4A (Expenses $ 52032282 including grants of $ 0) (Revenue $ 45543531)
ANCILLARY SERVICES - THERE WERE 439,214 PROCEDURES INCLUDING RADIOLOGY, LAB, CARDIOLOGY, THERAPY, ETC. IN 2021.

4B (Expenses $ 56814534 including grants of $ 0) (Revenue $ 49729406)
PSYCHIATRIC INPATIENT & LONG TERM PSYCH - THERE WERE 149 BEDS AVAILABLE FOR THE TREATMENT OF 48,539 PATIENT DAYS FOR 2021. APPROXIMATELY 225 MEDICAL PERSONNEL ARE ASSIGNED TO THIS UNIT.THE BREAKDOWN FOR INPATIENT & LONG TERM PSYCH IS AS FOLLOWS: INPATIENT HAD 43,680 PATIENT DAYS AND APPROXIMATELY 234 MEDICAL PERSONNEL. LONG TERM PSYCH HAD 4,859 PATIENT DAYS AND APPROXIMATELY 5 MEDICAL PERSONNEL.

4C (Expenses $ 96957621 including grants of $ 0) (Revenue $ 86015430)
GENERAL SERVICE FACILITIES FOR MEDICAL/SURGICAL PATIENTS (EXPENSES: $43,668,127, REVENUE: $38,704,840):THE HOSPITAL HAD 122 BEDS AVAILABLE TO THE PUBLIC FOR MEDICAL AND SURGICAL SERVICES IN 2021. THE HOSPITAL HAD 19,294 PATIENT DAYS FOR GENERAL SERVICE AND APPROXIMATELY 73 MEDICAL PERSONNEL ASSIGNED TO THIS SERVICE.EMERGENCY SERVICE (EXPENSES: $3,713,939, REVENUE: $3,250,788): THE HOSPITAL HAD 23,870 EMERGENCY VISITS DURING THE YEAR OF WHICH 2,902 RESULTED IN ADMITTANCE INTO THE HOSPITAL. THERE WERE APPROXIMATELY 44 NURSES, AIDES AND PHYSICIANS ASSIGNED.OUTPATIENT PSYCHIATRIC CLINICS (EXPENSES: $15,550,077, REVENUE: $13,610,885): THERE WERE 158,383 VISITS FOR 2021 AND 44 FTES.OUTPATIENT SERVICES (EXPENSES: $16,398,028, REVENUE: $14,353,091): THERE WERE 113,929 VISITS FOR 2021 AND 53 FTES.INTENSIVE CARE UNIT AND CORONARY CARE UNIT (EXPENSES: $12,236,005, REVENUE: $10,710,099): THERE WERE 6 BEDS AVAILABLE. 1,202 PATIENT DAYS OCCURRED IN 2021 FOR THE COMBINATION OF ICU AND CCU SERVICES. APPROXIMATELY 22 FTES WERE ASSIGNED TO THIS AREA.SUPPORTED CASE MANAGEMENT (EXPENSES: $2,327,067, REVENUE: $2,036,867): THERE WERE 14,128 VISITS FOR 2021.PARTIAL HOSPITALIZATION (EXPENSES: $3,064,378, REVENUE: $2,682,231): THERE WERE 10,199 VISITS IN 2021 AND 18 FTES.PEDIATRIC UNIT (EXPENSES: $0, REVENUE: $0): THERE WERE 2 BEDS AVAILABLE, 0 PATIENT DAY AND APPROXIMATELY 0 FTES IN 2021.THE HOSPITAL ALSO PROVIDED SERVICES TO RELATED ORGANIZATIONS WHICH YIELDED TOTAL REVENUE OF $666,629.

4D (Expenses $ 20764618 including grants of $ 0) (Revenue $ 18175140)
METHADONE MAINTENANCE TREATMENT PROGRAM CLINIC - THERE WERE 442,432 VISITS FOR 2021 AND APPROXIMATELY 117 FULL TIME EMPLOYEES.

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: ST. JOSEPH'S HOSPITAL YONKERS, NY, - FACILITY 2: ST. VINCENT'S HOSPITAL WESTCHESTER

FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:
"SAINT JOSEPH'S MEDICAL CENTER (SJMC), FOUNDED BY THE SISTERS OF CHARITY OF NEW YORK, HAS SERVED THE CITY OF YONKERS SINCE 1888. EACH YEAR, MORE THAN 55,000 INDIVIDUALS ARE TOUCHED BY SAINT JOSEPH'S AND/OR ITS ST. VINCENT'S WESTCHESTER DIVISION IN HARRISON. SJMC STRIVES FOR EXCELLENCE IN HEALTHCARE IN AN ATMOSPHERE OF SUPPORT AND SHARED MINISTRY. WE BELIEVE IN RESPECT AND COMPASSION FOR OURSELVES AND OTHERS, EXCELLENCE IN SERVICE, THE DIGNITY OF HUMAN LIFE, AND COMMITMENT TO THE COMMUNITY. SAINT JOSEPH'S EXPANDED IN WESTCHESTER COUNTY AND NEW YORK CITY THROUGH ITS 2010 ACQUISITION OF THE BEHAVIORAL HEALTH SERVICES OF ST. VINCENT'S HOSPITAL WESTCHESTER, BECOMING ONE OF THE LARGEST BEHAVIORAL HEALTH PROVIDERS IN NEW YORK STATE. THE OPENING OF NEW PRIMARY CARE, CARDIOVASCULAR, AND ADVANCED WOUND CARE AND HYPERBARIC MEDICINE CENTERS IN YONKERS AND AN IMAGING CENTER IN RIVERDALE DEMONSTRATE SAINT JOSEPH'S CONTINUING COMMITMENT TO THE COMMUNITY.TO GUIDE OUR COMMUNITY BENEFIT AND HEALTH IMPROVEMENT EFFORTS, AND IN ACCORDANCE WITH THE REQUIREMENTS SET FORTH BY THE NEW YORK STATE PREVENTION AGENDA, IN COLLABORATION WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH AND THE NOT FOR PROFIT HOSPITALS IN WESTCHESTER COUNTY, SJMC CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019 AND DEVELOPED A SUPPORTING COMMUNITY SERVICE PLAN (CSP) THAT WOULD SPAN A THREE YEAR PERIOD COVERING 2019-2021.THE CHNA INCLUDED QUANTITATIVE AND QUALITATIVE RESEARCH METHODS TO DETERMINE HEALTH TRENDS AND DISPARITIES ACROSS WESTCHESTER COUNTY AND THE CITY OF YONKERS. PRIMARY STUDY METHODS WERE USED TO SOLICIT INPUT FROM RESIDENTS AND KEY COMMUNITY STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. SECONDARY STUDY METHODS WERE USED TO IDENTIFY AND ANALYZE STATISTICAL DEMOGRAPHIC AND HEALTH TRENDS.SPECIFIC CHNA STUDY METHODS INCLUDED: - AN ANALYSIS OF SECONDARY DATA SOURCES, INCLUDING PUBLIC HEALTH, DEMOGRAPHIC, AND SOCIAL MEASURES. A COMPREHENSIVE LIST OF DATA REFERENCES IS INCLUDED IN APPENDIX A. 2019 CSP REPORT DECEMBER 2019 3 - A COMMUNITY HEALTH SURVEY WITH 2,727 WESTCHESTER COUNTY RESIDENTS, 452 FROM SJMC'S PRIMARY SERVICE AREA, TO ASSESS PERCEPTIONS OF PRIORITY HEALTH ISSUES, HEALTH RISK FACTORS, AND BARRIERS TO ACCESSING CARE. - A COMMUNITY HEALTH SUMMIT WITH WESTCHESTER COUNTY HEALTH AND HUMAN SERVICE PROVIDERS TO SOLICIT INPUT ON COMMUNITY HEALTH AND SOCIAL NEEDS AND TACTICS TO ADVANCE THE NEW YORK STATE 2019-2021 PREVENTION AGENDA. THE CHNA WAS A COMMUNITY COLLABORATIVE PROCESS, INITIATED WITH THE GOAL OF DEVELOPING AN ASSESSMENT THAT IS REFLECTIVE OF THE NEEDS OF THE COMMUNITY, INCLUDING CLINICAL AND SOCIAL DETERMINANTS OF HEALTH. SJMC PARTNERED WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH AS WELL AS THE MONTEFIORE HUDSON VALLEY COLLABORATIVE (MHVC), A GROUP OF REGIONAL HOSPITALS AND COMMUNITY BASED ORGANIZATIONS, TO GATHER RESEARCH IN SUPPORT OF THE CHNA. TO WORK TOWARD HEALTH EQUITY, IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TO ADDRESS THE MOST PRESSING HEALTH NEEDS WITHIN OUR COMMUNITY. TAKING INTO ACCOUNT SJMC'S EXPERTISE AND RESOURCES, IN ALIGNMENT WITH THE NEW YORK STATE PREVENTION AGENDA AND CONTINUING WITH THE INITIATIVES ORIGINALLY DEVELOPED IN THE MHVC DELIVERY SYSTEM REFORM INCENTIVE (DSRIP) PROGRAM, SJMC WILL FOCUS HEALTH IMPROVEMENT EFFORTS ON THE FOLLOWING PRIORITY AREAS FOR THE 2019-2021 CYCLE: - PREVENT CHRONIC DISEASES WITH A FOCUS ON ASTHMA GOAL #1: PROMOTE THE USE OF EVIDENCE-BASED CARE TO MANAGE ASTHMA. GOAL #2: IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH ASTHMA. - PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS GOAL #1: PREVENT OPIOID AND OTHER SUBSTANCE MISUSE AND DEATHS. SJMC FOCUSED ON CHRONIC DISEASE PREVENTION EFFORTS ON ASTHMA. SJMC HAS MADE SIGNIFICANT INVESTMENT AND STRIDES TO IMPROVE ASTHMA HEALTH IN PARTNERSHIP WITH ITS FAMILY HEALTH CENTER AND SAINT JOSEPH'S SCHOOL BASED HEALTH PROGRAMS, AMONG OTHERS. SJMC HAS ALSO FOCUSED ON EXPANSION OF SUBSTANCE USE DISORDER TREATMENT SERVICES IN RESPONSE TO GROWING COMMUNITY NEED. SJMC'S ASTHMA INITIATIVES ALIGN WITH AND BUILD UPON THE INITIATIVE IMPLEMENTED IN THE MHVC DSRIP PROGRAM FOR EVIDENCE-BASED CLINICAL- AND SELF-MANAGEMENT STRATEGIES. ALTHOUGH THE MHVC DSRIP INITIATIVE IS NO LONGER IN EFFECT, AS PART OF THE CSP, WE WILL CONTINUE TO PROMOTE MEDICAL ASTHMA MANAGEMENT IN ACCORDANCE WITH NATIONAL GUIDELINES, IMPROVE ACCESS AND ADHERENCE TO MEDICATIONS AND DEVICES, AND EXPAND ACCESS TO SELF-MANAGEMENT INTERVENTIONS. WE TARGETED HIGH-RISK PATIENTS IN OUR FAMILY HEALTH CENTER, A DESIGNATED LEVEL 3 PATIENT CENTERED MEDICAL HOME. THE COLLECTIVE OBJECTIVES AND PROCESS MEASURES FOR THESE PROGRAMS ARE DECREASED ASTHMA-RELATED ED VISITS AND HOSPITALIZATIONS, AND A HIGHER PERCENTAGE OF PATIENTS WHO HAVE A DISEASE MANAGEMENT PLAN AND RECEIVE DISEASE SELF-MANAGEMENT INSTRUCTION AND SUPPORT. SAINT JOSEPH'S SCHOOL BASED HEALTH PROGRAMS ARE PRIMARY CARE SCHOOL-BASED CLINICS OPERATING IN FOUR YONKERS PUBLIC SCHOOLS. SINCE 1989, WE HAVE PROVIDED FREE, ACCESSIBLE, HIGH QUALITY HEALTH SERVICES TO HIGH-RISK CHILDREN AND HAS BECOME AN INTEGRAL COMPONENT OF THE YONKERS HEALTHCARE DELIVERY SYSTEM. THESE PROGRAMS PROVIDE A FULL ARRAY OF PRIMARY HEALTH SERVICES, INCLUDING, BUT NOT LIMITED TO, ROUTINE CARE OF CHILDREN WITH ASTHMA. AS PART OF THE CSP, SAINT JOSEPH'S IMPLEMENTED KICKIN' ASTHMA AND OPEN AIRWAYS FOR SCHOOLS AT CLINIC SITES. THESE PROGRAMS, DEVELOPED BY THE AMERICAN LUNG ASSOCIATION, ARE AMONG THE MOST WIDELY RECOGNIZED ASTHMA MANAGEMENT TOOLS FOR CHILDREN IN THE NATION, AND PROVEN-EFFECTIVE FOR DECREASING ASTHMA EMERGENCIES AND RAISING ASTHMA AWARENESS AMONG FAMILIES AND SCHOOL PERSONNEL. THE NURSE PRACTITIONERS WHO STAFF THE CLINICS AND ADMINISTER EDUCATIONAL PROGRAMS THAT ADHERE TO THE NATIONAL ASTHMA EDUCATION AND PREVENTION PROGRAM EXPERT PANEL REPORT 3 GUIDELINES FOR THE DIAGNOSIS AND MANAGEMENT OF ASTHMA. THREE OF THE NURSE PRACTITIONERS, AS WELL AS SJMC'S MEDICAL DIRECTOR FOR AMBULATORY PROGRAMS, ARE CERTIFIED ASTHMA EDUCATORS. SJMC OFFERS THE METHADONE MAINTENANCE TREATMENT PROGRAM, PROVIDING DETOXIFICATION AND METHADONE MAINTENANCE FOR PATIENTS WITH OPIATE USE DISORDER. INDIVIDUAL AND GROUP COUNSELING, ANNUAL PHYSICAL EXAMINATIONS, TESTING AND LAB WORK, AND PRIMARY CARE SERVICES ARE INCLUDED IN THE PROGRAM. SJMC WILL CONTINUE EFFORTS TO INCREASE ACCESS AND LINKAGES TO THE METHADONE PROGRAM, AS WELL AS AVAILABILITY OF OTHER MEDICATION-ASSISTED TREATMENT OPTIONS AND NALOXONE ADMINISTRATION TRAINING. THE MAXWELL INSTITUTE, A DIVISION OF SJMC IS A SUBSTANCE ABUSE TREATMENT CENTER, LOCATED IN TUCKAHOE, NEW YORK. THE OUTREACH DIRECTOR OF THE CLINIC HAS DEDICATED A LARGE PORTION OF HER TIME TRAINING POLICE DEPARTMENTS THROUGHOUT WESTCHESTER COUNTY ON NALOXONE ADMINISTRATION TRAINING FREE OF CHARGE. THE TRAINING COMES COMPLETE WITH KITS. SHE HAS ALSO CONDUCTED THE TRAINING IN HIGH SCHOOLS, COLLEGE CAMPUSES AND TO THE YONKERS HOUSING AUTHORITY. IN ADDITION, WE HAVE A LARGE PRESENCE AT MULTIPLE HEALTH FAIRS THROUGHOUT THE YEAR, PROVIDING NARCAN TRAINING TO COMMUNITIES AT LARGE WHERE DRUG OVERDOSE IS PREVALENT.IN ADDITION, SHE PROVIDES A FREE PRESENTATION CALLED ""HIDDEN IN PLAIN SIGHT"" THAT SETS UP A REPLICA OF A TEENAGER'S BEDROOM AND TEACHES PARENTS HOW AND WHERE TO LOOK FOR SUBSTANCES THAT ARE COMMONLY HIDDEN BEFORE THEIR OWN EYES TO HELP PREVENT SUBSTANCE USE AMONGST THIS VULNERABLE POPULATION. THESE PRESENTATIONS WERE DONE AT LOCAL LIBRARIES AND HIGH SCHOOLS THROUGHOUT THE COUNTY. AS PART OF ITS ON-GOING EFFORTS, SJMC WILL WORK WITH THE NEW YORK STATE OFFICE OF ADDICTION SERVICES AND SUPPORT TO ENHANCE SJMC'S PROGRAMS. SJMC IS DEDICATED TO PROVIDING TRAUMA-INFORMED CARE FOR PATIENTS WITH SUBSTANCE USE DISORDER, RECOGNIZING HIGH CO-MORBIDITY WITH BOTH TRAUMA AND ADVERSE CHILDHOOD EXPERIENCES. AS PART OF THE CSP, SJMC TRAINED MEDICAL STAFF IN TRAUMA-INFORMED CARE PRACTICES; TARGETING INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH PROVIDERS IN THE FIRST YEAR OF IMPLEMENTATION. SJMC PROVIDES SIMILAR TRAINING IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, INCLUDING PUBLIC SCHOOL STAFF, COMMUNITY RESIDENCES/MENTAL HEALTH HOUSING, AND THE HEALTHY YONKERS INITIATIVE. IN ADDITION TO THE WORK COVERED BY THE SCOPE OF THE CSP, SJMC HAS ALSO FOCUSED ON A STROKE INITIATIVE AND PRESENTED EDUCATIONAL MATERIAL TO RESIDENTS OF OUR FRAIL ELDERLY LOW INCOME HOUSING COMPLEX. SJMC ALSO PRESENTED STROKE EDUCATIONAL INFORMATION AT 4 HEALTH FAIRS IN 2021 AS WELL AS PUSHING OUT HEALTHCARE EDUCATIONAL MATERIALS THROUGH OUR SOCIAL MEDIA CHANNELS TO THE COMMUNITY AT LARGE."

FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:
ONE CHNA WAS PERFORMED FOR THE TWO HOSPITAL FACILITIES, ST. JOSEPH'S HOSPITAL YONKERS, NY AND ST. VINCENT'S HOSPITAL WESTCHESTER UNDER THE ENTITY ST. JOSEPH'S HOSPITAL YONKERS, NY.FURTHER, SAINT JOSEPH'S HOSPITAL YONKERS PARTNERED WITH THE WESTCHESTER COUNTY HEALTH DEPARTMENT AS PART OF THE MONTEFIORE HUDSON VALLEY COLLABORATIVE (MHVC), A GROUP OF REGIONAL HOSPITALS AND COMMUNITY BASED ORGANIZATIONS, TO GATHER RESEARCH IN SUPPORT OF THE 2019 CHNA. THE FOLLOWING IS A LIST OF THE PARTNERS: BURKE REHABILITATION HOSPITAL, HUDSON VALLEY HOSPITAL, LAWRENCE HOSPITAL, MONTEFIORE MOUNT VERNON HOSPITAL, MONTEFIORE NEW ROCHELLE HOSPITAL, MONTEFIORE HEALTH SYSTEM, NORTHERN WESTCHESTER HOSPITAL, SAINT JOHN'S RIVERSIDE HOSPITAL, SAINT JOSEPH'S HOSPITAL YONKERS, WESTCHESTER COUNTY DEPARTMENT OF HEALTH, AND WHITE PLAINS HOSPITAL.

FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:
THE CHNA IDENTIFIED CANCER CARE, ADOLESCENT CARE AND DOMESTIC VIOLENCE AS PRIORITY AREAS TO BE ADDRESSED. THE HOSPITAL IS NOT A CANCER CENTER, AND DOES NOT PROVIDE ADOLESCENT CARE AND THEREFORE IS UNABLE TO ADDRESS THESE SPECIFIC NEEDS DUE TO BUDGETARY CONSTRAINTS. ALTHOUGH THE HOSPITAL DOES PROVIDE MEDICAL AND PSYCHIATRIC CARE TO PATIENTS WHO HAVE EXPERIENCED DOMESTIC VIOLENCE, THE HOSPITAL DOES NOT HAVE THE RESOURCES TO ADDRESS THE CAUSE OF THIS SPECIFIC NEED. HOWEVER, ANY PATIENT PRESENTING TO THE HOSPITAL WHO REQUIRES CANCER THERAPY, ADOLESCENT CARE OR COUNSELING FOR DOMESTIC ABUSE IS REFERRED TO THE APPROPRIATE HEALTHCARE PROVIDER OR SOCIAL SERVICE AGENCY.

PART V, SECTION B, LINE 5 CONT'D:
AS A RESULT OF COVID, SJMC REALIZED ITS COMMUNITY WAS SUFFERING FROM FOOD INSECURITY. THEREFORE, WE PARTNERED WITH FEEDING WESTCHESTER AND HOLD MONTHLY MOBILE FOOD DISTRIBUTIONS IN OUR PARKING LOT WHERE WE DISTRIBUTE OVER 7,000 POUNDS OF FOOD A MONTH TO THOSE IN NEED. IN 2021, WE SERVED CLOSE TO 3,000 INDIVIDUALS AND FAMILIES WHO PRESENTED WITH FOOD INSECURITY. WE ALSO USE THIS AS AN OPPORTUNITY TO PASS OUT EDUCATIONAL HEALTHCARE INFORMATION AND RESOURCES WHILE INDIVIDUALS WAIT ON THE FOOD LINE.AFTER SURVEYING OUR OWN PATIENTS IN THE FAMILY HEALTH CENTER, WE LEARNED THAT MOST OF THE PATIENTS ARE FOOD INSECURE. AGAIN, WE PARTNERED WITH FEEDING WESTCHESTER AND BUILT AN ON-SITE FOOD PANTRY IN THE FAMILY HEALTH CENTER TO PROVIDE PATIENTS WITH FOOD IN REAL TIME WHEN THEY COME FOR A VISIT AND PRESENT WITH FOOD INSECURITY ON THEIR SCREENING. WE SERVED OVER 1,000 INDIVIDUALS AND FAMILIES IN 2021.WE ARE ALSO NEARING THE FINAL STAGES OF THE CREATION OF AN AFFORDABLE AND SUPPORTIVE HOUSING DEVELOPMENT, AN 80 UNIT APARTMENT BUILDING WE HAVE BEEN IN THE PROCESS OF BUILDING SINCE 2014. THE BUILDING WILL BE STATE OF THE ART AND HAVE ON SITE COMMON SPACES SUCH AS A GYM, A COMMUNITY ROOM, A LIBRARY AND A BOARD ROOM OPEN TO COMMUNITY ORGANIZATIONS TO UTILIZE. ALSO, ON SITE WILL BE 24/7 SUPPORT SERVICES FOR THOSE WHO ARE IN NEED OF BEHAVIORAL HEALTH SUPPORTS AND SOCIAL SERVICES. THE BUILDING IS SCHEDULED TO OPEN IN 2022.LASTLY, WE SERVED AS A COVID VACCINATION CENTER FOR MUCH OF 2021 FOR MEMBERS OF THE COMMUNITY TO COME AND RECEIVE THEIR COVID VACCINATIONS FREE OF CHARGE. WE ALSO DID A LOT OF BOTH IN-PERSON AND VIRTUAL EDUCATION AROUND THE IMPORTANCE OF GETTING THE VACCINE IN BOTH ENGLISH AND SPANISH TO COMMUNITY ORGANIZATIONS, SCHOOLS, YONKERS HOUSING AUTHORITY AND THE COMMUNITY AT LARGE.

PART I, LINE 7:
GLOBAL COST TO CHARGE RATIO WAS UTILIZED TO COMPUTE COST OF CHARITY CARE PROVIDED. ALLOWABLE COST DIVIDED BY TOTAL CHARGES.

PART I, LINE 7G:
THE FAMILY HEALTH CENTER IS INCLUDED IN SUBSIDIZED HEALTH SERVICES AND ITS TOTAL COST IS $2,558,694 FOR 2021.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $5,945,563.

PART III, LINE 2:
THE RATIO OF PATIENT COST TO CHARGE APPLIED TO THE BAD DEBT EXPENSES WAS UTILIZED.

PART III, LINE 3:
THE RATIO OF PATIENT COST TO CHARGE APPLIED TO THE BAD DEBT EXPENSES WAS UTILIZED. THE HOSPITALS ARE LOCATED IN AN IMPOVERISHED AREA IN SOUTHWEST YONKERS, NEW YORK WHICH CONTAINS A LARGE NUMBER OF UNINSURED AND MEDICAID ELIGIBLE PATIENTS. MANY OF THESE PATIENTS ARE INDIGENT AND/OR ILLEGAL IMMIGRANTS WHO ARE UNWILLING TO COOPERATE WITH THE HOSPITAL IN APPLYING FOR GOVERNMENT INSURANCE. AS A RESULT, UNCOLLECTIBLE AMOUNTS ARE RECORDED AS BAD DEBT EVEN THOUGH THESE PATIENTS TYPICALLY DO NOT HAVE THE ABILITY TO PAY DUE TO THEIR SOCIO-ECONOMIC STATUS.

PART III, LINE 4:
A SUMMARY OF THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTION OF RECEIVABLES INVOLVES SIGNIFICANT ASSUMPTIONS AND JUDGEMENTS. THE HOSPITALS HAVE IMPLEMENTED A MONTHLY STANDARDIZED APPROACH TO ESTIMATE AND REVIEW THE COLLECTABILITY OF RECEIVABLES BASED ON THE PAYER CLASSIFICATION AND THE PERIOD THE RECEIVABLES HAVE BEEN OUTSTANDING. PAST DUE BALANCES OVER 90 DAYS FROM THE DATE OF BILLING AND OVER A SPECIFIED AMOUNT ARE CONSIDERED DELINQUENT AND ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE WHEN MANAGEMENT FEELS IT IS PROBABLE THE RECEIVABLES WILL NOT BE RECOVERED. HISTORICAL COLLECTION AND PAYER REIMBURSEMENT EXPERIENCE IS AN INTEGRAL PART OF THE ESTIMATION PROCESS RELATED TO RESERVES FOR DOUBTFUL ACCOUNTS. IN ADDITION, THE HOSPITAL ASSESSES THE CURRENT STATE OF ITS BILLING FUNCTIONS TO IDENTIFY ANY KNOWN COLLECTION OR REIMBURSEMENT ISSUES LINKED TO THE QUALITY OF ITS BILLING PROCESSES, MOST NOTABLY THOSE RELATED TO OBTAINING THE CORRECT INFORMATION IN ORDER TO BILL EFFECTIVELY FOR THE SERVICES PROVIDED. REVISIONS IN RESERVE FOR DOUBTFUL ACCOUNTS ESTIMATES ARE RECORDED AS AN ADJUSTMENT TO THE PROVISION FOR BAD DEBTS. A SUMMARY OF THE PAYMENT ARRANGEMENTS WITH MAJOR THIRD-PARTY PAYERS FOLLOWS: 1) MEDICARE PAYMENTS. INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS EFFECTIVE OCTOBER 1, 2007, WHEN THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) REVISED THE MEDICARE PATIENT CLASSIFICATION SYSTEM. THE NEW MEDICARE SEVERITY ADJUSTED DIAGNOSIS RELATED GROUPS (MS-DRGS) REFLECT CHANGES IN TECHNOLOGY AND CURRENT METHODS OF CARE DELIVERY. CMS HAS EXPANDED THE NUMBER OF DRGS FROM 538 TO 989 AND REQUIRES IDENTIFICATION OF CONDITIONS THAT ARE PRESENT UPON ADMISSION.2) NON-MEDICARE PAYMENTS -THE NEW YORK HEALTH CARE REFORM ACT OF 1996, AS UPDATED, GOVERNS PAYMENTS TO HOSPITALS IN NEW YORK STATE. UNDER THIS SYSTEM, HOSPITALS AND ALL NON-MEDICARE PAYERS, EXCEPT MEDICAID, WORKERS' COMPENSATION AND NO-FAULT INSURANCE PROGRAMS, NEGOTIATE HOSPITALS' PAYMENT RATES. IF NEGOTIATED RATES ARE NOT ESTABLISHED, PAYERS ARE BILLED AT THE HOSPITAL'S ESTABLISHED CHARGES. MEDICAID, WORKERS' COMPENSATION AND NO-FAULT PAYERS PAY HOSPITAL RATES PROMULGATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH (DOH) ON A PROSPECTIVE BASIS. ADJUSTMENTS TO CURRENT AND PRIOR YEARS' RATES FOR THESE PAYERS WILL CONTINUE TO BE MADE IN THE FUTURE. EFFECTIVE JANUARY 1, 2008, THE DOH UPDATED THE DATA UTILIZED TO CALCULATE THE NYS DRG SERVICE INTENSITY WEIGHTS (SIW) TO UTILIZE MORE CURRENT DATA IN DOH PROMULGATED RATES. SIMILAR TYPE OUTPATIENT REFORMS WERE IMPLEMENTED EFFECTIVE DECEMBER 1, 2008. THERE ARE ALSO VARIOUS OTHER PROPOSALS AT THE FEDERAL AND STATE LEVELS THAT COULD, AMONG OTHER THINGS, REDUCE PAYMENT RATES. THE ULTIMATE OUTCOME OF THESE AND MEDICAID PROGRAMS ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY FOR ADJUSTMENTS ON AMOUNTS DUE TO OR DUE FROM MEDICARE AND NON-MEDICARE PAYERS FOR CURRENT AND PRIOR YEARS' PAYMENT RATES BASED ON INDUSTRY-WIDE AND HOSPITAL-SPECIFIC DATA. THE HOSPITAL'S MEDICARE COST REPORTS HAVE BEEN AUDITED AND FINALIZED BY THE MEDICARE FISCAL INTERMEDIARY THROUGH DECEMBER 31, 2011.ON FEBRUARY 19, 2004, THE SECRETARY OF HEALTH AND HUMAN SERVICES CONFIRMED THAT HOSPITALS CAN PROVIDE DISCOUNTS FOR UNINSURED PATIENTS WHICH ALLOW THE HOSPITALS TO IMPLEMENT A DISCOUNT POLICY IN ACCORDANCE WITH STATE LAW. THE HOSPITAL'S GOAL WAS TO CREATE A FINANCIAL AID PROGRAM CONSISTENT WITH THE MISSION, VALUES AND CAPACITY OF THE HOSPITALS, WHILE CONSIDERING AN INDIVIDUAL'S ABILITY TO CONTRIBUTE TO HIS OR HER CARE. THE HOSPITALS HAVE A DISCOUNT POLICY AND PROVIDES DISCOUNTS TO UNINSURED PATIENTS. UNDER THIS POLICY, THE DISCOUNT OFFERED TO UNINSURED PATIENTS IS REFLECTED AS A REDUCTION TO THE NET PATIENT SERVICE REVENUE AT THE TIME THE UNINSURED BILLINGS ARE RECORDED.NET PATIENT REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHER SERVICES RENDERED AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. FEDERAL AND STATE REGULATIONS PROVIDE FOR CERTAIN RETROSPECTIVE ADJUSTMENTS TO CURRENT AND PRIOR YEARS' PAYMENT RATES BASED ON INDUSTRY-WIDE AND HOSPITAL-SPECIFIC DATA. THE HOSPITALS HAVE ESTIMATED POTENTIAL IMPACT OF SUCH RETROSPECTIVE ADJUSTMENTS BASED ON INFORMATION PRESENTLY AVAILABLE AND ADJUSTMENTS ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS ADDITIONAL INFORMATION BECOMES AVAILABLE OR FINAL SETTLEMENTS ARE DETERMINED. AS DISCUSSED ABOVE, THE CURRENT MEDICAID AND MEDICARE PROGRAMS ARE BASED UPON COMPLEX LAWS AND REGULATION.NONCOMPLIANCE WITH SUCH LAWS AND REGULATIONS COULD RESULT IN FINES, PENALTIES AND EXCLUSION FROM SUCH PROGRAMS. THE HOSPITAL IS NOT AWARE OF ANY ALLEGATIONS OF NONCOMPLIANCE THAT COULD HAVE A MATERIAL ADVERSE EFFECT ON THE FINANCIAL STATEMENTS AND BELIEVES THAT IT IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, NET PATIENT REVENUE FOR INDIVIDUAL PAYERS CONSISTED OF THE FOLLOWING: MEDICARE 2021-27%, 2020-27%, MEDICAID/MEDICAID HMO 2021-63%, 2020-63%, SELF PAY 2021-0%, 2020-0%, OTHER 2021-10%, 2020-10%.

PART III, LINE 8:
THE COSTING METHODOLOGY USED FOR ALLOWABLE COSTS IN PART III LINE 6 IS BASED ON THE MEDICARE COSTS INCLUDED IN THE WORKSHEET D SCHEDULES OF THE 2021 MEDICARE COST REPORT. THERE WAS A SURPLUS.

PART III, LINE 9B:
THE COLLECTION POLICY FOR CHARITY CARE PATIENTS IS THE SAME COLLECTION POLICY THAT IS APPLIED TO THE LARGEST NUMBER OF ITS PATIENTS.

PART VI, LINE 2:
FROM AN ONGOING NEEDS ASSESSMENT BASIS, ST. JOSEPH'S IS A PARTICIPANT IN THE HEALTHY YONKERS INITIATIVE WHICH IS A COALITION OF VARIOUS HEALTH CARE PROVIDERS AND SOCIAL SERVICES AGENCIES. THE HEALTHY YONKERS INITIATIVE CONDUCTS PERIODIC FOCUS GROUPS TARGETING BOTH PATIENTS AND THEIR FAMILY MEMBERS TO IDENTIFY UNMET HEALTH CARE NEEDS WITHIN THE COMMUNITY. A RESULT OF A RECENT FOCUS GROUP WAS TO DEVELOP AN INITIATIVE TO EXPAND AND ENHANCE HEALTH CARE SERVICES FOR INDIVIDUALS DIAGNOSED WITH ASTHMA AND/OR NUTRITIONAL DISORDERS.

PART VI, LINE 3:
ST. JOSEPH'S HOSPITAL MAKES AVAILABLE WRITTEN COMMUNICATIONS IN BOTH ENGLISH AND SPANISH EXPLAINING THE HOSPITAL'S POLICY OF PROVIDING CHARITY CARE AND FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS. NOTICES ARE POSTED THROUGHOUT THE HOSPITAL IN BOTH ENGLISH AND SPANISH STATING THAT CHARITY CARE AND FINANCIAL ASSISTANCE ARE AVAILABLE TO QUALIFYING INDIVIDUALS THAT INCLUDE A TELEPHONE NUMBER FOR PATIENTS TO CONTACT A FINANCIAL COUNSELOR TO DISCUSS ELIGIBILITY. IN ADDITION, HOSPITAL REPRESENTATIVES INTERVIEW PATIENTS WITHOUT INSURANCE TO DETERMINE IF THEY MAY QUALIFY FOR MEDICAID OR OTHER GOVERNMENTAL INSURANCE PROGRAMS AND WILL ASSIST THEM IN COMPLETING REQUIRED APPLICATIONS.

PART VI, LINE 4:
ST. JOSEPH'S HOSPITAL SERVES A PREDOMINATELY LOW INCOME, MEDICALLY UNDERSERVED POPULATION WITHIN ITS SERVICE AREA. ST. JOSEPH'S SERVICE AREA POPULATION, WHICH INCLUDES SOUTHWEST YONKERS AND THE NORTH BRONX, IS A MINORITY ONE WITH ALMOST 1/3 OF THE POPULATION AFRICAN-AMERICAN AND ANOTHER 1/3 BEING HISPANIC. MANY OF THE PATIENTS DO NOT HAVE A PRIVATE PHYSICIAN AND USE THE HOSPITAL'S EMERGENCY ROOM AND CLINIC FOR THEIR PRIMARY MEDICAL NEEDS. SJMC SERVES ALL OF YONKERS, BUT DEFINES ITS PRIMARY SERVICE AREA AS ZIP CODES 10701 AND 10705. THE ESTIMATED POPULATION OF THE PRIMARY ZIP CODES IS 100,500, REPRESENTING APPROXIMATELY 50% OF THE TOTAL YONKERS POPULATION. THE PRIMARY SERVICE AREA POPULATION IS MORE CULTURALLY AND ETHNICALLY DIVERSE THAN THE CITY OF YONKERS AND EXPERIENCES GREATER SOCIOECONOMIC DISPARITY. THE AREA IS AN URBAN MIX OF HIGH-RISE APARTMENTS, OLDER WOOD FRAME HOMES, AND A DOWNTOWN BUSINESS AREA THAT CONTAINS COMMUNITY-BASED NOT-FOR-PROFIT ORGANIZATIONS. ZIP CODES 10701 AND 10705 ARE SOME OF THE MOST POPULATION DENSE AREAS IN NEW YORK STATE WITH A POPULATION DENSITY OF 23,372 PER SQUARE MILE. THE POPULATION DENSITY FOR ALL OF YONKERS IS 10,903 RESIDENTS PER SQUARE MILE. OUR SECONDARY SERVICE AREA INCLUDES ZIP CODES 10703, 10704, 10710, 10474, 10463, 10470, 10466 AND 10467.WESTCHESTER COUNTY, LOCATED JUST NORTH OF NEW YORK CITY IN THE HUDSON VALLEY, SPANS 450 SQUARE MILES AND 48 MUNICIPALITIES DESIGNATED AS URBAN, SUBURBAN, AND RURAL GEOGRAPHIES. THE 2017 ESTIMATED COUNTY POPULATION OF 949,113 IS UP 3.0% BETWEEN 2000 AND 2010. THE COUNTY SEAT IS THE CITY OF WHITE PLAINS. OTHER MAJOR CITIES INCLUDE YONKERS, NEW ROCHELLE, AND MOUNT VERNON. THE 2017 MEDIAN HOUSEHOLD INCOME FOR WESTCHESTER COUNTY ($89,968) IS THE FOURTH HIGHEST IN NEW YORK STATE AFTER NASSAU, PUTNAM AND SUFFOLK COUNTIES.YONKERS IS 18.4 SQUARE MILES WITH AN ESTIMATED POPULATION OF 200,999. THE POPULATION INCREASED 3% BETWEEN 2010 AND 2017. APPROXIMATELY 18% OF RESIDENTS ARE UNDER 15 YEARS AND 16% ARE SENIORS. THE YONKERS COMMUNITY IS ONE OF THE MOST CULTURALLY AND ETHNICALLY DIVERSE IN WESTCHESTER COUNTY AND NEW YORK STATE. DURING THE LAST TWO DECADES, A DEMOGRAPHIC SHIFT HAS TAKEN PLACE IN THE CITY WITH A LARGE INFLUX OF IMMIGRANTS. APPROXIMATELY 31% OF THE YONKERS POPULATION IS FOREIGN-BORN; 56% OF FOREIGN BORN RESIDENTS WERE BORN IN A LATIN AMERICAN COUNTRY. IMMIGRANTS FROM ALL OVER THE WORLD BRING A GREAT VITALITY TO OUR COMMUNITY, BUT THEY CHALLENGE THE HOSPITAL AND OTHER COMMUNITY SERVICE PROVIDERS TO UNDERSTAND AND MEET THEIR UNIQUE AND COMPLEX HEALTH NEEDS.

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ST. JOSEPH'S HOSPITAL HAS A FAMILY PRACTICE TEACHING PROGRAM WHICH INCLUDES APPROXIMATELY 30 RESIDENTS. THE RESIDENTS SPEND THE MAJORITY OF THEIR TIME PROVIDING MEDICAL CARE UNDER THE SUPERVISION OF FACULTY TO CLINIC PATIENTS, MOST OF WHOM EITHER HAVE NO INSURANCE OR ARE MEDICAID PATIENTS. DURING 2021, THE FAMILY HEALTH CENTER, A PRIMARY CARE CLINIC, HAD 20,512 VISITS OF WHICH 62% WERE APPLICABLE TO MEDICAID/MEDICAID HMO OR UNINSURED PATIENTS.

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ST. JOSEPH'S HOSPITAL IS PART OF AN AFFILIATED HEALTH SYSTEM WHICH INCLUDES THE FOLLOWING: SJMC, INC. IS THE PARENT CORPORATION WHICH WAS ESTABLISHED TO COORDINATE, PLAN AND DEVELOP CHARITABLE, EDUCATIONAL AND SCIENTIFIC ACTIVITIES, PROGRAMS AND PROJECTS FOR THE ADVANCEMENT OF QUALITY HEALTH CARE BY AND THROUGH ITS AFFILIATED ENTITIES AND TO PROMOTE AND ADVANCE RELATIONSHIPS AMONG HEALTH CARE INSTITUTIONS AND THE COMMUNITIES THEY SERVE. ST. JOSEPH'S HOSPITAL YONKERS, A SUBSIDIARY OF SJMC, INC., IS A 327 BED HEALTH CARE PROVIDER THAT PROVIDES MEDICAL, PSYCHIATRIC, EMERGENCY AND OUTPATIENT CLINIC SERVICES TO PATIENTS LOCATED THROUGHOUT WESTCHESTER COUNTY AND THE NEW YORK CITY REGION. ST. JOSEPH'S HEALTH FUND IS A FUNDRAISING SUBSIDIARY OF SJMC, INC., ITS SOLE BENEFICIARY, AND SOLICITS CONTRIBUTIONS FROM THE COMMUNITY FOR USE IN PROMOTING AND/OR EXPANDING HEALTH PROGRAMS AND SERVICES FOR WHICH THERE IS A COMMUNITY NEED.

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