2015-11-10T09:44:02-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 150524324 DELAWARE VALLEY HOSPITAL INC DELA 6078652197 1 TITUS PLACE WALTON NY 138561457 PAUL SUMMERS CHIEF EXECUTIVE OFFICER 6078652160 2015-10-30 1 ANGELA M FRANCO P00589741 3154463600 2014 2016-02-25 16:41:14Z PAUL SUMMERS 1 TITUS PLACE WALTON NY 138561457 18779027 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 5 225 41 0 0 291690 496656 16114738 17299407 26776 47308 1415056 935656 17848260 18779027 0 0 0 0 9179506 8453297 0 0 28358 7475050 9703340 16654556 18156637 1193704 622390 16901435 16390107 8793262 7729410 8108173 8660697 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 4553400 8604891 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 2014 WERE COMPRISED OF 349 ACUTE, 184 SWING BED, AND 69 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 1,218 PATIENT DAYS, IN ADDITION TO THE 1,759 PATIENT DAYS FOR SWING BED AND 1,054 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 6,877 LAB TESTS, 7,029 RESPIRATORY TREATMENTS, 369 X-RAYS, 889 PHYSICAL THERAPY SESSIONS, AND 249 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. EQUIPMENT PURCHASES IN 2014 CONSISTED OF A NEW MAMMOGRAPHY MACHINE, CABINETS FOR PRESCRIPTION DISPENSING, EXTENDED SIZE STRETCHER AND SEVERAL SERVER AND INFORMATION TECHNOLOGY ITEMS TO ENSURE NETWORK SECURITY. IN 2014 WE ADDED AN OUTPATIENT COMMUNITY PHARMACY AS A NEW SERVICE. WITH THIS ADDITION, SEVERAL CAPITAL ITEMS WERE PURCHASED INCLUDING CABINETRY, HARDWARE/SOFTWARE, AND FURNISHINGS. 3466624 3574825 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 2014 OUR CLINICS PROVIDED CARE TO 12,586 PATIENTS IN WALTON, 1,385 IN ROSCOE, AND 1,117 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. 5711636 5119691 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 2014 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,169 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 64,124 TESTS, AND 6,821 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,450 X-RAYS, CT SCANS, MRI'S AND MAMMOGRAPHIES FOR OUTPATIENT SERVICES. OUTPATIENT SERVICES WERE ALSO PERFORMED IN 2014 FOR 162 AMBULATORY PROCEDURES, 1,098 OPIATED ADDICTION SESSIONS, AND 568 SERVICES ASSOCIATED WITH CARIOPULMONARY REHABILITATION. 909474 OTHER PROGRAM SERVICES REVENUE IS PRIMARILY MADE UP OF MEANINGFUL USE MEDICARE FUNDING OF $909,474. 909474 13731660 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 29 0 1 225 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 258103 0 35556 JOHN CARRIGG 2ND VICE CHAIR 1.00 55.00 X X 0 517502 36392 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 138250 0 7139 SHELLEY KAISER DIRECTOR 1.00 X 0 0 0 DR RAJESH DAVE PAST 2ND VICE CHAIR 1.00 55.00 X 0 598368 31558 JOAN GUARNIERI V.P. COMM HEALTH SVCS 55.00 X 97381 0 11281 DOTTIE KRUPPO V.P. ANCILLARY SVCS 55.00 X 92487 0 4212 DEBORAH HITT V.P. QUALITY/SUPPORT SVCS 55.00 X 98935 0 4552 VICTORIA CONKLING V.P. NURSING/CNO 55.00 X 105094 0 5315 790250 1115870 136005 3 0 1 1 LOCUMTENENS PO BOX 405547 ATLANTA GA 30384 STAFFING SERVICE 595188 SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH NY 13815 PHYSICAL/OCC. THERAPY 351917 MEDHOST OF TENNESSEE 2739 MOMENTUM PLACE CHICAGO IL 60689 INFORMATION TECHNOLOGY 250950 DONALD SHERWOOD MDPC 1197 STATE HWY 357 UNADILLA NY 13849 PHYSICIAN SERVICES 199387 ALLIANCE HEALTHCARE SYSTEMS PO BOX 96485 CHICAGO IL 60693 MEDICAL SUPPORT 197112 9 473491 23165 11170 496656 NET PATIENT REVENUE 900099 17299407 17299407 17299407 47308 47308 MEANINGFUL USE MEDICARE 900099 867762 867762 PHYSICIAN OTHER REVENUE 621498 29861 29861 VENDING MACHINE 722210 22739 22739 15294 11851 3443 935656 18779027 18208881 0 73490 X 564646 408239 156407 6222147 4303859 1918288 182597 118688 63909 992814 630437 362377 491093 324121 166972 2360 2360 4966 4966 97328 97328 5984 5984 4363 4363 4571896 4101190 464706 6000 917 917 2224991 1625624 595677 3690 13789 13789 224191 41552 182639 40213 28044 9942 2227 30500 11440 3536 15524 271945 271945 816539 805519 11020 182992 154557 28435 BAD DEBT EXPENSE 1124922 1124922 MISCELLANEOUS 85444 53468 31976 18156637 13731660 4396619 28358 2714926 2380818 846247 1352899 1709266 1889306 132691 440094 344493 321124 20581168 13555110 6921078 7026058 962908 1025200 2116230 1909608 1153596 45000 16901435 16390107 846771 887125 4381525 4116920 693814 612001 1138963 1645482 1732189 467882 8793262 7729410 X 7759595 8299158 30368 43329 318210 318210 8108173 8660697 16901435 16390107 X 622390 40885 -110751 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 5984 5984 0 PART II-B, LINE 1: DELAWARE VALLEY HOSPITAL HAS LIMITED LOBBYING ACTIVITIES WHICH ARE CONDUCTED ON BEHALF OF THE ORGANIZATION THROUGH MEMBERSHIP IN IROQUOIS HEALTHCARE ALLIANCE AND THE HEALTH CARE ASSOCIATION OF NEW YORK STATE (HANYS). THESE ACTIVITIES INCLUDE ADVERTISEMENTS AND CONTACTS WITH THE LEGISLATORS ON VARIOUS HEALTHCARE ISSUES. 348578 12961 361539 379742 1700 32864 348578 381035 -1293 379742 342832 38203 381035 424391 6550 88109 342832 0.88020 0.11980 1 0 51202 51202 9677664 4705424 4972240 10381537 8849686 1531851 470765 470765 7026058 WELLS FARGO - PRIN. PMTS. ON BOND 142594 F TEMP.RESTRICTED DONATIONS 50970 F CAPITAL CONST(FUNDED DEPR) 1716044 F 1909608 DUE UNITED MED. ASSOC. / CHEN. MEM. 171960 DUE UHS HOSPITALS 174728 MALPRACTICE INSURANCE RESERVE 121194 467882 X 18779027 0 18779027 0 18779027 18267388 110751 110751 18156637 0 18156637 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, 2014 AND 2013, 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 2011 THROUGH 2014. PART XII, LINE 2D - OTHER ADJUSTMENTS: INTEREST RATE SWAP 110,751. 1 1 X 1 X 1 X 1 1 0 1 1 3780513 2739267 1041246 0.06110 111900 9052 102848 0.00600 3892413 2748319 1144094 0.06710 160661 160661 0.00940 22213 22213 0.00130 10369542 7520324 2849218 0.16730 1418 1418 0.00010 10553834 7520324 3033510 0.17810 14446247 10268643 4177604 0.24520 0 469531 105084 4813339 4779339 34000 X 1 0 1 1 DELAWARE VALLEY HOSPTITAL 1 TITUS PLACE WALTON NY 13856 X X X DELAWARE VALLEY HOSPITAL 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 300.000000000000 X X X X 1 1 X X X X 1 X X X X X X X 1 X 0 X X X X 1 X 0 0 DELAWARE VALLEY HOSPITAL 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 HOSPITAL PART V, SECTION B, LINE 6A: UNITED HEALTH SERVICE HOSPITALS, INC.CHENANGO MEMORIAL HOSPITAL DELAWARE VALLEY HOSPITAL 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.IN 2014, THE HOSPITAL WILL WORK WITH DELAWARE COUNTY PUBLIC HEALTH TO INSURE THE CORE GROUP OF STAKEHOLDERS FORM A COALITION TO ASSESS EXISTING RESOURCES AND NEEDED RESOURCES; DETERMINE HOW AND WHAT DATA CAN BE COLLECTED; IDENTIFY AND PRIORITIZE OPPORTUNITIES TO COLLABORATE BASED ON NEEDS OF THE COMMUNITY; EVALUATE ANY OBSTACLES AND PLAN A COURSE OF ACTION TO ADDRESS ISSUES.SUPPORT EFFORTS TO INTEGRATE MEB DISORDER SCREENING AND TREATMENT INTO PRIMARY CARE.IN 2014, THE HOSPITAL WILL BEGIN WORK TO ASSIST APPROPRIATE STAKEHOLDERS IN TRAINING PRIMARY CARE GIVERS ON WAYS TO INTEGRATE PREVENTION, SCREENING AND TREATMENT INTO THEIR PRACTICE TO ENHANCE THEIR COMFORT LEVEL.WORK WITH THE UHS SYSTEM TO DETERMINE HOW SCREENING AND TREATMENT DONE IN PRIMARY CARE SETTINGS CAN BE MEASURED THROUGH THE EXISTING ELECTRONIC MEDICAL RECORD WILL BE COMPLETED BY MID 2015.BY THE END OF 2015, UHS DELAWARE VALLEY HOSPITAL PRIMARY CARE PHYSICIANS WILL HAVE INTEGRATED PREVENTION, SCREENING AND TREATMENT INTO THEIR PRACTICE.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.2014 SERVICE REPORT UPDATETHE PREVALENCE OF SUBSTANCE ABUSE AND PATIENTS WITH MENTAL, EMOTIONAL AND BEHAVIORAL (MEB) ISSUES IS OVERWHELMING THE EXISTING RESOURCES. PRIMARY CARE PROVIDERS ARE NOT WELL EQUIPPED TO DEAL WITH THESE PATIENTS AND THE COUNTY MENTAL HEALTH AND DRUG ABUSE DEPARTMENTS ARE OVERWHELMED BY THE SHEER NUMBERS OF PATIENTS NEEDING CARE. THE VASTNESS OF DELAWARE COUNTY ALSO MAKES DELIVERING SERVICES EXTREMELY DIFFICULT.WE ARE WORKING MOSTLY WITH THE MEB PROVIDERS TO DETERMINE HOW BEST TO ADDRESS THE NEEDS. BECAUSE ALL OF OUR AGENCIES ARE SMALL AND MOST PERSONNEL WEAR SEVERAL HATS, IT IS DIFFICULT TO FIND THE TIME FOR ALL OF US TO MEET REGULARLY, YET WE HAVE MANAGED TO COMMUNICATE FREQUENTLY WITH THE DIRECTOR OF OUR LOCAL MEB AND SUBSTANCE ABUSE DEPARTMENTS. IN ADDITION, OUR INITIAL PLAN WAS TO HIRE A LICENSED CLINICAL SOCIAL WORKER TO WORK IN PRIMARY CARE TO ADDRESS THE NEEDS OF THESE PATIENTS BUT WE HAVE REALIZED THAT THERE IS A LACK OF THESE IN OUR AREA. BASED ON THE LACK OF LICENSED CLINICAL SOCIAL WORKERS IN THE AREA (ONLY TYPE OF SOCIAL WORKER FOR WHICH REIMBURSEMENT FOR THEIR SERVICES IS AVAILABLE) AND REALIZING IN OUR DISCUSSIONS THAT THE OVERRIDING NEED IS FOR CLINICIANS WHO CAN PRESCRIBE PSYCHOTROPIC DRUGS, WE WILL BE USING OUR VAP FUNDING TO SECURE A TELEMEDICINE CONSULTANT WHO CAN HELP US IDENTIFY WAYS TO ADDRESS THIS NEED, UTILIZING CLINICIANS FROM OTHER AREAS.THROUGH THE DELAWARE COUNTY HEALTHCARE ALLIANCE MEMBERSHIP, IT WAS IDENTIFIED THAT PRISONERS WERE NOT RECEIVING SERVICES AS THEY ARE NOT REIMBURSABLE, SO FUNDING HAS BEEN SECURED TO DEVELOP A RECOVERY COACH PROGRAM SO THAT PRISONERS RECEIVE SOME INTERVENTION PRIOR TO RELEASE. IN ADDITION, PRISONERS HAD BEEN RELEASED AT MIDNIGHT. NOW THAT HAS BEEN CHANGED TO 9 AM TO HELP ENSURE THEY HAVE ACCESS TO SERVICES UPON RELEASE AND DON'T HAVE TO RELY ON THEIR "FRIENDS" WHO OFTEN ARE NOT THE BEST INFLUENCE ON THEM. THIS HAS HELPED ADDRESS ONE PART OF THE POPULATION THAT NEEDED SERVICES.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 2014.WORKING WITH THE TOWNSEND SCHOOL PTA WALTON ELEMENTARY SCHOOL CHILDREN WILL BE ENROLLED IN THE PROGRAM DURING 2014.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 2014-15, 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 2014-15, 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.2014 SERVICE REPORT UPDATE WE HELD A HEALTHY COOKING CLASS ON 4 EVENINGS. ONE EVENING FOCUSED ON BEEF, ONE ON PORK, POULTRY AND FISH. WE COOKED AN ENTR E AND A SIDE DISH AT EACH SESSION. NOTEBOOKS WERE CREATED AND GIVEN TO EACH PARTICIPANT. THE CLASSES WERE VERY INTERACTIVE SO THAT EVERYONE HAD THE OPPORTUNITY TO ASK QUESTIONS AND MAKE SUGGESTIONS.BECAUSE THIS WAS A NEW PROGRAM, WE TOOK SUGGESTIONS AND ADVICE FROM THE PARTICIPANTS THEMSELVES TO AUGMENT THE PROGRAM TO ENSURE IT WAS RESPONSIVE TO THEIR VISION OF WHAT THEY WANTED TO LEARN FROM THE PROGRAM, IN ADDITION TO THE PROGRAMMING WE HAD ALREADY DEVELOPED FOR EACH EVENING SESSION.CUMULATIVE NUMBER OF PARTICIPANTS ATTENDING PROGRAMMING OVER 4 WEEK PERIOD - 22 NUMBER OF RECIPES PREPARED - 9NUMBER OF OTHER RECIPES, TIPS, INFORMATION SHARED IN TAKE HOME BINDER-27WHILE THIS WAS A SUCCESSFUL PROGRAM AND THE PARTICIPANTS WERE HIGHLY ENGAGED AND TRIED NEW RECIPES AND FOODS THEY NORMALLY WOULD NOT TRY; THE REALITY IS, THIS PROGRAM CAN ONLY REACH A FEW PEOPLE AT A TIME AND TAKES A LOT OF RESOURCES IN TIME AND MATERIALS TO HOLD. REALISTICALLY, WE WILL PROBABLY BEGIN TO FOCUS MORE CLOSELY ON EVIDENCE-BASED PROGRAMMING.CREATE COMMUNITY ENVIRONMENTS THAT PROMOTE AND SUPPORT HEALTHY BEVERAGE CHOICES AND PHYSICAL ACTIVITY.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.2014 SERVICE REPORT UPDATETHE WALTON MAYOR AND ULTIMATELY THE WALTON VILLAGE BOARD WAS APPROACHED TO CONSIDER A COMPLETE STREETS POLICY.DURING 2014, WE WORKED WITH O'CONNOR HOSPITAL AND THE DELAWARE COUNTY PUBLIC HEALTH DEPT. ON A PRESCRIPTION TRAILS INITIATIVE. A WEBSITE (GETOUTANDWALK.ORG) HAS BEEN DEVELOPED; FLYERS AND PRESCRIPTION PADS HAVE BEEN CREATED. DELAWARE VALLEY HOSPITAL PROVIDERS WILL BE PARTICIPATING IN THE INITIATIVE BY ENCOURAGING THEIR PATIENTS TO GET OUT AND WALK.PROMOTE USE OF EVIDENCE-BASED CARE TO MANAGE CHRONIC DISEASES. OBJECTIVESBY 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 PAT PART V, SECTION B, LINE 11, CONTINUED: OTHER COMMUNITY SERVICE ACTIVITIES SUBSTANCE ABUSEDELAWARE VALLEY HOSPITAL HOSTS A WEEKLY NARCOTICS ANONYMOUS MEETING. THE HOSPITAL STAFF ALSO PROVIDES FREE SPECIMEN COLLECTIONS FOR THE DELAWARE COUNTY DRUG COURT.HEALTHY LIFESTYLESTHE HOSPITAL'S CERTIFIED DIETITIAN NUTRITIONIST HELD A LIFESTEPS PROGRAM IN FEBRUARY FOR COMMUNITY MEMBERS TO LEARN WAYS EAT HEALTHIER AND HAVE A HEALTHIER LIFESTYLE. IN ADDITION, SHE GAVE A TALK TO THE CULINARY STUDENTS AT SUNY DELHI ABOUT DIABETES; ATTENDED THE AREA DIABETIC FAIR, HELD ANNUALLY IN SIDNEY AND HAD AN INFORMATION TABLE AND TIME SET ASIDE FOR STAFF AND MEMBERS OF THE PUBLIC TO GET QUESTIONS REGARDING NUTRITION ANSWERED DURING NUTRITION MONTH.THE HOSPITAL ALSO HAS A BOOTH AT THE DELAWARE COUNTY FAIR EACH YEAR. THE BOOTH FEATURES INFORMATION ABOUT NUTRITION, EXERCISE, AND FEATURES FREE BLOOD PRESSURE, BALANCE AND PULSE-OX SCREENING.THE HOSPITAL WAS A SPONSOR OF DOWNSVILLE'S DAMTOWN 5K AND THE DELAWARE COUNTY FAIR'S 5K, AS WELL AS, THE WALTON LITTLE LEAGUE.HEALTHCARE EDUCATIONWE HOST RN STUDENTS FROM SUNY DELHI AND CAN STUDENTS FROM BOCES EACH YEAR, AS THEY DO THEIR CLINICALS FOR THEIR RESPECTIVE CURRICULUMS. WE ALSO HOLD A MASH CAMP FOR HIGH SCHOOL STUDENTS TO HAVE A HANDS-ON EXPERIENCE AND LEARN MORE ABOUT HEALTHCARE CAREERS." PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY DELAWARE VALLEY HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.UHS.NET DELAWARE VALLEY HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: HTTP://WWW.UHS.NET DELAWARE VALLEY HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.UHS.NET 5 WALTON FAMILY HEALTH CENTER 2 TITUS PLACE WALTON NY 13856 OUTPATIENT PHYSICIAN CLINIC DOWNSVILLE FAMILY HEALTH CENTER 28315 STATE HWY 206 DOWNSVILLE NY 13755 OUTPATIENT PHYSICIAN CLINIC ROSCOE FAMILY HEALTH CENTER 1982 OLD ROUTE 17 ROSCOE NY 12776 OUTPATIENT PHYSICIAN CLINIC PHYSICAL AND OCCUPATIONAL THERAPY 123 STOCKTON AVENUE WALTON NY 13856 REHABILITATION CLINIC 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 IN DVH'S ALLOWABLE COSTS (INPATIENT AND OUTPATIENT) 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 $1,124,922 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 WELLNESS AND COMMUNITY COMMITTEES OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL HOSTS BOTH RN AND CNA STUDENTS DURING THE YEAR; HOSTS A MASH CAMP TO PROVIDE AN OPPORTUNITY FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT HEALTHCARE CAREERS. 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. 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: A SYSTEM-WIDE POLICY CLEARLY STATES "FORWARDING A CLAIM TO A COLLECTION AGENCY WHILE FINANCIAL ASSISTANCE IS BEING DETERMINED IS PROHIBITED." AFTER PATIENTS' REQUESTS FOR FINANCIAL ASSISTANCE ARE APPROVED THE ORGANIZATION WILL PROVIDE THEM WITH THE SAME LEVEL OF FINANCIAL ASSISTANCE FOR 6 MONTHS AT WHICH TIME ANOTHER EVALUATION OF THE PATIENT'S FINANCIAL CONDITION WILL BE MADE. PART VI, LINE 2: THE HOSPITAL HOSTS BOTH RN AND CNA STUDENTS AND A MASH CAMP 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. DURING 2014, 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. IT PARTICIPATED WITH O'CONNOR HOSPITAL AND DEL. CO. PUBLIC HEALTH IN BEGINNING THE PROCESS OF SPEAKING WITH COMMUNITIES ABOUT CONSIDERING THE IMPLEMENTATION OF A COMPLETE STREETS POLICY. IN ADDITION, DVH PARTICIPATED IN THE NEWLY DEVELOPING PRESCRIPTION TRAILS INITIATIVE. SEVERAL MEETINGS WERE HELD WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. OVER THE COURSE OF THESE MEETINGS, IT BECAME APPARENT THAT MORE PROFESSIONALS ARE NEEDED TO ADDRESS OUR LOCAL ISSUES AND THE BEST WAY TO DO THAT WOULD BE THROUGH TELEMEDICINE. DELAWARE VALLEY THEN INCLUDED A TELEMEDICINE CONSULTANT IN ITS APPLICATION FOR VITAL ACCESS PROVIDER FUNDING. THIS WAS APPROVED AND BEGAN IN JANUARY 2015. THE HOSPITAL ALSO PARTICIPATED IN THE UHS PPS FOR THE DSRIP PROGRAM. 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. 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. 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 $ 43,554 AND 17.1% 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, CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH ITS ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE ITS 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 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. IN THE IMAGING CENTER X-RAY, FLUOROSCOPY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE 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, OB/GYN AND PODIATRIST. DURING 2014, 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, PERFORMED AT LEAST 384 BLOOD PRESSURE CHECKS; 155 PULSE OX (HEART RATE AND OXYGEN LEVEL TESTS; AND 17 BALANCE SCREENINGS. IN ADDITION 146 PEOPLE PLAYED THE SPIN THE WHEEL GAME, WHICH FEATURED QUESTIONS ABOUT PHYSICAL ACTIVITY, NUTRITION AND OTHER HEALTH QUESTIONS. NUTRITION EDUCATION, ESPECIALLY ABOUT SALT AND FAT, AND DIABETES WAS ALSO A FEATURE. 31 EMPLOYEES SPENT A TOTAL OF 189 HOURS AT THE 6 DAY LONG EVENT. THE DIETICIAN ALSO PARTICIPATED IN A DIABETES HEALTH FAIR IN SIDNEY, REACHING 15 PEOPLE; AND DID A PRESENTATION FOR SUNY DELHI CULINARY ARTS STUDENTS (10) REGARDING DIABETES. SHE ALSO HAD INFORMATION AND HANDOUTS AVAILABLE, FOR STAFF AND COMMUNITY MEMBERS, ONE AFTERNOON DURING NUTRITION MONTH. TEN PEOPLE TOOK ADVANTAGE OF THIS 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 4 WEDNESDAYS DURING THE SUMMER. COOKING CLASSES WERE HELD OVER A 4 WEEK PERIOD AND IN ADDITION TO ACTUALLY GAINING HANDS-ON COOKING EXPERIENCE, 9 PARTICIPANTS WERE GIVEN A BINDER FILLED WITH HEALTHY RECIPES, TIPS, HOW TO USE HERBS, TYPES OF BEEF AND OTHER USEFUL INFORMATION. FALL PREVENTION IS A CONCERN FOR EVERYONE AS THE POPULATION AGES. DELAWARE VALLEY HOSPITAL SENT 2 STAFF MEMBERS TO A TWO DAY TRAINING TO TEACH THE EVIDENCE-BASED MATTER OF BALANCE PROGRAM. THE EIGHT WEEK PROGRAM WAS HELD WITH 14 PARTICIPANTS BEGINNING THE CLASS AND 11 RECEIVING COMPLETION CERTIFICATES.DELAWARE VALLEY HOSPITAL STAFF ATTENDED THE ROSCOE CENTRAL SCHOOL OPEN HOUSE AND DISTRIBUTED HEALTHY MEAL PLANNING AND SNACK TIPS FOR KIDS, AS WELL AS FRISBEES TO ENCOURAGE APPROXIMATELY 50 KIDS AND PARENTS TO LIVE A LIFESTYLE THAT INCLUDES A HEALTHY DIET AND PHYSICAL ACTIVITY. DELAWARE VALLEY STAFF ALSO ATTENDED THE ACCO COMPANY HEALTH FAIR WHERE NUTRITION INFORMATION WAS PROVIDED TO APPROXIMATELY 75 EMPLOYEES. 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 2014, 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 LOCAL TOY DRIVE FOR CHILDREN DURING DECEMBER. IN ADDITION, STAFF COLLECTED ITEMS TO BE SENT OVERSEAS TO OUR LOCAL SERVICEMEN AND WOMEN SO THEY REALIZE THAT THEY ARE NOT FORGOTTEN. THE HOSPITAL ALSO SUPPORTED THE FREE HOLIDAY DINNER AT THE LOCAL CHURCH FOR THOSE WHO HAVE NO ONE TO BE WITH OR LACK THE FUNDS FOR A HOLIDAY MEAL. 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 258103 0 0 0 0 0 13849 0 21707 0 293659 0 0 0 JOHN CARRIGG 2ND VICE CHAIR 0 458578 0 58924 0 0 0 14280 0 22112 0 553894 0 0 DR RAJESH DAVE PAST 2ND VICE CHAIR 0 516524 0 67390 0 14454 0 14280 0 17278 0 629926 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 258,103 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 55770 EMPLOYEE WAGES 0 BONNIE CRAIG SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES 35103 EMPLOYEE WAGES 0 NANCY VOLLKOMMER SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO 29775 EMPLOYEE WAGES 0 MILA KATANIC-TUCKER STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS 25346 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, CORPORATE COUNSEL, 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-CARTER, 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 4,101,190. MANAGEMENT AND GENERAL EXPENSES 464,706. FUNDRAISING EXPENSES 6,000. TOTAL EXPENSES 4,571,896. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -110,751. FORM 990, PART XII, LINE 2C: NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT OR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT HAS CHANGED DURING THE CURRENT 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 4401 VESTAL PARKWAY EAST VESTAL NY 13850 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 4401 VESTAL PARKWAY EAST VESTAL NY 13850 222438211 HOME HEALTH CARE NY 501(C)(3) 7 UNITED HEALTH SERVICES INC 0 PROJECT HEAR INC 4401 VESTAL PARKWAY EAST VESTAL NY 13850 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