2016-11-03T12:38:03-05:00 2015-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2015-01-01 150524324 DELAWARE VALLEY HOSPITAL INC DELA 6078652197 1 TITUS PLACE WALTON NY 138561457 PAUL SUMMERS CHIEF EXECUTIVE OFFICER 6078652160 2016-10-28 1 ANGELA M FRANCO P00589741 3154463600 2015 2017-02-10 21:41:12Z PAUL SUMMERS 1 TITUS PLACE WALTON NY 138561457 21626305 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, RAHABILITATIVE, PRIMARY CARE AND WELLNESS SERVICES. 8 5 221 23 0 0 496656 491375 17299407 20803358 47308 43318 935656 288254 18779027 21626305 0 0 0 0 8453297 8465037 0 0 113196 9703340 12175307 18156637 20640344 622390 985961 16390107 17094367 7729410 7451663 8660697 9642704 X TO SERVE ITS PATIENTS WITH COMPASSION AND IN AN EFFICIENT AND PATIENT FOCUSED MANNER WHILE OFFERING A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE, PRIMARY CARE AND WELLNESS SERVICES. 0 0 4209687 9560720 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 IT'S 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2015 WERE COMPRISED OF 316 ACUTE, 187 SWING BED, AND 79 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 943 PATIENT DAYS, IN ADDITION TO THE 1,801 PATIENT DAYS FOR SWING BED AND 1,222 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 6,348 LAB TESTS, 15,846 RESPIRATORY TREATMENTS, 336 X-RAYS, 842 PHYSICAL THERAPY SESSIONS, AND 181 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 THROUGH AN AGREEMENT WITH A MOBILE VENDOR. 3208310 4421606 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. IN 2015 OUR CLINICS PROVIDED CARE TO 14,518 PATIENTS IN WALTON, 1,211 IN ROSCOE, AND 1,341 IN DOWNSVILLE. WITH A FOCUS ON CONTINUOUS IMPROVEMENT THE PRIMARY CARE CENTERS OPERATE UNDER A NEW HEALTH INFORMATION MANAGEMENT SYSTEM AND CONTINUE TO BE SMOKE AND TOBACCO FREE. THEY HAVE ALSO BECOME A KEY TO THE IMPROVEMENT OF CHILDHOOD IMMUNIZATION LEVELS IN COORDINATION WITH DELAWARE COUNTY'S PUBLIC HEALTH NURSING SERVICES AND OTHER AREA HEALTHCARE PROVIDERS. 8640657 6821032 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 REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, AND ACCESS TO SPECIALTY SERVICES. THE HOSPITAL ALSO CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS AND DIABETES EDUCATION. A FREE PRESCRIPTION DELIVERY PROGRAM IS PROVIDED FOR ROSCOE AND DOWNSVILLE PATIENTS. DOWNSVILLE IS WITHOUT A LOCAL PHARMACY AND ROSCOE JUST RECENTLY HAD A NEW PHARMACY OPEN IN THE COMMUNITY. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION. IN 2015 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,606 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 68,939 TESTS, AND 6,410 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,888 X-RAYS, CT SCANS, MRI'S AND MAMMOGRAPHIES FOR OUTPATIENT SERVICES. OUTPATIENT SERVICES WERE ALSO PERFORMED IN 2015 FOR 137 AMBULATORY PROCEDURES, 1,200 OPIATED ADDICTION SESSIONS, AND 875 SERVICES ASSOCIATED WITH CARDIOPULMONARY REHABILITATION. 283547 OTHER PROGRAM SERVICES REVENUE IS PRIMARILY MADE UP OF MEANINGFUL USE MEDICARE FUNDING OF $283,547. 283547 16058654 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 24 0 1 221 1 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 DR MICHAEL FREEMAN MEDICAL STAFF PRESIDENT 56.00 X X 248091 0 36566 JOHN CARRIGG 2ND VICE CHAIR 1.00 55.00 X X 0 524410 33429 LARRY LIGHT TREASURER 1.00 X X 0 0 0 EDWARD SNOW SECRETARY 1.00 X X 0 0 0 ERIN NEALE DIRECTOR 1.00 X 0 0 0 AMANDA HALL DIRECTOR 1.00 X 0 0 0 PAUL SUMMERS DIRECTOR/CEO 55.00 X X 192783 0 16632 JOAN GUARNIERI V.P. COMM HEALTH SVCS 55.00 X 100201 0 13514 DOTTIE KRUPPO V.P. ANCILLARY SVCS 55.00 X 80279 0 16952 DEBORAH HITT V.P. QUALITY/SUPPORT SVCS 55.00 X 87495 0 17725 VICTORIA CONKLING V.P. NURSING/CNO 55.00 X 104564 0 6228 DR RAJESH DAVE FORMER 2ND VICE CHAIR 1.00 55.00 X 0 598971 33584 813413 1123381 174630 4 1 1 1 CARDINAL HEALTH DRUGS 7000 CARDINAL PLACE DUBLIN OH 43017 PHARMACEUTICAL 571506 SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH NY 13815 PHYSICAL/OCC. THERAPY 354626 MEDHOST OF TENNESSEE 2739 MOMENTUM PLACE CHICAGO IL 60689 INFORMATION TECHNOLOGY 276444 LOCUMTENENS PO BOX 405547 ATLANTA GA 30384 STAFFING SERVICE 240663 ALLIANCE HEALTHCARE SYSTEMS PO BOX 96485 CHICAGO IL 60693 MEDICAL SUPPORT 207306 5 477115 14260 491375 NET PATIENT REVENUE 900099 20803358 20803358 20803358 43318 43318 MEANINGFUL USE MEDICARE 900099 216810 216810 PHYSICIAN OTHER REVENUE 621498 48763 48763 VENDING MACHINE 722210 4707 4707 17974 17974 288254 21626305 21086905 0 48025 X 636374 460098 176276 6214699 4298260 1916439 189066 122893 66173 924998 587373 337625 499900 329934 169966 2818 2818 7405 7405 81406 81406 6849 6849 4557 4557 5157495 4531153 538722 87620 310 310 4444148 3821320 616273 6555 43589 43589 226400 46418 179982 37785 25091 10168 2526 25118 5688 3245 16185 247968 247968 823539 812519 11020 98984 86185 12799 BAD DEBT EXPENSE 870984 870984 MISCELLANEOUS 95952 60738 35214 20640344 16058654 4468494 113196 2380818 2554440 1352899 1357318 1889306 2153339 440094 523224 321124 464907 21370461 14367630 7026058 7002831 1025200 1017387 1909608 1955921 45000 65000 16390107 17094367 887125 971189 4116920 3814257 612001 527784 1645482 1663573 467882 474860 7729410 7451663 X 8299158 9318035 43329 6460 318210 318209 8660697 9642704 16390107 17094367 X 985961 -26261 22307 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 6849 6849 0 PART II-B, LINE 1: AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY AND IROQUOIS HEALTHCARE. 361539 5286 42156 324669 348578 12961 361539 379742 1700 32864 348578 381035 -1293 379742 342832 38203 381035 0.98010 0.01990 1 0 51202 51202 9982137 5028958 4953179 10907798 9338672 1569126 429324 429324 7002831 WELLS FARGO - PRIN. PMTS. ON BOND 150109 F TEMP.RESTRICTED DONATIONS 14147 F CAPITAL CONST(FUNDED DEPR) 1791665 F 1955921 DUE UNITED MED. ASSOC. / CHEN. MEM. 252281 DUE UHS HOSPITALS 157579 MALPRACTICE INSURANCE RESERVE 65000 474860 X 21626305 0 21626305 0 21626305 20640344 0 20640344 0 20640344 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, 2015 AND 2014, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTERST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2012 THROUGH 2015. 1 1 X 1 X 0 1 1 0 1 1 135971 82929 53042 0.00270 135971 82929 53042 0.00270 154738 154738 0.00780 43270 43270 0.00220 10234139 7866435 2367704 0.11980 517 517 0.00000 10432664 7866435 2566229 0.12980 10568635 7949364 2619271 0.13250 0 325022 95839 4742710 4691734 50976 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 13 1 1 1 1 X HTTP://WWW.UHS.NET X 1 13 1 HTTP://WWW.UHS.NET 0 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 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: UNITED HEALTH SERVICE HOSPITALS, INC.CHENANGO MEMORIAL HOSPITAL 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: THREE YEAR PLAN OF ACTIONPROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSESUPPORT COLLABORATION AMONG LEADERS, PROFESSIONALS AND COMMUNITY MEMBERS WORKING IN MEB HEALTH PROMOTION, SUBSTANCE ABUSE AND OTHER MEB DISORDERS AND CHRONIC DISEASE PREVENTION, TREATMENT AND RECOVERY.OBJECTIVES:IDENTIFY AND STRENGTHEN OPPORTUNITIES FOR SHARING DATA ON ACCESS TO CARE, IDENTIFY SERVICE GAPS, STUDY COST EFFECTIVENESS STRATEGIES FOR INTEGRATION AND COORDINATION AND IMPACT OF INTERVENTIONS.SUPPORT EFFORTS TO INTEGRATE MEB DISORDER SCREENING AND TREATMENT INTO PRIMARY CARE.UHS DELAWARE VALLEY HOSPITAL ANTICIPATES IT WILL HAVE OTHER OBJECTIVES IT WILL WANT TO FOCUS ON WITHIN THIS PRIORITY BASED ON THE FINDINGS AND WORK OF THE COALITION.2015 SERVICE REPORT UPDATE IN OUR REGULAR CONTACT WITH OUR COUNTY MENTAL HEALTH DEPARTMENT, ESPECIALLY DURING TRAVEL TO DSRIP MEETINGS, WE CAME TO REALIZE THE SEVERE SHORTAGE OF MENTAL HEALTH PROFESSIONALS IN OUR AREA; AND THE EXTREME DIFFICULTY IN RECRUITING OTHERS WOULD ONLY BE SOLVED THROUGH THE ADVANCEMENT OF TELEPSYCH SERVICES. USING VAP GRANT FUNDING, DVH WAS ABLE TO HIRE A TELEMEDICINE CONSULTANT AND THE DECISION WAS MADE TO FOCUS FIRST ON TELEPSYCH SERVICES. UHS HAS AGREED TO SUPPLY THE PROFESSIONALS FOR THIS PROGRAM. THE GOAL IS TO OFFER A SPECIALTY CLINIC TO PATIENTS WHO ARE REFERRED FROM THEIR PRIMARY CARE PHYSICIANS FOR EVALUATION. BY OFFERING THIS SERVICE, THE COUNTY DEPARTMENT WILL HAVE MORE TIME TO CARE FOR THOSE WHO HAVE MORE SERIOUS CONDITIONS. TELEMEDICINE IS SCHEDULED TO BEGIN IN 2016, ONCE THE TELECOMMUNICATION VENDOR IS SELECTED. THE DVH VOLUNTEERS AGREED TO PURCHASE A MONITOR AND CAMERA WHICH WILL MAKE PATIENTS FEEL MORE COMFORTABLE THAN THEY MIGHT BE LOOKING AT AN IPAD OR COMPUTER SCREEN. THAT WILL BE COMPLETED IN THE 1ST QUARTER OF 2016. IN ADDITION, DVH IS ALSO CONSIDERING HAVING ONE OF ITS PRIMARY CARE PHYSICIANS ACCEPT PATIENTS FROM THE COUNTY MENTAL HEALTH DEPARTMENT WHO DO NOT HAVE A PRIMARY CARE PROVIDER AND WISH TO COME TO DVH. AGAIN THIS WILL ALLOW THE COUNTY DEPARTMENT MORE TIME FOR MORE SERIOUS CASES, AS THE PROVIDER WILL BE ABLE TO PRESCRIBE THE MEDICATIONS, THESE STABLE PATIENTS REQUIRE.PREVENT CHRONIC DISEASESREDUCE OBESITY IN CHILDREN AND ADULTS OBJECTIVES:BY 12/31/17, REDUCE THE % OF CHILDREN WHO ARE OBESE BY 5% IN PUBLIC SCHOOL CHILDREN.BY 12/31/15 10% OF ELEMENTARY SCHOOL CHILDREN IN GRADES 2-4 IN THE WALTON, ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOL DISTRICTS WILL PARTICIPATE IN THE UHS STAY HEALTHY! "TAKING SMALL STEPS TOGETHER" PROGRAM, WHICH ENCOURAGES CHILDREN TO EAT 5 SERVINGS OF FRUITS AND VEGETABLES PER DAY, HAVE 2 HOURS OR LESS OF SCREEN TIME AND 1 HOUR OR MORE OF PHYSICAL ACTIVITY.WORKING WITH THE SCHOOL NURSES AT ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOLS, CHILDREN WILL BE ENROLLED IN THE PROGRAM DURING 2015.WORKING WITH THE TOWNSEND SCHOOL PTA WALTON ELEMENTARY SCHOOL CHILDREN WILL BE ENROLLED IN THE PROGRAM DURING 2015.WORKING WITH EACH SCHOOL, CHILDREN WILL BE ENCOURAGED TO COMPLETE AT LEAST 2 ROUNDS OF THE 5 WEEK PROGRAM. CHILDREN COMPLETING EACH ROUND WILL RECEIVE A "CHARM" TO PUT ON A BRACELET.THE PROGRAM WILL BE REPEATED EACH YEAR OF THE COMMUNITY SERVICE PLAN.BY 12/31/15 AT LEAST 100 CHILDREN IN WALTON, ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOLS WILL PARTICIPATE IN AN AFTER SCHOOL COOKING CLASS LEARNING HOW TO MAKE AND CHOOSE HEALTHY SNACKS.IN 2015, UHS DELAWARE VALLEY HOSPITAL WILL WORK WITH THE 21ST CENTURY RISE PROGRAM TO OFFER AFTER SCHOOL COOKING CLASSES TO ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR STUDENTS SO THEY CAN IDENTIFY AND MAKE HEALTHY SNACKS. STUDENTS WILL PREPARE SNACKS; RECEIVE RECIPE CARDS TO TAKE HOME AND HEALTHY SNACK TIP SHEETS FOR PARENTS.IN 2015, UHS DELAWARE VALLEY HOSPITAL WILL WORK WITH THE WALTON CENTRAL SCHOOL WELLNESS COMMITTEE TO OFFER AFTER SCHOOL COOKING CLASSES TO STUDENTS AS ABOVE.BY 12/31/17, REDUCE THE % OF ADULTS 18 AND OVER WHO ARE OBESE.DUE TO REQUESTS FROM COMMUNITY MEMBERS, BY 12/31/15 AT LEAST 20 ADULTS WILL PARTICIPATE IN HEALTHY COOKING CLASSES. EACH PARTICIPANT WILL RECEIVE RECIPE CARDS TO TAKE HOME AND THE CLASSES WILL FEATURE A MEAT, POULTRY, FISH AND VEGETABLE DISHES.2015 SERVICE REPORT UPDATE HEALTHY COOKING CLASSES ALTHOUGH THIS WAS AN INITIAL PLAN OF DVH, WE FOUND THAT WITH LIMITED RESOURCES THIS IS JUST NOT GOING TO BE A FEASIBLE PROJECT FOR US, OR THAT THE PLANNED EFFORTS WOULD REALLY MOVE THE NEEDLE IN TERMS OF MAKING A DIFFERENCE. ALTHOUGH WELL RECEIVED, OUR COOKING CLASSES CAN ONLY REACH A FEW PEOPLE AT A TIME. INSTEAD, WE HAVE TEAMED UP WITH THE UHS BARIATRIC SURGERY PROGRAM AND OUR DIETITIAN IS NOW COUNSELING MANY OF OUR AREA PATIENTS WHO ARE CONSIDERING THIS OPTION. SHE ALSO CONTINUES TO OFFER THE LIFESTEPS PROGRAM AT LEAST ONCE EACH YEAR AND GENERALLY REACHES APPROXIMATELY 10 PEOPLE.BY 12/31/17, INCREASE THE NUMBER OF TOWNS AND VILLAGES THAT HAVE PASSED COMPLETE STREETS POLICIES FROM 23-46. COMPLETE STREETS ARE DESIGNED TO ALLOW EASY AND SAFE TRAVEL BY WALKING, RIDING AND BIKING. (TRI-STATES TRANSPORTATION CAMPAIGN)OBJECTIVES:BY 12/31/17 50% OF DELAWARE COUNTY TOWNS WILL HAVE ONE TRAIL MAPPED AND/OR MARKED.BY 12/31/17 25% OF PRIMARY CARE PRACTICES WILL UTILIZE THE PRESCRIPTION TRAIL PROGRAM IN THEIR PRACTICES TO ENCOURAGE PATIENTS TO BE PHYSICALLY ACTIVE.WORKING WITH DELAWARE COUNTY PUBLIC HEALTH, O'CONNOR HOSPITAL, MARGARETVILLE HOSPITAL, THE CATSKILL MOUNTAIN CLUB, AND DELAWARE COUNTY CHAMBER OF COMMERCE EXISTING TRAILS WILL BE IDENTIFIED, THEIR DIFFICULTY LEVEL ASSESSED. POSSIBILITIES OF CREATING NEW TRAILS WILL BE EXPLORED.A WEBSITE WILL BE DEVELOPED TO ENCOURAGE USE OF THE TRAILS, AND MAKE MORE PEOPLE AWARE OF THEIR EXISTENCE AND ANY ACTIVITIES THAT MAY BE HELD ON THE TRAILS.PRIMARY CARE PROVIDERS WILL BE EDUCATED ABOUT THE PRESCRIPTION TRAILS PROGRAM AND THE EXISTING TRAILS.2015 SERVICE REPORT UPDATE IN ADDITION DVH SPOKE WITH WALTON VILLAGE BOARD MEMBERS, IN CONJUNCTION WITH DELAWARE COUNTY PUBLIC HEALTH ABOUT THE COMPLETE STREETS PROGRAM. SINCE SUBMITTING OUR COMMUNITY SERVICE PLAN, WE WERE TOLD THE VILLAGE OF WALTON DID PASS A COMPLETE STREETS POLICY IN DECEMBER, 2015. WE ALSO SPOKE WITH THE TOWN OF COLCHESTER BOARD MEMBERS. THEY TOO PASSED A COMPLETE STREETS POLICY LAST YEAR.IN 2015, WE EXPANDED THE PROFESSIONALS USING THE PRESCRIPTION TRAIL PROGRAM TO INCLUDE THE DIETITIAN, PHYSICAL THERAPY DEPARTMENT AND THE CARDIAC/PULMONARY REHAB DEPARTMENT.PROMOTE USE OF EVIDENCE-BASED CARE TO MANAGE CHRONIC DISEASES. OBJECTIVES:BY DECEMBER 31, 2017, INCREASE THE PERCENTAGE OF PATIENTS, AGES 18-85 YEARS WHO HAVE CONTROLLED THEIR BLOOD PRESSURE (BELOW 140/90)BY DECEMBER 31, 2017 INCREASE THE PERCENTAGE OF PATIENTS WITH DIABETES WHOSE BLOOD GLUCOSE IS IN GOOD CONTROL (HEMOGLOBIN A1C LESS THAN 9%).UHS IS CURRENTLY WORKING TO PROVIDE UHS DELAWARE VALLEY HOSPITAL WITH BASELINE DATA SO THAT TARGETS CAN BE ESTABLISHED FOR THESE 2 OBJECTIVES. THIS IS A SYSTEM FOCUS THAT IS TIED TO PATIENT CENTERED MEDICAL HOME STATUS.2015 SERVICE REPORT UPDATEFALL PREVENTION WITHIN THIS PRIORITY WE FOCUSED ON FALL PREVENTION. WE HAVE HAD 2 DELAWARE VALLEY HOSPITAL (DVH) STAFF TRAINED TO CONDUCT MATTER OF BALANCE CLASSES THROUGH THE DELAWARE COUNTY OFFICE OF THE AGING (OFA). ONE CLASS, WITH A DVH STAFF MEMBER AND A PUBLIC HEALTH STAFF MEMBER WAS HELD. 10 ENROLLED AND 8 COMPLETED ALL OF THE SESSIONS. THE OFA OFFERS THE CLASSES FOR FREE WITH A DONATIONS WELCOME MODEL. WHEN DVH SPONSORS THE CLASS, WE SUPPLY ALL OF THE MATERIALS, SNACKS AND VENUE FREE OF CHARGE TO THE OFA SO THAT ANY DONATIONS THEY RECEIVE CAN BE UTILIZED FOR OTHER CLASSES ELSEWHERE. DVH NEEDS TO IDENTIFY ADDITIONAL STAFF MEMBERS TO BE TRAINED IN THIS PROGRAM AS ONE OF THE TRAINERS HAS LEFT DVH'S EMPLOY. DVH ALSO LEARNED OF THE OPPORTUNITY TO HAVE VOLUNTEERS FROM DELAWARE COUNTY BECOME TAI CHI LEADERS, THROUGH A PROGRAM IN BROOME COUNTY. DVH BROUGHT THIS TO THE ATTENTION OF OFA AND THEY SENT 3 PEOPLE TO THE TRAINING. ALTHOUGH SENDING A STAFF MEMBER TO THE TRAINING AND HAVING THEM CONDUCT CLASSES IS JUST TOO TIME INTENSIVE FOR OUR LIMITED STAFF RESOURCES, DVH AGREED TO SPONSOR A TAI CHI PROGRAM IN WALTON DURING 2016. EVIDENCE-BASED PROGRAMMING CHRONIC DISEASE SELF MANAGEMENT PROGRAM IN OUR WORK ON CHRONIC DISEASE AND OUR PARTNERSHIPS WITHIN OUR PPS OF THE DSRIP INITIATIVE, WE ALLOTTED MONEY WITHIN OUR VAP GRANT FUNDING TO BE UTILIZED TO OFFER STANFORD UNIVERSITY'S EVIDENCE BASED CHRONIC DISEASE SELF MANAGEMENT PROGRAM'S MASTER TRAINER PROGRAM LOCALLY. WHILE WE HAD PLANNED TO HOLD THE CLASS IN 2015, IT WILL BE HELD IN JUNE OF 2016 SO THAT MORE ORGANIZATIONS WITHIN THE 9 COUNTY PPS CAN PREPARE TO PARTICIPATE. DVH WILL BE SENDING AT LEAST 2 STAFF MEMBERS TO THE CLASS, AS WELL AS 2 MEMBERS OF THE UHS STAY HEALTHY! STAFF. O'CONNOR HOSPITAL PLANS TO SEND PARTICIPANTS ALSO. IN ADDITION, DVH INTENDS TO UTILIZE TELECOMMUNICATION TO HELP PATIENTS HAVE ACCESS TO MORE WELLNESS PROGRAMMING. IT HAS SUBMITTED A GRANT APPLICATION TO THE 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. DELAWARE VALLEY HOSPTITAL PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY MAXIMUM CHARGE AMOUNT FOR FAP-ELIGIBLE INDIVIDUALS DID NOT EXCEED 65% OF THE HIGHEST VOLUME PAYOR GROSS CHARGE RATE. DURING 2015, THE HIGHEST VOLUME PAYOR WAS EXCELLUS BLUE CROSS & BLUE SHIELD. 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 $870,984 IN PART IX, LINE 24A. THE AFOREMENTIONED BAD DEBT EXPENSE WAS NOT 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 COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). WEEKLY NARCOTICS ANONYMOUS MEETINGS ARE HELD AT THE HOSPITAL AND HOSPITAL STAFF PERFORMS DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG COURT FREE OF CHARGE. THE WALTON PRIDE COMMITTEE HAS BEEN WORKING TO REVITALIZE THE COMMUNITY AFTER ITS DEVASTATING FLOOD IN 2006. THE HOSPITAL MADE A 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, AND THE WALTON VETS CLUB AUXILIARY BY COLLECTING ITEMS TO BE SENT TO OUR TROOPS. THE HOSPITAL ALSO WORKED WITH THE WALTON CENTRAL SCHOOL STUDENT COUNCIL AS THEY CREATED A HIGHLY IMPACTFUL SET OF VIDEOS DRAMATIZING A CHAIN OF EVENTS LEADING UP TO A DEADLY DWI ACCIDENT. DELAWARE VALLEY ALLOWED STUDENTS TO VIDEOTAPE IN ITS ED AND MANY DVH STAFF PARTICIPATED. THE FINAL VIDEO WAS SHOWN IN AN ASSEMBLY JUST BEFORE PROM NIGHT. DVH HOSTED SEVERAL PUBLIC EDUCATIONAL SESSIONS PRESENTED BY THE ALZHEIMER'S ASSOCIATION. THE HOSPITAL GROUNDS ARE ALSO HOST TO A FARMER'S MARKET 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. 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. 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. 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. 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 2015 STUDENTS ATTENDED OVER A TWO DAY PERIOD. DURING 2015, 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. CONTINUING ON OUR PREVIOUS EFFORTS, BOTH THE VILLAGE OF WALTON AND TOWN OF COLCHESTER ADOPTED COMPLETE STREETS POLICIES. MENTAL HEALTH AND SUBSTANCE ABUSE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2015, 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. THE MOST CHALLENGING BARRIER TO ACCESS TO CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. DELAWARE VALLEY HIRED THE 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 WILL BE RECEIVING EQUIPMENT, AS A LOAN, FROM BINGHAMTON UNIVERSITY, THROUGH ONE OF THEIR PROGRAMS. THE HOSPITAL IS CURRENTLY WORKING WITH ITS UHS COUNTERPARTS TO IDENTIFY PROFESSIONALS TO PROVIDE CARE. THE HOSPITAL ALSO PARTICIPATED IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR SAT ON THE EXECUTIVE COMMITTEE AND WAS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS. CHRONIC DISEASE MANAGEMENT IS ANOTHER IDENTIFIED NEED AND THE DIRECTOR ALSO SAT ON THE TWO PROJECT COMMITTEES TO ADDRESS CARDIOVASCULAR HEALTH AND COPD. THE HOSPITAL IS PLANNING TO SPONSOR A STANFORD UNIVERSITY BASED, CHRONIC DISEASE SELF MANAGEMENT MASTER TRAINER TRAINING IN 2016. 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 HOSPITALS FINANCIAL ASSISTANCE POLICY CHANGED TO PROVIDE ALL SELF-PAY PATIENTS AN AUTOMATIC 30% 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. DVH'S 85% 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 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 WHITE, 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, NO HUSBAND PRESENT HAS RISEN TO 66.7% FOR CHILDREN UNDER 5 YEARS OF AGE IN DELAWARE COUNTY. THIS IS WELL ABOVE 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 AND TREATMENT 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. 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.DURING 2015, THE COMMUNITY RELATIONS DIRECTOR MET WITH THE STAFF OF THE UHS STAY HEALTHY AND NURSE DIRECT DEPARTMENTS, AS WELL AS THE NEW UHS CARDIAC NAVIGATOR TO PROVIDE THEM WITH INFORMATION ABOUT SERVICES AVAILABLE TO PATIENTS IN OUR AREA. OUT OF THIS MEETING THE BARIATRICS COUNSELOR DECIDED TO PRESENT A SEMINAR FOR DVH AREA RESIDENTS IN WALTON. DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST HELD A LIFESTEPS CLASS WHICH FOCUSES ON PARTICIPANTS' LIFESTYLES AS IT RELATES TO DIET AND EXERCISE. 7 PEOPLE PARTICIPATED. 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 384 BLOOD PRESSURE CHECKS; 155 PULSE OX (HEART RATE AND OXYGEN LEVEL TESTS); AND 17 BALANCE SCREENINGS. IN ADDITION, PROPER HANDWASHING WAS A FEATURE OF THE HOSPITAL'S BOOTH. 31 EMPLOYEES SPENT A TOTAL OF 189 HOURS AT THE 6 DAY LONG EVENT. 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 8 WEDNESDAYS DURING THE SUMMER. THIS IS DOUBLE THE TIME THAT THEY WERE HELD LAST YEAR; REFLECTING THEIR POPULARITY. FALL PREVENTION IS A CONCERN FOR EVERYONE AS THE POPULATION AGES. DELAWARE VALLEY HOSPITAL HELD ITS SECOND, EIGHT WEEK MATTER OF BALANCE PROGRAM, WITH 14 PARTICIPANTS BEGINNING THE CLASS AND 11 RECEIVING COMPLETION CERTIFICATES. WHEN DVH STAFF HEARD OF A TAI CHI TRAINING BEING PRESENTED IN OUR AREA, STAFF RECRUITED OTHERS FROM OTHER ORGANIZATIONS TO TAKE THE TRAINING. SEVERAL DID AND BEGINNING IN 2016, CLASSES WILL BE HELD.BECAUSE TWO LOCAL COMMUNITIES HAD NO PHARMACY AND TRAVEL CAN BE DIFFICULT, THE HOSPITAL CONTINUED TO OFFER ITS FREE PRESCRIPTION DELIVERY PROGRAM TO RESIDENTS IN THE DOWNSVILLE AND ROSCOE AREA. IN 2015, 17 PATIENTS WERE SERVED, RECEIVING 143 PRESCRIPTIONS THROUGH THE SERVICE. THE ROSCOE COMMUNITY DID GET THEIR OWN PHARMACY DURING THE YEAR, REDUCING THE NEED TO CONTINUE THE SERVICE FOR THOSE COMMUNITY MEMBERS. IN ORDER TO ADDRESS A LONG-STANDING REQUEST BY MEMBERS OF THE COMMUNITY, THE HOSPITAL OPENED ITS RETAIL COMMUNITY PHARMACY IN OCTOBER. THE HOSPITAL OFFERS A FREE MAIL SERVICE FOR THOSE WHO ARE UNABLE TO COME TO THE PHARMACY TO PICK UP THEIR PRESCRIPTIONS.STAFF PARTICIPATED IN THE AMERICAN HEART ASSOCIATION'S GO RED FOR WOMEN EVENT AND HEART WALK; A LOCAL TOY DRIVE FOR CHILDREN; 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 ORGANIZATION INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. IN 2010, THE UNITED HEALTH SERVICES SYSTEM ENGAGED IN A STRATEGIC PLANNING PROCESS FOR THE YEARS 2010-2014. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSED ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND FOUR OBJECTIVES: CLINICAL EXCELLENCE, SERVICE EXCELLENCE, MARKET GROWTH AND FINANCIAL STRENGTH. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE UHS COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO UHS WITH THE OTHER AFFILIATES SUBMITTING SEPARATE REPORTS. 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 SOARIAN CLINICAL SYSTEMS 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 0 0 0 0 DR MICHAEL FREEMAN MEDICAL STAFF PRESIDENT 248091 0 0 0 0 0 14141 0 22425 0 284657 0 0 0 JOHN CARRIGG 2ND VICE CHAIR 0 451780 0 72630 0 0 0 16165 0 17264 0 557839 0 0 PAUL SUMMERS DIRECTOR/CEO 174968 0 17815 0 0 0 7658 0 8974 0 209415 0 0 0 DR RAJESH DAVE FORMER 2ND VICE CHAIR 0 506732 0 81489 0 10750 0 16165 0 17419 0 632555 0 0 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 248,091 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 53331 EMPLOYEE WAGES 0 BONNIE CRAIG SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 36446 EMPLOYEE WAGES 0 NANCY VOLLKOMMER SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO 29311 EMPLOYEE WAGES 0 MILA KATANIC-TUCKER STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS 24168 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 11 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 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 BASIS FOR ESTABLISHING ACCEPTABLE RANGE OF COMPENSATION 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 4,531,153. MANAGEMENT AND GENERAL EXPENSES 538,722. FUNDRAISING EXPENSES 87,620. TOTAL EXPENSES 5,157,495. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 22,307. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR 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) 9 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER 508 HIGH STREET ENDICOTT NY 13760 222902896 SENIOR LIVING CENTER NY 501(C)(3) 3 UNITED HEALTH SERVICES INC 0 IDEAL SENIOR LIVING CENTER HOUSING 508 HIGH STREET ENDICOTT NY 13760 222902899 SENIOR HOUSING NY 501(C)(3) 9 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) 9 UNITED HEALTH SERVICES INC BOARD OF DIRECTORS 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) 9 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