEPT OF SOCIAL SERVICES, SHERIFF'S DEPT, ALCOHOL AND DRUG ABUSE COUNCIL, PLANNING DEPT, EMERGENCY SERVICES, DRUG TREATMENT COURT, WATERSHED AFFAIRSHOSPITAL AND HEALTH SERVICES:UHS DELAWARE VALLEY HOSPITAL, BASSETT HEALTHCARE-O'CONNOR HOSPITAL AND TRI-TOWN, MARGARETVILLE HOSPITAL, 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 HOSPTITALPART V, SECTION B, LINE 11: 2016-2018 ACTION PLANPREVENTION STRATEGY: PREVENT CHRONIC DISEASE FOCUS AREA: REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSUREGOAL: PROMOTE TOBACCO USE CESSATION, ESPECIALLY AMONG LOW SES POPULATIONS AND THOSE WITH POOR MENTAL HEALTH. OBJECTIVE: PROVIDE DELAWARE COUNTY RESIDENTS WITH ACCESS TO TOBACCO CESSATION CLASSES THROUGH VIDEO-CONFERENCING, ELIMINATING THE NEED TO TRAVEL LONG DISTANCES. STRATEGY: DVH WILL OFFER SMOKING CESSATION CLASSES TO BE IMPLEMENTED WITH UHS STAY HEALTHY STAFF THROUGH THE USE OF VIDEO CONFERENCING. THIS TECHNOLOGY IS CURRENTLY IN THE DEVELOPMENT STAGE AND IS SLATED TO BE COMPLETED BY MID-2017. THERE ARE NO SMOKING CESSATION CLASSES IN DELAWARE COUNTY AT THIS TIME. DVH WILL ADVERTISE TOBACCO CESSATION PROGRAMMING TO AREA RESIDENTS IN COLLABORATION WITH OTHER HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND HEALTH CARE PROVIDERS. CLASSES WILL BEGIN TO BE OFFERED IN FALL OF 2017. THE CLASS WILL BE OFFERED AT LEAST ONCE PER YEAR. MEASURE: THROUGH THIS PARTNERSHIP, WHICH INCLUDES NOT ONLY THE DELAWARE COUNTY-BASED PROVIDERS BUT ALSO THE LARGER UHS HOSPITAL SYSTEM, THE NUMBER OF PARTICIPANTS PARTICIPATING IN AND COMPLETING TOBACCO CESSATION CLASSES WILL BE MEASURED.FOCUS AREA: INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS GOAL: PROMOTE CULTURALLY RELEVANT CHRONIC DISEASE SELF-MANAGEMENT EDUCATION.OBJECTIVE: PATIENTS AND CAREGIVERS WILL LEARN DISEASE-MANAGEMENT STRATEGIES. STRATEGY 1. PROMOTE THE USE OF EVIDENCE-BASED INTERVENTIONS TO PREVENT OR MANAGE CHRONIC DISEASES THROUGH PATIENT MEETINGS WITH DVH'S RN PATIENT CARE COORDINATOR AND/OR CERTIFIED DIETICIAN/NUTRITIONIST. MEASURE: NUMBER OF CHRONIC DISEASE PATIENT VISITS WITH DVH PATIENT CARE COORDINATOR AND/OR DIETICIAN/NUTRITIONIST FOR EDUCATION AND/OR HELP IN ELIMINATING BARRIERS TO CARE. STRATEGY 2: DVH AND O'CONNOR HOSPITAL WILL UTILIZE RESOURCES AT THEIR DISPOSAL THROUGH THEIR RESPECTIVE HOSPITAL SYSTEMS TO IMPLEMENT THE STANFORD UNIVERSITY'S EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP). BETWEEN DVH AND O'CONNOR, THERE ARE CURRENTLY FOUR TRAINED PEER LEADERS FOR CDSMP. THE APPROACH TO THIS GOAL WILL BE TO CO-LEAD PROGRAMS WITHIN THE SERVICE AREAS OF EITHER ENTITY, AND TO UTILIZE THE RESOURCES OF THE CARE COMPASS NETWORK PPS (WHICH ALSO HAS AN ADDITIONAL TRAINED PEER LEADER), AS NEEDED. EACH ENTITY WILL PROMOTE THE USE OF THIS EVIDENCE-BASED STRATEGY TO PREVENT OR MANAGE CHRONIC DISEASES, AND THE PROGRAM WILL BE OFFERED TWICE EACH YEAR. THIS WILL BEGIN IN THE SPRING OF 2017. MEASURE: THE NUMBER OF CDSMP PROGRAMS OFFERED AND THE NUMBER OF INDIVIDUALS PARTICIPATING IN AND COMPLETING THE PROGRAM. STRATEGY 3: ONCE EACH OF THE HOSPITALS' PEER LEADERS HOLDS TWO PUBLIC CDSMP PROGRAMS, THEY WILL EARN THEIR MASTER TRAINING CERTIFICATION AND WILL BE ABLE TO TRAIN OTHERS TO BECOME PEER LEADERS, WHICH WOULD INCREASE THE AVAILABILITY OF THIS PROGRAMMING, THROUGHOUT THE SERVICE AREA, AS WELL AS THE CARE COMPASS NETWORK AREA. DVH WILL HOLD AT LEAST ONE CDSMP PEER LEADER TRAINING PER YEAR. MEASURE: NUMBER OF PROGRAMS AND NUMBER OF PEER LEADERS SUCCESSFULLY TRAINED. STRATEGY 4: IN ADDITION, DVH AND O'CONNOR PLAN TO HAVE UP TO FOUR PEOPLE TRAINED IN THE STANFORD UNIVERSITY DIABETES SELF-MANAGEMENT PROGRAM (DSMP). DVH INTENDS TO PAY FOR THE TRAINING FROM A VAP GRANT IT HAD SECURED. ONCE COMPLETED, AREA RESIDENTS WILL HAVE THE OPPORTUNITY TO TAKE PART IN THE DSMP. MEASURE: NUMBER OF PEER TRAINERS IN DSMP.STRATEGY 5: DVH WILL OFFER THE DSMP PROGRAM TO AREA RESIDENTS AT LEAST ONCE PER YEAR, BEGINNING IN THE SPRING OF 2018. MEASURE: NUMBER OF CLASSES OFFERED AND NUMBER OF PARTICIPANTS BEGINNING AND SUCCESSFULLY COMPLETING THE PROGRAM.STRATEGY 6: RESIDENTS WILL BE OFFERED OPPORTUNITY TO PARTICIPATE IN THE EVIDENCE-BASED LIFESTEPS PROGRAM. THIS PROGRAM WILL BE OFFERED TWICE EACH YEAR INTEREST PERMITTING. MEASURE: THE NUMBER OF PARTICIPANTS BEGINNING AND COMPLETING THE COURSE AND THE TOTAL WEIGHT LOSS FOR THE GROUP WILL BE REPORTED.2016 PROGRESS UPDATE: DVH CONTINUED TO OFFER THE LIFESTEPS PROGRAM. IN ADDITION, THE HOSPITAL SPONSORED A WEEK-LONG MASTER TRAINER TRAINING PROGRAM FROM THE STANFORD UNIVERSITY'S CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. NINE PEOPLE ATTENDED AND COMPLETED THE PROGRAM. DVH HAD THREE OF THOSE GRADUATES; ANOTHER WAS FROM O'CONNOR HOSPITAL; TWO CAME FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY AND TWO FROM CARE COMPASS NETWORK. ONE OTHER CAME FROM OUT OF THE AREA. DVH ALSO HIRED A REGISTERED NURSE WHO PERFORMS CARE COORDINATION FOR PATIENTS NEEDING EXTRA GUIDANCE OR ASSISTANCE IN HELPING TO MANAGE THEIR CHRONIC CONDITIONS. MUCH OF HER FOCUS HAS BEEN GIVEN TO DIABETIC PATIENTS WHOSE HGA1C LEVELS FALL ABOVE 7 AND HAVE NOT SEEN A PHYSICIAN RECENTLY, OR WHO WOULD BENEFIT FROM A DIETARY CONSULTATION.PREVENTION STRATEGY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOCUS AREA: INJURIES, VIOLENCE, AND OCCUPATIONAL HEALTH GOAL: REDUCE RISK OF FALLS, PARTICULARLY AMONG THE ELDERLY. OBJECTIVE: EVIDENCE BASED FALL PREVENTION PROGRAMMING WILL BE AVAILABLE TO AREA RESIDENTS.STRATEGY 1. PROMOTE COMMUNITY-BASED PROGRAMS FOR FALLS PREVENTION UTILIZING THE EVIDENCE-BASED MATTER OF BALANCE PROGRAM. DVH WILL PROVIDE OPPORTUNITIES THROUGHOUT THE COMMUNITY, IN PARTNERSHIP WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND THE DELAWARE COUNTY OFFICE FOR THE AGING (OFA), TO PARTICIPATE IN AN EVIDENCE-BASED FALLS PREVENTION PROGRAM: MATTER OF BALANCE. DVH HAS ONE CERTIFIED MATTER OF BALANCE LEADER. IT WILL WORK WITH BOTH OFA AND THE COUNTY HEALTH DEPARTMENT TO PARTNER AND OFFER ONE PROGRAM EACH YEAR AT ITS WELLNESS CENTER. ONE OF ITS PHYSICAL REHABILITATION STAFF MEMBERS WILL CONDUCT THE SESSION FOCUSING ON PHYSICAL AIDS AND HOW TO GET UP AFTER A FALL. OFA WILL ASSIST WITH IDENTIFYING AND RECRUITING THE TARGET POPULATION, SENIOR CITIZENS, AND ALSO HOLDS THE MASTER TRAINER LICENSE. WITH THIS LICENSE, OFA HAS THE OPPORTUNITY TO TRAIN NEW FACILITATORS FOR THE MATTER OF BALANCE CLASS. DVH WILL ALSO OFFER ITS SITE FOR USE FOR ADDITIONAL PROGRAMS. MEASURE: THE NUMBER OF PARTICIPANTS, NUMBER OF GRADUATES AND NUMBER OF PROGRAMS WILL BE REPORTED. STRATEGY 2: SUSTAIN SPONSORSHIP OF DEL CO OFFICE FOR AGING'S TAI CHI CLASSES.DVH WILL CONTINUE TO SPONSOR TAI CHI CLASSES FOR DELAWARE COUNTY'S OFFICE FOR THE AGING (OFA). ALTHOUGH DVH DOES NOT HAVE THE PHYSICAL OR HUMAN RESOURCES TO INDEPENDENTLY OFFER THIS PROGRAM, IT DOES WANT TO SEE THE PROGRAM AVAILABLE TO AREA RESIDENTS SO DVH WILL SPONSOR THE CLASSES BY PAYING FOR THE USE OF THE VENUES SELECTED BY OFA. THE HOSPITAL WILL SPONSOR UP TO 4 PROGRAMS EACH YEAR, CONDUCTED IN ITS SERVICE AREA. OFA WILL CONTINUE THEIR ROLE IN RECRUITING BOTH TRAINERS AND PARTICIPANTS. MEASURE: THE IMPACT FOR THIS ACTIVITY WILL BE SHOWN THROUGH THE NUMBER OF PROGRAMS SPONSORED. 2016 PROGRESS UPDATE: DVH WAS UNABLE TO OFFER THE MATTER OF BALANCE PROGRAM IN 2015 BECAUSE THE SECOND TRAINED FACILITATOR NO LONGER WORKS AT DVH. HOWEVER, DVH HAS SPOKEN WITH DELAWARE COUNTY PUBLIC HEALTH AND THE OFFICE FOR THE AGING AND HAVE IDENTIFIED POTENTIAL PARTNERS FOR FUTURE PROGRAMMING. THE HOSPITAL ALSO WORKED WITH OFFICE FOR THE AGING SO THEY COULD HOLD TAI CHI PROGRAMS IN THE WALTON AREA. WE SPONSORED THE PROGRAMMING BY PAYING FOR THE VENUE. THEY HELD 3 PROGRAMS SO FAR IN 2016. BECAUSE WE DON'T HAVE THE PHYSICAL SPACE OR THE STAFF TO COMMIT TO FACILITATING A TAI CHI PROGRAM, WE FELT THIS WAS THE BEST WAY TO HELP ENSURE IT WOULD BE AVAILABLE TO AREA RESIDENTS.PREVENTION STRATEGY: PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE FOCUS AREA: PREVENT SUBSTANCE ABUSE AND OTHER MENTAL EMOTIONAL AND BEHAVIORAL DISORDERSGOAL: PREVENT SUICIDES AMONG YOUTH AND ADULTS OBJECTIVE: BY SHARING INFORMATION, PATTERNS AND TRENDS, IF ANY, CAN BE IDENTIFIED AND ADDRESSED. STRATEGY 1: SHARE DATA ON SUICIDE, SUICIDE ATTEMPTS, AND PREVENTION EFFORTS. DVH WILL WORK CLOSELY WITH THE DELAWARE COUNTY SUICIDE PREVENTION NETWORK, MADE UP OF SEVERAL HEALTH AND HUMAN SERVICES PROVIDERS ACROSS DELAWARE COUNTY, TO AGGREGATE DATA ON COMPLETED SUICIDES, SUICIDE ATTEMPTS, AND SUICIDAL IDEATION. THE OBJECTIVE OF SHARING AND AGGREGATING DATA IN PARTNERSHIP WITH THE DELAWARE COUNTY SUICIDE PREVENTION NETWORK WILL BE TO IDENTIFY AND ADDRESS PATTERNS AND TRENDS. THE COLLECTIVE IMPACT ON THE COMMUNITY AND THE IDENTIFIED HEALTH DISPARATE POPULATION WILL BE TO UTILIZE THE INFORMATION TO DEVELOP MITIGATION STRATEGIES, PREVENTING FUTURE SUICIDES AMONG YOUTH AND ADULTS. MEASURE: DVH WILL SHARE THIS DATA ON A MONTHLY BASIS. STRATEGY 2: IN ADDITION, DVH WILL OFFER A VENUE, AS NEEDED, FOR THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT TO COORDINATE AND SCHEDULE GATEKEEPER TRAININGS, EVIDENCE-BASED SUICIDE PREVENTION PROGRAMS SUCH AS ASSIST, SAFE TALK, AND QPR (QUESTION, PERSUADE, REFER). (CONTINUED)
DELAWARE VALLEY HOSPTITALPART 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: 2016-2018 ACTION PLAN (CONTINUED)THESE TRAININGS WILL SERVE AS AN AVENUE FOR COMMUNITY MEMBERS AND PROVIDERS ALIKE TO INCREASE TOOLS DESIGNED TO PREVENT SUICIDES. THEY DEVELOP INDIVIDUALS' KNOWLEDGE, ATTITUDES, AND SKILLS TO IDENTIFY THOSE AT RISK, AND MAKE REFERRALS WHEN NECESSARY. MEASURE: GATEKEEPER TRAININGS WILL BE MEASURED BY THE NUMBER OF TRAININGS HELD AT THE DVH VENUE.GOAL: PREVENT SUBSTANCE ABUSE STRATEGY 1: BRING STANFORD UNIVERSITY'S EVIDENCE-BASED CHRONIC PAIN SELF-MANAGEMENT PROGRAM (CPSMP) TO DELAWARE COUNTY RESIDENTS. DVH WILL SUPPORT AND FACILITATE THE TRAINING OF UP TO TWO PEER LEADERS TO PARTICIPATE IN THE EVIDENCE-BASED STANFORD UNIVERSITY PAIN SELF-MANAGEMENT COURSE IN THE SUMMER OF 2017. THIS HAS BEEN AN ONGOING OBJECTIVE, AS DVH ALREADY HAS THREE PEER LEADERS TRAINED IN CDSMP, WHICH IS A PRE-REQUISITE FOR THE ONLINE PAIN-MANAGEMENT TRAINING PROGRAM. MEASURE: NUMBER OF PEER LEADERS SUCCESSFULLY COMPLETING TRAINING STRATEGY 2: ONCE THOSE PEER LEADERS ARE TRAINED, DVH WILL OFFER THE CHRONIC PAIN SELF-MANAGEMENT COURSE, BEGINNING IN FALL OF 2017, AND INTENDS TO OFFER AT LEAST 1 CLASS PER YEAR. MEASURE: NUMBER OF CLASSES HELD AND NUMBER OF PARTICIPANTS BEGINNING AND SUCCESSFULLY COMPLETING CLASSFOCUS AREA 3: STRENGTHEN INFRASTRUCTURE GOAL: STRENGTHEN THE MENTAL HEALTH INFRASTRUCTURE OBJECTIVE: INCREASE AVAILABILITY OF MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH SERVICES THROUGH THE USE OF TELEMEDICINE TECHNOLOGY. STRATEGY 1: TELEMEDICINE TECHNOLOGY IS BEING DEVELOPED AT DVH AND WILL BE USED TO PROVIDE MEB SERVICES UTILIZING OUT-OF-AREA PROVIDERS TO STRENGTHEN INFRASTRUCTURE. DELAWARE VALLEY HOSPITAL IS WORKING CLOSELY WITH THE LARGER UHS SYSTEM TO FINALIZE PLANS FOR TELEMEDICINE TECHNOLOGY SO THAT PATIENTS HAVE INCREASED ACCESS TO MENTAL HEALTH PROFESSIONALS BY SPRING 2017. WHILE DVH DEVELOPS SYSTEMS FOR REFERRALS AND PARTNERSHIPS WITH MENTAL HEALTH PROVIDERS, UHS WILL DELIVER THE REQUIRED IT INFRASTRUCTURE. MEASURE: DVH WILL MEASURE THE NUMBER OF TIMES PER MONTH THE SERVICES ARE AVAILABLE TO PATIENTS, THE NUMBER OF VISITS COMPLETED THROUGH TELEMEDICINE EACH MONTH, AND THE NUMBER OF UNIQUE PATIENTS UTILIZING THE SERVICE. STRATEGY 2: DVH SEEKS TO STRENGTHEN THE INFRASTRUCTURE NOT ONLY WITHIN THE HOSPITAL, BUT ALSO IN THE COMMUNITY BY WORKING WITH THE DELAWARE COUNTY OFFICE OF MENTAL HEALTH (DCMH) ON THIS OBJECTIVE. DISCUSSIONS HAVE BEEN ONGOING THROUGH PARTNERSHIPS DEVELOPED, IN PART, BY THE CARE COMPASS NETWORK PPS TO INTEGRATE PRIMARY CARE AND MENTAL, EMOTIONAL, BEHAVIORAL (MEB) HEALTH SERVICES. DVH, WHICH PROVIDES A HIGH LEVEL OF EXPERTISE AND SERVICE THROUGH THEIR PRIMARY CARE PRACTICES, AND DCMH, WHICH BRINGS THE EXPERTISE OF MEB PROVIDERS, WILL CONTINUE CONVERSATIONS REGARDING THE INTEGRATION OF PRIMARY CARE AND MEB SERVICES. WHILE THESE ARE DIFFICULT SYSTEMS TO INTEGRATE DUE TO REGULATORY ISSUES THAT NEED TO BE WORKED OUT, THE FACILITIES REMAIN COMMITTED TO STRATEGIZING WAYS TO SHARE THE RESOURCES NECESSARY TO PROVIDE MORE HOLISTIC SERVICES TO PATIENTS. MEASURE: SUCCESS FOR THIS ACTIVITY WILL BE MEASURED BY THE NUMBER OF MEETINGS.2016 PROGRESS UPDATE: DVH HAS CONTINUED ITS WORK TOWARD BRINGING MENTAL HEALTH SERVICES TO AREA RESIDENTS THROUGH A TELEMEDICINE PROGRAM. POLICIES AND PROCEDURES, CONTRACTS AND FORMS HAVE BEEN APPROVED, CREDENTIALING AND BILLING ASPECTS HAVE BEEN RESEARCHED AND ARE UNDERSTOOD, A DESIGNATED ROOM HAS BEEN CREATED IN THE WALTON PRIMARY CARE CENTER AND AN EXAM ROOM IN THE ROSCOE PRIMARY CARE CENTER HAS BEEN DESIGNATED FOR THE SERVICE. WORKING WITH ITS PARTNER, BINGHAMTON UNIVERSITY, THE HOSPITAL HAS RECEIVED 3 TELEMEDICINE CARTS. DVH AND UHS HAVE FORMED A TEAM THAT IS WORKING OUT THE LOGISTICS OF THE IT COMPONENT SO THAT BY THE FIRST QUARTER OF 2017, THIS SHOULD BE IN PLACE. DVH IS SIMULTANEOUSLY WORKING WITH UHS TO ENSURE UHS STAY HEALTHY CENTER PROGRAMMING CAN BE BROUGHT TO DVH THROUGH TELECONFERENCING. THIS TOO SHOULD BE IN PLACE BY THE FIRST QUARTER. A DVH STAFF MEMBER SITS ON THE COUNTY'S MENTAL HEALTH COMMITTEE AND HAS REGULAR CONVERSATIONS WITH THE MENTAL HEALTH DIRECTOR REGARDING INTEGRATING PRIMARY CARE AND MENTAL HEALTH. IN 2015, ONE OF DVH'S PRIMARY CARE PHYSICIANS AGREED TO SEE MENTAL HEALTH OFFICE CLIENTS WHO HAD NO PRIMARY CARE PHYSICIAN AND WERE CLINICALLY STABLE IN TERMS OF THEIR MENTAL HEALTH. BY DOING THIS, SOME APPOINTMENTS ARE NOW AVAILABLE FOR NEW CLIENTS OR UNSTABLE CLIENTS AT THE MENTAL HEALTH CLINIC. DVH ALSO TOOK PART IN COMMUNITY SEMINAR REGARDING SUICIDE, MENTAL HEALTH AND WARNING SIGNS THAT WAS HELD AT THE WALTON CENTRAL SCHOOL AUDITORIUM IN MARCH.RATIONALE FOR FOREGOING SOME PRIORITY AREAS PREVENT CHRONIC DISEASE- FOCUS AREA: REDUCE OBESITY IN CHILDREN AND ADULTS DVH'S CERTIFIED DIETITIAN/NUTRITIONIST CONTINUES TO OFFER THE LIFESTEPS PROGRAM. IN PRIOR YEARS, DVH HAD REACHED OUT TO SCHOOLS TO PARTICIPATE IN AFTER SCHOOL PROGRAMMING, BUT IT NEVER CAME TO FRUITION. THE HOSPITAL HAD ALSO OFFERED COOKING CLASSES AND WHILE THEY WERE VERY WELL RECEIVED, THEY ONLY REACHED A VERY LIMITED NUMBER OF PEOPLE. THEREFORE, DVH HAS DECIDED TO SHIFT ITS FOCUS TO EVIDENCE BASED CHRONIC DISEASE MANAGEMENT PROGRAMMING AS IT CONTAINS NUTRITION AND EXERCISE INFORMATION IN THE CURRICULUM AND WOULD PROVIDE PARTICIPANTS WITH A BETTER UNDERSTANDING OF THEIR DISEASE OVERALL. PROMOTE A HEALTHY AND SAFE ENVIRONMENT AIR AND WATER QUALITY ARE NOT A SERIOUS ISSUE IN OUR AREA. BUILT ENVIRONMENT THE HOSPITAL DID HELP SECURE BOTH THE WALTON VILLAGE BOARD AND THE TOWN OF COLCHESTER'S BOARD AGREEMENT TO ADOPT COMPLETE STREETS POLICIES. AND IT CONTINUES TO PROMOTE THE PRESCRIPTION TRAILS PROGRAM. PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN DVH DOES NOT OFFER OB/GYN CARE OR DELIVERY CARE. AS A MATTER OF FACT, NO HOSPITALS OFFER THESE SERVICES IN DELAWARE COUNTY. WOMEN ARE TRAVELING OUTSIDE OF THE COUNTY TO SEEK THIS CARE. IT IS FELT THAT THEIR PROVIDERS WILL ENCOURAGE BREAST FEEDING, AS DOES DELAWARE COUNTY PUBLIC HEALTH AND THE WIC OFFICE IN DELAWARE COUNTY IS VERY SUPPORTIVE. PREVENT HIV, STDS, VACCINE PREVENTABLE DISEASES AND HEALTH CARE ASSOCIATED INFECTIONS DVH DOES PROMOTE VACCINATION OF CHILDREN THROUGH ITS PRIMARY CARE PRACTICES AND FLU SHOTS FOR ALL RESIDENTS. DVH'S INFECTION CONTROL NURSE CONTINUALLY PROVIDES INFORMATION REGARDING PPE, HAND WASHING, AND IMMUNIZATIONS. THIS IS DONE AS A PART OF DVH'S NORMAL BUSINESS AND IS NOT CONSIDERED TO BE A SPECIAL INITIATIVE. THE HOSPITAL DID PROVIDE HAND WASHING EDUCATION AT THE COUNTY FAIR FOR THE PAST TWO YEARS. A HAND WASH STATION WAS SET UP, PARTICIPANTS WASHED THEIR HANDS, THEN APPLIED A SPECIAL GEL AND LOOKED AT THEIR HANDS UNDER A BLACK LIGHT TO SEE WHERE THEY MAY HAVE MISSED.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - WALTON FAMILY HEALTH CENTER
2 TITUS PLACEWALTONNY13856OUTPATIENT PHYSICIAN CLINIC
2 - DOWNSVILLE FAMILY HEALTH CENTER
28315 STATE HWY 206DOWNSVILLENY13755OUTPATIENT PHYSICIAN CLINIC
3 - ROSCOE FAMILY HEALTH CENTER
1982 OLD ROUTE 17ROSCOENY12776OUTPATIENT PHYSICIAN CLINIC
4 - PHYSICAL AND OCCUPATIONAL THERAPY
123 STOCKTON AVENUEWALTONNY13856REHABILITATION CLINIC
5 - SPECIALTY CLINIC
121 STOCKTON AVENUEWALTONNY13856OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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. A. COSTS:I. FYE COSTS AS INDEPENDENTLY AUDITED. NON-ALLOWABLE COSTS (I.E.-PHYSICIANS, ETC.) ARE USED TO REDUCE COSTS TO ARRIVE AT ALLOWABLE COSTS.II. VARIOUS STATISTICAL BASIS ARE USED TO ALLOCATE GENERAL SERVICE COSTS (I.E.-ADMINISTRATION, PLANT OPERATIONS, HOUSEKEEPING, ETC.), VIA A "STEPDOWN" METHODOLOGY TO REVENUE PRODUCING COST CENTERS SUCH AS ANCILLARY COST CENTERS (I.E. - RADIOLOGY, LAB, PHYSICAL THERAPY, ETC.) ROUTINE COST CENTERS (MEDICAL SURGICAL, ETC.) AND OUTPATIENT COST CENTERS (EMERGENCY, CLINIC, ETC.). III. ROUTINE COSTS PER DAY ARE THEN CALCULATED BY DIVIDING DIRECT AND INDIRECT COSTS (STEPDOWN) BY TOTAL DAYS. THIS PER DAY COST CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC DAYS TO ARRIVE AT ROUTINE PAYOR COSTS.IV. ANCILLARY AND OUTPATIENT COSTS RELATED TO SPECIFIC PAYORS CAN BE DETERMINED BASED ON THE RATIO OF COST TO CHARGES (RCC).1. THE RCC IS CALCULATED BY DIVIDING THE DIRECT AND INDIRECT COSTS (STEPDOWN COSTS)BY GROSS CHARGES. THE RCC CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC GROSS CHARGES TO ARRIVE AT PAYOR SPECIFIC COSTS. B. REVENUE: I. MEDICARE: NET REVENUE IS BASED ON DVH'S ALLOWABLE COSTS (INPATIENT AND OUTPATIENT) AND ARE REIMBURSED WITH A 1% MARKUP. II. MEDICAID: NET REVENUE IS BASED ON THE FOLLOWING:A. INPATIENT - A BASE YEAR COST PER DAY TRENDED ANNUALLY FOR INFLATION.B. OUTPATIENT - MEDICAID PUBLISHED RATES.III. OTHER PAYORS: REVENUE IS BASED ON NEGOTIATED RATES OF PAYMENT.
PART I, LN 7 COL(F):DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $619,554 IN PART IX, LINE 24A. THE AFOREMENTIONED BAD DEBT EXPENSE WAS USED IN THE CALCULATIONS OF SCHEDULE H, PART 1, 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 HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY. STAFF MEMBERS ALSO SERVE ON THE COMMUNITY AND WELLNESS COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER) AND THE NY CONNECTS COMMITTEE. CONTINUING ON OUR PREVIOUS EFFORTS, BOTH THE VILLAGE OF WALTON AND TOWN OF COLCHESTER HAVE ADOPTED COMPLETE STREETS POLICIES.WEEKLY NARCOTICS ANONYMOUS MEETINGS ARE HELD AT THE HOSPITAL AND HOSPITAL STAFF PERFORMS DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG TREATMENT COURT FREE OF CHARGE. THE DELAWARE COUNTY DRUG TREATEMENT 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 MEMEBERS OF THE COMMUNITY. SEMINARS ON SUBOXONE WERE ALSO HELD.THE WALTON PRIDE COMMITTEE HAS BEEN WORKING TO REVITALIZE THE COMMUNITY AFTER ITS DEVASTATING FLOOD IN 2006. IN 2016, THE HOSPITAL MADE ANOTHER DONATION TO HELP THEM BRIGHTEN AND CLEAN A CORNER OF ITS MAIN STREET. IT ALSO SUPPORTED THE COMMUNITY HOLIDAY DINNER, THE TOWN'S LITTLE LEAGUE ORGANIZATION, THE LOCAL TOY BANK DRIVE, AND PROVIDES A VENUE FOR A LOCAL FARMER'S MARKET HELD TWICE A MONTH FROM JULY THROUGH OCTOBER. IN AN EFFORT TO ASSIST THE LOCAL COOPERATIVE EXTENSION WITH THE PROMOTION OF HEALTHY EATING AND EATING FRESH, LOCAL FARM PRODUCTS, THE HOSPITAL AGREED TO CONTINUE TO HOST A FARMER'S MARKET ON EIGHT WEDNESDAYS FROM JULY THROUGH OCTOBER. THE PRESIDENT/CEO OF DELAWARE VALLEY IS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB.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 WAS A LEADING SPONSOR OF THE EVENT AND STAFF SERVED ON THE PLANNING COMMITTEE. THIS PARTICIPATION CONTINUED IN 2016.HOWEVER, THE SINGLE LARGEST COMMUNITY BUILDING ACTIVITY DVH ACCOMPLISHED WAS THE CREATION OF OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE IS IN WHITNEY POINT, NY, OVER AN HOUR AWAY FROM DELAWARE COUNTY, ONE OF THEIR TARGET AREAS. BY PROVIDING THEM WITH FREE OFFICE SPACE, THEY WILL HAVE A HOME BASE MORE CENTRALLY LOCATED TO THOSE THEY ARE TRYING TO SERVE. THE ORGANIZATION OFFERS MANY NAVIGATION-TYPE PROGRAMS, MOST ESPECIALLY ACCESS TO TRANSPORTATION SERVICES. THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR NOW ALSO SERVES ON THE ORGANIZATION'S BOARD OF DIRECTORS.
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 2016 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2016 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2016, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 45% 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 K, PAGE 10 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 COSTING METHODOLOGY UTILIZING AMOUNTS FROM OUR 2016 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.UHSH REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. UHSH 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. UHSH ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENDING LEGAL ACTION.
PART VI, LINE 2:RECRUITMENT OF HEALTHCARE PROFESSIONALS IS ALWAYS A CHALLENGE, ESPECIALLY IN OUR RURAL AREA. DELAWARE VALLEY HOSPITAL (DVH) AND ITS 3 PRIMARY CARE CENTERS MAINTAIN THEIR STANDING AS APPROVED SITES FOR PROFESSIONALS SEEKING ASSISTANCE THROUGH THE NATIONAL HEALTH SERVICE CORPS. THE HOSPITAL ALSO HOSTS BOTH RN AND CNA STUDENTS, FROM OUR LOCAL COLLEGE, (SUNY DELHI) AND BOARD OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). A VERY SUCCESSFUL MASH CAMP IS HELD DURING THE YEAR TO PROVIDE AN OPPORTUNITY FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT HEALTHCARE CAREERS AND ENCOURAGE THEM TO PRACTICE IN OUR RURAL COMMUNITY. IN 2016, 18 STUDENTS ATTENDED OVER A TWO DAY PERIOD AND ONE STUDENT SHADOWED OUR PHYSICAL THERAPIST FOR A DAY. DURING 2016, THE HOSPITAL CONTINUED TO WORK HAND IN HAND WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND A MULTITUDE OF COMMUNITY ORGANIZATIONS AND HEALTHCARE PROVIDERS TO ADDRESS NEEDS IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT. SEVERAL MEETINGS WERE HELD THROUGHOUT 2016, IN ORDER TO PREPARE A COHESIVE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY SERVICE PLANS FOR EACH HOSPITAL LOCATED IN DELAWARE COUNTY. MENTAL HEALTH AND SUBSTANCE ABUSE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2016, MEETINGS CONTINUED WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. THE DIRECTOR OF COMMUNITY RELATIONS SITS ON THE MENTAL HEALTH COMMITTEE OF DELAWARE COUNTY. DVH PROVIDED A VENUE, IT SUPPORT AND REFRESHMENTS FOR A FULL-DAY TRAINING FOR DELAWARE COUNTY COMMUNITY SERVICES STAFF. THE MOST CHALLENGING BARRIER IN ACCESSING CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. DELAWARE VALLEY HIRED A TELEMEDICINE CONSULTANT AND THROUGH HIS ASSISTANCE, AND THE FORMATION OF AN INTER-DISCIPLINARY TEAM, THE HOSPITAL NOW HAS ITS POLICIES AND PROCEDURES IN PLACE, IDENTIFIED LOCATIONS FOR EQUIPMENT, ASSESSED VARIOUS VENDORS TO PROVIDE SERVICES AND RECEIVED TELEHEALTH EQUIPMENT, ON LOAN, FROM BINGHAMTON UNIVERSITY THROUGH ONE OF THEIR FUNDING PROGRAMS. THE HOSPITAL WORKED TO IDENTIFY A PRIVATE PRACTICE PSYCHIATRIST, WHO IS WILLING TO PROVIDE TELEPSYCH SERVICES TO SOME DVH PATIENTS. THIS SERVICE WILL START IN EARLY 2017.A SECOND NEED IS FOR CHRONIC DISEASE MANAGEMENT AND PREVENTION. THE HOSPITAL SPONSORED A STANFORD UNIVERSITY BASED, CHRONIC DISEASE SELF-MANAGEMENT MASTER TRAINER FOR ONE WEEK IN 2016. THREE DVH STAFF MEMBERS COMPLETED THE TRAINING WHILE SEVERAL OTHERS REPRESENTED ORGANIZATIONS IN DELAWARE COUNTY, OR IN THE REGION COVERED BY THE CARE COMPASS NETWORK PPS. DURING 2017, SEVERAL PROGRAMS WILL BE HELD FOR THE PUBLIC, AS WELL AS PEER LEADER TRAINING.THE HOSPITAL ALSO ACTIVELY PARTICIPATES IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR IS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS.
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.
PART VI, LINE 4:DELAWARE VALLEY HOSPITAL'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY, WITH 79% OF THE PATIENTS COMING FROM THE WESTERN HALF OF DELAWARE COUNTY, AND ANOTHER 15% FROM NORTHERN SULLIVAN, BROOME, OTSEGO, AND CHENANGO COUNTIES. 85% OF DVH'S ZIP CODE SERVICE AREA INCLUDES THE COMMUNITIES OF WALTON, DOWNSVILLE, ONEONTA, ROSCOE, HANCOCK, DELHI, EAST BRANCH, SIDNEY, SIDNEY CENTER, BINGHAMTON, UNADILLA, LONG EDDY, AND HAMDEN. DELAWARE COUNTY IS LOCATED ON THE WESTERN EDGE OF THE CATSKILL MOUNTAINS IN RURAL, UPSTATE NEW YORK. ENCOMPASSING 1446.37 SQUARE MILES, ITS 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 A COUPLE OF PRIVATE TRANSPORTATION SERVICES HAVE BEGUN, THEY ARE 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. 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.THE MEDIAN AGE IN DELAWARE COUNTY IS 45.4 YEARS, WHILE 35% ARE AGE 55 AND OVER, AND 20% OF THOSE ARE 65 YEARS AND OVER. 95.6% OF THE POPULATIONS ARE CAUCASIAN, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN FAMILY INCOME IS $ 44,470 AND APPROXIMATELY 14% OF THE POPULATION LIVES IN POVERTY. ACCORDING TO THE 2009-2011 AMERICAN COMMUNITY SURVEY BY THE U.S. CENSUS BUREAU THE PERCENTAGE OF RELATED CHILDREN LIVING BELOW THE POVERTY LEVEL WITH A FEMALE HEAD OF HOUSEHOLD, WITH NO HUSBAND PRESENT HAS RISEN TO 66.7% FOR CHILDREN UNDER 5 YEARS OF AGE IN DELAWARE COUNTY. THIS IS WELL ABOVE THE NEW YORK AND UNITED STATES COMPARISONS OF 42.8% AND 47% RESPECTIVELY.
PART VI, LINE 5:DELAWARE VALLEY HOSPITAL, A CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH ITS ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE IT SERVES. ITS INPATIENT SERVICES INCLUDE ACUTE CARE FOR THOSE PATIENTS REQUIRING 96 HOURS OR LESS OF HOSPITALIZATION; LONGER TERM REHABILITATIVE CARE FOR THOSE NEEDING TIME TO GAIN STRENGTH OR 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, AS WELL AS HOME SLEEP STUDY EQUIPMENT. IN THE IMAGING CENTER X-RAY, FLUOROSCOPY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE TWICE WEEKLY. ITS OUTPATIENT REHABILITATION DEPARTMENT OFFERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AND A CARDIOPULMONARY REHABILITATION PROGRAM IS ALSO IN PLACE. THROUGH ITS 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. OCCUPATIONAL HEALTH SERVICES INCLUDE PRE-EMPLOYMENT AND DOT PHYSICALS, IMMUNIZATIONS, DRUG TESTING AND ANNUAL PHYSICALS FOR FIRE DEPARTMENT MEMBERS. VISITING SPECIALISTS INCLUDE A GENERAL SURGEON, CARDIOLOGIST AND PODIATRIST.DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST HELD TWO LIFESTEPS SERIES OF WORKSHOPS WHICH FOCUSED ON PARTICIPANTS' LIFESTYLES AS RELATED TO DIET AND EXERCISE. THE HOSPITAL CONTINUED ITS ANNUAL PRESENCE AT THE WEEK-LONG DELAWARE COUNTY FAIR. DURING THE WEEK, THE HOSPITAL STAFF PROVIDED LOTS OF HEALTH AND NUTRITION INFORMATION TO FAIRGOERS, PERFORMING AT LEAST 402 BLOOD PRESSURE CHECKS, 117 PULSE OX (HEART RATE AND OXYGEN LEVEL TESTS), AND 13 BALANCE SCREENINGS. IN ADDITION, PROPER HAND WASHING WAS A FEATURE OF THE HOSPITAL'S BOOTH. 33 EMPLOYEES SPENT A TOTAL OF 191 HOURS AT THE 6-DAY LONG EVENT.DVH CONTINUED TO SPONSOR TAI CHI CLASSES DURING 2016 BY PAYING FOR A VENUE FOR THE CLASSES TO BE HELD; TWO SERIES OF CLASSES WERE ABLE TO BE HELD THROUGH THIS SUPPORT.THE HOSPITAL OPENED ITS RETAIL COMMUNITY PHARMACY IN OCTOBER, 2015. THE HOSPITAL OFFERS A FREE MAIL SERVICE FOR THOSE WHO ARE UNABLE TO COME TO THE PHARMACY TO PICK UP THEIR PRESCRIPTIONS. THE PHARMACY CONTINUES TO DELIVER PRESCRIPTIONS TO ITS OUTLYING PRIMARY CARE CENTERS FOR PATIENTS WHO CANNOT GET TO WALTON TO PICK UP THEIR MEDICATION AND NEED IT MORE QUICKLY THAN MAIL WOULD ALLOW. STAFF PARTICIPATED IN THE AMERICAN HEART ASSOCIATION'S GO RED FOR WOMEN EVENT AND HEART WALK, COMMUNITY FIT DAYS IN DELHI, AND THE DELAWARE COUNTY SENIOR PICNIC WHERE MEDICATION SAFETY WAS A HIGHLIGHT.
PART VI, LINE 6:DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT PART OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UHS 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 WOULD RELATE TO THE HOSPITAL'S SERVICES AND THE NEEDS OF IT PATIENTS. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE DVH COMMUNITY SERVICE REPORT IS INCLUDED WITH THE DELAWARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, AND THE COMMUNITY SERVICE PLANS OF O'CONNOR HOSPITAL, TRI-TOWN REGIONAL HOSPITAL AND MARGARETVILLE HOSPITAL, IN ONE DOCUMENT.CLINICAL EXCELLENCE: UHS IS FOCUSED ON BUILDING UPON PREVIOUS EFFORTS THAT ESTABLISHED A CONSISTENT SYSTEM-WIDE FOCUS FOR EVALUATING AND ASSURING EXCELLENCE IN THE DELIVERY OF CLINICAL CARE. UHS IS FOCUSED ON THE DEVELOPMENT OF A COMPREHENSIVE OUTPATIENT CARE MODEL, IMPLEMENTATION OF ELECTRONIC MEDICAL RECORDS TO SUPPORT SERVICE QUALITY AND EXCELLENCE, IMPLEMENTATION OF A MULTI-YEAR PROVIDER RECRUITMENT AND RETENTION STRATEGY, ORGANIZE UHS PROVIDERS TO ACCOMMODATE FUTURE PAYMENT METHODOLOGIES, ALONG WITH THE DEVELOPMENT OF A TALENT MANAGEMENT INITIATIVE TO REALIZE THE LONG TERM STRATEGY FOR A SUSTAINABLE WORKFORCE.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN CARRIGG
2ND VICE CHAIR$0$464,819$0$110,838$0$0$0$16,165$0$18,665$0$610,487$0$0
DR MICHAEL FREEMAN
MEDICAL STAFF PRESIDENT$234,272$0$5,800$0$0$0$14,260$0$24,005$0$278,337$0$0$0
PAUL SUMMERS
PRESIDENT/CEO$187,300$0$37,780$0$0$0$7,629$0$8,673$0$241,382$0$0$0
DR RAJESH DAVE
FORMER 2ND VICE CHAIR$0$521,343$0$124,350$0$10,750$0$16,165$0$17,319$0$689,927$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6THE EXECUTIVE COMPENSATION PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE THOSE FOR CLINICAL EXCELLENCE, SERVICE EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. A PORTION OF THE 2016 INCENTIVE COMPENSATION PAYMENT WAS ATTRIBUTABLE TO THE ORGANIZATION'S NET INCOME GOALS. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED UHS SYSTEM NET INCOME. A PORTION OF THE 2016 INCENTIVE COMPENSATION PAYMENT WAS ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME 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 $278,337.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN161137407BondIssuerEIN
CUSIP245867AA4CUSIPNum
Bond Issued2007-06-29BondIssuedDt
Issue Price$5,805,000IssuePriceAmt
PurposeCONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGEPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$5,805,000TotalProceedsAmt
Issuance Costs From Proceeds$250,826IssuanceCostsFromProceedsAmt
Capital Expenditures$5,805,000CapitalExpendituresAmt
Substantial Completion2008SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestYes (1)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledYes (1)Form8038TFiledInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
MICHAEL LAYTON
BROTHER-IN-LAW OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES$54,059EMPLOYEE WAGES0
BONNIE CRAIG
SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES$35,961EMPLOYEE WAGES0
NANCY VOLLKOMMER
SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO$29,898EMPLOYEE WAGES0
MILA KATANIC-TUCKER
STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS$25,187EMPLOYEE WAGES0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION B, LINE 11BTHE 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,INDEPENDENT AUDITORS, AND THE DVH BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CDIRECTORS, 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 15APERFORMANCE 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 19THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GPHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 4,831,408. MANAGEMENT AND GENERAL EXPENSES 583,449. FUNDRAISING EXPENSES 23,651. TOTAL EXPENSES 5,438,508.
FORM 990, PART X, LINE 23IN ORDER TO BE IN ALIGNMENT WITH THE FASB ACCOUNTING STANDARD UPDATE 2015-3, DEBT ISSUANCE COSTS FOR 2015 WERE RESTATED ON THE AUDITED 2016 FINANCIAL STATEMENTS FROM A DEFERRED CHARGE ASSET TO A LIABILITY AS A DIRECT DEDUCTION FROM THE CARRYING VALUE OF THE ASSOCIATED DEBT LIABILITY. FOR THE PURPOSES OF THE 2016 FORM 990 FILING, THE BALANCE SHEET BEGINNING OF YEAR BALANCES REMAIN CONSISTENT WITH THE 2015 FORM 990 FILINGS.
FORM 990, PART XII, LINE 2CNEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
UNITED HEALTH SERVICES HOSPITALS INC
10-42 MITCHELL AVENUEBINGHAMTONNY13903161165049HOSPITALNY501(C)(3)3UNITED HEALTH SERVICES INC0
PROFESSIONAL HOME CARE
601 RIVERSIDE DRIVEJOHNSON CITYNY13790161261977HOME HEALTH CARENY501(C)(3)10UNITED HEALTH SERVICES INC0
IDEAL SENIOR LIVING CENTER
508 HIGH AVENUEENDICOTTNY13760222902896SENIOR LIVING CENTERNY501(C)(3)3UNITED HEALTH SERVICES INC0
IDEAL SENIOR LIVING CENTER HOUSING
508 HIGH AVENUEENDICOTTNY13760222902899SENIOR HOUSINGNY501(C)(3)10UNITED HEALTH SERVICES INC0
CHENANGO MEMORIAL HOSPITAL
179 NORTH BROAD STREETNORWICHNY13815150532180HOSPITALNY501(C)(3)3UNITED HEALTH SERVICES INC0
UNITED HEALTH SERVICES INC
20-40 MITCHELL AVENUEBINGHAMTONNY13903222682421PARENT COMPANYNY501(C)(3)10BOARD OF DIRECTORS UHS INC0
TWIN TIER HOME HEALTH INC
601 RIVERSIDE DRIVEJOHNSON CITYNY13790222438211HOME HEALTH CARENY501(C)(3)7UNITED HEALTH SERVICES INC0
PROJECT HEAR INC
601 RIVERSIDE DRIVEJOHNSON CITYNY13790161462675HOME EMERGENCY ALARM SYSTEMNY501(C)(3)10TWIN TIER HOME HEALTH INC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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