2017-11-09T16:10:10-06:00 2016-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2016-01-01 150524324 DELAWARE VALLEY HOSPITAL INC DELA 6078652197 1 TITUS PLACE WALTON NY 138561457 PAUL SUMMERS CHIEF EXECUTIVE OFFICER 6078652160 2017-10-23 1 ANGELA M FRANCO P00589741 3154463600 2017-10-23 24.39.85.114 2017-10-23 09:15:53 ED P 9ED0318F8F0D15647C4BFB992883BD7B1D0B79EC 315614A2A569D91B0F4A84342C1D145A8997199D 2016 2021-01-29 14:40:06Z PAUL SUMMERS 1 TITUS PLACE WALTON NY 138561457 23532288 0 X WWW.UHS.NET/ X 1950 NY TO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE,PRIMARY CARE AND WELLNESS SERVICES. 8 5 215 28 0 0 491375 1281516 20803358 21976456 43318 -24738 288254 224273 21626305 23457507 0 0 0 0 8465037 8904417 0 0 194205 12175307 12825965 20640344 21730382 985961 1727125 17094367 18857786 7451663 7426972 9642704 11430814 X AS A CRITICAL ACCESS HOSPITAL AND MEMBER OF THE UHS HEALTHCARE SYSTEM, UHS DELAWARE VALLEY HOSPITAL'S MISSION IS TO PROVIDE THE COMMUNITY WITH THE HIGH QUALITY, PATIENT-CENTERED SERVICES THAT ARE MOST OFTEN NEEDED; THEREBY IMPROVING ACCESS TO CARE AND REDUCING THE NEED TO TRAVEL LONG DISTANCES. WE DO THIS BY OFFERING EMERGENCY CARE, INPATIENT SHORT-TERM ACUTE CARE, PHYSICAL REHABILITATIVE CARE AND ADDICTION TREATMENT. IN ADDITION, WE PROVIDE HIGH QUALITY PRIMARY CARE; A WIDE RANGE OF DIAGNOSTIC AND TREATMENT SERVICES; ACCESS TO TOP LOCAL SPECIALTY CARE AND AN OUTPATIENT PHARMACY. UHS DELAWARE VALLEY HOSPITAL ALSO SERVES AS THE GATEWAY FOR PATIENTS TO ACCESS THE STATE-OF-THE-ART TECHNOLOGY AND HIGHLY QUALIFIED SPECIALISTS OF THE UHS SYSTEM, WHEN MORE SPECIALIZED CARE IS NEEDED. 0 0 4481905 9638938 INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT 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. 3403071 4621162 CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH ITS PRIMARY CARE CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE PRIMARY CARE CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. 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. 10121168 7716356 OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC CARDIOPULMONARY, IMAGING LAB AND TREATMENT SERVICES AT ITS WALTON CAMPUS. THESE INCLUDE A 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE PHYSICAL AND OCCUPATIONAL REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, CARDIAC AND PULMONARY REHABILITATION AND ACCESS TO SPECIALTY SERVICES. 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. 90505 OTHER PROGRAM SERVICE REVENUE CONSISTS OF VARIOUS OTHER PHYSICIAN SERVICE REVENUE INCLUDING MEDICAL RECORD AND TRANSCRIPTION FEES. 90505 18006144 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 17 0 1 215 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X PAUL SUMMERS 6078652197 DELAWARE VALLEY HOSPITAL 1 TITUS WALTON NY 138561457 HELEN JOHNSTON BOARD CHAIR 1.00 X X 0 0 0 JOHN CARRIGG 2ND VICE CHAIR 1.00 55.00 X X 0 575657 34830 LARRY LIGHT TREASURER 1.00 X X 0 0 0 EDWARD SNOW SECRETARY 1.00 X X 0 0 0 ERIN NEALE TRUSTEE 1.00 X 0 0 0 AMANDA HALL TRUSTEE 1.00 X 0 0 0 DR MICHAEL FREEMAN MEDICAL STAFF PRESIDENT 56.00 X X 240072 0 38265 PAUL SUMMERS PRESIDENT/CEO 56.00 X X 225080 0 16302 DR JOHN GIANNONE CHIEF MEDICAL OFFICER 5.00 X 32236 0 0 JOAN GUARNIERI V.P. ANCILLARY SVCS 55.00 X 102248 0 13608 DOTTIE KRUPPO V.P. COMMUNITY RELATIONS 55.00 X 79340 0 17516 DEBORAH HITT V.P. QUALITY/SUPPORT SVCS 55.00 X 88853 0 18487 VICTORIA CONKLING V.P. NURSING/CNO 55.00 X 108130 0 6055 KATHLEEN ULMSCHNEIDER STAFF NURSE 55.00 X 109460 0 19221 DR RAJESH DAVE FORMER 2ND VICE CHAIR 0.00 55.00 X 0 656443 33484 985419 1232100 197768 6 1 1 1 MCKESSON 12748 COLLECTIONS CENTER DR CHICAGO IL 60693 PHARMACEUTICAL 3262576 SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH NY 13815 PHYSICAL/OCC. THERAPY 395662 MEDHOST OF TENNESSEE 2739 MOMENTUM PLACE CHICAGO IL 60689 INFORMATION TECHNOLOGY 350966 ALLIANCE HEALTHCARE SYSTEMS PO BOX 96485 CHICAGO IL 60693 MEDICAL SUPPORT 291774 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB TESTING SERVICE 218089 11 1159138 122378 1281516 NET PATIENT REVENUE 900099 21976456 21976456 21976456 50043 50043 74781 -74781 -74781 -74781 INTEREST RATE SWAP 900099 133768 133768 PHYSICIAN OTHER REVENUE 621498 33794 33794 MEDICAL RECORD FEES 900099 6945 6945 49766 49766 224273 23457507 22066961 0 109030 X 675618 386938 191824 96856 6595108 5120110 1474998 173353 138332 35021 940902 750821 190081 519436 406189 113247 22947 22947 7152 7152 100349 100349 5063 5063 7429 7429 5438508 4831408 583449 23651 1421977 947336 445343 29298 66719 66719 226467 55427 171040 32239 25632 5172 1435 57850 12985 1900 42965 220963 151285 69678 835450 835450 97676 81382 16294 DRUGS 3171523 3171523 BAD DEBT EXPENSE 619554 619554 MEDICAL SUPPLIES 387780 387780 106319 83992 22327 21730382 18006144 3530033 194205 X 2554440 4014103 1357318 1370438 2153339 1994226 523224 587536 464907 493679 22067981 14913604 7002831 7154377 1017387 1100629 1955921 2077798 65000 65000 17094367 18857786 971189 1233964 3814257 3220060 527784 441081 1663573 2046868 474860 484999 7451663 7426972 X 9318035 11100454 6460 12150 318209 318210 9642704 11430814 17094367 18857786 1727125 60985 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5063 5063 0 PART II-B, LINE 1: AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY AND IROQUOIS HEALTHCARE. 324669 5691 330360 361539 5286 42156 324669 348578 12961 361539 379742 1700 32864 348578 381035 -1293 379742 0.96000 0.04000 1 0 51202 51202 10175831 5355651 4820180 10915869 9557953 1357916 925079 925079 7154377 WELLS FARGO-PRIN. PYMTS ON BONDS 162763 F TEMP.RESTRICTED DONATIONS 19851 F CAPITAL CONST(FUNDED DEPR) 1895184 F 2077798 DUE UNITED MED. ASSOC. 216229 DUE UHS HOSPITALS 203770 MALPRACTICE INSURANCE RESERVE 65000 484999 X 23339838 0 23339838 117669 117669 23457507 21730382 0 21730382 0 21730382 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. 1 1 X 1 X 0 1 1 1 0 1 1 4088627 3868847 219780 0.01040 147274 20485 126789 0.00600 4235901 3889332 346569 0.01640 195209 195209 0.00920 44869 44869 0.00210 11227206 8319226 2907980 0.13770 11467284 8319226 3148058 0.14900 15703185 12208558 3494627 0.16540 2087 2087 0.00010 11994 11994 0.00060 15548 15548 0.00070 29629 29629 0.00140 0 619554 278799 4291509 4220788 70721 X 1 1 1 1 DELAWARE VALLEY HOSPTITAL 1 TITUS PLACE WALTON NY 13856 X X X DELAWARE VALLEY HOSPTITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.UHS.NET X 1 16 1 HTTP://WWW.UHS.NET 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.UHS.NET X HTTP://WWW.UHS.NET X HTTP://WWW.UHS.NET X X X X X X 1 X 0 X X X X 1 X 0 0 DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 5: DELAWARE VALLEY HOSPITAL HAS MEMBERSHIP IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY, AS WELL AS ON ITS WELLNESS COMMITTEE. A STAFF MEMBER ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR PARTICIPATES IN ALL DVH VOLUNTEER MEETINGS AND ACTIVELY SEEKS THEIR INPUT AND FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES INPUT AS TO WHAT THEY HEAR FROM COMMUNITY MEMBERS. PATIENT SATISFACTION SURVEYS ARE ALSO USED IN GAINING INPUT FROM OUR PATIENTS. DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6A: O'CONNOR HOSPITAL, DELHI, NYTRI-TOWN REGIONAL HOSPITAL, SIDNEY, NYMARGARETVILLE COMMUNITY HOSPITAL, MARGARETVILLE, NY DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, 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 HOSPTITAL PART 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 HOSPTITAL PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE. PART V, SECTION B, LINE 11: 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. 5 1 - WALTON FAMILY HEALTH CENTER 2 TITUS PLACE WALTON NY 13856 OUTPATIENT PHYSICIAN CLINIC 2 - DOWNSVILLE FAMILY HEALTH CENTER 28315 STATE HWY 206 DOWNSVILLE NY 13755 OUTPATIENT PHYSICIAN CLINIC 3 - ROSCOE FAMILY HEALTH CENTER 1982 OLD ROUTE 17 ROSCOE NY 12776 OUTPATIENT PHYSICIAN CLINIC 4 - PHYSICAL AND OCCUPATIONAL THERAPY 123 STOCKTON AVENUE WALTON NY 13856 REHABILITATION CLINIC 5 - SPECIALTY CLINIC 121 STOCKTON AVENUE WALTON NY 13856 OUTPATIENT PHYSICIAN CLINIC 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 STATES NY X X X X 0 0 0 0 0 1 1 0 0 JOHN CARRIGG 2ND VICE CHAIR 0 464819 0 110838 0 0 0 16165 0 18665 0 610487 0 0 DR MICHAEL FREEMAN MEDICAL STAFF PRESIDENT 234272 0 5800 0 0 0 14260 0 24005 0 278337 0 0 0 PAUL SUMMERS PRESIDENT/CEO 187300 0 37780 0 0 0 7629 0 8673 0 241382 0 0 0 DR RAJESH DAVE FORMER 2ND VICE CHAIR 0 521343 0 124350 0 10750 0 16165 0 17319 0 689927 0 0 PART I, LINE 6 THE 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. A COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY 161137407 245867AA4 2007-06-29 5805000 CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE 0 0 0 A 5805000 250826 5805000 2008 0 0 1 1 A 0 0 0 0 1 0 1 A 1 1 0 0 0 0 A 0 MICHAEL LAYTON BROTHER-IN-LAW OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 54059 EMPLOYEE WAGES 0 BONNIE CRAIG SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 35961 EMPLOYEE WAGES 0 NANCY VOLLKOMMER SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO 29898 EMPLOYEE WAGES 0 MILA KATANIC-TUCKER STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS 25187 EMPLOYEE WAGES 0 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. FORM 990, PART VI, SECTION B, LINE 11B THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE DELAWARE VALLEY HOSPITAL, INC. (DVH) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF FORM 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO,INDEPENDENT AUDITORS, AND THE DVH BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMMITTEE. FORM 990, PART VI, SECTION B, LINE 15A PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY THE BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. THE COMMITTEE USES SULLIVAN-COTTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS THE BASIS FOR ESTABLISHING AN ACCEPTABLE COMPENSATION RANGE TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 4,831,408. MANAGEMENT AND GENERAL EXPENSES 583,449. FUNDRAISING EXPENSES 23,651. TOTAL EXPENSES 5,438,508. FORM 990, PART X, LINE 23 IN 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 2C NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE YEAR. UNITED HEALTH SERVICES HOSPITALS INC 10-42 MITCHELL AVENUE BINGHAMTON NY 13903 161165049 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 PROFESSIONAL HOME CARE 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 161261977 HOME HEALTH CARE NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER 508 HIGH AVENUE ENDICOTT NY 13760 222902896 SENIOR LIVING CENTER NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER HOUSING 508 HIGH AVENUE ENDICOTT NY 13760 222902899 SENIOR HOUSING NY 501(C)(3) 10 UNITED HEALTH SERVICES INC 0 CHENANGO MEMORIAL HOSPITAL 179 NORTH BROAD STREET NORWICH NY 13815 150532180 HOSPITAL NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 UNITED HEALTH SERVICES INC 20-40 MITCHELL AVENUE BINGHAMTON NY 13903 222682421 PARENT COMPANY NY 501(C)(3) 10 BOARD OF DIRECTORS UHS INC 0 TWIN TIER HOME HEALTH INC 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 222438211 HOME HEALTH CARE NY 501(C)(3) 7 UNITED HEALTH SERVICES INC 0 PROJECT HEAR INC 601 RIVERSIDE DRIVE JOHNSON CITY NY 13790 161462675 HOME EMERGENCY ALARM SYSTEM NY 501(C)(3) 10 TWIN TIER HOME HEALTH INC 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1 1 1 0 0