4A (Expenses $ 271357744 including grants of $ 0) (Revenue $ 194018713)
IN 2021, ST. JOHN'S TREATED 9,958 INPATIENTS, THROUGH 49,680PATIENT DAYS, WITH A LARGE PROPORTION (60%) BEING MEDICARE ANDMEDICAID PATIENTS. THE HOSPITAL'S INPATIENT AND OUTPATIENTSPECIALTY SERVICES INCLUDE BARIATRIC SURGERY, BEHAVIORAL HEALTHSERVICES, BREAST CARE, CANCER CARE, CARDIOLOGY SERVICES,DIAGNOSTIC IMAGING, EMERGENCY SERVICES, HOLISTIC CARE SERVICES,HOPE CENTER, HYPERBARIC OXYGEN TREATMENT, MATERNITY, ORTHOPEDICSURGERY CENTER, PHYSICAL THERAPY, RESPIRATORY THERAPY SERVICES,SLEEP SERVICES, SURGICAL SERVICES AND WOUND HEALING.

4B (Expenses $ 14050138 including grants of $ 0) (Revenue $ 37324428)
IN 2021, ST. JOHN'S PROVIDED 38,531 DAYS OF INPATIENT DRUG ANDALCOHOL SUBSTANCE ABUSE SERVICES TO 6,879 PATIENTS. OUTPATIENTFOLLOW-UP TREATMENT AND SUPPORT SERVICES PROVIDED FOR 60,040CLIENT VISITS. THE INPATIENT REHABILITATION PROGRAM IS BASED UPONTHE 12 STEP PHILOSOPHY AND PROVIDES A COMPREHENSIVE ARRAY OFSERVICES TO MEN AND WOMEN IN SEPARATE, GENDER-SPECIFIC UNITS.PATIENTS WITH CO-OCCURRING PSYCHIATRIC DISORDERS AND THOSE WITH AHISTORY OF RELAPSE ARE WELCOMED. OUTPATIENT TREATMENT PROGRAMSINCLUDE A DAY REHABILITATION PROGRAM AND A CLINIC PROGRAM. FORMORE INFORMATION, SEE SCHEDULE O.

4C (Expenses $ 2479665 including grants of $ 0) (Revenue $ 1245683)
ST. JOHN'S OPERATES THE COCHRAN SCHOOL OF NURSING, AN ASSOCIATEDEGREE PROGRAM WHOSE PURPOSE IS TO TRAIN NURSES. IN 2021, 130STUDENTS WERE ENROLLED AT THE SCHOOL. FOUNDED IN 1894 AT ST.JOHN'S RIVERSIDE HOSPITAL, THE COCHRAN SCHOOL OF NURSING IS THEOLDEST HOSPITAL-BASED SCHOOL OF NURSING IN THE METROPOLITANREGION. THE SCHOOL OFFERS A REGISTERED NURSE (RN) CURRICULUMLEADING TO A DEGREE OF ASSOCIATE IN APPLIED SCIENCE. FOR MOREINFORMATION, SEE SCHEDULE O.

4D (Expenses $ 1467347 including grants of $ 0) (Revenue $ 2515377)

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: SJR HOSPITAL ANDRUS PAVILION, - FACILITY 2: SJR PARK CARE PAVILION, - FACILITY 3: SJR DOBBS FERRY PAVILION

GROUP A-FACILITY 1 -- ALL FACILITIES PART V, SECTION B, LINE 5:
COMMUNITY HEALTH NEEDS ASSESSMENTTHE ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) COMMUNITY HEALTH NEEDSASSESSMENT (CHNA) WAS CONDUCTED AND IS A JOINT REPORT OF ITS THREEHOSPITAL SITES: THE ANDRUS, PARK CARE AND DOBBS FERRY PAVILIONS. THEFACILITIES SERVE A DIVERSE POPULATION IN WESTCHESTER COUNTY AND SHARE ANAUTHORIZED BODY THAT ADOPTED THIS ASSESSMENT IN DECEMBER 2019.THE ST. JOHN'S CHNA WAS DEVELOPED DURING 2019 IN COLLABORATION WITH THEWESTCHESTER COUNTY DEPARTMENT OF HEALTH'S 'HEALTH AND HOSPITAL PLANNINGTEAM AND THE MONTEFIORE OFFICE OF COMMUNITY AND POPULATION HEALTH(INCLUDING MONTEFIORE'S HUDSON VALLEY COLLABORATIVE PERFORMING PROVIDERSYSTEM (PPS) HOSPITAL GROUP).THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH (WCDOH),HTTP://HEALTH.WESTCHESTERGOV.COM/, AND THE MONTEFIORE HUDSON VALLEYCOLLABORATIVE PPS,HTTP://WWW.MONTEFIORE.ORG/HUDSON-VALLEY-COLLABORATIVE,COMMUNITY HEALTH NEEDS ASSESSMENTS, WHICH MEET BOTH IRS AND NYS NEEDSASSESSMENT AND SERVICE PLAN REQUIREMENTS, CONTAIN MORE DETAILEDINFORMATION AND DATA ON THE HEALTH STATUS OF THE POPULATION ANDDISTRIBUTION OF HEALTH ISSUES BASED ON ANALYSIS OF DEMOGRAPHIC FACTORSAND IDENTIFICATION OF THE MAIN HEALTH CHALLENGES FACING THE COMMUNITY; ASWELL AS A DISCUSSION OF THE CONTRIBUTING CAUSES OF THESE CHALLENGES,INCLUDING BROAD DETERMINANTS OF HEALTH.OUR PARTNER SESSIONS GAVE THE OPPORTUNITY FOR AREA HOSPITALS TO DISCUSSNYS PREVENTION AGENDA PRIORITIES, FEEDBACK FROM THEIR PUBLIC NEEDSASSESSMENTS, SERVICES PROVIDED, GAPS IN SERVICE AND BEST PRACTICES. WHILEALL HOSPITALS IN WESTCHESTER COUNTY SHARE THE SAME PRIORITIES, EACHHOSPITAL SELECTED PRIORITIES THAT ALIGNED WITH THEIR MISSION, WEREATTAINABLE, AND CREATED A PROGRAM THAT BEST SUITED ITS INSTITUTION ANDPATIENT SERVICE AREA. THE PUBLIC INPUT PROCESS ALSO ENCOMPASSEDCOLLABORATION WITH THE FOLLOWING PARTNERS: CITY OF YONKERS/SJRH'S HEALTHYYONKERS INITIATIVE AND THE SJRH COMMUNITY ADVISORY COMMITTEE.A MULTIDISCIPLINARY GROUP WAS INVOLVED IN ASSESSING COMMUNITY HEALTHNEEDS IN WESTCHESTER COUNTY WITH PUBLIC PARTICIPATION SOLICITED VIA ASURVEY SPONSORED BY THE WCDOH AND COMMUNITY PARTNERS. THE COLLABORATIVEPROCESS WAS BENEFICIAL IN RESEARCHING CURRENT HEALTH DATA, CONDUCTINGHEALTH NEEDS ASSESSMENTS WITHIN OUR COMMUNITIES, SHARING OF BEST PRACTICEINTERVENTIONS AND LEVERAGING OF RESOURCES.TO DETERMINE THE MOST PRESSING HEALTH NEEDS OF OUR COMMUNITY, WE SURVEYEDMEMBERS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITYPOPULATIONS IN THE SJRH SERVICE AREA, WHO REPRESENT THE HEALTH INTERESTSOF OUR PATIENTS AND THEIR FAMILIES. THE COLLABORATIVE SURVEY WASCOMPLETED BY MORE THAN 3,500 RESPONDENTS BETWEEN JANUARY AND MAY 2019.THE SURVEY COMPRISED THE PRIMARY DATA COLLECTION WITH QUERIES TAILORED TO ALIGN WITH THE PREVENTION AGENDA; THE PROCESS INCLUDED COMMUNITY BASEDFOCUS GROUPS, GRASS ROOTS DISTRIBUTION, COLLECTION ANDINTRA-ORGANIZATIONAL REVIEW OF RESIDENT NEEDS, SERVICE UTILIZATION ANDOUTCOMES. 32% OF RESPONDENTS IDENTIFIED AS HISPANIC AND43.7% IDENTIFIED AS NON-HISPANIC WHITE AND 16.2% AS NON-HISPANIC BLACK.RESPONDENTS RESIDED THROUGHOUT THE COUNTY, WITH 13% LIVING IN A WHITEPLAINS ZIP CODE (10601, 10603, 10604, 10605, 10606, 10607, 10608) ANDAPPROXIMATELY 34.6% LIVING IN THE ST. JOHN'S RIVERSIDE SERVICE AREA. ST.JOHN'S LEADERSHIP ALSO CONSIDERED ITS OWN RESOURCES, STRENGTHS, ANDABILITIES IN THE SELECTION OF SJRH'S PRIORITY COMMUNITY NEEDS.TO HELP SUPPORT AND COORDINATE THIS COLLABORATION, THE WCDOH INVITED ALLWESTCHESTER HOSPITALS TO ATTEND A KICK-OFF MEETING IN EARLY 2019. TOSUPPORT IN THE SELECTION OF PRIORITIES THE WCDOH'S HEALTH AND HOSPITALPLANNING TEAM HELD COLLABORATIVE MEETINGS THROUGHOUT 2019. IN ADDITION,MEMBERS OF THAT GROUP JOINED WITH THE WORK OF MONTEFIORE'S OFFICE OFCOMMUNITY AND POPULATION HEALTH FOR MONTHLY MEETINGS THROUGHOUT THESPRING, SUMMER, AND FALL 2019.THE COLLECTION OF PRIMARY DATA FROM A SAMPLE OF THE WESTCHESTER COUNTYRESIDENTS WAS AN IMPORTANT ELEMENT OF THE DEVELOPMENT OF THE COMMUNITYHEALTH NEEDS ASSESSMENT. SJRH ENGAGED WITH THE WCDOH'S ON-LINE COMMUNITYRESIDENT AND PROVIDER HEALTH SURVEYS TO FACILITATE THE IMPLEMENTATION OFTHE DATA COLLECTION PROCESS. WE IDENTIFIED THE FOLLOWING PARTNERS TO HELPIMPLEMENT INTERVENTIONS IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT: HUDSON RIVER HEALTHCARE FQHC, HUDSON COMMUNITY HEALTHALLIANCE'S LOCAL IMPACT INITIATIVE, PRIMARY PRACTICE OFFICES, CANCERCOALITION OF WESTCHESTER, HEALTHY YONKERS INITIATIVE, SJRH BEHAVIORALHEALTH SERVICES, SJRH COMMUNITY ADVISORY TEAM, WESTCHESTER COUNTYDEPARTMENT OF HEALTH AND THE MONTEFIORE HUDSON VALLEY COLLABORATIVE.OUR PLANNING TEAM ALSO CONDUCTED A SURVEY OF SELECTED STAKEHOLDERSREPRESENTING HEALTH CARE AND SERVICE-PROVIDING AGENCIES WITHIN THECOUNTY. THE PURPOSE OF THE STUDY WAS TO PROVIDE FEEDBACK FROM COMMUNITYSERVICE PROVIDERS IN ORDER TO: 1) GUIDE STRATEGIC PLANNING, 2) HIGHLIGHTTOPICS FOR INCREASED PUBLIC AWARENESS, 3) IDENTIFY AREAS FOR TRAINING,AND 4) INFORM THE STATEWIDE PREVENTION AGENDA. THE SURVEY WAS DEVELOPEDTHROUGH A COLLABORATIVE EFFORT BY AN EIGHTEEN-MEMBER SURVEY COMMITTEEREPRESENTING COUNTY PUBLIC HEALTH DEPARTMENT AND LOCAL HOSPITALS DURINGTHE SPRING-SUMMER OF 2017. A TOTAL OF 3,500 COMMUNITY SURVEYS WERECOLLECTED, THIS IS 2,182 MORE SURVEYS THAN THE ONE CONDUCTED FOR THEPREVIOUS COMMUNITY SERVICE PLANNING PROCESS AND THE COMMUNITY HEALTHNEEDS ASSESSMENT PROCESS.TO ENSURE A BROAD ASSESSMENT OF OUR COMMUNITY HEALTH NEEDS, WE ENGAGED AVARIETY OF PARTICIPANTS INCLUDING, BUT NOT LIMITED TO, THECOMMUNITY-AT-LARGE THROUGH LOCAL RESIDENTS PARTICIPATING IN SJRHSPEAKER'S BUREAU'S HEALTH EDUCATION PROGRAMS. WE SHARED HEALTH DATA ANDSOUGHT FEEDBACK THROUGH THE FOLLOWING SJRH GROUPS: COMMUNITY ADVISORYCOMMITTEE, PASTORAL CARE COMMITTEE, PHYSICIAN ALIGNMENT COMMITTEE,RADIOLOGY ADVISORY COMMITTEE, WELLNESS COMMITTEE, BOARD OF TRUSTEES AND OUR EMPLOYEES.WE PLAN TO PROVIDE ONGOING OPPORTUNITIES FOR HOSPITALS AND OTHERSTAKEHOLDERS, I.E. COMMUNITY-BASED ORGANIZATIONS, TO STRATEGIZE ON HOW TOADDRESS HEALTH PRIORITIES. WE WILL ALSO WORK WITH PARTNERS TO PROVIDEMORE REFINED DATA TO TRACK AND EVALUATE PROGRESS IN ACHIEVING GOALSRELATED TO SELECTED PRIORITIES. SJRH WILL CONTINUE TO COMMUNICATE WITHOTHER COMMUNITY-BASED ORGANIZATIONS REGARDING ADVOCACY, PARTICIPATION INLOCAL COMMUNITY EVENTS, AND EXCHANGE OF REFERRAL INFORMATION. ENGAGINGLOCAL COMMUNITY MEMBERS IN OUR EFFORTS ENABLES US TO INVOLVE OUR HEALTHCARE INSTITUTION AND THE COMMUNITY IN THE ACTIVITIES OF NATIONAL HEALTHADVOCACY ORGANIZATIONS, INCLUDING WALKS, FAIRS, AND OTHERAWARENESS-RAISING ACTIVITIES FOR HEALTH ISSUES THAT IMPACT THECOMMUNITY.IN EARLY 2020, BEFORE THE FIRST COVID SURGE IN WESTCHESTER COUNTY, THE HOSPITAL HELD ITS FIRST MEETING OF THE CALENDAR YEAR TO REVIEW THE ONGOING SELECTED ACTIVITIES. IN LATE 2020, NY STATE DEPARTMENT OF HEALTH NOTED THAT HOSPITALS MIGHT CHANGE THEIR PRIORITIES TO ONES RELATED TO COVID OR MIGHT KEEP THE ITEMS IDENTIFIED IN THE 2019 ASSESSMENT. WHILE SJRH CONTINUES TO BE ACTIVE AND INSTRUMENTAL IN FIGHTING COVID IN THE COMMUNITY IT SERVES, THE HOSPITAL CHOSE TO CONTINUE WITH THE TWO PRIORITY AREAS CHOSEN IN LATE 2019, FOR 2021 AS WELL.

GROUP A-FACILITY 1 -- ALL FACILITIES PART V, SECTION B, LINE 7D:
"CHNA PUBLICATIONTHE ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) COMMUNITY HEALTH NEEDSASSESSMENT (CHNA) PROCESS WAS CONDUCTED DURING THE 2019 PERIOD ANDAPPROVED BY ITS BOARD OF TRUSTEES ON DECEMBER 9, 2019. THE FINALAPPROVED CHNA REPORT WAS ALSO UPLOADED TO THE SJRH PUBLIC WEBSITEWWW.RIVERSIDEHEALTH.ORG BY DECEMBER 30, 2019, SHARED WITH COMMUNITYPARTNERS AND A PAPER COPY WAS MADE AVAILABLE FOR PUBLIC INSPECTION UPONREQUEST AND WITHOUT CHARGE AT THE HOSPITAL FACILITY. A PRESS RELEASE WAS SENT TO ALL LOCAL MEDIA FOR PUBLICATION, THAT THE REPORT IS AVAILABLE FORTHE PUBLIC TO REVIEW. ALL HOSPITAL ADMINISTRATIVE OFFICES ARE GIVEN ACOPY OF THE REPORT TO PRODUCE UPON REQUEST. THE COMMUNITY RECEIVEDCOMMUNICATION THROUGH OUR PRINT NEWSLETTER, ""RIVERSIDE"". SJRH EMPLOYEES,PHYSICIANS AND COMMUNITY PARTNERS RECEIVED NOTIFICATION THROUGH THEIREMAIL NEWSLETTERS WITH A LINK TO CONNECT THEM TO OUR WEBSITE.NOTIFICATION WAS ALSO POSTED ON THE SJRH FACEBOOK PAGE, ON YOUTUBE,TWITTER, AND INSTAGRAM. EMPLOYEES CAN ALSO ACCESS THE REPORT THROUGH THEHOSPITAL INTRANET AND COPIES CAN BE OBTAINED BY CALLING THE HOSPITAL'SPUBLIC RELATIONS OFFICE. DIRECT URL TO CHNA AND THE COMMUNITY SERVICEPLAN IS:HTTPS://WWW.RIVERSIDEHEALTH.ORG/PORTALS/0/CHNA_ISR%2012_2019.PDFBECAUSE OF THE COVID SURGE IN 2020, SJRH WAS NOT REQUIRED TO SUBMIT A REPORT TO NEW YORK STATE ON THE CHNA ACTIVITIES IN 2020. INSTEAD, SJRH WAS REQUIRED TO SUBMIT THE CONTINUING OR NEW PRIORITIES FOR 2021. DATA ON THESE ACTIVITIES WAS SUBMITTED TO NY STATE DEPARTMENT OF HEALTH, AS REQUIRED, IN EARLY 2022. THOSE EFFORTS ARE OUTLINED BELOW."

GROUP A-FACILITY 1 -- ALL FACILITIES PART V, SECTION B, LINE 11:
ADDRESSING COMMUNITY NEEDSTHE AFFORDABLE CARE ACT REQUIRES NOT-FOR-PROFIT HOSPITALS TO ASSESS ANDADDRESS THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE THROUGH THEDEVELOPMENT OF A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)AND IMPLEMENTATION STRATEGY (I/S). ACCORDINGLY, ST. JOHN'S RIVERSIDEHOSPITAL (SJRH) HAS TAKEN INTO ACCOUNT THE BROAD INTERESTS OF ITSCOMMUNITY MEMBERS, ANALYZED HEALTH DATA AND SUBSEQUENTLY ADOPTED A PLANTO PRIORITIZE AND MEET THE HEALTH NEEDS IDENTIFIED. THE SJRH CHNAPROVIDES A REPORT OF THE PROCESS AND RESULTS OF A COMPREHENSIVEASSESSMENT OF THE NEEDS OF ITS COMMUNITY SERVED. THE SJRH I/S ADDRESSESTHE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AND DELINEATES THE METRICS TO BE USED TO EVALUATE THE IMPACT OF THESEINITIATIVES. THE SJRH CHNA WAS DEVELOPED BASED UPON BOTH FEDERAL AND NEWYORK STATE (NYS) GUIDELINES. THE NYS GUIDELINES WERE DESIGNED TO MEET THEFEDERAL HEALTHY PEOPLE 2020 GOALS AND ENCOMPASS THE NYS DEPARTMENT OFHEALTH PREVENTION AGENDA 2019-2024.SJRH HAS CONSIDERED THE CHNA AND PREVENTION AGENDA DOCUMENTS ALONG WITHTHE DIALOGUE OF ITS COMMUNITY PARTNERS IN THE ESTABLISHMENT OF ITSTHREE-YEAR ACTION PLAN THAT INCLUDES TWO PREVENTION AGENDA PRIORITIES;BOTH OF WHICH ADDRESS A HEALTH DISPARITY IN THE COMMUNITY AND INVOLVESONGOING COLLABORATION AND ENGAGEMENT WITH PARTNERS TO ACHIEVE HEALTHIMPROVEMENT. THE SJRH CHNA IS AN OUTCOME OF THE COLLABORATIVE HEALTHNEEDS ASSESSMENT CONDUCTED BY THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH(WCDOH) HEALTH AND HOSPITAL PLANNING TEAM AND THE MONTEFIORE OFFICE OFCOMMUNITY AND POPULATION HEALTH (IN CONJUNCTION WITH MONTEFIORE'S HUDSONVALLEY COLLABORATIVE PPS). SJRH WAS AN ACTIVE PARTICIPANT IN ALL OF THESEEFFORTS. PARTNER SESSIONS GAVE THE OPPORTUNITY FOR AREA HOSPITALS TODISCUSS PREVENTION AGENDA PRIORITIES, FEEDBACK FROM THEIR PUBLIC NEEDSASSESSMENTS, SERVICES PROVIDED, GAPS IN SERVICE AND BEST PRACTICES. AREVIEW OF THE RESULTS FROM THE PRIMARY AND SECONDARY DATA COLLECTIONPROCESS HIGHLIGHTED TWO MAJOR CATEGORIES OF HEALTH NEEDS THAT WEREIMPORTANT ACROSS THE POPULATIONS SURVEYED, REFLECTED IN THE DATA ASCRITICAL, AND IN ALIGNMENT WITH THE NYS PREVENTION AGENDA.MULTIPLE DATA SOURCES WERE USED TO SUPPORT THE ASSESSMENT OF HEALTH NEED PRIORITY ITEMS THAT WERE IDENTIFIED, SELECTED, AND REVIEWED WITHCOMMUNITY PARTNERS. A LISTING AND BRIEF SUMMARY OF THE DATA SOURCES USEDTO COMPLETE THE SECONDARY DATA ANALYSIS AND IDENTIFY THE ISSUES OFCONCERN BEYOND EXPERIENCE AND DIRECT OBSERVATION ARE INCLUDED IN THISREPORT. NUMEROUS CONVERSATIONS AND MEETINGS WERE CONVENED INTERNALLY ANDWITH EXTERNAL PARTNERS, AND A THOROUGH REVIEW OF THE DATA WAS CONDUCTED,ALL OF WHICH HAVE FRAMED THE DEVELOPMENT OF THE CHNA AND I/S. THEPRIORITY AREAS SELECTED AND EACH OF THE PLANNED INTERVENTIONS FOCUS ONSPECIFIC PRIORITY POPULATIONS AND ADDRESS THE ETHNIC AND CULTURALDISPARITY DEFINED IN THE INDICATORS FOR THE POPULATION SERVED BY SJRH.THE PROCESS TO IDENTIFY THE NEEDS OF THE COMMUNITY INVOLVED THECOLLECTION OF BOTH PRIMARY AND SECONDARY DATA.- PRIMARY DATA - SURVEYS, TOWN HALLS, FOCUS GROUPS- SECONDARY DATA - HEALTH SYSTEM, PUBLIC HEALTH, DEMOGRAPHIC DATASOURCES.THE SURVEY IDENTIFIED THE TOP COMMUNITY HEALTH PRIORITY IN SJRH'S SERVICEAS MENTAL HEALTH AND THE SECOND PRIORITY AS CHRONIC DISEASE SCREENING ANDCARE.THROUGH THIS PROCESS AND BASED ON THIS COMMUNITY INPUT, SJRH HAS SELECTEDTHE FOLLOWING PREVENTION AGENDA PRIORITIES:- PREVENT CHRONIC DISEASES (TOBACCO USE CESSATION AMONG LOW SOCIOECONOMICPOPULATIONS), AND- PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE (TREATMENT OFINDIVIDUALS WITH SUBSTANCE ABUSE AND CO-OCCURRING DEPRESSIVE DISORDERSAMONG LOW-SOCIOECONOMIC POPULATIONS).THE PRIORITIES SELECTED ALSO CREATE BETTER ALIGNMENT WITH THE INITIATIVESOF THE NEW YORK STATE DEPARTMENT OF HEALTH'S DELIVERY SYSTEM REFORMINCENTIVE PAYMENT (DSRIP) PROGRAM. DSRIP HAS A VERY STRONG FOCUS ON BOTHTHE PREVENTION AND MANAGEMENT OF CHRONIC DISEASES AND BEHAVIORAL HEALTHISSUES, INCLUDING MENTAL HEALTH.THE 2019 CHNA CONTINUES TO ADDRESS THEMES ALSO IDENTIFIED IN OUR 2016CHNA.2020 PRIORITY AREA 1 (CONTINUED FROM 2019): PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS.FOCUS AREA: MENTAL AND SUBSTANCE USE DISORDERS PREVENTIONGOAL 1.2: PREVENT OPIOID AND OTHER SUBSTANCE MISUSE AND DEATH.THIS PRIORITY AREA CONTINUED IN 2020. BECAUSE OF THE COVID SURGES, NO REPORTING ON THIS PROIRITY AREA WAS REQUIRED BY NY STATE IN 2020. WORK DID CONTINUE ON THIS PRIORITY AREA THROUGHOUT THE YEAR, AS POSSIBLE. AS THE NUMBER OF PEOPLE SEEING SUBSTANCE USE TREATMENT CONTINUES TO INCREASE IN 2021 (NOT YET MEETING 2019 LEVELS) THIS CONTINUES AS A PRIORITY AREA IN 2021. THE OPIOID MORTALITY RATE TRIPLED IN WESTCHESTER COUNTY OVER THE PAST DECADE. DATA REVEALED AN INCREASE IN OPIOID OVERDOSE DEATHS BETWEEN 2014 AND 2016 BY 6.0% BASED ON A RATE PER 100,000. MEDICATION ASSISTED TREATMENT (MAT) IS AN EVIDENCE-BASED INTERVENTION FOR OPIOID USE DISORDER. IN APRIL 2019, SJRH BEGAN TO TRACK USE OF MAT IN ALL OUTPATIENT SETTINGS. (NOTE THAT SJRH HAD OFFERED MAT IN ONE OF ITS OUTPATIENT TREATMENT PROGRAMS BEGINNING IN 2018. IN 2019, MAT WAS OFFERED IN TOW ADDITIONAL OUTPATIENT CLINICAL TREATMENT AREAS ARCHWAY (IN MT. VERNON) AND GREENBURGH ATS (IN GREENBURGH). FOR THE WORKPLAN REQUIRED BY NY STATE, THE FOLLOWING INDICATORS WERE MEASURED:(1) PERCENT OF CLIENTS WITH A DIAGNOSIS OF ALCOHOL USE DISORDER (AUD) WHO ACCEPTED MAT ON THE FIRST DAY OF TREATMENT AND PERCENT WHO ACCEPTED MAT BY DAY 30 FOLLOWING ASSESSMENT. (2) PERCENT OF CLIENTS WITH A DIAGNOSIS OF OPIOID USE DISORDER (OUD) WHO ACCEPTED MAT ON THE FIRST DAY OF TREATMENT AND PERCENT WHO ACCEPTED MAT BY DAY 30 FOLLOWING ASSESSMENT. CUMULATIVE DATA FOR 2021 INDICATES THAT: CUMULATIVE FIGURES FOR 2021 INDICATE THAT 2020'S EFFORTS WERE SEVERELY IMPACTED BY COVID AND ALL OUTPATIENT BEHAVIORAL HEALTH LOCATIONS HAD TO WORK REMOTELY DURING COVID SURGES. IN ADDITION, THE HEALTH DISPARITIES HIGHLIGHTED BY THE PANDEMIC MADE MANY OF OUR CLIENTS RELUCTANT TO BEGIN MAT. THIS RELUCTANCE HAS CONTINUED THROUGH 2021 (SEE FIGURES). 1. OF 235 INDIVIDUALS ASSESSED WITH AUD IN THAT YEAR, 4 (1.70%) ACCEPTED VIVITROL ON THE DAY OF ASSESSMENT AND AN ADDITIONAL 10 (4.26%) ACCEPTED MAT BY DAY 30. 2. OF THE 126 ASSESSMENTS FOR OUD IN 2021, 21 CLIENTS ACCEPTED MAT ON THE DAY OF ASSESSMENT (16.67%) AND AN ADDITIONAL 25 (19.84%) ACCEPTED MAT BY DAY 30. THIS IS A TOTAL OF 37% OF THE OUD CLIENTS IN OUR CARE WHO ACCEPTED OUTPATIENT MAT FROM THE PROGRAM IN 2021 DURING THE FIRST 10 MONTHS OF THAT YEAR. WE CONTINUE TO BATTLE THE IMPACTS OF HEALTH INEQUITY IN OUR SUBSTANCE USE POPULATION. MANY CLIENTS ARE RELUCTANT TO ACCEPT MEDICATION ASSISTED TREATMENT. WE CONTINUE WITH PERFORMANCE IMPROVEMENT STRATEGIES TO IMPROVE OUR OUTCOMES. WE ALSO IMPLEMENTED AVAILABILITY OF MAT TO OUR INPATIENT. REHAB CLIENTS IN 2020. AND, WE IMPLEMENTED AN INPATIENT MAT STRATEGY (MICRO DOSING) ON OUR DETOXIFICATION UNITS. THE WORK ON THE DETOX UNITS BEGAN ON 1/18/22. IN THE FIRST WEEK, WE TREATED FIVE CLIENTS WITH MAT IN THAT DETOX SETTING AND TRANSITIONED THOSE CLIENTS TO OUTPATIENT SERVICES. WHILE WE CONTINUE TO ACCESS TRAINING AND SUPPORT FROM OASAS, OUR PRIMARY PARTNERSHIP THAT HAS BEEN MOST PRODUCTIVE HAS BEEN ENGAGING OUR PROVIDERS TO MEET WITH EVERY CLIENT WHO COMES INTO TREATMENT TO DISCUSS THE ADVANTAGES OF MAT. THESE MEETINGS SPECIFICALLY FOCUS ON THE ADVANTAGES OF MAT FOR AUD AND OUD TREATMENTS. THEY IDENTIFY CLIENT CONCERNS AND BARRIERS AND WORK WITH THE CLIENTS TO ADDRESS THOSE BARRIERS. ANOTHER KEY PARTNERSHIP HAS BEEN WITH OUR PEER EDUCATOR WHO IS TRAINED ON MAT AND WHO CAN DISCUSS THIS MODALITY WITH CLIENTS. FINALLY, OUR SUCCESSFUL MAT CLIENTS HAVE RETURNED TO THE PROGRAMS TO GIVE PRESENTATIONS ON HOW ACCESSING MAT HAS BENEFITED THEIR RECOVERY. WE ARE CURRENTLY WORKING WITH THE WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH AND THE WESTCHESTER COUNTY DEPARTMENT OF CORRECTION ON A THREE-PHASE PROGRAM TO IMPLEMENT MAT IN THE COUNTY JAIL. (THIS WILL BE FINANCED THROUGH OASAS FUNDS.) (NARRATIVE FOR PART V, SECTION B, LINE 11: ADDRESSING COMMUNITY NEEDS CONTINUED AT END OF PART V NARRATIVES.)

GROUP A-FACILITY 1 -- ALL FACILITIES PART V, SECTION B, LINE 13B:
FINANCIAL ASSISTANCE POLICYAS PART OF THE HOSPITAL'S HEALTH SOLUTIONS FINANCIAL ASSISTANCE POLICY,UNINSURED INDIVIDUALS WITH DOCUMENTED INCOME AND FAMILY SIZE LEVELS THATFALL AT OR BELOW 100% FEDERAL POVERTY LEVEL (FPL) WILL BE ENTITLED TO PAYTHE AMOUNTS SPECIFIED UNDER THE STATE'S NOMINAL PAYMENT GUIDELINES (ASSHOWN BELOW):I. INPATIENT SERVICES - $150/DISCHARGEII. AMBULATORY SURGERY - $150/PROCEDUREIII. ALL ANCILLARY SERVICES - $150/PROCEDUREIV. ADULT ER/CLINIC SERVICES - $15/VISITV. PRENATAL AND PEDIATRIC ER/CLINIC SERVICES - NO CHARGEIN THE EVENT THE TOTAL CHARGES FOR THE SERVICES RENDERED WERE LESS THANEITHER THE NOMINAL PAYMENT GUIDELINES AMOUNT, OR THE PERCENTAGE DISCOUNTOF THE AGB (AMOUNT GENERALLY BILLED) RATE, THEN THE PATIENT WILL ONLY BELIABLE FOR THE LOWER AMOUNT. WHEN APPLYING A PERCENTAGE OF THE AGB RATETO ESTABLISH THE DISCOUNT, IT WILL BE FOR THE SPECIFIC SERVICE(S)RENDERED.UNDER THE HOSPITAL'S HEALTH SOLUTIONS FINANCIAL ASSISTANCE POLICY,UNINSURED INDIVIDUALS WHOSE DOCUMENTED INCOME AND FAMILY SIZE FALLBETWEEN 101%-150% OF THE FPL GUIDELINES WILL BE ENTITLED TO DISCOUNTEDFEES BASED ON A SLIDING SCALE FOR COVERED SERVICES BASED WITH THE LOWESTINCOMES PAYING THE LOWEST AMOUNT, AND THEN INCREASING IN EQUAL INCREMENTSUP TO A MAXIMUM OF 20% OF THE RATE FOR THE SERVICE RENDERED.UNINSURED INDIVIDUALS WHOSE DOCUMENTED INCOME AND FAMILY SIZE FALL BETWEEN 151%-250% OF THE FPL GUIDELINES WILL BE ENTITLED TO DISCOUNTED FEES BASED ON A SLIDING SCALE FOR COVERED SERVICES FROM 30%-75% OF THE RATE FOR THE SERVICE RENDERED CAPPED AT THE HIGHER RATE.UNINSURED INDIVIDUALS WHOSE DOCUMENTED INCOME AND FAMILY SIZE FALL BETWEEN 251%-300% OF THE FPL GUIDELINES WILL BE CHARGED NO MORE THAN THE RATES FOR THE SERVICES RENDERED.INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HEALTH SOLUTION PROGRAM MAY RECEIVE ADDITIONAL FEE DISCOUNTS DUE TO EXTRAORDINARY CIRCUMSTANCES, WHICH WILL BE REVIEWED AND APPROVED BY THE DIRECTOR OF PATIENT ACCOUNTS.

GROUP A-FACILITY 1 -- ALL FACILITIES PART V, SECTION B, LINE 13H:
AMOUNTS CHARGED TO PATIENTSTHE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES ASSISTANCE TOINDIVIDUALS IN THE FOLLOWING GEOGRAPHIC AREAS:1. FOR EMERGENCY CARE SERVICES: ALL NEW YORK STATE RESIDENTS.2. FOR MEDICALLY NECESSARY NON-EMERGENT INPATIENT, AMBULATORY SURGERY,AND OUTPATIENT SERVICES (INCLUDING CLINICS), THE HOSPITAL'S PRIMARYSERVICE AREA (PSA) INCLUDES ALL PATIENTS RESIDING IN THE FOLLOWINGCOUNTIES: WESTCHESTER, ORANGE, PUTNAM, ROCKLAND, BRONX, MANHATTAN (NEWYORK), BROOKLYN (KINGS) AND QUEENS.PART V, LINE 16ATHE FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT THE FOLLOWING WEBSITE:HTTPS://RIVERSIDEHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/PART V, LINE 16BTHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT THE FOLLOWINGWEBSITE:HTTPS://RIVERSIDEHEALTH.ORG/WP-CONTENT/UPLOADS/HS-APPLICATION-REVISED-MARCH-2017.PDFPART V, LINE 16CA PLAIN LANGUAGE SUMMARY OF THE SJRH FAP CAN BE FOUND AT THE FOLLOWING WEBSITE:HTTPS://RIVERSIDEHEALTH.ORG/WP-CONTENT/UPLOADS/HEALTH-SOLUTION-SUMMARY-2021-ENGLISH.PDFPART V, LINE 16IPUBLICATION OF FINANCIAL ASSISTANCE POLICYSEE SUPPLEMENTAL INFORMATION, PART VI, LINE 3 FOR MORE INFORMATION.

PART V, SECTION B, LINE 11: ADDRESSING COMMUNITY NEEDS (CONTINUED.)
2020 PRIORITY AREA 2 (CONTINUED FROM 2019): PREVENT CHRONIC DISEASESFOCUS AREA: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTGOAL 4.1: INCREASE CANCER SCREENING RATES FOR BREAST CANCER.THIS PRIORITY AREA CONTINUED IN 2020 AND IN 2021. BECAUSE OF THE COVID SURGES, NO REPORTING ON THIS PROIRITY AREA WAS REQUIRED BY NY STATE IN 2020. WORK DID CONTINUE ON THIS PRIORITY AREA THROUGHOUT THE YEAR, AS POSSIBLE. AS THE NUMBER OF PEOPLE SEEING SUBSTANCE USE TREATMENT CONTINUED TO INCREASE IN 2021, THIS CONTINUED AS A PRIORITY AREA IN 2021. HOWEVER, BECAUSE OF COVID THE NUMBER OF WOMEN SEEKING AND RECEIVING BREAST CANCER SCREENINGS DECREASED. THIS CONTINUES AS A PRIORITY AREA IN 2021 WITH EFFORTS TO INCREASE THE NUMBER OF WOMEN SEEKING SCREENING SERVICES.ADDITIONAL PRIORITY AREA FOR 2020 - COVID-19: IN 2020, WESTCHESTER COUNTY WAS ONE OF THE FIRST COUNTIES IN THE NATION TO BE DECLARED A COVID HOT SPOT. THE HOSITAL EXPERIENCED TWO MAJOR SURGES OF COVID INFECTION DURING THAT YEAR. THE FIRST BEGAN IN MARCH 2020 AND ABATED IN JUNE 2020. THE SECOND BEGAN IN NOVEMBER 2020 AND CONTINUED INTO 2021. THE HOSPITAL PROVIDED ONGOING SUPPORT TO THE COMMUNITY DURING BOTH SURGES. DURING THE 2020 SURGES, SJRH HAD A TOTAL OF 897 ADMISSIONS FOR COVID-19 AND 181 DEATHS. THE HIGHEST SINGLE MONTH OF ADMISSIONS WAS IN APRIL 2020 WITH 482 COVID-RELATED ADMISSIONS AND 131 DEATHS. PARTICULARLY HARD HIT IN OUR AREA WERE COMMUNITIES OF COLOR. AS A RESULT, IN LATE 2020 PLANS BEGAN FOR A HOSPITAL-WIDE HEALTH EQUITY PROJECT TO BEGIN TO ADDRESS THESE HEALTH DISPARITIES. WE EXPERIENCED COVID-19 ADMISSIONS IN 2021 OF 873 PATIENTS AND 107 DEATHS.SJRH COLLABORATED WITH WESTCHESTER COUNTY AND OUR COMMUNITY PARTNERS FOR PRIMARY DATA COLLECTION. WE ALSO PARTICIPATED IN REVIEW OF SECONDARY DATA AND KOMEN GRANT DATA TO DETERMINE AREAS OF IMPROVEMENT IN SERVICE. THROUGHOUT THIS PROCESS, WE IDENTIFIED THE NEED FOR INCREASED SCREENING FOR THOSE WOMEN IN LOWER INCOME HOUSEHOLDS AND THOSE WITH MEDICAID AS PRIMARY PAYOR; AND ALSO IDENTIFIED DISPARITY IN RACE RELATIVE TO THOSE SEEKING SCREENING. AS PART OF OUR ONGOING PROVISION OF CANCER SERVICES, WE WILL CONTINUE OUR EFFORTS TOWARD IMPROVING TARGETED POPULATION PARTICIPATION IN BREAST CANCER SCREENING. OUR SERVICES ALREADY INCLUDE COMMUNITY OUTREACH PROGRAMS, METHODS OF COLLECTING DATA AND ANALYZING SAME TO IDENTIFY PROGRAM IMPROVEMENTS. SCREENING REMINDERS AND CORRESPONDING EDUCATIONAL MATERIAL ALREADY EXISTS WITH THE LATTER SUPPLIED BY THE SUSAN G. KOMEN FOUNDATION. EVIDENCE-INFORMED INTERVENTIONS FROM THE AMERICAN JOURNAL OF PREVENTIVE MEDICINE INCLUDE ONE-ON-ONE EDUCATION, GROUP EDUCATION, REDUCING STRUCTURAL BARRIERS, REDUCING PATIENT OUT-OF-POCKET EXPENSES, AND CLIENT REMINDERS. DATA AS OF 12/15/21: AS OF 1/1/20 WE HAD HIRED A PART-TIME BILINGUAL/BICULTURAL PATIENT NAVIGATOR/EDUCATOR TO ASSIST WITH THE PROGRAM. THAT PERSON LEFT JUST BEFORE MARCH 2020, JUST AS THE COVID PANDEMIC HIT. DURING THE PANDEMIC THERE WERE CLOSURES AND DECREASES IN PREVENTIVE SERVICES (NO ROUTINE SCREENING MAMMOGRAMS 3/23-5/18) AS CRITICAL HEALTH CARE RESOURCES WERE RE-DIRECTED TO CARE FOR THE SICK AND DYING. AND, IT WAS SEVERAL MONTHS BEFORE PATIENTS FELT COMFORTABLE RETURNING TO PREVENTIVE CARE IN THE HOSPITAL SETTING. TELEPHONIC SERVICES WERE USED FOR PATIENT CARE; HOWEVER, THE VOLUME DID NOT RETURN TO NORMAL AND THE PROGRAM WAS UNABLE TO HIRE A NEW PART-TIME NAVIGATOR/EDUCATOR. EFFORTS FOR THE PROGRAM FOCUSED ON OUTREACH TO COMMUNITIES OF COLOR AND HOUSEHOLDS WITH INCOME LESS THAN $25,000/YEAR. MAMMOGRAPHY SERVICES ARE AVAILABLE AT TWO LOCATIONS WITHIN THE SYSTEM- ANDRUS PAVILION AND DOBBS FERRY. THE ANDRUS PAVILION SERVES THE MAJORITY OF CLIENTS AND TENDS TO SEE MORE LOWER INCOME AND WOMEN OF COLOR. OUTREACH EFFORTS WERE MINIMAL BECAUSE OF COVID RESTRICTIONS. IN OCTOBER 2020 THERE WAS A BREAST CANCER PREVENTION WEBINAR FROM THE HOSPITAL AND IN OCTOBER 2021, THE NEW BREAST SURGEON AND THE ONCOLOGY PATIENT SERVICES MANAGER PRESENTED A BREAST CANCER PREVENTION WEBINAR AND A SEPARATE BREAST HEALTH AWARENESS WEBINAR. IN 2021 (THROUGH 12/15/21), THE NUMBER OF MAMMOGRAPHY SCREENINGS BEGAN TO REBOUND. WITH THE LOSS OF THE ASHIKARI BREAST CENTER, SCREENINGS AT DOBBS FERRY PAVILION DECREASED WHILE THOSE AT ANDRUS PAVILION INCREASED. AT ANDRUS, SCREENINGS INCREASED TO 4,299 WITH 432 (10%) BEING FROM HOUSEHOLDS WITH INCOMES UNDER $25,000. (THE NUMBER OF SCREENINGS FOR WOMEN WITH A HOUSEHOLD INCOME LESS THAN $25,000 INCREASED BY .04% DURING THE TUMULTUOUS TWO-YEAR PERIOD. WE NOW ENTER A PHASE OF REBUILDING SURGICAL SERVICES FOR BREAST-RELATED ISSUES. WE HOPE TO REVITALIZE OUR COMMUNITY OUTREACH AS WE LEAVE THIS EARLY 2022 COVID SURGE. ACCORDING TO PROGRAM STAFF, THE CANCER SERVICES PROGRAM OF THE HUDSON VALLEY HAS BEEN THE KEY RESOURCE FOR UNINSURED PATIENTS. THE CSP PROVIDES CANCER BREAST CANCER SCREENINGS AT NO COST TO WOMEN WHO DO NOT HAVE HEALTH INSURANCE OR HAVE HEALTH INSURANCE THAT DOES NOT COVER THE COST OF THESE SCREENINGS. WOMEN AGES 40 AND OLDER WHO MEET INCOME ELIGIBILITY REQUIREMENTS ARE ELIGIBLE FOR THE PROGRAM. IF SCREENING TESTS FIND SOMETHING ABNORMAL, DIAGNOSTIC SERVICES ARE ALSO AVAILABLE THROUGH CSP AT NO COST. IN EARLY SEPTEMBER A HISPANIC WOMAN 52 YEARS OF AGE CAME TO OUR FACILITY WITH AN OUTSIDE MAMMOGRAM AND REFERRAL FOR BIOPSY. SHE PAID OUT OF POCKET FOR HER MAMMOGRAM AT THE OUTSIDE FACILITY BECAUSE SHE WAS UNAWARE OF THE CSP PROGRAM. THE PATIENT NAVIGATOR CONTACTED CSP IMMEDIATELY TO GET HER ENROLLED IN THE PROGRAM AND APPROVED TO SEE OUR PARTNERING BREAST SURGEON FOR A BIOPSY. CSP APPROVED THE BIOPSY AND GOT HER REIMBURSED FOR THE INITIAL IMAGING.ADDITIONAL PRIORITY AREA FOR 2021 - COVID-19: IN 2020, WESTCHESTER COUNTY WAS ONE OF THE FIRST COUNTIES IN THE NATION TO BE DECLARED A COVID HOT SPOT. THE HOSPITAL EXPERIENCED TWO MAJOR SURGES OF COVID INFECTION DURING THAT YEAR. THE FIRST BEGAN IN MARCH 2020 AND ABATED IN JUNE 2020. THE SECOND BEGAN IN NOVEMBER 2020 AND CONTINUED INTO 2021. THE HOSPITAL PROVIDED ONGOING SUPPORT TO THE COMMUNITY DURING BOTH SURGES. DURING THE 2020 SURGES, SJRH HAD A TOTAL OF 897 ADMISSIONS FOR COVID-19 AND 181 DEATHS. THE HIGHEST SINGLE MONTH OF ADMISSIONS WAS IN APRIL 2020 WITH 482 COVID-RELATED AMISSIONS AND 131 DEATHS. PARTICULARLY HARD HIT IN OUR AREA WERE COMMUNITIES OF COLOR. AS A RESULT, IN LATE 2020 PLANS BEGAN FOR A HOSPITAL-WIDE HEALTH EQUITY PROJECT TO BEGIN TO ADDRESS THESE HEALTH DISPARITIES.IN 2021, SJRH HAD 873 COVID-19 RELATED ADMISSIONS TO THE INPATIENT UNITS. OF THESE ADMISSIONS, 107 INDIVIDUALS DIED. THIS WAS CLOSE TO THE SAME NUMBER OF ADMISSIONS AS THE 2020 YEAR (THE BEGINNING OF THE PANDEMIC) HOWEVER THERE WERE MANY LESS DEATHS ONLY 107 VS. THE 181 OF THE PREVIOUS YEAR. THE HOSPITAL ALSO CONTINUED COMMUNITY IMMUNIZATION EFFORTS. DURING 2021, SJRH STAFF VACCINATED 1,109 STAFF MEMBERS AND 2,496 COMMUNITY MEMBERS. IN 2021, THE CARES COMMITTEE ALSO WAS FORMED BY THE HOSPITAL TO ADDRESS HEALTH EQUITY ISSUES IN OUR COMMUNITY. THE CARES MISSION IS TO ACHIEVE HEALTHCARE EQUITY IN OUR COMMUNITY BY IDENTIFYING HEALTHCARE DISPARITIES AND PROMOTING EFFECTIVE STRATEGIES TO OPTIMIZE HEALTHCARE DELIVERY. WE CHAMPION COMPASSIONATE, PROFESSIONAL, RESPECTFUL, AND ETHICAL CARE FOR ALL WHOM WE SERVE. OUR VISION TO ELIMINATE HEALTHCARE DISPARITIES IN THE CITY OF YONKERS AND THE SURROUNDING AREAS AND IMPROVE OVERALL HEALTH OF THE POPULATION. WE STARTED OUR MISSION MARCH OF 2021. OUR TARGETED AREAS OF CONCERNS WERE REDUCING DISPARITIES IN MATERNAL OUTCOMES AND BREAST CANCER, ADDRESSING ASTHMA OUTCOMES, OBESITY, INCREASING EDUCATION REGARDING COVID VACCINATION AND ENHANCING PRIMARY CARE.

PART III, LINE 8:
THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.

PART I, LINE 3A AND PART V, LINE 13
FREE CAREAS OUTLINED IN THE NEW YORK STATE HOSPITAL FINANCIAL ASSISTANCE LAW,UNINSURED INDIVIDUALS WITH DOCUMENTED INCOME AND FAMILY SIZE LEVELS THAT FALL AT OR BELOW 100% FPL WILL BE ENTITLED TO PAY THE AMOUNTS SPECIFIED UNDER THE STATE'S NOMINAL PAYMENT GUIDELINES (AS SHOWN BELOW AND INCLUDED IN THE HOSPITAL'S FINANCIAL AND CHARITY CARE PROGRAM POLICY):I. INPATIENT SERVICES - $150/DISCHARGEII. AMBULATORY SURGERY - $150/PROCEDUREIII. ALL ANCILLARY SERVICES - $150/PROCEDUREIV. ADULT ER/CLINIC SERVICES - $15/VISITV. PRENATAL AND PEDIATRIC ER/CLINIC SERVICES - NO CHARGEPART I, LINE 6ATHE HOSPITAL SUBMITTED A COMMUNITY SERVICE PLAN (CSP) TO NEW YORK STATE IN 2020 AND PREPARED A COMMUNITY HEALTH NEEDS ASSESMENT (CHNA) REPORT IN 2019. BOTH OF THESE ARE MADE AVAILABLE TO THE PUBLIC THROUGH POSTING ON THE HOSPITAL'S WEBSITE AND UPON REQUEST. BEGINNING IN MARCH 2020 THE HOSPITAL'S EFFORTS FOCUSED ON MEDICAL SUPPORT OF THE FIGHT AGAINST COVID-19 IN THE COMMUNITY. THE MAJORITY OF THE HOSPITAL'S EFFORTS IN 2020 FOCUSED ON THIS FIGHT AGAINST COVID AND SUPPORT OF THE COMMUNITY WE SERVED. INFORMATION ON THE SPECIFIC OUTCOMES OF THE CSP AREAS OF GOCUS WAS SUBMITTED TO NY STATE AS REQUIRED IN JANUARY 2022. THE HOSPITAL'S MISSION STATEMENT HAS NOT CHANGED FOR 2021. THE HOSPITAL CONTINUES TO ADDRESS PLANNING ISSUES INCLUDING QUALITY, CULTURE AND COMMUNICATION, ACCESS TO CARE, MARKET SHARE, FINANCIAL, AND PHYSICIAN ALIGNMENT. PLEASE NOTE THAT THE HOSPITAL'S PRIMARY SERVICE AREA USED IN THE 2019 COMMUNITY SERVICE PLANNING REMAINS THE SAME AS THAT REPORTED IN THE PREVIOUS CSP. PART I, LINE 7THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNTS INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM THE MEDICARE COST REPORT.PART III, LINES 2 & 4THE HOSPITAL REGULARLY REVIEWS ITS PAST COLLECTION HISTORY AND PAYMENTTRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE TO ESTIMATE THE APPROPRIATE RESERVES. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH UNINSURED PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT IMPLICIT PRICE CONCESSION FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE RESERVE ACCOUNTS AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED.THE 2021 CONSOLIDATED AUDITED FINANCIAL STATEMENTS CONTAIN A PATIENT ACCOUNTS RECEIVABLE FOOTNOTE ON PAGE 10 AND A CHARITY CARE AND UNCOMPENSATED CARE FOOTNOTE ON PAGE 13.PART III, LINE 3THE HOSPITAL IS DEDICATED TO PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE IN A COMPASSIONATE, PROFESSIONAL, RESPECTFUL AND ETHICAL MANNER TO EVERY PATIENT REGARDLESS OF ABILITY TO PAY. THE AMOUNT OF $3,711,089 REPRESENTS THE HOSPITAL'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY AND IS COMPRISED OF THE DOLLAR VALUE OF THE DISCOUNTS MADE AVAILABLE TO PATIENTS UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY AS WELL AS THE UNCOMPENSATED CARE PROVIDED TO THE MEMBERS OF OUR COMMUNITY THAT WE SERVE WHO ARE IN NEED OF EMERGENCY AND MEDICALLY NECESSARY CARE AND DO NOT HAVE THE ABILITY TO PAY.PART III, LINE 8TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE ON PART III, LINE 6, MEDICARE CHARGES WERE MULTIPLIED BY THE COST TO CHARGE RATIO, AS DERIVED FROM THE MEDICARE COST REPORT.

3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
THE ST. JOHN'S FINANCIAL ASSISTANCE UNIT EDUCATES PATIENTS AND THE PUBLIC ABOUT THEIR RIGHTS, RESPONSIBILITIES AND OPTIONS TO ATTAIN SOME COVERAGE OF COSTS FOR THEIR HEALTH CARE. ST. JOHN'S RIVERSIDE HOSPITAL EDUCATES OUR PATIENTS ABOUT OUR CHARITY CARE PROGRAM CALLED HEALTH SOLUTION* IN THE FOLLOWING MANNER:A. THE HOSPITAL WEB SITE HAS THE COMPLETE HEALTH SOLUTION SUMMARY. THESUMMARY DESCRIBES THE RESIDENTIAL AREAS WE COVER, THE TYPE OF SERVICES THAT ARE NOT COVERED, WHERE TO APPLY, THE PHONE NUMBER TO OBTAIN INFORMATION, THE FEDERAL POVERTY GUIDELINES INCOME LEVEL AND HOW TO APPEAL THE APPLICATION DECISION.B. THERE ARE POSTED NOTICES IN ALL REGISTRATION AND CASHIER AREAS WITHIN THE HOSPITAL.C. THE HEALTH SOLUTION SUMMARY IS INCLUDED IN THE REGISTRATION PACKET THAT IS GIVEN TO ALL PATIENTS.D. THE FINANCIAL ASSISTANT UNIT STAFF WHEN VISITING PATIENT ROOMS WILL DISCUSS THE HEALTH SOLUTION PROGRAM.* HEALTH SOLUTION, OFFERED SINCE 2000, IS AN OPTION FOR PATIENTS WITH AFINANCIAL NEED. PATIENTS WHO APPLY ARE ASSESSED TO DETERMINE ELIGIBILITY TO PAY DOWN HEALTHCARE BILLS WITHIN THEIR BUDGET. HEALTH SOLUTION IS A CHARITY CARE PROGRAM WHERE PAYMENTS BY PATIENTS CAN BE MADE OVER TIME. ELIGIBILITY FOR MEDICAID IS DETERMINED FIRST. WHEN ELIGIBLE, HEALTH SOLUTION PAYMENTS CAN ALSO BE USED TO PAY INSURANCE DEDUCTIBLES.

PART III, LINE 9B
1. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HEALTH SOLUTION PROGRAM WILL HAVE THEIR OPEN ACCOUNTS ADJUSTED TO THE AMOUNT DUE BASED ON THE LEVEL OF ASSISTANCE THEY RECEIVE, SO THAT BILLS AND STATEMENTS WILL REFLECT THE DISCOUNTED AMOUNT DUE. PATIENTS WILL THEN BE EXPECTED TO PAY THE ADJUSTED AMOUNT DUE.2. PATIENTS WHO ARE UNABLE TO PAY THE ADJUSTED AMOUNT DUE WILL BE OFFERED PAYMENT PLANS.3. PAYMENT PLANS WILL NOT REQUIRE A PATIENT TO PAY MORE THAN 10% OF THEIR MONTHLY GROSS INCOME TOWARDS MONTHLY INSTALLMENT PAYMENTS. IF THE HOSPITAL ELECTS TO CONSIDER OTHER NON-EXCLUDED ASSETS IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY, THEN MONTHLY PAYMENTS MAY EXCEED 10%.4. THE HOSPITAL WILL NOT COLLECT FROM A PATIENT WHO IS DETERMINED TO BE ELIGIBLE FOR MEDICAID, OR WHO IS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED.5. IF A PATIENT OR RESPONSIBLE PARTY DEFAULTS ON ITS PAYMENT OBLIGATIONS, OR FAILS TO MEET THE TERMS OF ANY FINANCIAL AGREEMENT, THE ACCOUNT IN QUESTION WILL BE CONSIDERED DELINQUENT, AND MAY BE REFERRED TO A COLLECTION AGENCY BASED ON THE HOSPITAL'S COLLECTION POLICY.6. THE HOSPITAL WILL NOT SEND AN ACCOUNT TO COLLECTION IF THE PATIENT HAS SUBMITTED A COMPLETED APPLICATION FOR FINANCIAL AID, INCLUDING REQUIRED SUPPORTING DOCUMENTATION, WHILE THE HOSPITAL DETERMINES THE PATIENT'S ELIGIBILITY FOR SUCH AID, OR DURING THE PROCESS WHERE THE PATIENT HAS APPEALED AN ELIGIBILITY DETERMINATION.7. THE HOSPITAL WILL REVIEW ALL ACCOUNTS DETERMINED TO BE REFERRED TOOUTSIDE COLLECTION TO ENSURE THAT ITS FINANCIAL POLICY AND PROCEDURESWERE FOLLOWED.8. THE HOSPITAL WILL PROVIDE WRITTEN NOTIFICATION AND A NOTICE ON THE PATIENT'S BILL LESS THAN 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO OUTSIDE COLLECTION.9. THE HOSPITAL WILL SEND EACH OF ITS COLLECTION AGENCIES A COPY OF ITS FINANCIAL ASSISTANCE POLICY AND PROCEDURES, AND WILL INSTRUCT THE AGENCY TO FOLLOW THESE PROCEDURES WHEN INSTRUCTING THE PATIENT HOW TO APPLY FOR SUCH AID.10. COLLECTION AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT PRIOR TO COMMENCING A LEGAL ACTION ON A PATIENT'S ACCOUNT.11. LEGAL ACTION MAY INCLUDE GARNISHMENT OF WAGES WHERE THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS/HER FINANCIAL OBLIGATION UNDER THIS POLICY.12. THE HOSPITAL WILL NOT PERMIT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE IN ORDER TO COLLECT AN OUTSTANDING MEDICAL BILL.2. NEEDS ASSESSMENTWHILE UNPLANNED, THE COVID-19 PANDEMIC QUICKLY BECAME THE HOSPITAL'S NUIMBER ONE PRIORITY IN 2020. COVID-19 WAS THE MAJOR FOCUS FOR THE HOSPITAL AND ITS COMMUNITY DURING THE YEAR. THE HOSPITAL HAD 897 COVID-RELATED INPATIENT ADMISSIONS IN 2020 AND 181 DEATHS FROM THE DISEASE. ONCE THE VACCINE BECAME AVAILABLE, ONCE THE VACCINE BECAME AVAILABLE, A MAJOR FOCUS FOR THE HOSPITAL BECAME VACCINATION OF OUR STAFF AND PRIORITY POPOULATION COMMUNITY MEMBERS. VACCINE DISTRIBUTION BEGAN ON DECEMBER 15, 2020. BY DECEMBER 30, 2020, VACCINE DISTRIBUTION HAD ACCOMPLISHED THE FOLLOWING AT EACH OF OUR THREE SITES: ANDRUS PAVILION 754 STAFF MEMBERS RECEIVED A FIRST DOSE AND 275 MEMBERS OF PRIOIRITY POPULATIONS RECEIVED FIRST DOSES; PARK CARE PAVILION 85 STAFF MEMBERS AND 5 COMMUNITY MEMBERS RECEIVED A FIRST DOSE; DOBBS FERRY PAVIION 70 STAFF MEMBERS AND 79 PRIORITY COMMUNITY MEMBERS RECEIVED FIRST DOSES. (NOTE: DURING THIS PERIOD FIRST DOSES FOR COMMUNITY MEMBERS WERE LIMITED TO THOSE OVER 65 YEARS OF AGE.) TOTAL VACCINE DOSES IN 2020 WERE 909 STAFF MEMBERS AND 359 PRIORITY COMMUNITY MEMBERS, TOTALING 1,268 TOTAL DOSES OF VACCINE ADMINISTERED.IN ADDITION, THE HOSPITAL'S TESTING FOR COVID-19 WAS A MAJOR EMPHASIS THROUGHOUT THE TWO SURGES IN 2020 AND CONTINUING INTO 2021. IN 2021, THE HOSPITAL ADMINISTERED A TOTAL OF 33,310 COVID TESTS. (THESE WERE ADMINISTERED AS FOLLOWS: INPATIENT: 16,094, EMERGENCY ROOM: 7,088, AND OUTPATIENT: 10,128). FINALLY, VACCINATION WAS A PRIORITY FOR THE HOSPITAL WITH 9,373 TOTAL VACCINATION SHOTS, INCLUDING INITIAL DOSES AND BOOSTERS, PROVIDED TO COMMUNITY MEMBERS AND HOSPITAL EMPLOYEES.ONGOING HEALTH NEEDS ASSESSMENTS AND EFFORTS TO ADDRESS THOSE ARE NOTED BELOW: ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) LOCATED IN THE HUDSON VALLEY REGION WITHIN WESTCHESTER COUNTY, SERVES THE CITY OF YONKERS AND THE RIVERTOWN AREAS AND ACTIVELY WORKS WITH THE FOLLOWING PARTNERS TO ASSESS THE COMMUNITIES' HEALTH CARE NEEDS: LOCAL COMMUNITY-BASED ORGANIZATIONS, BUSINESSES, CITY PLANNING COUNCILS, SCHOOLS, THE WESTCHESTER COUNTY HEALTH DEPARTMENT, OTHER HEALTH CARE ORGANIZATIONS AND THE HOSPITALS' COMMUNITY ADVISORY COMMITTEE. WE ALSO PARTNER WITH THE AMERICAN CANCER SOCIETY, DIABETES AND HEART ASSOCIATIONS, FEMA, MARCH OF DIMES, CABRINI IMMIGRANT SERVICES AND OTHERS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY THAT WE SERVE. THIS IS ACCOMPLISHED THROUGH SHARED DATA FOR PLANNING PURPOSES, AWARENESS OF SERVICES OFFERED BY OUR PARTNERS, COLLABORATIVE PROGRAM PLANNING, IMPLEMENTATION AND EVALUATION, AND COORDINATED HEALTH OUTREACH AND PROMOTION. THESE EFFORTS HAVE RESULTED IN ST. JOHN'S PROVIDING ON-GOING EDUCATION AND GUIDANCE TO THE YONKERS PTA COORDINATING COUNCIL AND THE LOCAL YMCA'S HEALTH INITIATIVE RELATIVE TO HEALTH CARE ISSUES. THE COMMUNITY SERVICE PLAN AGENDA WAS ESTABLISHED BASED ON A COMPREHENSIVE HEALTH NEEDS ASSESSMENT AND ITS FINDINGS. SEVERAL SURVEYS AND COMMUNITY FOCUS GROUPS WERE ALSO CONDUCTED TO GATHER DATA. THE RESPONSES OF THE PARTICIPANTS AS TO WHAT HEALTH CARE EDUCATION IS NEEDED WAS ONE OF THE KEY COMMUNITY INPUTS TO SETTING THE FRAMEWORK FOR PLANNING EDUCATIONAL PROGRAMS FOR THE COMMUNITY.SJRH IS A LEADER IN COMMUNITY COLLABORATION AND HAS A LONG HISTORY OFDEVELOPING INNOVATIVE APPROACHES TO CARE AND TAILORING PROGRAMS TO BESTSERVE THE CHANGING NEEDS OF ITS COMMUNITY. THESE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: ST. JOHN'S COMMUNITY ADVISORY TEAM, HEALTHY YONKERS INITIATIVE PARTNERSHIP, DISEASE MANAGEMENT PROGRAMS, COMPREHENSIVE LAY AND CLINICAL PATIENT NAVIGATION PROGRAMS, COMMUNITYHEALTH OUTREACH WORKERS AND A SPEAKER'S BUREAU. THE INTEGRATION OF THESE INNOVATIVE APPROACHES SUPPORTS SJRH WELL IN ITS PROVISION OF SERVICES TO ITS COMMUNITY. SJRH PROMOTES WELLNESS IN ADDITION TO TREATING DISEASE AND ADDRESSES NEEDS RANGING FAR BEYOND MEDICAL CARE. WE EXTEND THIS RESPONSIBILITY TO THE CARE OF OUR EMPLOYEES AND MEDICAL STAFF, MANY OF WHOM LIVE IN THE SURROUNDING COMMUNITY. SJRH SERVES A DIVERSE COMMUNITY AND HAS BEEN A FORERUNNER OF PROGRAMS THAT IMPROVE PATIENTS' ACCESS TO CULTURALLY APPROPRIATE SERVICES. ITS PROGRESSIVE FINANCIAL AID POLICY AND ROBUST ENTITLEMENT AND ENROLLMENT PROGRAM THROUGH OUR FINANCIAL ASSISTANCE UNIT, SUPPORTS ACCESS TO CARE FOR THOSE IN NEED. HISTORICALLY, SJRH HAS VIEWED COMMUNITY SERVICE AND COMMUNITY HEALTH IMPROVEMENT AS AN INTEGRAL PART OF ITS HOSPITAL MISSION, REACHING OUT TO SERVE THE UNDERSERVED.SERVICES TO THE COMMUNITY ARE AN EXPLICIT AND ESSENTIAL COMPONENT OF SJRH'S MISSION AND ONE OF ITS MOST VALUED TRADITIONS. WE REACH BEYOND THE WALLS OF OUR CAMPUSES TO IDENTIFY AND MEET THE NEEDS OF THE COMMUNITY, NOT JUST MEDICALLY, BUT SOCIALLY, ECONOMICALLY AND ENVIRONMENTALLY. SJRH PARTICIPATES IN A VARIETY OF ORGANIZED PARTNERSHIPS AND COLLABORATIONS, WORKING WITH OTHER PROVIDERS IN WESTCHESTER COUNTY, INCLUDING THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH, COMMUNITY-BASED ORGANIZATIONS AND MEMBERS OF THE COMMUNITY IN PLANNING AND DEVELOPING INITIATIVES AIMED AT IMPROVING THE OVERALL HEALTH OF THE PEOPLE OF WESTCHESTER COUNTY.

4. COMMUNITY INFORMATION
"ST. JOHN'S RIVERSIDE HOSPITAL (SJRH), A NOT-FOR-PROFIT, NEW YORK STATEDEPARTMENT OF HEALTH (NYSDOH) LICENSED 378-BED ACUTE CARE COMMUNITYHEALTH SYSTEM, OPERATES THREE (3) CAMPUSES: ANDRUS PAVILION (225 BEDS),PARK CARE PAVILION (141 BEDS), AND DOBBS FERRY PAVILION (12 BEDS). THEANDRUS PAVILION, PROVIDES EMERGENCY SERVICES, GENERAL ACUTE AND CANCERCARE, WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES; ISDESIGNATED BY THE NYSDOH AS A STROKE CENTER AND LEVEL II PERINATALCENTER, AND IS THE ONLY PROVIDER OF MATERNITY SERVICES IN THE CITY OFYONKERS.THE PARK CARE PAVILION PROVIDES INPATIENT AND OUTPATIENT SUBSTANCE ABUSE SERVICES AND IS DESIGNATED BY NYSDOH AS AN AIDS CENTER. THE DOBBS FERRY PAVILION, PROVIDES INPATIENT AND PRIMARY MEDICAL CARE, AMBULATORY SURGERY AND EMERGENCY SERVICES, AND IS THE HUB FOR CENTERS OF EXCELLENCE IN BREAST AND ORTHOPEDIC CARE. AT ST. JOHN'S, OVER 600 MEDICAL AND ALLIED HEALTH PROFESSIONALS PROVIDE A WIDE RANGE OF AMBULATORY AND INPATIENT SERVICES; AND OVER 250,000 INDIVIDUALS ARE SERVED ANNUALLY WITHIN OUR NETWORK. SJRH, GOVERNED BY A VOLUNTARY TWENTY-SIX MEMBER BOARD OF TRUSTEES, IS A SAFETY-NET HOSPITAL SERVING THE URBAN, ETHNICALLY DIVERSE AND ECONOMICALLY DISADVANTAGED COMMUNITY OF SOUTHWEST YONKERS, NEW YORK. AS A DESIGNATED NYS 'ESSENTIAL COMMUNITY PROVIDER', WE SERVE PREDOMINANTLY LOW-INCOME MEDICALLY UNDERSERVED INDIVIDUALS.THE ST. JOHN'S RIVERSIDE HOSPITAL PRIMARY SERVICE AREA INCLUDES THE CITY OF YONKERS, VILLAGE OF DOBBS FERRY AND THE SURROUNDING TOWNS AND VILLAGES OF HASTINGS-ON-HUDSON, ARDSLEY, IRVINGTON, TARRYTOWN, ELMSFORD, TUCKAHOE, BRONXVILLE, AND SCARSDALE WITHIN WESTCHESTER COUNTY, NEW YORK. WITHIN THE CITY OF YONKERS AND DOBBS FERRY, THE SJRH FACILITIES ARE THE LARGEST HEALTH SERVICE PROVIDERS AND IT IS WITHIN THIS GEOGRAPHIC AREA THAT THESE SJRH FACILITIES HAVE THEIR COMMUNITY-BASED PRIMARY CARE AND SPECIALTYAMBULATORY SERVICES.OUR ANDRUS AND PARK CARE PAVILIONS ARE LOCATED IN AND PRIMARILY SERVE THE CITY OF YONKERS. THE DOBBS FERRY PAVILION SERVES THE RIVERTOWN COMMUNITIES OF DOBBS FERRY, HASTINGS-ON-HUDSON, ARDSLEY AND IRVINGTON. THE RESIDENT POPULATION OF THE CITY OF YONKERS COMPRISES ONE-THIRD OF THE HOSPITAL'S SERVICE AREA AND DEPENDING ON ZIP CODE ACCOUNTS FOR BETWEEN 30 TO SO PERCENT OF ITS ADMISSIONS.THE COMMUNITIES SERVED BY OUR HEALTH SYSTEM ARE WIDESPREAD AND DIVERSE.ST. JOHN'S PROVIDES CONVENIENT ACCESS TO HIGH QUALITY ACUTE, PRIMARY AND SPECIALTY CARE TO INDIVIDUALS AND FAMILIES LIVING IN A PRIMARY SERVICE AREA OF FOURTEEN (14) ZIP CODES SURROUNDING ITS LOCATION. THE ZIP CODES THAT WE MOST COMMONLY PROVIDE SERVICES FOR ARE: 10701, 10703, 10704, 10705, 10706, 10707, 10708, 10710, 10502, 10522, 10523, 10533, 10583, AND 10591. FIVE ZIP CODE AREAS IN SOUTHWEST YONKERS (10701, 10703, 10704, 10705, AND 10710) HAVE BEEN FEDERALLY DEFINED AS MEDICALLY UNDERSERVED AREAS. AS SUCH, IT IS A KEY EMERGENCY MEDICAL SERVICE (EMS) PARTICIPANT OPERATING IN ITS TWO HOSPITALS WITH 48,599 EMERGENCY VISITS IN 2019.YONKERS IS THE LARGEST CITY IN WESTCHESTER AND THE 3RD LARGEST CITY IN NEW YORK STATE, WITH A 2021 POPULATION ESTIMATE OF 209,530 AS PER THE U.S. CENSUS BUREAU. IT IS AN AGING INDUSTRIAL CITY WITH NEEDS OFTEN OVERLOOKED IN A COUNTY DOMINATED BY AFFLUENT SUBURBS. YONKERS BORDERS THE BRONX AND SHARES MANY OF NEW YORK CITY'S URBAN PROBLEMS; AND ACCOMPANYING ITS DIVERSITY, ARE SIGNIFICANT INEQUITIES IN HEALTH STATUS. ONE IN FIVE FAMILIES' LIVES IN POVERTY AND OVER ONE THIRD OF THESE FAMILIES ARE HEADED BY FEMALES.ST. JOHN'S ECONOMICALLY, CULTURALLY AND ETHNICALLY DIVERSE SERVICE AREAENCOMPASSES NEIGHBORHOODS WITH LARGE NUMBERS OF HISPANIC ANDAFRICAN-AMERICAN RESIDENTS, INCLUDING HAITIAN AND DOMINICAN IMMIGRANTS.YONKERS HAS THE HIGHEST PROPORTION OF HISPANIC RESIDENTS IN WESTCHESTERCOUNTY, MANY OF WHOM ARE RECENT IMMIGRANTS WITH LIMITED FLUENCY INENGLISH. PUERTO RICANS AND MEXICANS ARE THE TWO LARGEST HISPANICCOMMUNITIES. ENGLISH AND SPANISH ARE THE DOMINANT LANGUAGES, ALTHOUGHTHERE ARE A SIGNIFICANT NUMBER OF RESIDENTS WHO SPEAK ITALIAN, PORTUGUESE AND ARABIC.THE PROFILE OF THIS AREA INCLUDES HIGH UNEMPLOYMENT, LARGE NUMBERS OFHIGH SCHOOL DROPOUTS, OVERCROWDED HOUSING, AND FAMILIES AND CHILDREN INPOVERTY. YONKERS IS FEDERALLY DESIGNATED AS A HIGH INTENSITY DRUGTRAFFICKING AREA. THERE IS A HIGH RATE OF TEEN PREGNANCY, LACK OFPRENATAL CARE, VACCINE PREVENTABLE DISEASE, TUBERCULOSIS, AND HIV/AIDS.THE CITY HAS THE HIGHEST CONCENTRATION OF HIV/AIDS IN THE COUNTY AND ONE OF THE HIGHEST IN NY STATE. OUR SUBSTANCE ABUSE TREATMENT AND TRAINING CENTER IS ONE OF NEW YORK'S LARGEST PROVIDERS OF SUBSTANCE ABUSE SERVICES.THE DOBBS FERRY FACILITY IS THE ONLY HOSPITAL LOCATED IN THE VILLAGE OFDOBBS FERRY, APPROXIMATELY 7 MILES FROM ITS SJRH SISTER FACILITIES INYONKERS. THE TOTAL POPULATION OF THIS SERVICE AREA IS APPROXIMATELY124,000. A POPULATION THAT IS LARGELY WHITE AND AFFLUENT DEFINES THISAREA.WESTCHESTER COUNTY IS A LARGE COUNTY LOCATED JUST TO THE NORTH OF NEW YORK CITY IN THE HUDSON VALLEY; WESTCHESTER COVERS AN AREA OF 450 SQUARE MILES (1,200 SQUARE KM) AND CONSISTS OF 48 MUNICIPALITIES. THE COUNTY INCLUDES URBAN, SUBURBAN AND RURAL GEOGRAPHIES. IN 2021, THE ESTIMATED POPULATION OF WESTCHESTER COUNTY WAS 997,895, SLIGHTLY HIGHER THAN THE POPULATION IN 2019. THE COUNTY SEAT OF WESTCHESTER IS THE CITY OF WHITE PLAINS (60,101) AND OTHER MAJOR CITIES INCLUDE YONKERS (214,647), NEW ROCHELLE (80,258) AND MOUNT VERNON (75,213). IN 2020, THE MEDIAN HOUSEHOLD INCOME FOR WESTCHESTER WAS $99,489, 2ND HIGHEST IN NEW YORK STATE, AFTER NEW YORK COUNTY. WESTCHESTER COUNTY IS THE 3RD HEALTHIEST COUNTY IN NEW YORK STATE, ACCORDING TO THE COUNTY HEALTH RANKINGS, PRODUCED BY THE ROBERT WOOD JOHNSON FOUNDATION AND UNIVERSITY OF WISCONSIN.DESPITE ITS OVERALL HIGH RANKING. THERE IS CONSIDERABLE ROOM TO BOTHIMPROVE POPULATION HEALTH AND REDUCE HEALTH DISPARITIES IN WESTCHESTERCOUNTY. SEVERAL OF ITS INDIVIDUAL MUNICIPALITIES CONTINUE TO MAINTAINSIGNIFICANT HEALTH GAPS, WITH PORTIONS OF LOWER WESTCHESTER SPECIFICALLY, MOUNT VERNON, YONKERS, NEW ROCHELLE AND WHITE PLAINS SERVING ""HOT SPOTS"" FOR ASTHMA, HIV, AND ILLICIT DRUG USE IN THE COUNTY. THESE AREAS ALSO DEMONSTRATE EXCESS MORTALITY RATES FROM HEART DISEASE, STROKE, AND DIABETES COMPARED TO COUNTY AND NEW YORK AVERAGES. MORTALITY RATES:ACCORDING TO THE NEW YORK STATE DEPARTMENT OF HEALTH'S (NYSDOH} VITALSTATISTICS OF NEW YORK STATE REPORT IN 2014-2016, WESTCHESTER COUNTY HAS AN AGE-ADJUSTED MORTALITY RATE OF 530.9 PER 100,000; LOWER THAN THE NY STATE AGE-ADJUSTED MORTALITY RATE OF 638.2. THIS IS AN IMPROVEMENT FROM THE COUNTY FROM THE 2011 DATA. ACCORDING TO THE COMMUNITY HEALTH RANKINGS IN 2014, WESTCHESTER COUNTY RANKED AS NUMBER 3 OUT OF 62 NY COUNTIES TO HAVE THE LOWEST MORTALITY RATE IN NEW YORK STATE. THE LEADING CAUSE OF DEATH AMONG WESTCHESTER COUNTY RESIDENTS IS CORONARY HEART DISEASE (148.9 PER 100,000). FOLLOWING ARE THE REMAINING FOUR LEADING CAUSES OF DEATH: CANCER, UNINTENTIONAL INJURY, STROKE, AND CHRONIC LOWER RESPIRATORY DISEASE. (NOTE THAT HEART DISEASE AND CANCER HAVE REMAINED THE NUMBERS 1 AND 2 CAUSES OF DEATH SINCE 2008.)DURING 2020, COVID-19 WAS A MAJOR HEALTH CONCERN. WESTCHESTER COUNTY HAD 136,000 CASES OF COVID-19 AND 2,303 DEATHS. SJRH HAD 897 COVID-RELATED INPATIENT ADMISSIONS IN 2020 AND 181 DEATHS FROM THE DISEASE. IN 2021, SJRH HAD 873 CASES OF COVID AND 107 DEATHS. DISPARITIES IN HEALTH OUTCOMES BY RACE LED TO ST JOHN'S RIVERSIDE DEVELOPING A BOARD COMMUNITY COALITION TO ADDRESS HEALTH DISPARITIES ACROSS THE SPECTRUM OF ILLNESSES FOR OUR RESIDENTS. THE CARES COMMITTEE (COMMITTEE FOR ACHIEVING REGIONAL EQUITY IN HEALTH CARE) WAS CONVENED IN 2021. THE COMMITTEE LED TO THE FORMATION FO 15 NEW RELATIONSHIPS IN THE COMMUNITY, 8 COMMUNITY ACTIVITIES AND EVENTS, AND TWO TRAININGS/PRESENTATION. THIS GROUP WILL BE INTEGRATED INTO THE PLANNING FOR THE 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENT AS WELL AS THE COMMUNITY SERVICE PLAN."

5. PROMOTION OF COMMUNITY HEALTH
ST. JOHN'S CONTINUES TO ADDRESS THE HEALTH CARE NEEDS OF OUR POPULATIONTHROUGH A VARIETY OF SOURCES. OUR COMMUNITY ADVISORY COMMITTEE IS A KEYFORUM FOR ACCESS TO INFORMATION ON COMMUNITY HEALTH CARE NEEDS ANDRESIDENT SATISFACTION WITH THE HEALTH CARE THAT THEY RECEIVE. ADVISORYMEMBERS ALSO PROVIDE ACCESS TO LOCAL COMMUNITY BASED ORGANIZATIONS ANDBUSINESSES FOR HEALTH PROMOTION. THE HEALTH YONKERS INITIATIVE (HYI) IS A COLLABORATION OF OVER THIRTY COMMUNITY/HEALTH/FAITH-BASED ORGANIZATIONS, BUSINESSES, SCHOOLS AND RESIDENTS, LED BY ST. JOHN'S AND THE CITY OF YONKERS. IT IS AN INTEGRAL COMPONENT OF OUR OUTREACH EFFORTS. THE HYI PARTNERS MEET QUARTERLY, PLAN HEALTH OUTREACH ACTIVITIES, SHARE INFORMATION AND PROVIDE ACCESS TO RESIDENTS AND PLANNED ORGANIZATION COMMUNITY EVENTS. A SPEAKER'S FORUM PROVIDES PHYSICIANS TO EDUCATE ON KEY HEALTH TOPICS IN THE COMMUNITY. FUNDS AVAILABLE THROUGH GRANTS ALSO PROVIDE THE ABILITY TO PROVIDE A HOST OF PREVENTION AND WELLNESS ACTIVITIES. SOME OF OUR KEY ACTIVITIES HAVE ENHANCED HEALTH CARE ACCESS, PROVIDED PATIENT NAVIGATION AND A HOST OF SUPPORT SERVICES FOR OUR PATENTS. OUR COMMUNITY, OUTPATIENT, INPATIENT AND CLINICAL PATIENT NAVIGATION SERVICES PROVIDE COMMUNITY HEALTH EDUCATION, COORDINATE SCREENINGS, DEMYSTIFY TREATMENT OPTIONS, UN-COMPLICATE THE PROCESS FROM DIAGNOSIS TO TREATMENT, FACILITATE SCREENING AND DIAGNOSTIC TEST AND HEALTH AND PSYCHOSOCIAL SUPPORT SERVICES. BARRIERS TO CARE AND ACCESS TO TECHNOLOGICAL ADVANCEMENTS IN TREATING DISEASE ARE CONTINUALLY ADDRESSED FOR THE UNDERINSURED/UNDERSERVED POPULATION. OUR BREAST HEALTH PROGRAM IS DESIGNED TO REDUCE THE RATE OF LATE DIAGNOSIS AMONG MINORITY POPULATIONS, PARTICULARLY AFRICAN AMERICAN, WHO ARE MORE LIKELY TO BE DIAGNOSED AT LATER STAGES. WE COORDINATE CLINICAL BREAST EXAMS THAT LEAD TO MAMMOGRAMS, DIAGNOSTIC SERVICES, DIAGNOSIS AND TREATMENT. FOLLOW-UP SERVICES AND CLINICAL PATIENT NAVIGATION PROVIDED FREE OF CHARGE TO PATIENTS IS AN EXTENSION OF THE HOSPITAL STAY FOR DISCHARGED PATIENTS WHO ARE FREQUENTLY AT RISK FOR READMISSION. TYPICALLY, THESE ARE CHRONICALLY ILL PATIENTS THAT ARE READMITTED BECAUSE OF THEIR UNIQUE FRAILTIES AND LACK OF SUPPORT FOR FOLLOW UP CARE REGIMENT. THEY HAVE LONGER PATIENT STAYS AND SIGNIFICANT AFTERCARE NEEDS. AS A RESULT, PATIENTS WELCOME THE ADDITIONAL CARE AND SUPPORT PROVIDED. GRANT FUNDS ACQUIRED DURING 2020 WERE UTILIZED TO SUPPORT PREVENTION AND HEALTH PROMOTION PROGRAMS AND SUPPORT SERVICES FOR THE COMMUNITY ALSO INCLUDING HIV PREVENTION PROGRAMS (INCLUDING PREP), HEPATITIS C TREATMENT PROGRAMS, EARLY INTERVENTION RELATING TO CANCER SCREENING AND TREATMENT, SUBSTANCE USE TREATMENT PROGRAMS (INCLUDING MEDICATION ASSISTER TREATMENT). IN ADDITION, THE HOSITAL IMPLEMENTED FEDERAL COMMUNICATION COMMISSION FUNDING TO IMPLEMENT TELEHEALTH SERVICES THROUGHOUT THE HOSPITAL SYSTEM IN ORDER TO BETTER DEAL WITH STOPPING THE TRANSMNISSION OF COVID-19 IN OUR COMMUNITY. FINALLY, AS PART OF THE NEW HEALTH EQUITY PROGRAMS, THE HOSPITAL WORKED WITH A COMMUNITY COALITION OF BLACK WOMEN TO ADDRESS HEALTH DISPARITIES IN OUR MATERNITY UNIT. THESE EFFORTS BEGAN IN 2021 AND RESULTED IN SUBMISSION OF A $990,000 GRANT TO SENATOR CHARLES SCHUMER'S OFFICE TO SUPPORT THESE HEALTH EQUITY EFFORTS. THIS GRANT WAS OFFICIALLY AWARDED IN 2022. THE HOSPITAL CONTRIBUTED TO THE COMMUNITY EFFORTS TO FIGHT COVID-19 DURING 2021 BY BEING A MAJOR TESTING HUB, PROVIDING BOTH INPATIENT AND OUTPATIENT TREATMENT, AND PROVIDING VACCINES. 6. AFFILIATED HEALTH CARE SYSTEMST. JOHN'S CONTINUES ITS CLINICAL AFFILIATION TO MONTEFIORE MEDICAL CENTER IN THE BRONX, NEW YORK TO STRENGTHEN ITS MISSION TO PROVIDE A COMPREHENSIVE PROGRAM OF CLINICAL ACCESS AND HEALTH EDUCATION FOR THE ST. JOHN'S COMMUNITY. THE GEOGRAPHICAL PROXIMITY TO MONTEFIORE, SIMILAR DEMOGRAPHICS AND COLLABORATION WITH THEIR TERTIARY CARE PROFESSIONALS, IS AN ASSET TO HEALTH PROMOTION ACTIVITIES AND QUALITY CARE FOR OUR GROWING COMMUNITIES. THE OFFICIAL AFFILIATION OCCURRED IN NOVEMBER OF 2014 AND BOTH ORGANIZATIONS FORMALLY ANNOUNCED THROUGH PRESS RELEASE IN MAY 2015.IN ADDITION, A MEMORANDUM OF UNDERSTANDING HAS BEEN SIGNED TO CREATE A FRAMEWORK FOR AN INTEGRATION BETWEEN SAINT JOHN'S RIVERSIDE HOSPITAL (SJRH) AND SAINT JOSEPH'S MEDICAL CENTER (SJMC) TO BENEFIT BOTH ORGANIZATIONS AND THE COLLECTIVE COMMUNITIES THEY SERVE. THE NEW YORK STATE DEPARTMENT OF HEALTH (DOH) IS DIRECTING SJR AND SJMC LEADERSHIP TO WORK COLLABORATIVELY TO DEVELOP A FINANCIALLY SUSTAINABLE BUSINESS MODEL FOR THE COMBINED ORGANIZATION. INITIAL REPORTS HAVE BEEN DEVELOPED AND WE ARE ACTIVELY ENGAGED WITH THE NYS DOH TO FORMULATE A MUTUALLY BENEFICIAL STRATEGY THAT WILL LEAD TO AN IMPROVED HEALTH CARE DELIVERY SYSTEM FOR THOSE COMMUNITIES WE SERVE AND GREATER FINANCIAL VIABILITY FOR BOTH ORGANIZATIONS. THESE INTEGRATION EFFORTS CONTINUED IN 2021 THROUGH THE SUPPORT OF NY STATE DEPARTMENT OF HEALTH.