2015-11-12T16:10:04-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 150532079 CORTLAND REGIONAL MEDICAL CENTER INC CORT 6077563501 134 HOMER AVENUE CORTLAND NY 13045 DENISE WRINN VP OF FINANCE/CFO 6077563501 2015-11-11 1 JOSEPH J SCHLEGEL P00301329 3154463600 2014 2016-02-25 16:41:14Z DENISE WRINN 134 HOMER AVENUE CORTLAND NY 13045 106794127 0 X WWW.CORTLANDREGIONAL.ORG X 1892 NY CORTLAND REGIONAL MEDICAL CENTER,INC., LOCATED IN CORTLAND, NY, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES GENERAL INPATIENT, INPATIENT PSYCHIATRIC, OUTPATIENT, EMERGENCY, LONG-TERM HOME HEALTH CARE AND SKILLED NURSING SERVICES FOR RESIDENTS IN THE GREATER CORTLAND COUNTY AREA. 16 15 1086 311 255703 -129097 9617428 2100533 78019082 80728937 1053733 909862 -6968855 3108262 81721388 86847594 0 0 0 0 52660746 46510897 0 0 149439 39377829 38439398 92038575 84950295 -10317187 1897299 123229396 115952391 51933413 54028595 71295983 61923796 X CORTLAND REGIONAL MEDICAL CENTER PROVIDES QUALITY HEALTH CARE WITH SKILL AND COMPASSION, MEETING THE LIFE LONG HEALTH CARE NEEDS OF ALL CITIZENS OF CORTLAND AND THE SURROUNDING COMMUNITIES. 0 0 70410283 83581496 CORTLAND REGIONAL MEDICAL CENTER IS DEDICATED TO SERVING THE LIFELONG HEALTH CARE NEEDS OF CORTLAND AND THE SURROUNDING AREA. AS A TEAM-ORIENTED COMMUNITY HEALTH AND MEDICAL ORGANIZATION, CORTLAND REGIONAL MEDICAL CENTER PROVIDES QUALITY CARE, SKILL AND COMPASSION TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. OUR HOSPITAL IS COMMITTED TO: *IMPROVING THE WELLNESS OF THE COMMUNITY THROUGH LEADERSHIP IN HEALTH-RELATED ACTIVITIES AND EDUCATION. *SUPPORTING AND PRESERVING THE PERSONAL AND PROFESSIONAL GROWTH OF OUR QUALITY HEALTH-CARE TEAM, THEREBY PROVIDING STIMULATING ENVIRONMENT FOR ALL EMPLOYEES. *RECRUITING AND RETAINING QUALITY HEALTH-CARE PROFESSIONALS. *COOPERATING WITH OTHER HEALTH-CARE PROVIDERS,REGULATORY AGENCIES, AND INSURANCE COMPANIES TO ADVANCE OUR SERVICE TO EVERY MEMBER OF THE COMMUNITY. *MAINTAINING THE HOSPITALS FINANCIAL VIABILITY FOR THE WELL-BEING OF THE COMMUNITY. *ACQUIRING AND MAINTAINING EQUIPMENT REQUIRED TO PROVIDE QUALITY CARE. *ENCOURAGING THE ACTIVE PARTICIPATION OF COMMUNITY MEMBERS IN A VOLUNTEER CAPACITY IN ORDER TO AUGMENT OUR SERVICES. CORTLAND REGIONAL MEDICAL CENTER IS A VOLUNTARY, NOT-FOR-PROFIT CORPORATION. THE MEDICAL CENTER PROVIDES HEALTH CARE SERVICES OF PREVENTIVE, CURATIVE AND EDUCATIONAL NATURE. THE PRIMARY SERVICES PROVIDED ARE: ACUTE MEDICAL INPATIENT CARE (INCLUDING PEDS AND MATERNITY), PSYCHIATRIC INPATIENT CARE, RESIDENTIAL CARE (SKILLED NURSING FACILITY), EMERGENCY ROOM, AMBULATORY SURGERY, OUTPATIENT DIAGNOSTIC SERVICES, LONG TERM HOME HEALTH CARE PROGRAM, COMMUNITY HEALTH WELLNESS SCREENING, ADULT DAY CARE AND CLINIC. INPATIENT PATIENT DAYS WERE 50,691 AND OUTPATIENT SERVICE (ER, CLINIC, AMB SURG, REF AMB & LTHHC) VISITS WERE 116,469. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE. THE CHARGES FOREGONE UNDER THIS POLICY AMOUNTED TO APPROXIMATELY $500,000 IN 2014. 70410283 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 1 98 0 1 1086 1 1 1 0 0 0 0 0 0 0 0 0 X 16 15 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X DENISE WRINN - CORTLAND REGIONAL MED 6077563501 134 HOMER AVENUE CORTLAND NY 13045 JEFFREY SEIBERT BOARD MEMBER - SECRETARY 1.00 X X 0 0 0 STEVEN CINQUANTI BOARD MEMBER 1.00 X 0 0 0 NANCY RONGO BOARD MEMBER - CHAIRPERSON 1.00 X X 0 0 0 WILLIAM POMEROY BOARD MEMBER - VICE CHAIRP 1.00 X X 0 0 0 JOHANNA AMES BOARD MEMBER - TREASURER 1.00 X X 0 0 0 DOUGLAS RAHNER MD BOARD MEMBER 1.00 X 0 0 0 PATRICK HAYES MD BOARD MEMBER 1.00 X 0 0 0 CHARLOTTE HAWKINS MD BOARD MEMBER 1.00 X 0 0 0 GARRY VANGORDER BOARD MEMBER 1.00 X 0 0 0 REV DAVID JOHNSON BOARD MEMBER 1.00 X 0 0 0 MARK RAYMOND BOARD MEMBER 1.00 X 0 0 0 LEO MCGRATTAN BOARD MEMBER 1.00 X 0 0 0 MARK PRUS BOARD MEMBER 1.00 X 0 0 0 LEE SHURTLEFF BOARD MEMBER 1.00 X 0 0 0 DAVID MAYO BOARD MEMBER 1.00 X 0 0 0 MARGARET PERI BOARD MEMBER 1.00 X 0 0 0 DAVID WIRTZ MD BD MBER EX OFFICIO TRUSTEE 1.00 X 30000 0 0 MARK WEBSTER PRESIDENT/CEO 37.50 1.00 X 365547 0 56269 DENNIS TREPANIER COO 37.50 X 185387 0 270 DENISE MIRONTI SENIOR VICE PRESIDENT 37.50 X 114712 0 4286 DENISE WRINN VICE PRESIDENT 37.50 X 224044 0 30641 ROGER SCOTT MD VICE PRESIDENT MEDICAL AFFAIRS 37.50 X 218423 0 9183 ROBERT KARPMAN VICE PRESIDENT MEDICAL AFF 37.50 1.00 X 339440 0 14569 JANICE JAMES PRESIDENT/CEO 37.50 X 16000 0 0 MARY WRIGHT VICE PRESIDENT-NURSING SERVICES 37.50 X 168257 0 32313 ARTHUR DUNN COO 37.50 X 67939 0 0 JUSSI MAIJALA VICE PRESIDENT 37.50 X 43905 0 7830 DAVID KAMINSKY PHARMACIST 37.50 X 120096 0 4870 THOMAS ROBERTS PHARMACIST 37.50 X 118379 0 22427 CHRISTINA DENNISTON DIRECTOR - PHARMACY 37.50 X 141919 0 24812 ALAN JAMES CONTROLLER 37.50 X 113919 0 25107 MICHELLE TUCKER PHARMACIST 37.50 X 116598 0 17426 2384565 0 250003 18 0 1 0 HAYNER HOYT CORPORATION 625 ERIE BLVD WEST SYRACUSE NY 13204 CONSTRUCTION SERVICES 5382132 REGIONAL MEDICAL PRACTICE PC 134 HOMER AVENUE CORTLAND NY 13045 PHYSICIAN SERVICES 3293422 PRISM HEALTHCARE PARTNERS LTD 190 S LASALLE ST SUITE 2900 CHICAGO IL 60603 CONSULTING SERVICES 1332774 EMERGENCY MEDICINE PHYSICIANS 4535 DRESSLER ROAD NW CANTON OH 44718 PHYSICIAN SERVICES 1019884 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LABORATORY SERVICES 543393 27 46498 1039626 1014409 2100533 PROGRAM SERVICE REVENUE 621990 80728937 80728937 80728937 633111 633111 20223284 19946533 276751 276751 276751 CHILD DAYCARE REVENUE 900099 323891 68188 255703 CAFETERIA REVENUE 900099 222117 222117 REBATES 900099 33115 33115 2529139 2529139 3108262 86847594 83581496 255703 909862 1929015 528074 1400941 34742355 29762002 4864720 115633 1637319 1356082 274562 6675 5636821 4851240 766923 18658 2565387 2133174 423874 8339 62353 62353 110208 110208 99071 99071 6043337 4023090 2020247 287321 249741 37580 636946 251873 385073 1302672 781603 521069 2396803 1799015 597788 492719 294002 198717 63155 34007 29148 5407637 4562615 845022 586938 503970 82968 SUPPLIES 9818524 9536321 282203 PURCHASED SERVICES 5231046 4356048 874864 134 BAD DEBT EXPENSE 3606184 3606184 EQUIPMENT RENTAL & MAIN 1052871 980604 72267 1241613 800638 440975 84950295 70410283 14390573 149439 14459 13900 6803635 7197692 6896490 1384464 11879563 10363023 17600056 19021722 501010 574874 721766 787684 135004217 93415424 42805622 41588793 19186763 19856315 16820032 15163924 123229396 115952391 15484032 8558185 21300000 20400000 1100216 1109895 14049165 23960515 51933413 54028595 X 63737702 55087467 3568982 2766445 3989299 4069884 71295983 61923796 123229396 115952391 X 1897299 7579 -11277065 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 99071 0 0 99071 0 PART II-B, LINE 1: CORTLAND REGIONAL MEDICAL CENTERS LOBBYING ACTIVITY CONSISTED OF: COUNSEL, ADVOCACY AND REPRESENTATION OF CORTLAND REGIONAL MEDICAL CENTER WITH THE GOVERNORS OFFICE, THE LEGISLATURE AND STATE AGENCIES IN REGARD TO BUDGET OR REGULATORY ISSUES. PART OF WHAT WE PAY LAW OFFICES OF WILSON, ELSER, MOSKOWITZ, EDELMAN & DICKER LLP AND A PORTION OF THE DUES PAID TO HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS), IROQUOIS HEALTHCARE ASSOCIATION, HOME CARE ASSOCIATION OF NEW YORK (HCA), AMERICAN HOSPITAL ASSOCIATION (AHA) AND LEADING AGE IS DESIGNATED TO LOBBYING ACTIVITIES. 7558281 73819 795766 6836329 14188155 1273892 188855 8092623 7558281 4676900 9189148 91654 -230453 14188155 4761500 169260 -28062 225798 4676900 4512049 252043 105167 107759 4761500 0.59500 0.40500 0 1 1 2968788 2968788 69882619 42428394 27454225 58432691 48376113 10056578 3720119 2610917 1109202 41588793 BENEFICIAL INTEREST IN NET ASSETS OF CORTLAND MEMORIAL FOUNDATION 5148965 UNAMORTIZED DEBT ISSUANCE COST 641872 OTHER RECEIVABLES 9373087 15163924 DUE TO THIRD PARTY PAYORS 3422231 ADDITIONAL MINIMUM PENSION LIABILITY 17571986 ADVANCES FROM THIRD PARTY PAYORS 920238 LONG TERM INSURANCE LIABILITY 1911575 LONG TERM INTEREST RATE SWAP LIABILITY 134485 23960515 X PART V, LINE 4: THE HOSPITAL'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED TO PURCHASE MEDICAL EQUIPMENT WHICH SUPPORTS VARIOUS DEPARTMENTS OF THE HOSPITAL. PART X, LINE 2: INCOME TAXES: THE HOSPITAL QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2014 AND 2013, 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 NEW YORK STATE TAXING AUTHORITIES ARE 2011 THROUGH 2014. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. 1 1 1 X 1 X 1 1 0 1 1 734 177017 177017 0.00220 30941 23518947 19451484 4067463 0.05000 31675 23695964 19451484 4244480 0.05220 12134339 8985206 3149133 0.03870 12134339 8985206 3149133 0.03870 31675 35830303 28436690 7393613 0.09090 1 3606184 357012 22253757 28869475 -6615718 X 1 1 1 1 CORTLAND REGIONAL MEDICAL CENTER INC 134 HOMER AVENUE CORTLAND NY 13045 WWW.CORTLANDREGIONAL.ORG 1101000H X X X CORTLAND REGIONALMEDICAL CENTER INC 1 0 0 1 X X X X X X X X 13 1 0 0 1 X WWW.CORTLANDREGIONAL.ORG/ABOUT-CRMC/COMMUNITY-SERVICE-P X CCHD.CORTLAND-CO.ORG/INDEX.PHP/DATA-AND-REPORTS X X 1 14 1 WWW.CORTLANDREGIONAL.ORG 0 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X X 1 X X X X X X 1 0 X X X 1 X 0 0 CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: DATA GATHERED WITH CORTLAND COUNTY HEALTH DEPARTMENT, SUNY CORTLAND, UNITED WAY FOR CORTLAND COUNTY, SEVEN VALLEYS HEALTH COALITION, CORTLAND COUNTY BUSINESS DEVELOPMENT CORPORATION, CORTLAND AREA COMMUNITIES THAT CARE COALITION AND FAMILY HEALTH NETWORK. PARTICIPATING FOCUS GROUPS WERE: 4-H TEEN COUNCIL MEMBERS, ACCESS TO INDEPENDENCE STAFF, CORTLAND COUNTY YOUTH BUREAU STUDENTS, LOAVES AND FISHES CLIENTS, WISHING WELLNESS CENTER CLIENTS, LEADERS OF HEALTH AND HUMAN SERVICE AGENCIES, SUNY CORTLAND STUDENTS, CHARLES STREET AND LAWRENCE HOUSE RESIDENTS, CORTLAND COUNTY HEALTH DEPARTMENT STAFF, CORTLAND REGIONAL MEDICAL CENTER STAFF, MEALS ON WHEELS RECIPIENTS, LGBT COMMUNITY MEMBERS, YWCA MODEL MOMS PARTICIPANTS, HOMER AND WILLET SENIOR CENTER PARTICIPANTS AND CORTLAND CAREER WORKS PARTICPANTS. CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 7D: CORTLAND REGIONAL MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT IS PLACED IN THE COUNTY'S PUBLIC LIBRARIES, INCLUDING CINCINNATUS, CORTLAND, HOMER, MARATHON AND MCGRAW. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE ON THE MEDICAL CENTER'S WEBSITE AT WWW.CORTLANDREGIONAL.ORG AND ON THE SEVEN VALLEYS HEALTH COALITION WEBSITE AT WWW.SEVENVALLEYSHEALTH.ORG. CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: ACCESS TO PRIMARY CARE PHYSICIANS, AS WELL AS, SPECIALTY PHYSICIANS IS A CURRENT NEED IN CORTLAND COUNTY. CORTLAND REGIONAL MEDICAL CENTER IS ACTIVELY RECRUITING FOR PRIMARY CARE PHYSICIANS, INTERNAL MEDICINE, PSYCHIATRIST, PULMONOLOGIST, OPHTHALMOLOGIST, ENDOCRINOLOGIST AND GASTROENTEROLOGIST. IT IS IMPORTANT TO HAVE THESE PHYSICIAN SERVICES IN CORTLAND, CLOSE TO HOME FOR THE RESIDENTS OF CORTLAND COUNTY. THESE NEW SERVICES WILL GREATLY BENEFIT THE COMMUNITY HEALTH NEEDS FOR THE SURROUNDING CORTLAND AREA. CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 22D: USED HIGHEST VOLUME THIRD PARTY PAYER RATE. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 16A WEBSITE: WWW.CORTLANDREGIONAL.ORG CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 16B WEBSITE: WWW.CORTLANDREGIONAL.ORG CORTLAND REGIONAL.MEDICAL CENTER, INC. PART V, SECTION B, LINE 16C WEBSITE: WWW.CORTLANDREGIONAL.ORG 5 CRNURSING & REHABILITATION FACILITY 134 HOMER AVENUE CORTLAND NY 13045 SKILLED NURSING FACILITY CRMC OUTPATIENT SERVICE CENTER 4005 WEST ROAD - ROUTE 281 CORTLAND NY 13045 PHYSICAL THERAPY AND IMAGING SERVICE CRMC LONG TERM HOME HEALTH CARE 134 HOMER AVENUE CORTLAND NY 13045 LONG TERM HOME HEALTH CARE CRMC LABORATORY SERVICE CENTER 4077 WEST ROAD - ROUTE 281 CORTLAND NY 13045 LABORATORY SERVICES CRMC LABORATORY SERVICE CENTER 6 EUCLID AVENUE CORTLAND NY 13045 LABORATORY SERVICES PART I, LINE 7: THE COST WAS CALCULATED USING WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES FROM SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: MANY PHYSICIANS NO LONGER WANT TO BE IN PRIVATE PRACTICE, BUT SEEK EMPLOYMENT ARRANGEMENTS WITH HOSPITALS OR HOSPITAL-AFFILIATED PHYSICIAN GROUPS. REGIONAL MEDICAL PRACTICE (RMP), A PHYSICIAN GROUP CONTROLLED AND SUPPORTED BY THE HOSPITAL, WAS FORMED TO FURTHER THE MEDICAL CENTER'S CHARITABLE PURPOSES TO HELP RECRUIT SPECIALTY PHYSICIANS INTO THE RURAL CORTLAND AREA. THROUGH RMP, WE HAVE BEEN ABLE TO RECRUIT SPECIALTY PHYSICIANS FOR CARDIOLOGY, INTERNAL MEDICINE/INFECTOUS DISEASE, HOSPITALIST, ONCOLOGY AND ORTHOPEDICS. PRIOR TO RMP, THERE WERE NO CARDIOLOGISTS AT ALL IN CORTLAND, NO ORTHOPEDIC SURGEONS PERFORMING SURGERY IN CORTLAND, SO PATIENTS HAD TO TRAVEL OVER 30 MILES FOR THESE SERVICES. THE HOSPITAL IS ACTIVELY RECRUITING FOR INTERNAL MEDICINE, PRIMARY CARE PHYSICIAN, PSYCHIATRIST, PULMONOLOGIST, OPHTHALMOLOGIST, ENDOCRINOLOGIST AND GASTROENTEROLOGIST. THE HOSPITAL IS CLASSIFIED AS A SOLE COMMUNITY PROVIDER BY MEDICARE BECAUSE OF THE DISTANCE FROM OTHER HOSPITALS, SO IT IS VERY IMPORTANT TO HAVE THESE PHYSICIAN SERVICES IN CORTLAND AND NOT OVER 30 MILES AWAY. THE AMOUNTS SHOWN ON PART I, LINE 7G REPRESENT REVENUES, EXPENSES, AND THE RESULTING LOSS FOR THE YEAR. THESE LOSSES ARE CONSIDERED SUBSIDIZED HEALTH SERVICES FOR 990 REPORTING PURPOSES BECAUSE IF THE HOSPITAL DID NOT SUPPORT THESE RMP PHYSICIAN SPECIALTIES, THESE VITAL SERVICES WOULD NOT BE AVAILABLE IN THE CORTLAND COMMUNITY. RMP HAS OBTAINED ITS EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE". PART I, LN 7 COL(F): BAD DEBT EXPENSE FROM THE INCOME STATEMENT IS SUBTRACTED OUT.CREDIT AND COLLECTION POLICY: CORTLAND REGIONAL MEDICAL CENTER WILL PRACTICE COLLECTION PROCEDURES IN A UNIFORM MANNER TO ENSURE THAT ALL PATIENTS / DEBTORS ARE TREATED FAIRLY WHEN DEALING WITH AMOUNTS OWED TO THE HOSPITAL. THE TRANSFER OF SELF-PAY ACCOUNT BALANCES TO BAD DEBT AND AN OUTSIDE COLLECTION AGENCY WILL OCCUR FOLLOWING SPECIFIC STANDARDS AND GUIDELINES.1. SELF-PAY (SP) ACCOUNTS ARE DEFINED AS ACCOUNTS FOR WHICH THE BALANCE DUE IS OWED BY THE PATIENT / GUARANTOR, RATHER THAN A THIRD PARTY RESOURCE.2. ALL BUSINESS OFFICE STAFF WILL GUIDE PATIENTS IN NEED OF ASSISTANCE PAYING ACCOUNT BALANCE(S). SPECIFICALLY, PATIENT ADVOCATES WILL CONTACT PATIENTS REGISTERED AT CRMC WITH SP STATUS TO VERIFY A THIRD PARTY PAYER DOES NOT EXIST, AND TO OFFER GUIDANCE TO POSSIBLY APPLY FOR INSURANCE OR CHARITY CARE. THE FINANCIAL COUNSELORS WILL REVIEW ALL ACCOUNTS WITH SP STATUS, AND THEN USE DISCRETION IN SETTING UP PAYMENT ARRANGEMENTS, ARRANGING CHARITY CARE OR TRANSFERRING THE ACCOUNT(S) TO BAD DEBT WITH AN OUTSIDE COLLECTION AGENCY.3. PATIENTS / GUARANTORS WILL RECEIVE 4 STATEMENTS AND A 10-DAY LETTER PRIOR TO TRANSFERRING THE ACCOUNT TO BAD DEBT AND COLLECTION. EXCEPTIONS:A. SMALL BALANCE ACCOUNTS UNDER $50.00 MAY RECEIVE ONLY ONE STATEMENT, THEN A 10-DAY LETTER.B. IF AT ANY TIME DURING THE SEQUENCE OF STATEMENTS A PATIENT/GUARANTOR ABSOLUTELY REFUSES TO MAKE PAYMENT ARRANGEMENTS TO CRMC, THE 4 STATEMENT SEQUENCE MAY BE BYPASSED AT ANY POINT AND THE 10-DAY LETTER MAY BE SENT. SHOULD THIS SITUATION OCCUR, THE ACCOUNT(S) WILL BE DOCUMENTED ACCORDINGLYPROCEDURE:1. ACCOUNTS REGISTERED AS SP ONLY, WILL HOLD THE FOLLOWING SEQUENCE:A. A FINAL BILL WILL DROP 5 DAYS AFTER DISCHARGE IF CODING OF ACCOUNT IS COMPLETE. OTHERWISE, A FINAL BILL WILL DROP UPON COMPLETION OF CODING.B. IF FULL PAYMENT IS NOT RECEIVED, STATEMENT 1 WILL DROP 20 DAYS AFTER THE FINAL BILL IS CUT.C. IF BALANCE REMAINS, STATEMENT 2 WILL DROP 23 DAYS AFTER STATEMENT 1.D. IF BALANCE REMAINS, STATEMENT 3 WILL DROP 23 DAYS AFTER STATEMENT 2.E. IF BALANCE REMAINS, STATEMENT 4 WILL DROP 23 DAYS AFTER STATEMENT 3.2. ACCOUNTS REGISTERED WITH INSURANCE(S), OTHER THAN MEDICARE PRIMARY, THAT HAVE SP BALANCES DUE WILL BE MAILED STATEMENT 1, THREE DAYS AFTER THE FINAL INSURANCE PAYMENT HAS BEEN POSTED. STATEMENT 2, 3, AND 4 WILL FOLLOW THE SAME 23 DAY SEQUENCE AS NOTED ABOVE.3. ACCOUNTS REGISTERED WITH MEDICARE AS THE PRIMARY INSURANCE THAT HAVE SP BALANCES DUE WILL BE MAILED STATEMENT 1 THREE DAYS AFTER THE FINAL INSURANCE PAYMENT HAS BEEN POSTED. STATEMENTS 2, 3 AND 4 WILL DROP AT 40 DAY INTERVALS.NOTE: IF THE ACCOUNT HAS A BALANCE AFTER MEDICARE, THE ACCOUNT WILL NOT BE REFERRED TO BAD DEBT AND COLLECTION FOR AT LEAST 120 DAYS AFTER THE INITIAL SP STATEMENT HAS BEEN SENT TO THE PATIENT / GUARANTOR.4. NO LONGER THAN 30 DAYS AFTER THE 4TH STATEMENT GOES OUT TO THE PATIENT / GUARANTOR, A 10-DAY LETTER IS ISSUED. THE 10 DAY LETTER SERVES AS A NOTICE OF INTENT TO SEND THE ACCOUNT(S) TO BAD DEBT AND COLLECTION.5. IF THERE IS NO PAYMENT OR RESPONSE FROM THE PATIENT / GUARANTOR WITHIN 14 DAYS OF SENDING THE 10-DAY LETTER, THE ACCOUNT WILL BE OFFICIALLY TRANSFERRED TO BAD DEBT AND AN OUTSIDE COLLECTION AGENCY.6. CONTRACT PAYMENT ARRANGEMENTS:IF AT ANY TIME IN THE ABOVE NOTED SEQUENCE OF STATEMENTS, THE PATIENT / GUARANTOR CONTACTS CRMC, BUT CANNOT MAKE PAYMENT IN FULL, CONTRACT PAYMENT ARRANGEMENTS WILL BE OFFERED.POLICY FOR CONTRACT PAYMENT ARRANGEMENT ACCOUNT BALANCE CONTRACT PAYMENT ARRANGEMENTS BELOW 200.00 EXPECTED PAYMENT IN FULL - MINIMUM PAYMENT $50.00 200.00 - 500.00 MINIMUM OF $50.00/MONTH 4 - 6 MONTHS 501.00 - 1000.00 MINIMUM OF 75.00/MONTH 7 - 13 MONTHS 1001.00 - 1500.00 MINIMUM OF 100.00/MONTH 10 - 15 MONTHS 1501.00 - 2000.00 MINIMUM OF 125.00/MONTH 12 - 16 MONTHS 2001.00 - 3000.00 MINIMUM OF 150.00/MONTH 13 - 20 MONTHS 3001.00 - OVER BALANCE IF FULL EXTEND UP TO 24 MONTHS MAX - 24 MONTHSONCE CONTRACT PAYMENT ARRANGEMENTS ARE FINALIZED, THE CONTRACT CONFIRMATION LETTER IS MAILED TO THE PATIENT / GUARANTOR. ALL TERMS ARE EXPLAINED TO AND AGREED UPON BY THE PATIENT / GUARANTOR. THE LETTER SERVES AS AN AGREEMENT BETWEEN CRMC AND THE DEBTOR. IF THE DEBTOR DEFAULTS, THE CONTRACT CONFIRMATION LETTER MAY BE USED AGAINST HIM / HER IF THE ACCOUNT IS REFERRED TO COLLECTION.7. CHARITY CARE APPLICATIONS:IF AT ANY TIME IN THE ABOVE NOTED SEQUENCE OF STATEMENTS THE PATIENT / GUARANTOR CONTACTS CRMC, BUT CANNOT MAKE EVEN A PARTIAL PAYMENT, A CHARITY CARE APPLICATION WILL BE OFFERED. - REFER TO POLICY 13-7000-3, CHARITY CARE.8. COLLECTIONS ACCOUNTS:ONCE AN ACCOUNT IS TRANSFERRED TO AN OUTSIDE COLLECTION AGENCY, IT IS PREFERRED THAT THE AGENCY HANDLE ALL DIRECT PATIENT / GUARANTOR COMMUNICATION. ALL CALLS REGARDING BAD DEBT ACCOUNTS SHOULD BE REFERRED TO THE AGENCY. HOWEVER, IF THE PATIENT / GUARANTOR INSISTS ON DEALING ONLY WITH CRMC, BUSINESS OFFICE STAFF WILL ACCEPT PAYMENT OR PAYMENT TERMS. ALL PAYMENT AND ARRANGEMENTS WILL BE COMMUNICATED TO THE COLLECTION AGENCY.9. ACCOUNT COMMENTS:ALL COMMUNICATION, AS WELL AS COMMUNICATION ATTEMPTS, WILL BE DOCUMENTED BY THE BUSINESS OFFICE STAFF IN THE PATIENT ACCOUNT COMMENTS. PART III, LINE 4: AUDITED FINANCIAL STATEMENT FOOTNOTE (PAGE 12) PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL AND PRACTICE ANALYZE PAST PAYMENT HISTORY AND IDENTIFY TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL AND PRACTICE ANALYZE CONTRACTUALLY DUE AMOUNTS AND PROVIDE AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS AND 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, THE HOSPITAL AND PRACTICE ALSO ANALYZE AMOUNTS DUE AND PROVIDE AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, INCLUDING CONSIDERATION OF CURRENT BUSINESS AND ECONOMIC CONDITIONS. WHEN THE HOSPITAL AND PRACTICE ESTABLISH THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BOTH TAKE INTO CONSIDERATION THE FACT THAT MANY SELF-PAY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S AND PRACTICE'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 27.7% AND 27.9% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY. THE SLIGHT INCREASE RELATES TO NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN RECENT YEARS AS A RESULT OF CONTINUING HIGH LEVELS OF UNEMPLOYED AND UNINSURED PATIENTS IN THE REGION. PART III, LINE 8: THE MEDICARE COST WAS CALCULATED USING THE WORKSHEET IN THE SCHEDULE H INSTRUCTIONS.FINANCIAL ASSISTANCE POLICY:PURPOSE: ALIGNED WITH OUR VALUES, WE PROVIDE CARE FOR PERSONS WHO ARE IN NEED AND GIVE SPECIAL CONSIDERATION TO THOSE WHO ARE MOST VULNERABLE, INCLUDING THOSE WHO ARE UNABLE TO PAY AND THOSE WHOSE LIMITED MEANS MAKE IT EXTREMELY DIFFICULT TO MEET THE HEALTH CARE EXPENSES INCURRED. CORTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO:" PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE. " CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES; AND" ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THAT THEY RECEIVE.DEFINITIONS: EMERGENT (SERVICE LEVEL) - MEDICAL SERVICES NEEDED FOR A CONDITION THAT MAY BE LIFE THREATENING OR THE RESULT OF A SERIOUS INJURY AND REQUIRING IMMEDIATE MEDICAL ATTENTION. THIS MEDICAL CONDITION IS GENERALLY GOVERNED BY EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA).FAMILY - AS DEFINED BY THE U.S. CENSUS BUREAU, A GROUP OF TWO OR MORE PEOPLE WHO RESIDE TOGETHER AND WHO ARE RELATED BY BIRTH, MARRIAGE, OR ADOPTION. IF A PATIENT CLAIMS SOMEONE AS A DEPENDENT ON THEIR INCOME TAX RETURN, ACCORDING TO THE INTERNAL REVENUE SERVICE RULES, THEY MAY BE CONSIDERED A DEPENDENT FOR THE PURPOSE OF DETERMINING ELIGIBILITY UNDER THE CRMC FINANCIAL ASSISTANCE POLICY.INCOME - INCOME INCLUDES WAGES, SALARIES, SALARY AND SELF-EMPLOYMENT INCOME, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION, PAYMENTS FROM SOCIAL SECURITY, VETERAN'S BENEFITS, ALIMONY, SURVIVOR'S BENEFITS, PENSIONS, RETIREMENT INCOME AND ANNUITY PAYMENTS, INCOME FROM ESTATES AND TRUSTS, RENTS RECEIVED, INTEREST/DIVIDENDS, AND INCOME FROM OTHER MISCELLANEOUS SOURCES.FAMILY INCOME - A PERSON'S FAMILY INCOME INCLUDES THE INCOME OF ALL FAMILY MEMBERS IN THE HOUSEHOLD WHO CAN BE CLAIMED UPON THE TAX RETURN FILED BY THE APPLICANT. FOR PATIENTS UNDER 18 YEARS OF AGE, FAMILY INCOME INCLUDES THAT OF THE PARENTS AND/OR STEP-PARENTS, OR CARETAKER RELATIVES. TOTAL HOUSEHOLD INCOME IS INCOME FROM ALL MEMBERS OF A HOUSEHOLD FROM THE FOLLOWING SOURCES: WAGES, UNEMPLOYMENT INCOME, WORKERS COMPENSATION, VETERANS BENEFITS, SOCIAL SECURITY INCOME, DISABILITY INCOME, ALIMONY, AND OTHER CASH INCOME INCLUDING PENSION/RETIREMENT.PROOF OF EARNINGS MAY BE DETERMINED BY ANNUALIZING THE YEAR-TO-DATE FAMILY INCOME, TAKING INTO CONSIDERATION THE CURRENT EARNINGS RATE.FINANCIAL SUPPORT - SUPPORT (FINANCIAL AID, DISCOUNTS, ETC.) PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A HARDSHIP TO PAY FOR THE FULL COST OF MEDICALLY NECESSARY SERVICES PROVIDED BY CRMC WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. UNINSURED PATIENT - AN INDIVIDUAL WHO IS UNINSURED, HAVING NO THIRD-PARTY COVERAGE BY A COMMERCIAL THIRD-PARTY INSURER, AN ERISA PLAN, A FEDERAL HEALTH CARE PROGRAM (INCLUDING WITHOUT LIMITATION MEDICARE, MEDICAID, SCHIP, AND CHAMPUS), WORKER'S COMPENSATION, OR OTHER THIRD PARTY ASSISTANCE TO COVER ALL OR PART OF THE COST OF CARE, INCLUDING CLAIMS AGAINST THIRD PARTIES COVERED BY INSURANCE TO WHICH CRMC IS SUBROGATED, BUT ONLY IF PAYMENT IS ACTUALLY MADE BY SUCH INSURANCE COMPANY. URGENT (SERVICE LEVEL) - MEDICAL SERVICES FOR A CONDITION NOT LIFE THREATENING, BUT REQUIRING TIMELY MEDICAL SERVICES.SERVICE AREA - A SERVICE AREA IS THE LIST OF ZIP CODES COMPRISING CRMC'S SERVICE MARKET AREA FOR PRIMARY HEALTH CARE SERVICES. PROCEDURE:I. QUALIFYING CRITERIA FOR FINANCIAL ASSISTANCE CRMC WILL ESTABLISH AND MAINTAIN A FINANCIAL ASSISTANCE POLICY (FAP) DESIGNED TO ADDRESS THE NEED FOR FINANCIAL ASSISTANCE AND SUPPORT TO PATIENTS FOR ALL ELIGIBLE SERVICES REGARDLESS OF RACE, CREED, SEX, OR AGE. ELIGIBILITY FOR FINANCIAL ASSISTANCE AND SUPPORT FROM CRMC WILL BE DETERMINED ON AN INDIVIDUAL BASIS USING SPECIFIC CRITERIA AND EVALUATED ON AN ASSESSMENT OF THE PATIENT'S AND/OR FAMILY'S HEALTH CARE NEEDS, FINANCIAL RESOURCES AND OBLIGATIONS. A. SERVICES ELIGIBLE FOR FINANCIAL SUPPORT:I. ALL MEDICALLY NECESSARY SERVICES, INCLUDING MEDICAL AND SUPPORT SERVICES PROVIDED BY CRMC WILL BE ELIGIBLE FOR FINANCIAL SUPPORT. II. EMERGENCY MEDICAL CARE SERVICES WILL BE PROVIDED TO ALL PATIENTS WHO PRESENT TO THE CRMC EMERGENCY DEPARTMENT, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SUCH MEDICAL CARE WILL CONTINUE UNTIL THE PATIENT'S CONDITION HAS BEEN STABILIZED PRIOR TO ANY DETERMINATION OF PAYMENT ARRANGEMENTS.B. SERVICES NOT ELIGIBLE FOR FINANCIAL SUPPORT: I. COSMETIC SERVICES, OTHER ELECTIVE PROCEDURES AND SERVICES THAT ARE NOT MEDICALLY NECESSARY. II. SERVICES PROVIDED IN CRMC'S SKILLED NURSING FACILITY AND SWING BED SERVICES.III. SERVICES NOT PROVIDED AND BILLED BY CRMC (E.G. INDEPENDENT PHYSICIAN SERVICES, PRIVATE DUTY NURSING, AMBULANCE TRANSPORT, ETC.).IV. AS PROVIDED IN SECTION II. CRMC WILL MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS. CRMC MAY DENY FINANCIAL SUPPORT TO THOSE INDIVIDUALS WHO DO NOT COOPERATE IN APPLYING FOR PROGRAMS THAT MAY PAY FOR THEIR HEALTH CARE SERVICES, BUT SHALL NOT ENGAGE IN EXTRAORDINARY COLLECTION EFFORTS THAT COULD JEOPARDIZE CRMC'S TAX EXEMPT STATUS.C. RESIDENCY REQUIREMENTSI. CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS WHO RESIDE WITHIN ITS SERVICE AREA AND QUALIFY UNDER CRMC'S FAP. II. CRMC MAY IDENTIFY SERVICE AREAS IN ITS FAP AND INCLUDE SERVICE AREA INFORMATION IN PROCEDURE DESIGN AND TRAINING. CRMC SERVICE AREA RESIDENCY REQUIREMENT WILL START WITH THE LIST OF ZIP CODES THAT DEFINE CRMC'S SERVICE AREAS. ELIGIBILITY WILL BE DETERMINED BY CRMC USING THE PATIENT'S PRIMARY RESIDENCE ZIP CODE. III. SERVICE AREA ZIP CODES: 13045, 13077, 13073, 13118, 13068, 13053, 13159, 13803, 13040, 13092, 13101, 13052, 13158, 13141, 13136IV. CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS FROM OUTSIDE ITS SERVICE AREA WHO QUALIFY UNDER CRMC FAP AND WHO PRESENT WITH AN URGENT, EMERGENT OR LIFE-THREATENING CONDITION.V. CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS IDENTIFIED AS NEEDING SERVICE BY PHYSICIAN FOREIGN MISSION PROGRAMS CONDUCTED BY ACTIVE MEDICAL STAFF FOR WHICH PRIOR APPROVAL HAS BEEN OBTAINED FROM CRMCS PRESIDENT OR DESIGNEE.D. DOCUMENTATION FOR ESTABLISHING INCOMEI. INFORMATION PROVIDED TO CRMC BY THE PATIENT AND/OR FAMILY SHOULD INCLUDE EARNED INCOME, INCLUDING MONTHLY GROSS WAGES, SALARY AND SELF-EMPLOYMENT INCOME; UNEARNED INCOME INCLUDING ALIMONY, RETIREMENT BENEFITS, DIVIDENDS, INTEREST AND INCOME FROM ANY OTHER SOURCE; NUMBER OF DEPENDENTS IN HOUSEHOLD; AND OTHER INFORMATION TO DETERMINE THE PATIENT'S FINANCIAL RESOURCES. II. SUPPORTING DOCUMENTS SUCH AS PAYROLL STUBS, TAX RETURNS, AND CREDIT HISTORY MAY BE REQUESTED TO SUPPORT INFORMATION REPORTED AND SHALL BE MAINTAINED WITH THE COMPLETED APPLICATION AND ASSESSMENT.E. PROTECTED ASSETSPROTECTION OF CERTAIN TYPES OF ASSETS AND PROTECTION OF CERTAIN LEVELS OF ASSETS ARE PROVIDED IN CRMC'S FAP. PROTECTED ASSETS:" BUSINESS USE VEHICLES," TOOLS OR EQUIPMENT USED FOR BUSINESS; REASONABLE EQUIPMENT REQUIRED TO REMAIN IN BUSINESS. " PERSONAL USE PROPERTY (CLOTHING, HOUSEHOLD ITEMS, FURNITURE)," IRAS, 401K, CASH VALUE RETIREMENT PLANS," FINANCIAL AWARDS RECEIVED FROM NON-MEDICAL CATASTROPHIC EMERGENCIES," IRREVOCABLE TRUSTS FOR BURIAL PURPOSES, PREPAID FUNERAL PLANS, AND/OR" FEDERAL/STATE ADMINISTERED COLLEGE SAVINGS PLANSALL OTHER ASSETS MAY BE CONSIDERED AVAILABLE FOR PAYMENT OF MEDICAL EXPENSES.F. PRESUMPTIVE SUPPORTI. CRMC RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON LIMITED AVAILABLE INFORMATION. WHEN SUCH APPROVAL IS GRANTED IT IS CLASSIFIED AS "PRESUMPTIVE SUPPORT". CRMC MAY UTILIZE CERTAIN TOOLS USING DEMOGRAPHIC INFORMATION COMMONLY AVAILABLE IN CONJUNCTION WITH A "FAST TRAK" FINANCIAL ASSISTANCE APPLICATION.II. EXAMPLES OF PRESUMPTIVE CASES INCLUDE:" DECEASED PATIENTS WITH NO KNOWN ESTATE " HOMELESS " UNEMPLOYED PATIENTS " NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS " PATIENT BANKRUPTCIES(CHAPTER 7), AND " MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.III. FOR PATIENTS WHO ARE NON-RESPONSIVE TO THE APPLICATION PROCESS, OTHER SOURCES OF INFORMATION, IF AVAILABLE, MAY BE USED TO MAKE AN INDIVIDUAL ASSESSMENT OF FINANCIAL NEED. THIS INFORMATION WILL ENABLE CRMC TO MAKE AN INFORMED DECISION ON THE FINANCIAL NEED OF NON-RESPONSIVE PATIENTS. IV. FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD-PARTY MAY BE UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. SEE SCHEDULE O FOR CONTINUATION PART III, LINE 9B: SEE FINANCIAL ASSISTANCE POLICY FROM PART III, LINE 8. PART VI, LINE 2: NEEDS ASSESSMENT: CRMC WORKS COLLABORATIVELY WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, SUNY CORTLAND, UNITED WAY FOR CORTLAND COUNTY, FAMILY HEALTH NETWORK, AND SEVEN VALLEYS HEALTH COALITION ON AN ANNUAL BASIS TO DO A COUNTY WIDE INTEGRATED ASSESSMENT. THIS ASSESSMENT LOOKS AT 1) HEALTH & WELLNESS; 2) SOCIAL COHESION, CULTURE & RECREATION; 3) EMPLOYMENT, ECONOMY, & WELFARE; 4) HOUSING & ENVIRONMENT; 5) POSITIVE DEVELOPMENT THROUGH THE LIFE STAGES & HOW THEY ALL INTERSECT WITH EACH OTHER TO EFFECT A COMMUNITIES WELL-BEING. IT IS THRU THESE ASSESSMENTS, IN CONJUCTION WITH RESOURCE AVAILABILITY THAT PUBLIC HEALTH PRIORITIES ARE ESTABLISHED.ASSESSMENT OF PUBLIC HEALTH PRIORITIES: CRITERIA OF PUBLIC HEALTH PRIORITIES-CRITERIA:FOCUS GROUPS IDENTIFIED THE PRIORITY AS ONE OF THE COUNTY'S MOST SIGNIFICANT HEALTH ISSUES.COUNTY HEALTH DEPARTMENT MEASURES RELATED TO HEALTH PRIORITIES SUPPORT THE PUBLIC'S SUBJECTIVE OPINION, I.E. THE PRIORITY-SPECIFIC COUNTY MEASURES PUBLISHED IN CORTLAND COUNTS DEVIATE FROM STATE AND NATIONAL BENCHMARKS AND HEALTHY PEOPLE 2020 GOALS.MEDICAL CENTER INTERNAL DATA SUPPORTS ISSUES AS PRIORITIES BASED ON PATIENT VOLUME AND UTILIZATION OF SERVICES ASSOCIATED WITH THEM. USE OF DATA: THE FOLLOWING WERE THE PRIMARY SOURCES OF DATA USED TO TARGET A POPULATION:COMMUNITY FORUM HEALTH TRACK, FOCUS GROUPS, AND COMMUNITY SURVEY RESULTS-AS DESCRIBED ABOVE, THESE ACTIVITIES ELICITED SUBJECTIVE DATA REGARDING HEALTH PRIORITIES. ISSUES CONSISTENTLY NAMED "TOP HEALTH PRIORITIES" INCLUDE ACCESS TO QUALITY HEALTHCARE, HEALTHY MOTHERS/HEALTHY BABIES, CHRONIC DISEASE, HEALTHY ENVIRONMENT, AND MENTAL HEALTH AND SUBSTANCE ABUSE.CORTLAND COUNTS COMMUNITY REPORT CARD: COUNTY STATISTICS (SEE FOLLOWING TABLE) THAT DEVIATED MOST SIGNIFICANTLY FROM STATE, REGIONAL, NATIONAL, AND HEALTHY PEOPLE 2020 GOALS WERE CONSIDERED IN DEFINING COUNTY PUBLIC HEALTH PRIORITIES.INDICATOR - CORTLAND COUNTY; UPSTATE NY; NYS; NATIONAL; HEALTHY PEOPLE 2020 GOALCIGARETTE USE IN WOMEN DURING PREGNANCY- 32.8%; 25.5%; N/A; 16.2%; 1.4%*COLORECTAL CANCER INCIDENCE WOMEN- 52.9; 40.8; 40.0; 39.3; N/A MEN-50.1; 52.1; 53.3, 52.2; N/A*LUNG/BRONCHUS CANCERMEN - 108.5; 82.1; 76.3; 74.3; N/A WOMEN- 70.5; 64.4; 56.0; 51.9; N/A*CEREBROVASCULAR DISEASE MORTALITY RATE - 44.9; 30.0; 26.6; 39.1; 33.8*CLRD OR COPDMORTALITY RATE - 72.3; 36.2; 30.5; 42.2; 98.5*RATE PER 100,000NEW YORK STATES PREVENTION QUALITY INDICATORS (PQI): REVIEW OF HOSPITALIZATION RATES BY ZIP CODE FOR CONDITIONS GENERALLY CONSIDERED PREVENTABLE WHEN GOOD PRIMARY CARE IS ACCESSIBLE (PQI) AIDED IN DETERMINING HEALTH PRIORITIES. BECAUSE CORTLAND COUNTY IS A HPSA FOR PRIMARY MEDICAL CARE (LOW-INCOME POPULATION), THE AREAS PQIS ARE EXPECTED TO BE HIGH. PQIS WERE DETERMINED USING THE FOLLOWING PARAMETERS:THE TWELVE CONDITIONS IN THE AREAS OF CIRCULATORY, DIABETES-RELATED, RESPIRATORY, AND ACUTE ILLNESSES. CORTLAND COUNTY ZIP CODES INDIVIDUALLY AND IN SUM.CORTLAND REGIONAL MEDICAL CENTER'S SERVICE AREA ZIP CODES INDIVIDUALLY AND IN SUM.RESULTS:CONDITIONS ASSOCIATED WITH HIGHEST PQI SCORES IN THE CORTLAND AREA ARE PNEUMONIA, COPD, AND CHF (ADMISSIONS AS PERCENT EXPECTED: 207%, 139%, AND 80%, RESPECTIVELY).FURTHER ASSESSMENT INDICATES THAT CORTLAND ZIP CODE 13045 IS ASSOCIATED WITH HIGHEST PNEUMONIA & COPD PQI'S (ADMISSION AS PERCENT EXPECTED: 249% & 168%, RESPECTIVELY). RACIAL/ETHNIC DISPARITIES ARE NOT INDICATED FOR ANY CONDITION PER PQI TOOL. ADMISSIONS AS PERCENT EXPECTED BY RACE/ETHNICITY FOR HISPANIC, AFRICAN, ASIAN, AND OTHER GROUPS WERE BELOW POPULATION THRESHOLD.CORTLAND REGIONAL MEDICAL CENTER DATA - INPATIENT CASE VOLUMES BY SERVICE LINE (MEASURED AS DISCHARGES) WERE CONSIDERED IN IDENTIFICATION OF HEALTH PRIORITIES. HIGHEST VOLUMES OF INPATIENT DISCHARGES HAVE CONSISTENTLY INCLUDED THE FOLLOWING: 2010; 2011; 2012; 2013; 2014PULMONARY/MEDICAL - 791; 816; 785; 696; 594CARDIOVASCULAR DISEASES- 484; 618; 547; 395; 355OBSTETRICS/DELIVERY - 465; 497; 585; 427; 411NEW BORN - 472; 507; 485; 436; 431MARKET EXPERT 2014MEASUREMENTS OF THE MEDICAL CENTER'S AMBULATORY CARE SENSITIVE CONDITIONS (ACSC), THOSE ADMISSIONS THAT COULD HAVE BEEN TREATED AS OUTPATIENTS, WERE ALSO CONSIDERED IN DETERMINING HEALTH PRIORITIES. ACCESSIBILITY OF PRIMARY CARE IS A COMMON REASON FOR ASCS ADMISSIONS, AND AS PREVIOUSLY STATED, CORTLAND COUNTY IS A HPSA FOR PRIMARY MEDICAL CARE (LOW-INCOME). DATA ANALYSIS INDICATES THE FOLLOWING TRENDS TOWARD IMPROVEMENT IN CRMC'S TOP ACSC SEVERITY 1 CASES.AMBULATORY PROMPT CARE IS CORTLAND REGIONAL MEDICAL CENTER'S PRIMARY CARE PROGRAM FOR NON-EMERGENCY CONDITIONS. EXTENDED HOURS OF SERVICE (7A-11P, 7DAYS/WK) ARE AVAILABLE TO SUPPLEMENT CARE PROVIDED AT PHYSICIANS' OFFICES DURING REGULAR BUSINESS HOURS. MEMBERS OF THE COMMUNITY WHO DO NOT HAVE ACCESS TO A MEDICAL HOME OFTEN SEEK TREATMENT THROUGH THIS SERVICE. PROMPT CARE'S PATIENT ENCOUNTER STATISTICS WERE ASSESSED IN CONSIDERATION OF PREVENTION PRIORITIES AND DEMONSTRATE CORTLAND'S STEADILY INCREASING UTILIZATION OF THE PROGRAM. THIS IS DESCRIBED AS FOLLOWS AND BASED ON INTERNAL STATISTICS:PROMPT CARE PATIENT ENCOUNTERS 2010; 2011; 2012; 2013; XXX-XX-XXXX; 12570; 11967; 11540; 13804UNINSURED ENCOUNTERS AT CORTLAND REGIONAL MEDICAL CENTER(2)2008; 2012; 2014TOTAL ENCOUNTERS 157,309; 144,421; 146,905NUMBER OF UNINSURED ENCOUNTERS 11,199; 5818; 4716% UNINSURED ENCOUNTERS 7.1%; 4.1%; 3.2%(2)CORTLAND REGIONAL MEDICAL CENTER SELECTED PREVENTION AGENDA PRIORITIESBASED ON DATA ANALYSIS, THE CORTLAND COUNTY HEALTH DEPARTMENT AND CORTLAND REGIONAL MEDICAL CENTER WILL COLLABORATE ON THE FOLLOWING PUBLIC HEALTH PRIORITIES:CHRONIC DISEASE: FOCUS WILL BE ON SMOKING CESSATION, WITH SPECIAL FOCUS ON PREGNANTWOMEN AND DECREASING DISABILITY RELATED TO SMOKING. ADDITIONAL FOCI INCLUDE OBESITY ANDEFFORTS TO INCREASE SCREENINGS FOR CARDIOVASCULAR DISEASE, DIABETES, AND BREAST, CERVICAL AND COLORECTAL CANCER.HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN:THE PRIMARY FOCUS WILL BE ONINCREASING THE NUMBER OF BABIES EXCLUSIVELY BREASTFEED WHILE IN THE HOSPITAL, WHILESECONDARILY ADDRESSING THE DISPARITY BETWEEN MEDICAID AND NON-MEDICAID MOTHERS' DECISIONTO BREASTFEED. DECREASING THE SMOKING RATE AMONG PREGNANT WOMEN WILL ALSO BE ADDRESSED.STATUS OF PRIORITIESALL PRIORITIES REPRESENT EXISTING PROGRAMS EITHER AT CORTLAND REGIONAL MEDICAL CENTER OR THE CORTLAND COUNTY HEALTH DEPARTMENT; HOWEVER, A GOAL OF THIS PROJECT IS TO INCREASE COMMUNITY AWARENESS OF EXISTING PROGRAMS BY INVOLVING MORE COMMUNITY MEMBERS IN THE IMPLEMENTATION OF NEW INITIATIVES RELATED TO IDENTIFIED PRIORITIES.THREE-YEAR PLAN OF ACTIONSTRATEGIES FOR SELECTED PRIORITIESTHE PRIORITIES SELECTED THROUGH THE COLLABORATIVE ASSESSMENT PROCESS DESCRIBED IN THE PREVIOUS SECTION ARE ALL PUBLIC HEALTH ISSUES THAT HAVE BEEN RECOGNIZED IN THE PAST AS PRIORITIES FOR THE GREATER CORTLAND COMMUNITY AND TO WHICH CRMC AND ITS COMMUNITY PARTNERS HAVE DEDICATED RESOURCES.CHRONIC DISEASECORTLAND REGIONAL MEDICAL CENTER AND ITS COMMUNITY PARTNERS WILL FOCUS ON DISEASES OF THE LUNG RELATED SPECIFICALLY TO SMOKING, OBESITY AND SCREENING FOR DIABETES, AND BREAST, CERVICAL AND COLORECTAL CANCER. THESE WILL ALL BE IMPLEMENTED USING THE MOST CURRENT EVIDENCE-BASED RECOMMENDATIONS. LUNG DISEASES: PULMONARY REHABILITATION PROGRAM V PULMONARY REHABILITATION IS AN EXERCISE PROGRAMDESIGNED FOR PATIENTS WITH CHRONIC PULMONARY OBSTRUCTIVE DISEASE (COPD) TO INCREASEEXERCISE TOLERANCE AND INDEPENDENCE IN ACTIVITIES OF DAILY LIVING AND TO DECREASESYMPTOMS AND UTILIZATION OF MEDICAL RESOURCES. PULMONARY REHABILITATION IS THE ONEINTERVENTION THAT STUDIES HAVE FOUND DECREASES HOSPITALIZATIONS, READMISSIONS, ANDINCREASES QUALITY OF LIFE FOR COPD PATIENTS. X GOAL: 25% INCREASE IN PATIENTS REFERRED TO PULMONARY REHABILITATION PROGRAM. X MEASUREMENT: NUMBER OF PATIENTS REFERRED TO PULMONARY REHABILITATION PROGRAM. (CONTINUED IN SCHEDULE O) PART VI, LINE 3: FINANCIAL AID PROGRAMSUCCESSES AND CHALLENGESPROCESS IMPROVEMENTS AND GENERAL ACCOMPLISHMENTS:A PAMPHLET HIGHLIGHTING CRMC'S FINANCIAL AID PROGRAM AND HOW TO APPLY IS AVAILABLE AT ALL REGISTRATION LOCATIONS, ON AND OFFSITE.POLICY IS TO PROVIDE FINANCIAL AID TO INCOME LEVELS UP TO 300% OF THE FEDERAL POVERTY LEVEL.SIGNAGE ABOUT CRMC'S FINANCIAL AID PROGRAM IS IN ALL REGISTRATION AREAS, BOTH ON AND OFFSITE, AS WELL IN THE BUSINESS OFFICE AND MAIN LOBBY.DISTRIBUTED CRMC FINANCIAL AID PAMPHLETS AND APPLICATIONS AT FAMILY HEALTH NETWORK CLINIC SITES.FACILITATED ENROLLER FOR TOTAL CARE IS ONSITE TO ASSIST PATIENTS TWO DAYS EACH MONTH.BEST PRACTICES:PROVIDE A FULL-TIME, ONSITE FACILITATED ENROLLER FOR FAMILY HEALTH PLUS, CHILD HEALTH PLUS, AND MEDICAID.CONTRACT WITH AN OUTSIDE AGENCY, AHC, TO ASSIST ELIGIBLE INPATIENT SELF-PAY POPULATION TO OBTAIN MEDICAID.SCREEN SELF-PAY REGISTRATIONS FOR BLUE CROSS, MEDICAID, AND/OR FIDELIS COVERAGE. PATIENTS WITHOUT COVERAGE ARE CALLED FOR CURRENT INSURANCE INFORMATION, AND IF THEY HAVE NONE, THEY ARE OFFERED FINANCIAL ASSISTANCE AND/OR MONTHLY PAYMENT OPTIONS.PARTICIPATE IN ANNUAL HEALTH INSURANCE FAIR TO HELP RAISE AWARENESS OF THE OPTIONS AVAILABLE TO INDIVIDUALS WHO HAVE NO INSURANCE OR ARE UNDER INSURED.CHALLENGES:DIFFICULTY GAINING PATIENT COOPERATION WITH THE APPLICATION PROCESS AND PATIENTS' NON-COMPLIANCE WITH POLICY.LACK OF VALID PATIENT DEMOGRAPHIC INFORMATION, INCLUDING TELEPHONE NUMBERS.APPLICANTS DISHONESTY.ALSO, SEE WRITE UP FOR PART III, LINE 9 PART VI, LINE 4: HOSPITAL SERVICE AREACORTLAND REGIONAL MEDICAL CENTER IS LOCATED IN THE CITY OF CORTLAND, COUNTY OF CORTLAND, IN THE CENTRAL REGION OF NEW YORK STATE. THE MEDICAL CENTER IS APPROXIMATELY 35 MILES SOUTH OF SYRACUSE, NEW YORK; 40 MILES NORTH OF BINGHAMTON, NEW YORK; AND 24 MILES NORTHEAST OF ITHACA, NEW YORK. AS THE ONLY HOSPITAL IN CORTLAND COUNTY, CRMC IS FEDERALLY DESIGNATED A SOLE COMMUNITY HOSPITAL. THE MEDICAL CENTER SERVES ALL OF CORTLAND COUNTY AND NEIGHBORING PARTS OF SEVEN CONTIGUOUS COUNTIES, INCLUDING ONONDAGA, MADISON, CHENANGO, BROOME, TIOGA, TOMPKINS, AND CAYUGA.DESCRIPTION OF SERVICE AREACORTLAND REGIONAL MEDICAL CENTER DEFINES ITS PRIMARY SERVICE AREA AS AN 18-ZIP-CODE AREA IN AND AROUND CORTLAND PROPER. IT ACCOUNTS FOR APPROXIMATELY 92.8% OF CORTLAND REGIONAL MEDICAL CENTER'S TOTAL INPATIENT ADMISSIONS; THIS REPRESENTS APPROXIMATELY 52% MARKET SHARE. CORTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES BY USING AVAILABLE RESOURCES TO MEET THE NEEDS OF THE PEOPLE WHO LIVE OR WORK IN ITS SERVICE AREA. PART VI, LINE 5: ACCESS TO QUALITY HEALTH CARETHE MEDICAL CENTER PARTNERS WITH COMMUNITY ORGANIZATIONS TO INCREASE MEDICAID ENROLLMENT, EXPAND ACCESS TO PROVIDERS, AND RECRUIT NEW PROVIDERS TO ENSURE A SUFFICIENT NUMBER OF PRIMARY CARE AND SPECIALTY PHYSICIANS TO MEET THE COMMUNITY'S NEEDS.MEDICAID ENROLLMENT:EMPLOY A FULL-TIME FACILITATED ENROLLER TO ASSIST INDIVIDUALS WITH THE MEDICAID ENROLLMENT PROCESS. THE CORTLAND COUNTY DEPARTMENT OF HEALTH ADMINISTERS THE GRANT THAT PROVIDES PARTIAL FUNDING FOR THIS POSITION. -OFFER ONSITE CONSULTATIONS WITH FACILITATED ENROLLER FOR TOTAL CARE. INITIATED DISCUSSIONS WITH FIDELIS TO OFFER SIMILAR SERVICE FOR ITS MANAGED CARE FOR MEDICAID PROGRAM; HOWEVER, FIDELIS DECLINED THE OPPORTUNITY. -CONTRACT WITH AHC TO ASSIST INPATIENTS WHO ARE MEDICAID ELIGIBLE TO OBTAIN COVERAGE. -PARTICIPATE IN ANNUAL HEALTH INSURANCE FAIR TO RAISE AWARENESS OF AVAILABLE COVERAGE. GOAL: REDUCE THE NUMBER OF UNINSURED INDIVIDUALS IN CORTLAND COUNTY. MEASUREMENT: NUMBER OF UNINSURED COUNTY RESIDENTS. THE GOAL OF REDUCING THE NUMBER OF UNINSURED INDIVIDUALS IN CORTLAND COUNTY IS BEING MET. THE NUMBER OF UNINSURED ENCOUNTERS AT CORTLAND REGIONAL MEDICAL CENTER HAS DECLINED FROM 7.1% IN 2008 TO 4.1% IN 2012.EXPAND ACCESS TO PROVIDERS:PROVIDE INCREASED ACCESS FOR MEDICAID RECIPIENTS BY HAVING PHYSICIANS EMPLOYED BY REGIONAL MEDICAL PRACTICE, P.C. ACCEPT MEDICAID AND OTHER INSURANCES THAT MANY PHYSICIAN PRACTICES DO NOT ACCEPT. GOAL: PROVIDE MEDICAID RECIPIENTS GREATER ACCESS TO OFFICE-BASED MEDICAL CARE. MEASUREMENT: NUMBER OF MEDICAID RECIPIENTS IN RMP PHYSICIAN PRACTICES.APPROXIMATELY 9% OF CORTLAND COUNTY RESIDENTS ARE MEDICAID RECIPIENTS WHILE NEARLY 20% OF THE PATIENTS SEEN BY RMP PHYSICIANS ARE INSURED BY MEDICAID. THESE STATISTICS SUGGEST THAT CRMC'S EFFORTS TO IMPROVE MEDICAID RECIPIENTS' ACCESS TO MEDICAL CARE HAVE BEEN SUCCESSFUL. PROVIDE SUFFICIENT NUMBERS OF PROVIDERS:PHYSICIAN RECRUITMENT AND RETENTION PLAN - CORTLAND REGIONAL MEDICAL CENTER ADOPTED A COMPREHENSIVE PHYSICIAN RECRUITMENT AND RETENTION PLAN THAT ESTABLISHES RECRUITMENT PRIORITIES OVER THE NEXT FIVE YEARS BASED ON A SURVEY OF COMMUNITY PHYSICIANS, INTERNAL DATA INCLUDING MEDICAL STAFF AGES AND ANTICIPATED RETIREMENTS, AND EXTERNAL DATA ON THE SUPPLY AND DISTRIBUTION OF PHYSICIANS. -PRIORITY SPECIALTY RECRUITMENT YEARS 1-3 -PRIMARY CARE: FAMILY PRACTICE, INTERNAL MEDICINE, ORTHOPEDICS, OB/GYN, GENERAL SURGERY, CARDIOLOGY, UROLOGY, PSYCHIATRY, ONCOLOGY AND PULMONOLOGIST. RECRUITMENT EFFORTS HAVE BEEN SUCCESSFUL IN THE AREAS OF ORTHOPEDICS, OBSTETRICS/ GYNECOLOGY, ONCOLOGY, INTERNAL MEDICINE AND CARDIOLOGY. -PRIORITY SPECIALTY RECRUITMENT YEARS 3-5 - NEUROLOGY, GASTROENTEROLOGY, PRIMARY CARE: FAMILY PRACTICE, AND INTERNAL MEDICINE. GOAL: SUCCESSFUL RECRUITMENT OF ADDITIONAL PHYSICIANS. MEASUREMENT: NUMBER OF NEW PHYSICIANS OPENING OR JOINING EXISTING PRACTICES. HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDRENCORTLAND REGIONAL MEDICAL CENTER, TOGETHER WITH COMMUNITY PARTNERS, IS FOCUSING ON IMPROVING THE QUALITY OF OBSTETRICAL AND PEDIATRIC CARE, PROVIDING EDUCATION TO PREGNANT WOMEN AND NEW MOTHERS, AND ENSURING THERE ARE SUFFICIENT NUMBERS OF PHYSICIANS IN THE COMMUNITY TO PROVIDE IMPROVED ACCESS TO OBSTETRICAL AND PEDIATRIC CARE. EDUCATION:-CHILD BIRTH CLASSES -EVERY OTHER MONTH, CRMC OFFERS A FULL TWO-DAY, WEEKEND CHILD BIRTH CLASS FOR EXPECTANT PARENTS THAT COVERS A VARIETY OF TOPICS, INCLUDING: NUTRITION; THE ROLE OF THE COACH; BREATHING AND RELAXATION TECHNIQUES FOR LABOR; CARE AND CHARACTERISTICS OF THE NEWBORN; BREASTFEEDING; PARENTING SKILLS; POST PARTUM ISSUES; AND INFANT SAFETY. CRMC ALSO PROVIDES SPACE FOR ITS COMMUNITY PARTNER, FAMILY HEALTH NETWORK, TO HOLD CHILD BIRTH CLASSES.-POSTPARTUM AND NEWBORN CARE EDUCATION - MATERNITY STAFF PROVIDE EDUCATION TO NEW MOTHERS ABOUT HOW TO CARE FOR THEMSELVES AND THEIR NEWBORNS.-POST DISCHARGE BREASTFEEDING SUPPORT - A FOLLOW UP SERVICE PROVIDED AFTER MOTHER AND BABY HAVE GONE HOME TO IMPROVE BREASTFEEDING SUCCESS AND ENCOURAGE THAT IT CONTINUES TO PROVIDE THE NEW INFANT A HEALTHY START.-HEALTHY BEGINNINGS PROGRAM - IN COLLABORATION WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, CRMC DISTRIBUTES PACKETS THAT EMPHASIZE THE IMPORTANCE OF IMMUNIZATIONS AND ALSO PROVIDES INFORMATION ON LEAD POISONING PREVENTION; INFANT/CHILD SAFETY; NUTRITION; AND HEALTH AND DENTAL CARE. CRMC REGISTERS MOTHERS FOR HEALTHY BEGINNINGS NEWSLETTERS, WHICH THE HEALTH DEPARTMENT SENDS TO PARENTS AT OR AROUND THE TIME THEIR CHILD IS DUE FOR A WELL-CHILD VISIT DURING THE FIRST TWO YEARS OF LIFE.(CONTINUED IN SCHEDULE O) PART VI, LINE 6: PARTICIPANTSCORTLAND REGIONAL MEDICAL CENTER COLLABORATES WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, SUNY CORTLAND, AND THE UNITED WAY FOR CORTLND COUNTY TO MAINTAIN AN ONGOING COMMUNITY NEEDS ASSESSMENT UNDER THE AUSPICES OF THE SEVEN VALLEYS HEALTH COALITION. A COMMUNITY ASSESSMENT TEAM (CAT) COMPRISED OF THE MEDICAL CENTER'S CEO AND THE CORTLAND COUNTY PUBLIC HEALTH DIRECTOR, AS WELL AS REPRESENTATIVES FROM EACH OF THE OTHER INVOLVED ORGANIZATIONS, OVERSEES THE ANNUAL UPDATING OF THE ASSESSMENT. AT A MINIMUM, THE CAT MEETS BIANNUALLY AND MORE FREQUENTLY IF NEEDED. CORTLAND COUNTS: AN ASSESSMENT OF HEALTH AND WELL BEING IN CORTLAND COUNTY IS A COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT THAT IS UPDATED EVERY FOUR YEARS. IN THE YEARS BETWEEN FULL ASSESSMENTS, AN ABBREVIATED VERSION, THE COMMUNITY REPORT CARD, IS PUBLISHED TO PROVIDE UPDATED HIGHLIGHTS OF THE COMPREHENSIVE ASSESSMENT IN AN "AT-A-GLANCE" FORMAT. THE MOST RECENT EDITION OF CORTLAND COUNTS COMPREHENSIVE REPORT WAS RELEASED IN OCTOBER 2013.OUTCOMESA BLUE RIBBON COMMITTEE (BRC) THAT INCLUDES BROAD COMMUNITY REPRESENTATION WAS ESTABLISHED IN 2002 TO REVIEW THE CORTLAND COUNTS ASSESSMENT IN LIGHT OF DATA PROVIDED BY FOCUS GROUPS AND CITIZEN SURVEYS CONDUCTED BY THE COMMUNITY ASSESSMENT TEAM, AS WELL AS OTHER COMMUNITY RESEARCH AND FEEDBACK. USING BOTH SUBJECTIVE AND OBJECTIVE DATA, THE BRC SET PRIORITIES AND DEVELOPED A STRATEGIC PLAN THAT CURRENTLY INCLUDES FIVE BROAD TRACKS: ECONOMIC DEVELOPMENT, YOUTH, HOUSING, HEALTH AND SUSTAINABILITY. A COMMUNITY ORGANIZATION, OR COALITION OF ORGANIZATIONS, IS TAKING THE LEAD TO ADDRESS EACH BROAD TRACK:THE CORTLAND COUNTY BUSINESS DEVELOPMENT CORPORATION IS SPEARHEADING ECONOMIC DEVELOPMENT INITIATIVES.THE CORTLAND AREA COMMUNITIES THAT CARE COALITION (CACTC) IS COORDINATING EFFORTS TO IMPROVE SERVICES AND EXPAND OPPORTUNITIES FOR THE YOUTH IN THE GREATER CORTLAND COMMUNITY.SEVERAL AGENCIES ARE INVOLVED IN ADDRESSING THE NEED FOR BETTER QUALITY, AFFORDABLE HOUSING.THE SEVEN VALLEYS HEALTH COALITION, IN COLLABORATION WITH CORTLAND REGIONAL MEDICAL CENTER, THE CORTLAND COUNTY HEALTH DEPARTMENT, FAMILY HEALTH NETWORK, AND OTHER COMMUNITY-BASED AGENCIES, IS DIRECTING THE FOCUS ON COMMUNITY HEALTH.THE BLUE RIBBON COMMITTEE MEETS ANNUALLY AND INVITES THE ENTIRE COMMUNITY TO PARTICIPATE IN REDEFINING PRIORITIES AND UPDATING THE STRATEGIC PLAN. CORTLAND COUNTS IS A KEY DOCUMENT THAT THE MEDICAL CENTER AND MANY COMMUNITY AGENCIES UTILIZE IN SETTING PRIORITIES FOR THE CONTINUATION OF EXISTING SERVICES AND THE DEVELOPMENT OF NEW/ENHANCED PROGRAMS AND SERVICES.PUBLIC INPUT IN THE ASSESSMENT PROCESSTHE 2013 CORTLAND COUNTS COMMUNITY FORUM, SPONSORED BY THE BLUE RIBBON COMMITTEE, WAS HELD JANUARY 11, 2013. MEMBERS OF THE COMMUNITY AT LARGE AND STAKEHOLDERS REPRESENTING EACH OF THE STRATEGIC PLAN TRACKS WERE IN ATTENDANCE. THE FINDINGS PUBLISHED IN THE LATEST EDITION OF CORTLAND COUNTS WERE REVIEWED AT THIS MEETING AND ATTENDEES WERE GIVEN THE OPPORTUNITY TO PROVIDE FEEDBACK AND INPUT ON 2013 PRIORITIES FOR EACH TRACK. CORTLAND COUNTS IS A KEY DOCUMENT THAT THE MEDICAL CENTER AND MANY COMMUNITY AGENCIES UTILIZE IN SETTING PRIORITIES FOR THE CONTINUATION OF EXISTING SERVICES AND THE DEVELOPMENT OF NEW/ENHANCED PROGRAMS AND SERVICES.BARRIERS TO CARE/GAPS IN SERVICETRANSPORTATION:LACK OF TRANSPORTATION CONTINUES TO BE A BARRIER TO ACCESSING SERVICES FOR MANY INDIVIDUALS IN THE GREATER CORTLAND COMMUNITY. DETERMINING HOW MANY RESIDENTS ARE UNABLE TO OBTAIN HEALTHCARE BECAUSE OF TRANSPORTATION ISSUES IS AN ONGOING CHALLENGE. THIS PROBLEM HAS BEEN COMPOUNDED IN THE PAST 12-18 MONTHS, BECAUSE OF THE STATE REDESIGN OF THE MEDICAID TRANSPORTATION PROGRAM.MENTAL HEALTH SERVICES:THE INADEQUACY OF MENTAL HEALTH SERVICES IN THE CORTLAND COMMUNITY, PARTICULARLY FOR CHILDREN, WAS THE PRIMARY TOPIC OF DISCUSSION REGARDING GAPS IN SERVICE. EXPANSION OF EXISTING CLINICS AND EXPLORATION OF PARTNERING WITH LARGER MEDICAL FACILITIES THROUGH TELEMEDICINE GRANT OPPORTUNITIES WERE DISCUSSED AS POSSIBLE SOLUTIONS. CORTLAND REGIONAL MEDICAL CENTER IS IN THE PROCESS OF RECRUITING A PSYCHIATRIST TO JOIN THE MEDICAL STAFF AND A REGIONAL PSYCHIATRY PRACTICE.PUBLIC NOTIFICATION OF OPPORTUNITIES TO PROVIDE INPUTADVERTISEMENTS WERE PLACED IN THE LOCAL NEWSPAPER AND ANNOUNCEMENTS WERE DISTRIBUTED VIA E-MAIL AND LISTSERVS. PUBLIC ASSISTANCE PROGRAMS WERE ALSO ENCOURAGED TO POST THE NOTIFICATIONS AND TO ADVISE CLIENTS OF OPPORTUNITIES TO PARTICIPATE. UPON EVALUATION, THE PROCESS OF NOTIFYING THE PUBLIC COULD BE IMPROVED BY PLACING NOTICES WHERE THOSE RESIDENTS WHOSE ACCESS TO HEALTHCARE IS LIMITED WOULD BE MORE LIKELY TO SEE THEM. SUGGESTED LOCATIONS INCLUDE THE COUNTYS SENIOR CENTERS, LOCAL FOOD PANTRIES, CORTLAND-CHENANGO RURAL SERVICES, AND THROUGH CONTACT WITH THE FAITH COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES NY X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 MARK WEBSTER PRESIDENT/CEO 364051 0 0 0 1496 0 32340 0 23929 0 421816 0 0 0 DENNIS TREPANIER COO 185387 0 0 0 0 0 0 0 270 0 185657 0 0 0 DENISE WRINN VICE PRESIDENT 223696 0 0 0 348 0 12527 0 18114 0 254685 0 0 0 ROGER SCOTT MD VICE PRESIDENT MEDICAL AFFAIRS 218423 0 0 0 0 0 8200 0 983 0 227606 0 0 0 ROBERT KARPMAN VICE PRESIDENT MEDICAL AFF 339440 0 0 0 0 0 1909 0 12660 0 354009 0 0 0 MARY WRIGHT VICE PRESIDENT-NURSING SERVICES 168078 0 0 0 179 0 6939 0 25374 0 200570 0 0 0 CHRISTINA DENNISTON DIRECTOR - PHARMACY 141919 0 0 0 0 0 4842 0 19970 0 166731 0 0 0 PART I, LINE 1A THE HOSPITAL PROVIDED HOUSING FOR CONTRACTED CEO AND COO. PART I, LINE 4A THOMAS HALLISEY RECEIVED SEVERANCE PAYMENTS OF $89,035, DENISE MIRONTI RECEIVED SEVERANCE PAYMENTS OF $80,392, AND ROBERT KARPMAN RECEIVED SEVERANCE PAYMENTS OF $278,922. A CORTLAND COUNTY DEVELOPMENT CORPORATION 455122714 2013-02-23 21300000 SEE PART VI 0 0 0 A 900000 21300000 637047 5967331 14695622 2014 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 1 1 FIRST NIAGARA BANK 10.000000000000 0 0 0 0 0 A 0 PART I, LINE A, COLUMN (F) BONDS WERE USED FOR THE PURPOSE OF ASSISTING IN FINANCING AND/OR REFINANCING ALL OR A PORTION OF THE COSTS OF A CERTAIN PROJECT, WHICH DID NOT INVOLVE ANY EXTERIOR CONSTRUCTION AND/OR EXPANSION OF THE EXTERIOR OF THE FACILITY CONSISTING OF: A) ACQUISITION AND INSTALLATION OF IMAGING EQUIPMENT, CARDIAC MONITORS, WIRELESS UPGRADES FOR IV PUMPS, BOILERS, AND RELATED HOSPITAL EQUIPMENT FOR USE AT THE FACILITY. B) THE REFUNDING OF ALL OR A PORTION OF THE OUTSTANDING PRINCIPAL AMOUNT OF THE CORTLAND COUNTY INDUSTRIAL DEVELOPMENT AGENCY CIVIC FACILITY RESERVE BONDS, SERIES 2002, ISSUED JUNE 20, 2002. PART II, LINE 11 - OTHER SPENT PROCEEDS OF $14,695,622 WERE USED TO REFUND A PORTION OF THE SERIES 2002 BONDS DESCRIBED IN PART I, LINE A, COLUMN (F). PART IV, LINE 2C - NO REBATE DUE BECAUSE THERE WAS ZERO INVESTMENT PROCEEDS. PART IV, LINE 7 - NO WRITTEN PROCEDURES SINCE NO ARBITRAGE WAS INVOLVED. PART V - THERE WAS A TAX COMPLIANCE AGREEMENT COMPLETED AT THE TIME OF ISSUANCE. THE VP FINANCE/CFO IS RESPONSIBLE FOR MONITORING COMPLIANCE AND CONSULTS WITH OUR BOND ATTORNEY AS NEEDED. JOHANNA AMES TRUSTEE 521547 OFFICER OF AMES LINEN SERVICES 0 DAVID MAYO MD TRUSTEE 53301 RENTS A BUILDING FROM REGIONAL MEDICAL PRACTICE. REGIONAL MEDICAL PRACTICE IS CONTROLLED BY THE HOSPITAL. 0 FORM 990, PART VI, SECTION A, LINE 2 CORTLAND REGIONAL MEDICAL CENTER CONDUCTS BUSINESS WITH AMES LINEN, WHOSE OFFICER, JOHANNA AMES IS A TRUSTEE ON THE CORTLAND REGIONAL MEDICAL CENTER BOARD. LEE SHURTLEFF IS THE PRESIDENT OF THE BOARD OF TRUSTEES FOR GROTON NURSING FACILITY AND IS A TRUSTEE FOR CORTLAND REGIONAL MEDICAL CENTER. CORTLAND REGIONAL MEDICAL CENTER HAS A MANAGEMENT AGREEMENT WITH GROTON NURSING FACILITY. THE CURRENT ADMINISTRATOR OF GROTON NURSING FACILITY IS CONTRACTED PER THIS AGREEMENT. FORM 990, PART VI, SECTION A, LINE 3 THE COO POSITION WAS TEMPORARILY CONTRACTED TO ARTHUR DUNN FROM JUNE 2013 TO FEBRUARY 2014 AND DENNIS TREPANIER FROM MARCH TO DECEMBER 2014. IN DECEMBER 2014, DAVID KOBIS WAS HIRED AS THE COO. FORM 990, PART VI, SECTION A, LINE 4 REVISIONS TO THE BYLAWS INCLUDE: 1. AUDIT COMMITTEE (ESTABLISHED SEPTEMBER 23, 2014) THE AUDIT COMMITTEE SHALL CONSIST OF AT LEAST THREE (3) INDEPENDENT TRUSTEES, AS DEFINED UNDER SECTION 10.2. THE PRIMARY FUNCTION OF THE AUDIT COMMITTEE IS TO ASSIST THE BOARD OF TRUSTEES IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES BY OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE FOLLOWING AUDIT FUNCTIONS: (A)ANNUALLY RETAINING OR RENEWING THE RETENTION OF, AND MONITORING THE AUDIT EFFORTS OF THE CORPORATION'S INDEPENDENT EXTERNAL AUDITORS, AND REVIEWING WITH THE AUDITORS THE RESULTS OF THEIR AUDIT AND ANY RELATED MANAGEMENT LETTER; (B)REVIEWING WITH THE INDEPENDENT EXTERNAL AUDITORS THE SCOPE AND PLANNING OF THE AUDIT PRIOR TO ITS COMMENCEMENT; (C)UPON COMPLETION OF THE AUDIT, REVIEWING AND DISCUSSING WITH THE INDEPENDENT EXTERNAL AUDITORS: A) ANY MATERIAL WEAKNESSES AND WEAKNESSES IN INTERNAL CONTROLS IDENTIFIED BY THE AUDITOR; B) ANY RESTRICTIONS ON THE SCOPE OF THE AUDITOR'S ACTIVITIES OR ACCESS TO REQUESTED INFORMATION; C) ANY SIGNIFICANT DISAGREEMENTS BETWEEN THE AUDITOR AND MANAGEMENT; AND D) THE ADEQUACY OF THE CORPORATION'S ACCOUNTING AND FINANCIAL REPORTING PROCESSES;(D)ANNUALLY CONSIDERING THE PERFORMANCE AND INDEPENDENCE OF THE INDEPENDENT EXTERNAL AUDITOR; (E)IMPLEMENTING AND OVERSEEING THE CONFLICT OF INTEREST POLICY, INCLUDING: I) DETERMINING WHETHER THERE IS A CONFLICT OF INTEREST IN ANY NON-RELATED PARTY TRANSACTION; II) REVIEWING THE PROCEDURES OF THE BOARD OR BOARD COMMITTEE CONSIDERING A CONFLICT OF INTEREST UNDER SECTION 10.2-2 AND III) REVIEWING THE ANNUAL STATEMENTS FOR EACH BOARD MEMBER REQUIRED UNDER SECTION 10.2-5;(F)IMPLEMENTING AND OVERSEEING THE WHISTLEBLOWER POLICY; AND,(G)REPORTING ON THE COMMITTEE'S ACTIVITIES TO THE BOARD OF TRUSTEES. 2.CORTLAND REGIONAL MEDICAL CENTER, INC. ADOPTED THE PROVISIONS OF THE NEW YORK STATE NON PROFIT REVITALIZATION ACT. FORM 990, PART VI, SECTION A, LINE 6 THE PARENT, CMH GROUP, INC, IS THE SOLE MEMBER. CMH GROUP, INC. APPOINTS THE HOSPITAL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A NO SINGLE PERSON, ONLY THE ORGANIZATION CMH GROUP, MAY ELECT OR APPOINT ONE OR MORE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE CORPORATION (THE C.M.H. GROUP) SHALL APPOINT ANNUALLY INDIVIDUALS TO FILL THE THEN-EXISTING VACANCIES ON THE BOARD (OF TRUSTEES) SO LONG AS THE BOARD HAS PROPOSED THAT THE VACANCY BE FILLED. FORM 990, PART VI, SECTION B, LINE 11 BEFORE THE 990 IS SUBMITTED, IT IS MADE AVAILABLE TO THE BOARD OF TRUSTEES FINANCE COMMITTEE FOR THEIR REVIEW. QUESTIONS ARE THEN DIRECTED TO THE CFO/CONTROLLER. THE 990 IS THEN MADE AVAILABLE TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CORTLAND REGIONAL MEDICAL CENTER ENFORCES ITS CONFLICT OF INTEREST POLICY REQUIRING OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 CORTLAND REGIONAL MEDICAL CENTER EXECUTIVE COMMITTEE COMPENSATION PHILOSOPHY AND RESPONSIBILITY PURPOSE: AS DELEGATED REPRESENTATIVES OF THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE HAS THE POWER, DUTY AND RESPONSIBILITY TO DETERMINE THE ORGANIZATION'S OVERALL COMPENSATION PHILOSOPHY AND TO ESTABLISH THE GUIDELINES, RULES AND PROCEDURES NECESSARY FOR THE PROPER AND EFFICIENT ADMINISTRATION OF THE EXECUTIVE COMPENSATION PROGRAM. FURTHER, THE COMMITTEE ACKNOWLEDGES ITS RESPONSIBILITY TO ENSURE THAT THE EXECUTIVE COMPENSATION PROGRAM IS APPROPRIATE IN VIEW OF ITS MISSION, TAX-EXEMPT STATUS, CHARITABLE PURPOSE, AND THAT ITS COMPENSATION AND BENEFITS ARE REASONABLE AND NOT EXCESSIVE. TO THAT END, THE EXECUTIVE COMMITTEE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULES OF SECTION 4958 OF THE IRC. MEMBERSHIP: THE COMMITTEE WILL CONSIST OF THE BOARD OF TRUSTEES EXECUTIVE COMMITTEE. COMPENSATION PHILOSOPHY: THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ESTABLISH AND MAINTAIN A COMPENSATION PACKAGE WHICH WILL ENABLE THE ORGANIZATION TO ATTRACT, RETAIN, MOTIVATE AND REWARD THE MANAGEMENT TEAM LEADERSHIP NEEDED TO SUCCESSFULLY ACCOMPLISH THE ORGANIZATION'S STRATEGIC AND OPERATIONAL GOALS. THE FOLLOWING GUIDELINES WILL BE USED: A TOTAL COMPENSATION CONCEPT WILL BE USED EMPLOYING A COMBINATION OF BASE SALARY, INCENTIVE OPPORTUNITY, FLEXIBLE BENEFITS, DEFERRED COMPENSATION AND OTHER PERQUISITES AS MAY BE NEEDED FROM TIME TO TIME TO MAINTAIN A COMPETITIVE POSITION WITH PEER INSTITUTIONS IN THE REGION. BASE SALARY WILL BE TARGETED AT APPROXIMATELY THE 60TH PERCENTILE OF SIMILAR POSITIONS IN PEER INSTITUTIONS FOR EXPERIENCED PROFESSIONALS. PAY LEVELS FOR INDIVIDUALS WILL DEPEND UPON EXPERIENCE, OVERALL PERFORMANCE, AND CONTRIBUTION TO THE SUCCESS OF THE ORGANIZATION. ANNUAL REVIEWS WILL TAKE PLACE AS OF JANUARY 1 EACH YEAR. INCREASING EMPHASIS WILL BE PLACED ON INCENTIVE COMPENSATION TO THE EXTENT CONSISTENT WITH THE OBJECTIVE TO MAINTAIN THE TAX EXEMPT STATUS OF THE VARIOUS CORPORATE ENTITIES. THE MANAGEMENT TEAM WILL HAVE THE OPPORTUNITY TO REACH THE MAXIMUM PERCENTAGE OF TOTAL COMPENSATION AVAILABLE AT THE TOP OF THE RANGE PAID AMONG PEER INSTITUTIONS BASED ON ACHIEVING OUTSTANDING PERFORMANCE WITH STRATEGIC GOALS IN THE INCENTIVE PLAN. TARGET OPPORTUNITIES WILL BE GEARED TO THE 75TH PERCENTILE OF TOTAL COMPENSATION. DEFERRED COMPENSATION AND PREQUISITE OPPORTUNITIES WILL BE DEVELOPED TO OPTIMIZE WHATEVER TAX DEFERRAL OPPORTUNITIES EXIST WITHIN THE TAX CODE AND TO BE COMPETITIVE WITH PEER INSTITUTIONS. THIS PHILOSOPHY SHALL BE APPLIED EXCEPT AS REQUIRED TO RECRUIT HIGHLY MARKET SENSITIVE POSITIONS. THE EXECUTIVE COMPENSATION PROGRAM SHALL OPERATE AND BE CONSISTENT WITH ALL FEDERAL AND STATE LAWS, CODES, AND PROCEDURES SO LEGISLATED. COMMITTEE RESPONSIBILITIES: THE EXECUTIVE COMMITTEE HAS THE RESPONSIBILITY TO: -SET THE OVERALL COMPENSATION PHILOSOPHY -SET, MONITOR AND REVIEW THE BASE SALARY OF THE CEO AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AS SET FORTH IN APPLICABLE LEGISLATION -ESTABLISH, MONITOR AND DETERMINE ACCOMPLISHMENT OF INCENTIVE AWARD GOALS FOR THE CEO AND OTHER APPLICABLE EXECUTIVES -OVERSEE THE CLEAR AND ACCURATE DISCLOSURE OF THE TOTAL VALUE OF COMPENSATION PAID TO EXECUTIVES AND OTHER KEY INDIVIDUALS ON THE HOSPITAL'S FORM 990 -RESOLVE AND DETERMINE ALL DISPUTES OR QUESTIONS ARISING UNDER THE PROGRAM, INCLUDING THE POWER TO DETERMINE THE RIGHTS OF EMPLOYEES AND TO REMEDY ANY AMBIGUITIES, INCONSISTENCIES OR OMISSIONS -AMEND OR RESTRUCTURE THE PROGRAM AT ANY TIME AND FOR ANY REASON ANNUAL PROCESS: BEGINNING OF CYCLE ACTIVITIES: -MEET WITH THE CEO TO IDENTIFY APPROPRIATE GOALS AND SUPPORTING OBJECTIVES TO BE INCLUDED IN THE INCENTIVE AWARD PROGRAM -PRIORITIZE OBJECTIVES, ESTABLISH/REVIEW STANDARDS OF PERFORMANCE AND AWARD LEVELS FOR THE CEO AND OTHER APPROPRIATE PARTIES -DETERMINE THE FUNDING MECHANISM FOR THE INCENTIVE AWARD -SECURE MARKET INFORMATION WITH REGARD TO THE POSITIONING OF THE CHIEF EXECUTIVE OFFICER AND OTHER APPROPRIATE EXECUTIVES AND SET BASE SALARY FOR THE PERIOD INTERIM ACTIVITY: CONDUCT PROGRESS REVIEW OF CEO'S STATED OBJECTIVES AND STANDARDS OF PERFORMANCE, AS NECESSARY END OF CYCLE ACTIVITY: -REVIEW THE STANDARDS OF PERFORMANCE FOR THE KEY OBJECTIVES AND MEASURE RESULTS -CONSIDER FACTORS INVOLVED IN MANAGERIAL EFFECTIVENESS -CONSIDER ANY UNANTICIPATED RESPONSIBILITIES OR SPECIAL ACCOMPLISHMENTS -SOLICIT PERFORMANCE EVALUATION FROM ALL BOARD MEMBERS -CONDUCT A PERFORMANCE REVIEW OF THE CEO -DETERMINE THE OVERALL EVALUATION AND AWARD LEVEL -RECEIVE A PERFORMANCE REVIEW FROM THE CEO FOR ALL OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND A SUMMARY OF PROPOSED SALARY AND INCENTIVE AWARDS FORM 990, PART VI, SECTION C, LINE 18 CORTLAND REGIONAL MEDICAL CENTER'S 990 IS AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 CORTLAND REGIONAL MEDICAL CENTER'S GOVERNING DOCUMENTS, FINANCIAL STATEMENT AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FOUNDATION 458,946. PENSION AND POST RETIREMENT -11,077,119. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -658,892. FORM 990, PART XII, LINE 2C AUDIT COMMITTEE (ESTABLISHED SEPTEMBER 23, 2014) THE AUDIT COMMITTEE SHALL CONSIST OF AT LEAST THREE (3) INDEPENDENT TRUSTEES, AS DEFINED UNDER SECTION 10.2. THE PRIMARY FUNCTION OF THE AUDIT COMMITTEE IS TO ASSIST THE BOARD OF TRUSTEES IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES BY OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE FOLLOWING AUDIT FUNCTIONS: (A)ANNUALLY RETAINING OR RENEWING THE RETENTION OF, AND MONITORING THE AUDIT EFFORTS OF THE CORPORATION'S INDEPENDENT EXTERNAL AUDITORS, AND REVIEWING WITH THE AUDITORS THE RESULTS OF THEIR AUDIT AND ANY RELATED MANAGEMENT LETTER; (B)REVIEWING WITH THE INDEPENDENT EXTERNAL AUDITORS THE SCOPE AND PLANNING OF THE AUDIT PRIOR TO ITS COMMENCEMENT; (C)UPON COMPLETION OF THE AUDIT, REVIEWING AND DISCUSSING WITH THE INDEPENDENT EXTERNAL AUDITORS: A) ANY MATERIAL WEAKNESSES AND WEAKNESSES IN INTERNAL CONTROLS IDENTIFIED BY THE AUDITOR; B) ANY RESTRICTIONS ON THE SCOPE OF THE AUDITOR'S ACTIVITIES OR ACCESS TO REQUESTED INFORMATION; C) ANY SIGNIFICANT DISAGREEMENTS BETWEEN THE AUDITOR AND MANAGEMENT; AND D) THE ADEQUACY OF THE CORPORATION'S ACCOUNTING AND FINANCIAL REPORTING PROCESSES;(D)ANNUALLY CONSIDERING THE PERFORMANCE AND INDEPENDENCE OF THE INDEPENDENT EXTERNAL AUDITOR; (E)IMPLEMENTING AND OVERSEEING THE CONFLICT OF INTEREST POLICY, INCLUDING: I) DETERMINING WHETHER THERE IS A CONFLICT OF INTEREST IN ANY NON-RELATED PARTY TRANSACTION; II) REVIEWING THE PROCEDURES OF THE BOARD OR BOARD COMMITTEE CONSIDERING A CONFLICT OF INTEREST UNDER SECTION 10.2-2 AND III) REVIEWING THE ANNUAL STATEMENTS FOR EACH BOARD MEMBER REQUIRED UNDER SECTION 10.2-5;(F)IMPLEMENTING AND OVERSEEING THE WHISTLEBLOWER POLICY; AND,(G)REPORTING ON THE COMMITTEE'S ACTIVITIES TO THE BOARD OF TRUSTEES. FORM 990, SCHEDULE H, PART III, LINE 8 CONTINUATION: FINANCIAL ASSISTANCE POLICY G. TIMELINE FOR ESTABLISHING FINANCIAL ELIGIBILITY I. EVERY EFFORT SHOULD BE MADE TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UP TO 240 DAYS AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. II. DETERMINATION FOR FINANCIAL SUPPORT MAY BE MADE PRESUMPTIVELY, HOWEVER PATIENT IS ENCOURAGED TO CONTINUE ALL EFFORTS TO QUALIFY FOR GOVERNMENTAL FINANCIAL ASSISTANCE OR OTHER PROGRAMS.III. CRMC WILL MAKE EVERY EFFORT TO MAKE A FINANCIAL SUPPORT DETERMINATION IN A TIMELY FASHION. IF OTHER AVENUES OF FINANCIAL SUPPORT ARE BEING PURSUED, CRMC WILL COMMUNICATE WITH THE PATIENT REGARDING THE PROCESS AND EXPECTED TIMELINE FOR DETERMINATION AND SHALL NOT ATTEMPT COLLECTION EFFORTS WHILE SUCH DETERMINATION IS BEING MADE. IV. A PATIENT MAY SUBMIT A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME WITHIN 240 DAYS AFTER THE FIRST BILLING STATEMENT. HOWEVER, EXTRAORDINARY COLLECTION EFFORTS MAY BE COMMENCED AFTER 120 DAYS FROM THE FIRST BILLING STATEMENT, IF NO APPLICATION HAS BEEN SUBMITTED. V. APPROVALS FOR FINANCIAL SUPPORT WILL BE FOR A PERIOD OF 6 MONTHS. ANY SERVICES PROVIDED BEYOND THE FAP APPROVAL PERIOD WILL REQUIRE A NEW APPLICATION.H. TERMS FOR FINANCIAL ASSISTANCE - FULL APPLICATION ONLYI. THE COMPLETED FULL APPLICATION MUST BE ACCOMPANIED WITH THE REQUIRED SUPPORTING DOCUMENTATION AND RETURNED TO CRMC FOR PROCESSING WITHIN 30 DAYS OF RECEIPT OF THE APPLICATION.II. ONCE THE COMPLETED APPLICATION AND REQUIRED DOCUMENTATION HAS BEEN RECEIVED, CRMC HAS 20DAYS TO PROCESS A WRITTEN APPROVAL OR WRITTEN DENIAL. DETERMINATION OF NEED FOR FINANCIAL ASSISTANCE WILL BE MADE BASED UPON THE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH DATA OBTAINED BY CRMC OR SUCH OTHER FIRM RETAINED TO ASSIST THE HOSPITAL IN PROCESSING SUCH APPLICATIONS.III. PATIENTS HAVE 20 DAYS FROM THE DATE OF THE APPROVAL OR DENIAL TO APPEAL THE DETERMINATION.IV. INCOMPLETE APPLICATIONS AND/OR MISSING DOCUMENTATION CAN RESULT IN A DENIAL. CRMC WILL ATTEMPT TO GET THE MISSING INFORMATION AFTER THE REVIEW OF THE ORIGINAL APPLICATION. APPLICATIONS DEEMED TO BE INCOMPLETE WILL BE RETURNED TO THE APPLICANT WITH NOTIFICATION THAT FAILURE TO PROVIDE ALL REQUIRED DATA WITHIN 20 DAYS OF RECEIPT OF THE RETURNED APPLICATION WILL RESULT IN A DENIAL FOR FINANCIAL AID. V. CRMC WILL HOLD THE BILLING FOR ANY ACCOUNTS THAT ARE BEING CONSIDERED FOR FINANCIAL AID. CRMC WILL INFORM THE PATIENT OF SUCH.VI. A SEPARATE POLICY, CRMC POLICY # OP-020-23 - BILLING AND COLLECTIONS, ADDRESSES THE ACTIONS THAT THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT.I. LEVEL OF FINANCIAL SUPPORTI. CRMC WILL FOLLOW THE INCOME GUIDELINES ESTABLISHED BELOW IN EVALUATING A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT. A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES (FAP), WHICH IS UPDATED ON AN ANNUAL BASIS, IS USED FOR DETERMINING A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT. HOWEVER, OTHER FACTORS, AS IDENTIFIED ABOVE, ALSO SHOULD BE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.II. FAMILY INCOME AT OR BELOW 200% OF FEDERAL POVERTY INCOME GUIDELINES:III. A FULL DISCOUNT OFF ALL UNINSURED PATIENT BALANCES AND/OR INSURED PATIENT RESPONSIBLE BALANCES SPECIFIED BY THEIR INSURANCE CARRIER WILL BE PROVIDED FOR PATIENTS WHOSE FAMILY'S INCOME IS AT OR BELOW 200% OF THE MOST RECENT FEDERAL POVERTY INCOME GUIDELINES. PATIENTS WITH FAMILY INCOME UP TO AND INCLUDING 200% OF THE FEDERAL POVERTY INCOME GUIDELINES WILL BE ELIGIBLE FOR FINANCIAL SUPPORT FOR CO-PAY AND DEDUCTIBLE AMOUNTS PROVIDED THAT THERE IS NO CONFLICT WITH CONTRACTUAL ARRANGEMENTS WITH THE PATIENT'S INSURER AND THAT THEY APPLY FOR FINANCIAL ASSISTANCE.IV.FAMILY INCOME BETWEEN 201% AND 300% OF FEDERAL POVERTY INCOME GUIDELINES: A DISCOUNT OFF ALL UNINSURED PATIENT BALANCES AND/OR PATIENT RESPONSIBLE BALANCES SPECIFIED BY THEIR INSURANCE CARRIER WILL BE PROVIDED FOR PATIENTS WHOSE FAMILY'S INCOME FALLS WITHIN 201% TO 300 %OF FPL. DISCOUNT WILL BE BASED UPON FAMILY SIZE AND INCOME, SEE ATTACHMENT A FOR INCOME AND DISCOUNT GUIDELINES.V. MEDICALLY INDIGENT SUPPORT / CATASTROPHIC: FINANCIAL SUPPORT IS ALSO PROVIDED FOR MEDICALLY INDIGENT PATIENTS. MEDICAL INDIGENCE OCCURS WHEN A PERSON IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS BECAUSE THEIR MEDICAL EXPENSES EXCEED A CERTAIN PERCENTAGE OF THEIR FAMILY OR HOUSEHOLD INCOME (FOR EXAMPLE, DUE TO CATASTROPHIC COSTS OR CONDITIONS), REGARDLESS OF WHETHER THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE FINANCIAL ELIGIBILITY REQUIREMENTS FOR FREE OR DISCOUNTED CARE UNDER CRMC'S FAP. CATASTROPHIC COSTS OR CONDITIONS OCCUR WHEN THERE IS A LOSS OF EMPLOYMENT, DEATH OF PRIMARY WAGE EARNER, EXCESSIVE MEDICAL EXPENSES OR OTHER UNFORTUNATE EVENTS. MEDICAL INDIGENCE / CATASTROPHIC CIRCUMSTANCES WILL BE EVALUATED ON A CASE-BY-CASE BASIS THAT INCLUDES A REVIEW OF THE PATIENT'S INCOME, EXPENSES AND ASSETS. IF AN INSURED PATIENT CLAIMS CATASTROPHIC CIRCUMSTANCES AND APPLIES FOR FINANCIAL ASSISTANCE, MEDICAL EXPENSES FOR AN EPISODE OF CARE THAT EXCEED 20% OF INCOME WILL PERMIT CO-PAYS AND DEDUCTIBLES TO QUALIFY AS CATASTROPHIC FINANCIAL ASSISTANCE DISCOUNTS FOR MEDICALLY INDIGENT CARE FOR THE UNINSURED WILL NOT BE LESS THAN CRMC'S AVERAGE CONTRACTUAL ADJUSTMENT AMOUNT FOR MEDICARE FOR THE SERVICES PROVIDED OR AN AMOUNT TO BRING THE PATIENTS CATASTROPHIC MEDICAL EXPENSE TO INCOME RATIO BACK TO 20%. MEDICAL INDIGENT AND CATASTROPHIC FINANCIAL ASSISTANCE WILL BE APPROVED BY CRMC DIRECTOR OF REVENUE CYCLE AND/OR MANAGER OF PATIENT FINANCIAL SERVICES VI. WHILE FINANCIAL SUPPORT SHOULD BE MADE IN ACCORDANCE WITH CRMC'S ESTABLISHED WRITTEN CRITERIA, IT IS RECOGNIZED THAT OCCASIONALLY THERE WILL BE A NEED FOR GRANTING ADDITIONAL FINANCIAL SUPPORT TO PATIENTS BASED UPON INDIVIDUAL CONSIDERATIONS. SUCH INDIVIDUAL CONSIDERATIONS WILL BE APPROVED BY CRMC CFO.G. ACCOUNTING AND REPORTING FOR FINANCIAL SUPPORTI.IN ACCORDANCE WITH THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, FINANCIAL SUPPORT PROVIDED BY CRMC IS RECORDED SYSTEMATICALLY AND ACCURATELY IN THE FINANCIAL STATEMENTS AS A DEDUCTION FROM REVENUE IN THE CATEGORY FINANCIAL ASSISTANCE. FOR THE PURPOSES OF COMMUNITY BENEFIT REPORTING, FINANCIAL ASSISTANCE IS REPORTED AT ESTIMATED COST. II.THE FOLLOWING GUIDELINES ARE PROVIDED FOR THE FINANCIAL STATEMENT RECORDING OF FINANCIAL SUPPORT:"FINANCIAL SUPPORT PROVIDED TO PATIENTS UNDER THE PROVISIONS OF "FINANCIAL ASSISTANCE PROGRAM", INCLUDING THE ADJUSTMENT FOR AMOUNTS GENERALLY ACCEPTED AS PAYMENT FOR PATIENTS WITH INSURANCE, WILL BE RECORDED UNDER "FINANCIAL ASSISTANCE ALLOWANCE." WRITE-OFF OF CHARGES FOR PATIENTS WHO HAVE NOT QUALIFIED FOR FINANCIAL SUPPORT UNDER THIS PROCEDURE AND WHO DO NOT PAY WILL BE RECORDED AS "BAD DEBT.""PROMPT PAY DISCOUNTS WILL BE RECORDED UNDER "OPERATIONAL ADJUSTMENTS- ADMINISTRATIVE" OR "CONTRACTUAL ALLOWANCE.""ACCOUNTS INITIALLY WRITTEN-OFF TO BAD DEBT AND SUBSEQUENTLY RETURNED FROM COLLECTION AGENCIES WHERE THE PATIENT WAS DETERMINED TO HAVE MET THE FINANCIAL SUPPORT CRITERIA BASED ON INFORMATION OBTAINED BY THE COLLECTION AGENCY WILL BE RECLASSIFIED FROM "BAD DEBT" TO FINANCIAL ASSISTANCE ALLOWANCE".II.ASSISTING PATIENTS WHO MAY QUALIFY FOR COVERAGE A.CRMC WILL MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. PREMIUM ASSISTANCE MAY ALSO BE GRANTED ON A DISCRETIONARY BASIS UPON APPROVAL OF CHIEF FINANCIAL OFFICER. B. CRMC WILL HAVE UNDERSTANDABLE, WRITTEN PROCEDURES TO HELP PATIENTS DETERMINE IF THEY QUALIFY FOR PUBLIC ASSISTANCE PROGRAMS OR CRMC'S FINANCIAL ASSISTANCE POLICY. III. EFFECTIVE COMMUNICATIONS A.CRMC WILL PROVIDE FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR HEALTH CARE BILLS RELATED TO THE SERVICES THEY RECEIVED AT CRMC AND WILL MAKE THE AVAILABILITY OF SUCH COUNSELING KNOWN. B.CRMC WILL RESPOND PROMPTLY AND COURTEOUSLY TO PATIENTS' QUESTIONS ABOUT THEIR BILLS AND REQUESTS FOR FINANCIAL ASSISTANCE. C.CRMC WILL UTILIZE A BILLING PROCESS THAT IS CLEAR, CONCISE, CORRECT AND PATIENT FRIENDLY. D.CRMC WILL MAKE AVAILABLE FOR REVIEW BY THE PUBLIC SPECIFIC INFORMATION IN AN UNDERSTANDABLE FORMAT ABOUT WHAT THEY CHARGE FOR SERVICES. E.CRMC WILL POST SIGNS AND DISPLAY BROCHURES THAT PROVIDE BASIC INFORMATION ABOUT THEIR FINANCIAL ASSISTANCE POLICY (FAP) IN PUBLIC LOCATIONS IN CRMC AND LIST THOSE PUBLIC LOCATIONS IN CRMC'S FAP. FORM 990, SCHEDULE H, PART III, LINE 8 CONTINUATION: FINANCIAL ASSISTANCE POLICY F. CRMC WILL MAKE THE FINANCIAL ASSISTANCE POLICY (FAP), A PLAIN LANGUAGE SUMMARY OF THE FAP AND THE FAP APPLICATION FORM AVAILABLE TO PATIENTS UPON REQUEST, IN PUBLIC PLACES IN CRMC, BY MAIL AND ON CRMC WEBSITE. ANY INDIVIDUAL WITH ACCESS TO THE INTERNET MUST BE ABLE TO VIEW, DOWNLOAD AND PRINT A HARD COPY OF THESE DOCUMENTS. CRMC MUST PROVIDE ANY INDIVIDUAL WHO ASKS HOW TO ACCESS A COPY OF THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY OF THE FAP ONLINE WITH THE DIRECT WEBSITE ADDRESS, OR URL, WHERE THESE DOCUMENTS ARE POSTED. G. THESE DOCUMENTS WILL BE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF ANY POPULATION WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTES MORE THAN 10 PERCENT OF THE RESIDENTS OF THE COMMUNITY SERVED BY CRMC. CRMC WILL LIST ITS FINANCIAL ASSISTANCE POLICY AND SUPPORTING DOCUMENTS ON THEIR WEBSITE. H. CRMC WILL PROVIDE A DESCRIPTION IN THE FAP OF THE MEASURES TAKEN TO NOTIFY MEMBERS OF THE COMMUNITY SERVED BY CRMC ABOUT THE FAP. SUCH MEASURES MAY INCLUDE, FOR EXAMPLE, THE DISTRIBUTION OF INFORMATION SHEETS SUMMARIZING THE FAP TO LOCAL PUBLIC AGENCIES AND NONPROFIT ORGANIZATIONS THAT ADDRESS THE HEALTH NEEDS OF THE COMMUNITY'S LOW INCOME POPULATIONS. IV. IMPLEMENTATION OF ACCURATE AND CONSISTENT POLICIES A. PATIENT FINANCIAL SERVICES AND PATIENT ACCESS WILL EDUCATE STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS, PHYSICIAN OFFICES) ABOUT BILLING, FINANCIAL ASSISTANCE, COLLECTION POLICIES AND PRACTICES, AND TREATMENT OF ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. B. CRMC WILL HONOR FINANCIAL SUPPORT COMMITMENTS THAT WERE APPROVED UNDER PREVIOUS FINANCIAL ASSISTANCE GUIDELINES. AT THE END OF THAT ELIGIBILITY PERIOD THE PATIENT MAY BE RE-EVALUATED FOR FINANCIAL SUPPORT USING THE GUIDELINES ESTABLISHED IN THIS PROCEDURE. REFERENCES: " PATIENT PROTECTION AND AFFORDABLE CARE ACT STATUTORY SECTION 501(R) " INTERNAL REVENUE SERVICE SCHEDULE H (FORM 990) " DEPARTMENT OF TREASURY, INTERNAL REVENUE SERVICE, ADDITIONAL REQUIREMENTS FOR CHARITABLE HOSPITALS; PROPOSED RULE: VOLUME 77, NO. 123, PART II, 26 CFR, PART 1 SCHEDULE H, PART VI, LINE 2 SMOKING CESSATION INITIATIVE - CRMC, IN COLLABORATION WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, HAS UNDERTAKEN A BROAD-BASED CAMPAIGN AGAINST SMOKING. IN SPITE OF THESE EFFORTS, A GROWING NUMBER OF CORTLAND COUNTY WOMEN SMOKE DURING PREGNANCY. TO ADDRESS THIS CONCERN, PRENATAL PROVIDERS WILL BE ENLISTED TO PARTICIPATE IN AN EFFORT TO DECREASE THE NUMBER OF PREGNANT WOMAN WHO SMOKE BY PROVIDING EDUCATION ABOUT PUBLIC HEALTH REFERRALS AND EVIDENCED-BASED SMOKING CESSATION STRATEGIES FOR PREGNANT WOMEN. X GOAL: 10% REDUCTION IN NUMBER OF CORTLAND COUNTY WOMEN WHO SMOKE DURING PREGNANCY. X MEASUREMENT: PERCENT OF CORTLAND COUNTY RESIDENTS WHO SMOKE DURING PREGNANCY. OBESITY: INITIATIVES TO DECREASE THE RATE OF OBESITY IN CORTLAND COUNTY WILL BE UNDERTAKEN TO INCLUDE MEDICAL CENTER STAFF AND THE COMMUNITY AT LARGE. PROMOTE INCREASED PHYSICAL ACTIVITY V THERE IS A PERCEIVED LACK OF AWARENESS AMONG COUNTY RESIDENTS ABOUT EXISTING PROGRAMS TO INCREASE PHYSICAL ACTIVITY. CRMC WILL JOIN AN EFFORT TO PUBLICIZE THESE PROGRAMS. PROMOTE BREASTFEEDING V STUDIES SHOW ADULT OBESITY IS SIGNIFICANTLY LOWER AMONG INDIVIDUALS WHO WERE BREASTFEED AS INFANTS. FURTHER, BREASTFEEDING SUCCESS IS STRONGLY CORRELATED TO HAVING A SOLID START WHILE IN THE HOSPITAL. THEREFORE, CRMC WILL FOCUS ITS EFFORTS ON INCREASING THE RATE OF EXCLUSIVE BREASTFEEDING DURING THE HOSPITAL STAY. X GOAL: INCREASE EXCLUSIVE BREASTFEEDING IN THE HOSPITAL TO 80%, AS COMPARED WITH 57.6% IN 2010. X MEASUREMENT: PERCENT OF MOTHER S DELIVERED AT CRMC WHO EXCLUSIVELY BREASTFEED THEIR INFANT WHILE IN THE HOSPITAL. SCREENING FOR CV DISEASE, DIABETES, AND BREAST, CERVICAL, AND COLORECTAL CANCER: CRMC DIABETES SERVICES V THE MEDICAL CENTER HAS BEEN OFFERING A COMPREHENSIVE RANGE OF SERVICES TO DIABETICS FOR MORE THAN 20 YEARS. A REGISTERED NURSE WHO IS ALSO A CERTIFIED DIABETIC EDUCATOR (CDE) THROUGH THE AMERICAN DIABETES ASSOCIATION COORDINATES THESE SERVICES. CRMC COMMITTED SIGNIFICANT FINANCIAL RESOURCES OVER A TWOYEAR PERIOD TO PERMIT A STAFF RN TO RECEIVE THE TRAINING NECESSARY TO BECOME CERTIFIED. NEW INITIATIVES WILL INCLUDE DETERMINING THE STATUS OF HBA1C TESTING, LIPID TESTING, DILATED EYE EXAMS, AND NEPHROPATHY MONITORING IN THE CDE S OVERALL EVALUATION OF INPATIENT DIABETICS. THERE WILL AN EFFORT TO INCREASE THE NUMBER OF PATIENTS RECEIVE HBA1C TESTING DURING THEIR HOSPITAL STAY. THIS WILL BE ACCOMPLISHED BY EDUCATION PROVIDERS CARING FOR THESE PATIENTS. X GOAL: INCREASE NUMBER OF DIABETIC PATIENTS RECEIVING APPROPRIATE HBA1C SCREENING WHILE HOSPITALIZED TO 50%. X MEASUREMENT: NUMBER OF DIABETIC PATIENTS WITH HBA1C DRAWN WHILE INPATIENT. BREAST, CERVICAL, AND COLORECTAL CANCER SCREENING V EVIDENCED-BASED SCREENING QUESTIONS WILL BE ADDED TO ALL ADMISSION ASSESSMENTS. IF INDIVIDUALS HAVE NOT HAD APPROPRIATE SCREENING, REFERRALS WILL BE MADE TO A PROVIDER OF THE PATIENT S CHOICE. AN INFORMATIONAL GUIDE REGARDING SCREENING RECOMMENDATIONS AND HOW TO ACCESS TESTING WILL BE DEVELOPED AND PLACED THOSE IN THE PUBLIC AREAS THROUGHOUT THE MEDICAL CENTER. X GOAL: INCREASE NUMBER OF PATIENTS 50-75 YEARS OLD WITH RECOMMENDED COLORECTAL SCREENING WITHIN THE LAST TWO YEARS FROM 64.4% TO 68%. X MEASUREMENT: PERCENTAGE OF ADULTS 50-75 YEARS OLD WHO HAVE RECEIVED THE RECOMMENDED SCREENING FOR COLORECTAL CANCER. HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN EXCLUSIVE BREASTFEEDING WHILE IN HOSPITAL V THE MEDICAL CENTER WILL COLLABORATE WITH THE CORTLAND COUNTY HEALTH DEPARTMENT AND OBSTETRICAL PROVIDERS TO CREATE AN EDUCATIONAL SERIES ON BREASTFEEDING BENEFITS FOR EACH TRIMESTER. THE DISPARITY OF EXCLUSIVE BREASTFEEDING RATES BETWEEN MEDICAID AND NON-MEDICAID MOTHERS WILL BE ADDRESSED THROUGH THIS INITIATIVE. X GOAL: INCREASE EXCLUSIVE BREASTFEEDING IN THE HOSPITAL TO 80% AS COMPARED WITH 57.6% IN 2010. X MEASUREMENT: PERCENT OF MOTHERS DELIVERED AT CRMC WHO EXCLUSIVELY BREASTFEED WHILE IN THE HOSPITAL. X GOAL: DECREASE DISCREPANCY BETWEEN NUMBERS OF MEDICAID MOTHERS WHO EXCLUSIVELY BREASTFEED COMPARED TO NON-MEDICAID MOTHERS FROM .74 TO .66. X MEASUREMENT: RATIOS OF MEDICAID TO NON-MEDICAID MOTHERS WHO EXCLUSIVELY BREASTFEED IN THE HOSPITAL. SMOKING CESSATION - A REMARKABLY HIGH PERCENTAGE OF WOMEN IN CORTLAND COUNTY SMOKE CIGARETTES THROUGHOUT THEIR PREGNANCY. THE MEDICAL CENTER WILL TARGET PREGNANT WOMEN TO RECEIVE SMOKING CESSATION EDUCATION THROUGH COLLABORATION WITH THE CORTLAND COUNTY HEALTH DEPARTMENT AND PRENATAL PROVIDERS TO INCREASE PUBLIC HEALTH REFERRALS AND TO IMPLEMENT EVIDENCED-BASED EFFORTS TO ASSIST PREGNANT WOMEN WITH SMOKING CESSATION. X GOAL: 10% REDUCTION IN NUMBER OF CORTLAND COUNTY WOMEN WHO SMOKE DURING PREGNANCY. X MEASUREMENT: PERCENT OF PREGNANT CORTLAND COUNTY RESIDENTS WHO SMOKE. PRE-TERM BIRTHRATE V LOWER THE PRETERM BIRTHRATE BY DECREASING SMOKING DURING PREGNANCY, INCREASING EARLY PRENATAL CARE, AND PROVIDING EDUCATION TO PROVIDERS ABOUT THE IMPORTANCE OF NOT PERFORMING ELECTIVE PRETERM DELIVERIES. X GOAL: REDUCE THE PERCENTAGE OF INFANTS DELIVERED PRIOR TO 37 WEEKS FROM 10.8% TO 9.5%. X MEASUREMENT: PERCENT OF INFANTS DELIVERED PRIOR TO 37 WEEKS. CMH GROUP 134 HOMER AVENUE CORTLAND NY 13045 222933722 PARENT CORPORATION NY 501(C)(3) 11D N/A 0 CMH FOUNDATION 134 HOMER AVENUE CORTLAND NY 13045 222230692 RAISE FUNDS ONLY FOR THE HOSPITAL NY 501(C)(3) 7 CMH GROUP 0 REGIONAL MEDICAL PRACTICE 134 HOMER AVENUE CORTLAND NY 13045 204848729 PHYSICIAN GROUP NY 501(C)(3) 3 CORTLAND REGIONAL MEDICAL CENTER 0 CMH SERVICES 134 HOMER AVENUE CORTLAND NY 13045 161370440 DURABLE MEDICAL EQUIPMENT NY CM GROUP C 1079281 740252 1.00000 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0