4A (Expenses $ 725353322 including grants of $ 0) (Revenue $ 805118312)
THE HOSPITAL CENTER IS THE CENTERPIECE OF THE BRONXCARE HEALTH SYSTEM, WHICH IS THE LARGEST VOLUNTARY, NOT-FOR-PROFIT HEALTH CARE SYSTEM SERVING THE SOUTH AND CENTRAL BRONX. THE HOSPITAL CENTER HAS 619 BEDS AT TWO MAJOR HOSPITAL DIVISIONS; A MAJOR PSYCHIATRIC FACILITY; AND AN EXTENSIVE BRONXCARE NETWORK OF MEDICAL PRACTICES, AS WELL AS A 240 BED SKILLED NURSING HOME FACILITY.

SCHEDULE H, PART V, SECTION B, LINE 5
BRONXCARE HEALTH SYSTEM-CONCOURSE: BRONXCARE HEALTH SYSTEM-FULTON HEALTH CARE NEEDS OF PATIENTS ARE EVALUATED TO IDENTIFY TRENDS RELATED TO HEALTH PRIORITIES. THESE TRENDS ARE THEN ADDRESSED BY MANAGEMENT BRONXCARE ALSO OBTAINS VALUABLE INFORMATION ON QUALITY OUTCOMES AND HOW WELL NEEDS ARE BEING MET THROUGH FEEDBACK FROM PATIENTS, STAFF, AND COMMUNITY ORGANIZATIONS. 1. HOSPITAL NEWSLETTER AND WEBSITE (WWW.BRONXCARE.ORG): THE NEWSLETTER IS DISTRIBUTED THROUGHOUT THE BRONX COMMUNITY AND PROMINENTLY DISPLAYED IN THE HOSPITAL'S LOBBY AREAS AND OUTPATIENT PRACTICE LOCATIONS. BRONXCARE'S WEBSITE, IN DESKTOP AND MOBILE FORMAT (WHICH IS BILINGUAL), OFFERS CONSUMERS IMPORTANT INFORMATION REGARDING PROGRAMS AND SERVICES. BRONXCARE HAS ALSO UTILIZED PUBLIC SERVICE ANNOUNCEMENTS ON RADIO STATIONS AND IN WIDELY CIRCULATED NEWSPAPERS, AS WELL AS THROUGH SPECIAL BROCHURES, BANNERS, AND EXTERIOR BUS SIDES, AND FLYERS TO INFORM THE PUBLIC REGARDING ITS PROGRAMS, SERVICES, AND INITIATIVES. THE MAJORITY OF BRONXCARE'S STAFF RESIDE IN ITS SERVICE AREA. INFORMATION REGARDING THE SYSTEM IS ALSO EASILY SPREAD THROUGH WORD OF MOUTH. THESE COMMUNICATION CHANNELS ALLOW FOR COMMUNITY INPUT REGARDING HEALTH ISSUES AND NEEDS. 2. MEETINGS/INTERVIEWS: DURING INTERVIEWS AND ONGOING DISCUSSIONS WITH COMMUNITY LEADERS, KEY HEALTH ISSUES ARE IDENTIFIED, AS WELL AS THE SERVICES RELATED TO THEM, SEVERAL THEMES EMERGED FROM PREVIOUS SESSIONS, INCLUDING THE IMPORTANCE OF MAINTAINING AND ENHANCING ACCESSIBLE SERVICES, AND CULTURALLY AND LINGUISTICALLY APPROPRIATE PROGRAMS TO HELP REDUCE HEALTH DISPARITIES IN THE LATINO, AFRICAN AMERICAN, AND OTHER COMMUNITIES. THE NEED TO ADDRESS THE ONGOING COVID-19 PANDEMIC, AS WELL AS HEART DISEASE, CANCER, HYPERTENSION, DIABETES, OBESITY, ASTHMA, MENTAL HEALTH, SUBSTANCE ABUSE, OTHER CHRONIC DISEASES SMEDICAL PREVENTIVE CARE, AND OUTREACH INITIATIVES, EDUCATION PROGRAMS ARE ALSO IDENTIFIED AND PRIORITIZED. 3. INPUT FROM STAKEHOLDERS: THE INPUT OF STAKEHOLDERS WAS OBTAINED THROUGH ONGOING SURVEYS AND DISCUSSIONS WITH BRONX RESIDENTS, AND COMMUNITY BASED ORGANIZATIONSAS WELL AS PATIENTS AND THEIR FAMILIES REGARDING HEALTH STATUS AND HEALTH NEEDS. SURVEY RESPONDENTS INCLUDED COMMUNITY BASED ORGANIZATIONS, SENIOR CENTERS, AND OTHER HEALTH CARE PROVIDERS, AND STREET FAIR AS WELL. IN ADDITION, IN-DEPTH INTERVIEWS WERE CONDUCTED WITH STAKEHOLDERS. AS A RESULT OF THIS INPUT FROM COMMUNITY PARTNERS, AND OTHERS, BRONXCARE DEVELOPED ITS COMMUNITY SERVICE PLAN AND NEEDS ASSESSMENT.

SCHEDULE H, PART V, SECTION B, LINE 6A
BRONXCARE HEALTH SYSTEM-FULTON: BRONXCARE HEALTH SYSTEM-CONCOURSE

SCHEDULE H, PART V, SECTION B, LINE 11
THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED IN BRONXCARE HEALTH SYSTEM'S 2020/21 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. PRIORITY AREA: PREVENT CHRONIC DISEASES - FOCUS AREA: PREVENTIVE CARE AND MANAGEMENT - GOAL 1: IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH ASTHMA, PREDIABETES AND DIABETES, CARDIOVASCULAR DISEASE, CANCER, AND OTHER CHRONIC DISEASES. - GOAL 2: INCREASE EARLY DETECTION OF ASTHMA, PREDIABETES AND DIABETES, CARDIOVASCULAR DISEASE, CANCER, AND OTHER CHRONIC DISEASES. - GOAL 3: INCREASE SCREENINGS FOR INDIVIDUALS WITH ASTHMA, PREDIABETES AND DIABETES, CARDIOVASCULAR DISEASE, CANCER, AND OTHER CHRONIC DISEASES. 2. PRIORITY AREA: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS - FOCUS AREA: PREVENT MENTAL AND SUBSTANCE ABUSE DISORDERS - GOAL 1: ADDRESS OPIOID CRISIS WITH THE AIM OF REDUCING OVERDOSES. - GOAL 2: ADDRESS HIGH INCIDENCE OF SUICIDE AND EXPAND ZERO SUICIDE GRANT PROGRAM TO REDUCE THIS MOST SERIOUS PROBLEM. - GOAL 3: CONTINUE TO ADDRESS THE SERIOUS MENTAL HEALTH ISSUES AND ACHIEVE EMOTIONAL WELLNESS IN THE BRONX COMMUNITY

SCHEDULE H, PART I, LINE 3C
DESCRIPTION OF OTHER FACTORS USED IN DETERMINING FAP ELIGIBILITY: IN ADDITION TO THE FPG BCHS ALSO USES INCOME LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS AND UNDER INSURANCE STATUS TO DETERMINE ELGIBILITY.

SCHEDULE H, PART I, LINE 7
THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A AND 7B. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS.

SCHEDULE H, PART I, LINE 7G
SUBSIDIZED HEALTH SERVICES INCLUDES VARIOUS MENTAL HEALTH CLINICS, EMERGENCY ROOM, PSYCHIATRY EMERGENCY ROOM, PSYCHIATRY IMPATIENT AND NEONATAL ICU. TOTAL COSTS FOR THE SUBSIDIZED SERVICES WERE $38,754,051 AND NET COMMUNITY BENEFIT OF THOSE SERVICES WAS DETERMINED TO BE $15,740,097.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE IS CHARGED IF THE RECEIVABLE IS DETERMINED TO BE UNCOLLECTIBLE BASED ON PERIODIC REVIEW BY MANAGEMENT. FACTORS USED TO DETERMINE WHETHER AN ALLOWANCE SHOULD BE RECORDED INCLUDE AGE OF THE RECEIVABLE AND A REVIEW OF PAYMENTS SUBSEQUENT TO YEAR END. BAD DEBTS ARE WRITTEN OFF AT GROSS CHARGES. COST IS DERIVED BY CONVERTING CHARGES USING INPATIENT AND OUTPATIENT RCC'S.

SCHEDULE H, PART III, SECTION A, LINE 3
Bad Debt Expense is charged if the receivable is determined to be uncollectible based on periodic review by management. Factors used to determine whether an allowance should be recorded include age of the receivable and a review of payments subsequent to year end. Bad Debts are written off at gross charges. Cost is derived by converting charges using inpatient and outpatient RCC's.

SCHEDULE H, PART III, SECTION A, LINE 4
THE FOOTNOTE ON THE ORGANIZATION'S FINANCIAL STATEMENTS THAT MENTIONS BAD DEBT EXPENSE CAN BE FOUND ON FOOTNOTE 2 ON PAGE 25 OF THE FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION B, LINE 8
MEDICARE COSTING METHODOLOGY BRONXCARE HEALTH SYSTEM'S USED A COST TO CHARGE RATIO TO DETERMINE THE MEDICARE AMOUNTS IN PART III.

SCHEDULE H, PART III, SECTION C, LINE 9B
IT IS THE POLICY OF BRONXCARE HEALTH SYSTEM TO MAKE EVERY EFFORT TO COLLECT ALL OPEN ACCOUNT TRIAL BALANCE AMOUNTS FROM SELF-PAYING PATIENTS AND/OR THIRD-PARTY PAYERS. AS PART OF THE PATIENT'S ADMISSION PROCESS, A FINANCIAL INVESTIGATOR REVIEWS EACH ADMISSION AND INTERVIEWS PATIENT, AS NECESSARY, TO VERIFY FINANCIAL COVERAGE. THIS IS DONE IN CONJUNCTION WITH ADMITTING TO ALSO NOTIFY INSURANCE CARRIERS AS REQUIRED. IF A PATIENT HAS NO HEALTH INSURANCE, HE IS EVALUATED FOR POSSIBLE GOVERNMENTAL ENTITLEMENT ELIGIBILITY AND IS ASSISTED IN OBTAINING A BENEFIT IF QUALIFIED. FINANCIAL INVESTIGATIONS IS CHARGED WITH THIS FUNCTION AND SUPPLIES THE INFORMATION TO PATIENT FINANCIAL SERVICES THROUGH AN ELECTRONIC FILE TRANSFER. HOSPITAL POLICY REQUIRES THAT A MINIMUM 274 DAYS ELAPSE BEFORE ANY EFFORT IS MADE TO WRITE OFF AN ACCOUNT OR ASSIGN IT TO COLLECTION.

SCHEDULE H, PART VI, LINE 2
BRONXCARE HEALTH SYSTEM ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. BRONXCARE CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, WITH UPDATES PROVIDED BETWEEN ASSESSMENTS. THE HOSPITAL INCORPORATES PLANNING FOR COMMUNITY BENEFITS AS PART OF THEIR BUSINESS AND STRATEGIC PLANNING AND PROCESSES. BRONXCARE RECOGNIZES THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. ITS COMMUNITY BENEFIT INCLUDES QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS, BASED ON AGE AND ETHNICITY; SOCIOECONOMIC DATA, INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES, PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES AND OUTCOMES. BRONXCARE ALSO WORKS CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS AND PUBLIC OFFICIALS IN ITS SERVICE AREA, AS WELL AS STATE AND LOCAL GOVERNMENT AUTHORITIES AND HEALTH ORGANIZATIONS.

SCHEDULE H, PART VI, LINE 3
BRONXCARE POSTS ON ITS WEBSITE THE CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF OUR FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. BRONXCARE HEALTH SYSTEM PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. WE INFORM PATIENTS OF THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION THE COMMUNITY FOR OUR HOSPITAL IS DEFINED BOTH BY MISSION AND GEOGRAPHY. THE GEOGRAPHIC COMMUNITY IS DEFINED BY OUR HOSPITAL'S IMMEDIATELY CONTIGUOUS AREAS AS WELL AS BY THE BROADER SURROUNDING COUNTIES/REGIONS WHERE THE MAJORITY OF DISCHARGED PATIENTS RESIDE. ADDITIONALLY, THE COMMUNITY INCLUDES PATIENTS WHO REQUIRE THE EXPERTISE AND SPECIALIZED SERVICES OFFERED BY BRONXCARE HEALTH SYSTEM.

SCHEDULE H, PART VI, LINE 7
NEW YORK

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH - BRONXCARE OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, BRONXCARE ALSO PROVIDES URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. BRONXCARE'S NUMEROUS OTHER SPECIALTY SERVICES INCLUDING DISEASE MANAGEMENT, SPECIALTY PRACTICES, DEVELOPMENTAL THERAPY, BEHAVIORAL SERVICES AND SUBSTANCE ABUSE SERVICES, AMONG OTHER PROGRAMS ARE RESPONDING TO THE NEEDS OF THE COMMUNITY. BRONXCARE ALSO HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITIES SERVED BY BRONXCARE. BRONXCARE'S BOARD IS COMPOSED OF MEMBERS OF THE COMMUNITIES SERVED WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT ITS MISSION. IN ADDITION, BOARD MEMBERS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO BRONXCARE AND ITS AFFILIATES IN TERMS OF FULFILLING ITS MISSION OF PROVIDING HEALTHCARE SERVICES TO THE POOR AND UNDERSERVED. BRONXCARE ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. RESIDENCY PROGRAMS, IN AFFILIATION WITH ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI AND OTHER TRAINING PROGRAMS. BRONXCARE PARTICIPATES IN MEDICAID, MEDICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS.

SCHEDULE H, PART VI, LINE 6
BRONXCARE IS THE LARGEST VOLUNTARY, NOT-FOR-PROFIT HEALTH AND TEACHING HOSPITAL SYSTEM SERVING THE SOUTH AND CENTRAL BRONX. IT IS ALSO AMONG THE LARGEST PROVIDERS OF OUTPATIENT SERVICES IN NEW YORK CITY, ER IS ALSO ONE OF THE BUSIEST IN NEW YORK. IN 2021, BRONXCARE RECEIVED FULL ACCREDITATION FROM THE JOINT COMMISSION, THE LEADING ACCREDITING AUTHORITY FOR HOSPITALS IN THE NATION. ITS MEDICAL SCHOOL AFFILIATION WITH THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI AND CLINICAL COLLABORATION WITH THE MOUNT SINAI HEALTH SYSTEM, AS WELL AS 16 ACCREDITED RESIDENCY AND FELLOWSHIP PROGRAMS, ARE STRONG INDICATORS OF EXCELLENCE. BRONXCARE'S OUTPATIENT PRACTICES ARE ALSO CERTIFIED AS A LEVEL THREE PATIENT-CENTERED MEDICAL HOME (THE HIGHEST DESIGNATION) BY THE NATIONAL CENTER FOR QUALITY ASSURANCE. AS AN ENGINE FOR POSITIVE CHANGE, BRONXCARE HAS INFUSED MORE THAN $300 MILLION INTO THE BRONX ECONOMY, INCLUDING A 60,000 SQUARE FOOT BRONXCARE HEALTH AND WELLNESS CENTER FOR OUTPATIENT CARE, 56,000 SQUARE FOOT BRONXCARE LIFE RECOVERY CENTER FOR CHEMICAL DEPENDENCY SERVICES, AND MOST RECENTLY, A 10,000 SQUARE FOOT STATE OF THE ART CANCER CARE FACILITY, AMONG NUMEROUS OTHER CAPITAL PROJECTS. THE IMPORTANCE OF FULFILLING BRONXCARE'S ESSENTIAL COMMUNITY ROLE IS EVIDENT THROUGHOUT THE BRONX. ITS BRONXCARE OUTPATIENT NETWORK REGULARLY PROVIDES FREE, SCREENINGS AND NUTRITIONAL COUNSELING AT SCHOOLS, NURSING HOMES, SENIOR CITIZEN CENTERS, CHURCHES, AND OTHER COMMUNITY ORGANIZATIONS. A DIASPORA OUTPATIENT PRACTICE IS ALSO RESPONDING TO THE HEALTH AND SOCIAL SERVICE NEEDS OF THE GROWING AFRICAN COMMUNITY. IN THE EDUCATIONAL AREA, BRONXCARE'S INNOVATIVE APPRENTICESHIP PROGRAM, A COLLABORATIVE EFFORT WITH THE 1199SEIU LABOR UNION AND OTHER KEY ORGANIZATIONS, IS WIDELY RECOGNIZED FOR ITS SUCCESS IN RECRUITING AND TRAINING FRONTLINE HEALTH CARE WORKERS TO EFFECTIVELY REACH OUT TO THE COMMUNITY. BRONXCARE'S MOBILE HEALTH UNITS ARE ALSO BRINGING MEDICAL SERVICES DIRECTLY INTO THE COMMUNITY. IN THE FINANCIAL AREA, BRONXCARE HAS MAINTAINED A STRONG BOTTOM LINE POSITION, ESPECIALLY SIGNIFICANT IN THE CURRENT ENVIRONMENT. BRONXCARE IS ALSO AMONG THE LARGEST EMPLOYERS IN THE SOUTH AND CENTRAL BRONX, WITH 3,600 EMPLOYEES. ULTIMATELY, A HEALTH CARE SYSTEM MUST BE JUDGED BY ITS ACCOMPLISHMENTS. AT THE BRONXCARE HEALTH SYSTEM, WE ARE PROUD OF OUR LONGSTANDING AND SUCCESSFUL EFFORTS TO DELIVER THE HIGHEST QUALITY, COMPREHENSIVE, COMPASSIONATE, AND ACCESSIBLE SERVICES TO THE BRONX COMMUNITY BY LEADING THE WAY IN CARING FOR THE BRONX.