4A (Expenses $ 153333473 including grants of $ 0) (Revenue $ 182113435)
NORTHERN DUTCHESS HOSPITAL IS AN 84-BED, NONPROFIT HOSPITAL IN PICTURESQUE RHINEBECK, NY. PATIENTS HAVE ACCESS TO QUALITY, CLOSE-TO-HOME CARE FROM CANCER AND HEART DISEASE PREVENTION TO BARIATRIC SURGERY AND HEALTH AGING SERVICES. NORTHERN DUTCHESS HOSPITAL HAS BUILT A REPUTATION AND ARE LEADERS IN THE HUDSON VALLEY FOR MATERNITY AND ORTHOPEDIC EXCELLENCE. NORTHERN DUTCHESS HOSPITAL IS PART OF NUVANCE HEALTH, WHICH IS A SIX-HOSPITAL SYSTEM, ON 7 CAMPUSES, WITH NUMEROUS OUTPATIENT FACILITIES THROUGHOUT THE HUDSON VALLEY AND ACROSS WESTERN CONNECTICUT. THE NUVANCE HEALTH SYSTEM GIVES THE COMMUNITY ACCESS TO A VARIETY OF SERVICES INCLUDING, BUT NOT LIMITED TO, BARIATRIC SURGERY AND MEDICAL WEIGHT LOSS, BLOOD DRAW, CRITICAL CARE, DIABETES EDUCATION, EMERGENCY SERVICES, HEART AND VASCULAR, IMAGING AND RADIOLOGY, INFUSION THERAPY, NEUROLOGY AND NEUROSURGERY, ORTHOPEDIC CARE, PHYSICAL REHABILITATION, PRIMARY CARE, RHEUMATOLOGY, SLEEP DISORDERS, URGENT CARE, WOMEN'S HEALTH, BEHAVIORAL HEALTH, CANCER CARE, DENTISTRY, DIGESTIVE HEALTH, ENDOCRINOLOGY, GENETIC COUNSELING, HOME HEALTH CARE, INFECTIOUS DISEASE, KIDNEY DISEASE AND NEPHROLOGY, OCCUPATIONAL MEDICINE, PATIENT BLOOD MANAGEMENTS AND BLOODLESS MEDICINE, PEDIATRICS, PODIATRY, PULMONARY CARE, SENIOR CARE AND GERIATRIC MEDICINE, SURGICAL SERVICES, UROLOGY, WOUND CARE AND HYPERBARIC MEDICINE. OUR TEAMS INCLUDE TOP MEDICAL AND SURGICAL TALENT, AND WE INVEST IN TECHNOLOGY AND COLLABORATE WITH LEADING DOCTORS AND SCIENTISTS TO BRING TOP-NOTCH SERVICES TO THE REGION. NORTHERN DUTCHESS HOSPITAL IS COMMITTED TO PROVIDING QUALITY SERVICE TO THE COMMUNITY AND HAS BEEN RECOGNIZED BY SEVERAL ORGANIZATIONS FOR THE QUALITY HEALTHCARE THAT IT PROVIDES TO THE REGION. NORTHERN DUTCHESS HOSPITAL IS JOINT COMMISSION ACCREDITED WITH A GOLD SEAL OF DISTINCTION IN BOTH TOTAL JOINT KNEE REPLACEMENT AND TOTAL JOINT HIP REPLACEMENT. THE HOSPITAL HAS BEEN RECOGNIZED AS BEST REGIONAL HOSPITAL FOR EXCELLENCE BY U.S. NEWS & WORLD REPORT FOR THEIR HIGH PERFORMANCE IN HIP FRACTURE, KNEE REPLACEMENT, HIP REPLACEMENT AND COPD TREATMENT. HEALTHGRADES HAS AWARDED THE HOSPITAL MULTIPLE RECOGNITIONS SUCH AS FIVE-STAR RECIPIENT FOR TREATMENT OF SEPSIS, FIVE-STAR RECIPIENT FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, JOINT REPLACEMENT EXCELLENCE AWARD, AND FOR THE LAST 6 YEARS IN A ROW THE FIVE-START RECIPIENT FOR TOTAL HIP REPLACEMENT, AS WELL AS FIVE-STAR RECIPIENT FOR TOTAL KNEE REPLACEMENT FOR THE LAST 15 YEARS IN A ROW. ADDITIONAL RECOGNITIONS INCLUDE A FIVE-STAR RATING FROM CENTERS FOR MEDICARE & MEDICAID SERVICES, NATIONAL DIABETES PREVENTION PROGRAM FULL PLUS RECOGNITION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION, DESIGNATED PRIMARY STROKE CENTER FROM NEW YORK STATE DEPARTMENT OF HEALTH, MBSAQIP ACCREDITED BARIATRIC CENTER BY THE AMERICAN COLLEGE OF SURGEONS AND AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY, RECEIVED THE GET WITH THE GUIDELINES STROKE GOLD PLUS FROM THE AMERICAN HEART ASSOCIATION, AND RECEIVED THE 2022 VIZIENT BERNARD A. BIRNBAUM QUALITY AND ACCOUNTABILITY AWARD. NORTHERN DUTCHESS HOSPITAL HAS ALSO RECENTLY BEEN DESIGNATED BY THE SURGICAL REVIEW CORPORATION AS A ROBOTIC CENTER OF EXCELLENCE. IN FY22, NORTHERN DUTCHESS HOSPITAL HAD 23,269 PATIENT DAYS AND 6,227 DISCHARGES IN ACUTE CARE. THERE WERE 21,845 IN EMERGENCY ROOM VISITS AND 68,458 IN OTHER OUTPATIENT VISITS/PROCEDURES. THE HOSPITAL PROVIDED APPROXIMATELY $2.9M IN CHARITY CARE TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - Northern Dutchess Hospital. EVERY THREE YEARS, THE NEW YORK STATE (NYS) DEPARTMENT OF HEALTH (DOH) REQUIRES LOCAL HEALTH DEPARTMENTS (LHD) TO SUBMIT COMMUNITY HEALTH ASSESSMENTS (CHA) AND HOSPITALS TO SUBMIT COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA). LHDS AND HOSPITALS COLLABORATE WITH COMMUNITY PARTNERS AND RESIDENTS TO CREATE COMMUNITY HEALTH IMPROVEMENT PLANS (CHIP) AND COMMUNITY SERVICE PLANS (CSP), RESPECTIVELY. THESE ASSESSMENTS AND PLANS ARE MEANT TO MEET SEVERAL REQUIREMENTS FROM NYS PUBLIC HEALTH LAW AND THE AFFORDABLE CARE ACT. IN RECENT YEARS, THE NYSDOH HAS ENCOURAGED LHDS AND HOSPITALS TO COLLABORATE IN THE CREATION OF THESE DOCUMENTS TO BETTER SERVE THEIR COMMUNITIES. IN 2017, THE SEVEN LHDS OF THE MID-HUDSON REGION (M-H REGION), INCLUDING DUTCHESS, ORANGE, PUTNAM, ROCKLAND, SULLIVAN, ULSTER, AND WESTCHESTER COUNTIES, CREATED THE LOCAL HEALTH DEPARTMENT PREVENTION AGENDA COLLABORATIVE WITH THE GOAL OF CONDUCTING REGIONAL RESIDENT AND PROVIDER SURVEYS, CREATING A REGIONAL CHA, AND COLLABORATING ON COMMON CHIP PRIORITIES. THIS REGIONAL APPROACH WAS CONTINUED FOR THE 2022 CHA, CHIP, AND CSP CYCLE, WITH THE COLLABORATIVE BEING RENAMED THE HUDSON VALLEY PUBLIC HEALTH COLLABORATIVE (HVPHC). A CHA DEPICTS A COMPREHENSIVE REVIEW OF A COMMUNITY'S CURRENT HEALTH STATUS, FACTORS CONTRIBUTING TO HIGHER HEALTH RISKS OR POORER HEALTH OUTCOMES, AND COMMUNITY RESOURCES AVAILABLE TO IMPROVE HEALTH. WHEN CONDUCTING THE REGIONAL CHA, THE HVPHC GATHERS DATA AND INFORMATION FROM AS MANY SOURCES AS POSSIBLE SO THAT A COMPREHENSIVE ASSESSMENT CAN BE COMPLETED. THE CHA CAN THEN INFORM THE COMMUNITY TO MAKE DECISIONS AND DEVELOP PLANS TO IMPROVE THE HEALTH OF THE REGION. THE LHDS CONTRACTED WITH SIENA COLLEGE RESEARCH INSTITUTE (SCRI) TO CONDUCT A REGIONAL COMMUNITY HEALTH SURVEY AS A COMPONENT OF THE REGIONAL CHA. SCRI, ON BEHALF OF THE SEVEN LOCAL HEALTH DEPARTMENTS (LHDS) OF THE MID-HUDSON REGION, CONDUCTED A PUBLIC OPINION SURVEY OF RESIDENTS FROM MARCH 14, 2022, TO MAY 22, 2022. RESPONDENTS WERE CONTACTED VIA LANDLINE TELEPHONE, CELL PHONE, AN ONLINE PANEL, AND ONLINE RECRUITMENT FROM EACH COUNTY AT VARIOUS IN-PERSON EVENTS AND OTHER COMMUNITY PARTNERSHIPS TO ENHANCE REPRESENTATION AND MEET BUDGET CONSTRAINTS. THE DESIGN OF THE LANDLINE SAMPLE WAS CONDUCTED TO ENSURE THE SELECTION OF BOTH LISTED AND UNLISTED TELEPHONE NUMBERS, USING RANDOM DIGIT DIALING (RDD). THE CELL PHONE SAMPLE WAS DRAWN FROM A SAMPLE OF DEDICATED WIRELESS TELEPHONE EXCHANGES FROM WITHIN EACH OF THE COUNTIES. RESPONDENTS WERE SCREENED FOR RESIDENCE IN NYS AND SPECIFIED COUNTIES. DATA FROM ALL FOUR SOURCES WERE COMBINED AND WEIGHTED AS ONE UNIVERSE TO PROVIDE A REPRESENTATIVE SAMPLE OF MID-HUDSON REGION RESIDENTS. TO FURTHER SUPPLEMENT THE DATA COLLECTED, MEMBERS OF THE HVPHC HELD FOCUS GROUPS AND CONDUCTED A SURVEY OF COMMUNITY PARTNERS TO UNDERSTAND THE NEEDS OF SPECIFIC COMMUNITIES AND POPULATIONS AND THE BARRIERS THEY FACE TO ACHIEVING OPTIMAL HEALTH. ALONG WITH THE PRIMARY DATA COLLECTED THROUGH THE SURVEYS AND FOCUS GROUPS, SECONDARY DATA WERE COMPILED TO DISPLAY HEALTH INDICATORS FOR THE M-H REGION. EACH HEALTH INDICATOR WAS NARRATED TO CONTEXTUALIZE THE DATA AND OUTLINE HOW EACH INDICATOR RELATES. THE REGIONAL COMMUNITY HEALTH ASSESSMENT WAS WRITTEN BY THE HVPHC AND IS INTENDED TO SERVE AS A REFERENCE FOR KEY HEALTH INFORMATION FOR ALL STAKEHOLDERS WITHIN THE MID-HUDSON REGION AND ASSIST THEM IN IDENTIFYING AND PRIORITIZING THE HEALTH NEEDS OF THE REGION AND ITS COMMUNITIES. AN ADDITIONAL GOAL OF THIS PROJECT IS TO INITIATE COLLABORATION TO ADDRESS KEY HEALTH ISSUES IN THE REGION AND TO INFORM THE CHIPS OF EACH COUNTY AND THE CSPS OF NON-PROFIT 501(C)(3) HOSPITALS. IN ADDITION TO THE SIENA COLLEGE RESEARCH INSTITUTE COMMUNITY SURVEY, NUVANCE HEALTH PARTICIPATED IN THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) 2022 CHNA SURVEY OF ADULTS AGED 18 OR OLDER WHO LIVE IN A ZIP CODE OR COUNTY SERVED BY THE HOSPITAL. THE SURVEY WAS INTENDED TO GARNER RESIDENT INPUT ON COMMUNITY HEALTH PRIORITIES BASED ON PERCEIVED IMPORTANCE AND SATISFACTION. THE SURVEY USED A NON-PROBABILITY CONVENIENCE SAMPLE. A WEB-BASED SURVEY TOOL AND A PAPER-BASED TOOLS WERE USED TO COLLECT THE SURVEY DATA FROM APRIL 11, 2022, THROUGH JUNE 30, 2022. SURVEYS WERE AVAILABLE IN ELEVEN LANGUAGES - ENGLISH, SPANISH, CHINESE, RUSSIAN, YIDDISH, BENGALI, KOREAN, HAITIAN CREOLE, ITALIAN, ARABIC, AND POLISH. A DETAILED OUTLINE OF COMMUNITY RESPONSES CAN BE FOUND IN THE COMMUNITY SERVICE PLAN LOCATED AT WWW.NUVANCEHEALTH.ORG/COMMUNITY.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - Northern Dutchess Hospital. THE MID-HUDSON REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DOCUMENT WAS CREATED THROUGH A COLLABORATIVE PARTNERSHIP BETWEEN THE FOLLOWING ORGANIZATIONS: BLYTHEDALE CHILDREN'S HOSPITAL; BON SECOURS CHARITY HEALTH SYSTEM, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; BURKE REHABILITAION CENTER, ELLENVILLE REGIONAL HOSPITAL, GARNET HEALTH; HEALTHALLIANCE HOSPITAL, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; MONTEFIORE MOUNT VERNON HOSPITAL; MONTEFIORE NEW ROCHELLE HOSPITAL; MONTEFIORE NYACK HOSPITAL; MONTEFIORE ST. LUKE'S CORNWALL; NEW YORK PRESBYTERIAN HUDSON VALLEY AND LAWENCE HOSITALS; NORTHERN WESTCHESTER HOSPITAL; PHELPS HOSPITAL; ST. JOSEPH'S MEDICAL CENTER; ST. JOHN'S RIVERSIDE HOSPITAL; WESTCHESTER MEDICAL CENTER; WHITE PLAINS HOSPITAL AND THE HOSPITALS OF NUVANCE HEALTH.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - Northern Dutchess Hospital. NUVANCE HEALTH PARTICIPATED IN THE MID-HUDSON REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), LED BY SEVEN HEALTH DEPARTMENTS AND AREA HEALTH SYSTEMS. THE HEALTH DEPARTMENTS INCLUDED: DUTCHESS COUNTY DEPARTMENT OF BEHAVIORAL & COMMUNITY HEALTH; ORANGE COUNTY DEPARTMENT OF HEALTH; PUTNAM COUNTY DEPARTMENT OF HEALTH; ROCKLAND COUNTY DEPARTMENT OF HEALTH; SULLIVAN COUNTY PUBLIC HEALTH SERVICES; ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH; AND WESTCHESTER COUNTY DEPARTMENT OF HEALTH.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - Northern Dutchess Hospital. THE CHNA IS AVAILABLE UPON REQUEST IN THE HOSPITAL AND NUVANCE HEALTH ADMINISTRATIVE OFFICES. THE CHNA WAS SHARED WITH THE HOSPITAL BOARD AND THE COMMUNITY HEALTH COMMITTEE FOR ADDITIONAL DISTRIBUTION THROUGHOUT THEIR NETWORKS.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - Northern Dutchess Hospital. TO WORK TOWARD HEALTH EQUITY, NUVANCE HEALTH COMMITS TO ENSURING HOSPITAL RESOURCES AND ACTIVITIES BUILD UPON EXISTING PRIORITIES AND COLLABORATIVE ACTIVITIES, WHILE ENSURING RESPONSIVENESS TO EMERGENT NEEDS. DETERMINATION OF PRIORITIES MADE BY LEADERSHIP OF NUVANCE HEALTH INCLUDED REVIEW OF EXISTING COMMITMENTS, NEW RESEARCH FINDINGS, AND COMMUNITY FEEDBACK. NUVANCE HEALTH WILL FOCUS EFFORTS ON THE FOLLOWING COMMUNITY HEALTH PRIORITIES AS PART OF ITS 2022- 2024 COMMUNITY SERVICE PLAN (CSP): PREVENT CHRONIC DISEASES AND PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. NUVANCE HEALTH IS COMMITTED TO CONTINUING ITS COLLABORATION WITH THE COMMUNITY HEALTH COMMITTEES AND OTHER STAKEHOLDERS TO FURTHER REFINE FOCUS AREAS WITHIN THE IDENTIFIED HEALTH PRIORITIES. TOGETHER WITH THESE PARTNERS AND STAKEHOLDERS, NUVANCE HEALTH CREATED A CSP THAT REFLECTS COLLECTIVE HEALTH IMPACT STRATEGY AND THE MANY STRENGTHS AND ASSETS OF OUR COMMUNITY PARTNERS TO ADDRESS THESE NEEDS. THE IDENTIFIED PRIORITIES ALIGN WITH AND ADVANCE THE NEW YORK STATE PREVENTION AGENDA. IN ACCORDANCE WITH THE PREVENTION AGENDA, THE NUVANCE HEALTH 2022-2024 CSP WILL PRIORITIZE EVIDENCE-BASED STRATEGIES TO ADDRESS DISPARITIES AND PROMOTE OPTIMAL HEALTH IMPROVEMENT OUTCOMES. KEY INITIATIVES FOR NORTHERN DUTCHESS HOSPITAL INCLUDE: * PUBLIC LIBRARY HYPERTENSION PROGRAM IN PARTNERSHIP WITH AHA TO CONDUCT HYPERTENSION EDUCATION AND SCREENING * OBESITY PREVENTION PROGRAM INCLUDING COMMUNITY SUPPORT GROUPS, WEEKLY EDUCATION PROGRAMS, AND NON-SURGICAL TREATMENT PROGRAM * LIFETIME LEARNING SPEAKER SERIES WITH LOCAL COLLEGE TO ADDRESS HEALTH AND WELL-BEING, HEART HEALTH, OBESITY * GET FIT PROGRAM * CDC'S DIABETES PREVENTION PROGRAM * NUVANCE HEALTH'S CENTER FOR HEALTHY AGING CAREGIVER SUPPORT PROGRAM * IMPLEMENTATION OF NUVANCE HEALTH SENIOR CARE TEAM TO INCREASE ACCESS AND MEET SDOH NEEDS OF COMMUNITY MEMBERS SEEKING CARE AT THE EMERGENCY DEPARTMENT * MENTAL HEALTH FIRST AID TRAINING * IMPLEMENT CONTROLLED SUBSTANCE AGREEMENT WITH PATIENTS IN PRIMARY CARE AREAS * PARTNER WITH LOCAL HEALTH DEPARTMENT PUBLIC EDUCATION COORDINATORS TO PROVIDE NARCAN TRAINING AND NARCAN KITS TO BE DISTRIBUTED TO THE COMMUNITY * PARTICIPATE IN PRESCRIPTION TAKE BACK EFFORTS IN PARTNERSHIP WITH DUTCHESS COUNTY HEALTH DEPARTMENT, LOCAL DEA, AND LAW ENFORCEMENT THE HOSPITAL ALSO PROVIDES A NUMBER OF ADDITIONAL COMMUNITY PROGRAMS THROUGHOUT THE YEAR IN OTHER AREAS THEY IDENTIFIED SUCH AS CHILDBIRTH AND SIBLING EDUCATION FOR EXPECTANT FAMILIES, NO COST CAR SEAT SAFETY CHECKS AND FREE REPLACEMENTS, COMPLIMENTARY CPR CLASSES, SUPPORT GROUPS AND EDUCATIONAL LECTURES. TO IMPROVE HEALTH DISPARITIES, IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES FOR MEANINGFUL COMMUNITY IMPACT. THROUGH THE CHNA RESEARCH AND ONGOING ENGAGEMENT OF COMMUNITY REPRESENTATIVES, NUVANCE HEALTH COLLECTED INPUT TO DETERMINE THE MOST PRESSING HEALTH NEEDS AFFECTING RESIDENTS IN THE NEW YORK SERVICE AREA. PRIORITY HEALTH NEEDS WERE DETERMINED THROUGH DISCUSSIONS WITH EACH HOSPITAL'S COMMUNITY HEALTH COMMITTEE AND INPUT FROM COMMUNITY STAKEHOLDERS INCLUDING PUBLIC HEALTH EXPERTS, HEALTH AND HUMAN SERVICE PROVIDERS, REPRESENTATIVES OF UNDERSERVED POPULATIONS, AND COMMUNITY MEMBERS. NUVANCE HEALTH REVIEWED RECOMMENDATIONS FOR PRIORITY AREAS IN CONSIDERATION WITH EXISTING RESOURCES AND GAPS IN SERVICES TO DETERMINE WHICH COMMUNITY HEALTH PRIORITIES THE HOSPITALS COULD BEST IMPACT. IN DETERMINING PRIORITY AREAS, SOME HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA WILL NOT BE DIRECTLY ADDRESSED IN NUVANCE HEALTH'S CHIP, HOWEVER THESE NEEDS WILL CONTINUE TO BE MET THROUGH CLINICAL CARE SERVICES. THESE ISSUES INCLUDE SEXUALLY TRANSMITTED INFECTIONS (STIS), IMMUNIZATIONS, TICKBORNE DISEASE, AND HARMFUL ALGAL BLOOMS. IN ADDITION TO CLINICAL CARE SERVICES, NUVANCE HEALTH WILL CONTINUE TO SUPPORT COMMUNITY WIDE EFFORTS TO RAISE AWARENESS FOR PREVENTIVE HEALTH MEASURES AND SUPPORT REGIONAL ORGANIZATIONS THAT FOCUS ON THESE ISSUES. NORTHERN DUTCHESS HOSPITAL'S COMMUNITY HEALTH NEEDS COMMITTEES MEETS ON A REGULAR BASIS TO VIEW PROGRESS TOWARD THE GOALS STATED THE COMMUNITY SERVICE PLAN AND DETERMINE IF ANY CHANGES TO OBJECTIVES ARE REQUIRED. ADDITIONALLY, NUVANCE HEALTH COMPILES DATA ON EACH IMPLEMENTATION AREA AND REPORTS IT TO THE NEW YORK STATE DEPARTMENT OF HEALTH ON AN ANNUAL BASIS.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - NORTHERN DUTCHESS HOSPITAL. THE FAP INDICATES A 75% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN 301% AND 350% OF THE FPG AND A 54.69% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN 351% AND 400% OF THE FPG.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - Northern Dutchess Hospital. A PATIENT MAY QUALIFY FOR ""MEDICAL HARDSHIP"" EVEN IF THEIR INCOME EXCEEDS 400% OF THE FPG. A PATIENT'S UNPAID MEDICAL DEBT IS FACTORED IN WHEN DETERMINING MEDICAL HARDSHIP."

Schedule H, Part V, Section B, Line 16 Facility , 1
Facility , 1 - Northern Dutchess Hospital. NORTHERN DUTCHESS HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. COUNSELORS ARE ALSO AVAILABLE TO PROVIDE FURTHER ASSISTANCE.

Schedule H, Part I, Line 3c factors other than FPG in determining eligibility
ASSETS ARE FACTORED IN FOR PATIENTS WHOSE INCOME IS ABOVE 400% OF THE FEDERAL POVERTY GUIDELINES WHEN FACED WITH MEDICAL HARDSHIPS. MEDICAL HARDSHIP COMBINES AVAILABLE INCOME WITH COUNTABLE ASSETS AND IS GRANTED WHEN THE UNPAID MEDICAL BILLS EXCEED THIS FIGURE.

Schedule H, Part I, Line 7 CHARITY CARE AT COST PERCENTAGE
A COST TO CHARGE RATIO WAS CALCULATED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, AND USED TO DETERMINE FINANCIAL ASSISTANCE AT COST. COST ACCOUNTING WAS USED TO DETERMINE MEDICARE COST, MEDICAID COST, AND THE COST FOR SUBSIDIZED HEALTH SERVICES.

Schedule H, Part I, Line 7e Community health improvement services and community benefit operations
NORTHERN DUTCHESS HOSPITAL PROVIDED COMMUNITY BENEFIT THROUGH VARIOUS PROGRAMS, GRANTS/SPONSORSHIPS AND EVENTS THAT WERE MADE AVAILABLE TO THE COMMUNITY AT LARGE. BELOW IS A LIST OF SOME OF THE PROGRAMS OFFERED/Supported. *ADDRESSING GENERAL HEALTH AND WELLNESS THROUGH HEALTH FAIRS *ADDRESSING CANCER THROUGH BREAST CANCER SCREENINGS, ARTICLES ON NUVANCE HEALTHLINE AND SOCIAL MEDIA POSTS. MANY LECTURES WERE HELD VIA OUR HOSPITALS' SOCIAL MEDIA CHANNELS. NUVANCE HEALTH ALSO PROMOTED EDUCATIONAL VIDEOS. *ADDRESSING HEART DISEASE THROUGH EDUCATION AND LECTURE CHANNELS *ADDRESSING INFECTIOUS DISEASE THROUGH COVID-19 AND FLU VACCINATION CLINICS *ADDRESSING OBESITY AND HEALTHY WEIGHT THROUGH THE GET FIT CHALLENGE. *PROVIDING SUPPORT GROUPS *SENIORS HEALTH AND WELLNESS VIA OUTREACH AND EDUCATION GRANTS AND IN-KIND SUPPORT WERE PROVIDED TO THE FOLLOWING ORGANIZATIONS: * ALZHEIMER'S ASSOCIATION * AMERICAN CANCER SOCIETY * AMERICAN HEART ASSOCIATION * AMERICAN LUNG ASSOCIATION * AMERICAN RED CROSS * CYSTIC FIBROSIS NY STATE CHAPTER * HUDSON VALLEY HOSPICE * LEGAL SERVICES OF THE HUDSON VALLEY * MENDED HEARTS OF THE HUDSON VALLEY * MILES OF HOPE BREAST CANCER FOUNDATION * REGIONAL FOOD BANK OF NE NY AND FOOD BANK OF THE HUDSON VALLEY * SPARROW'S NEST OF THE HUDSON VALLEY * SUN RIVER HEALTH * UNITED WAY

Schedule H, Part I, Line 7g Subsidized health services
THE AMOUNTS REPORTED AS SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE PHYSICIAN CLINIC COSTS.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
NDH FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN ITS RECOGNITION OF BAD DEBT EXPENSE. PATIENT ACCOUNT BALANCES WERE ONLY CONSIDERED FOR BAD DEBT AFTER APPLYING ALL CONTRACTUAL DISCOUNTS AND PAYMENTS, AND SCREENING FOR CHARITY ELIGIBILITY.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
NDH DOES RECOGNIZE THAT THERE WAS SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WERE ELIGIBLE UNDER THE ORGANIZATION'S CHARITY POLICY. WE DID NOT HAVE A REASONABLE BASIS FOR ESTIMATING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PATIENTS WHO WERE ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY WERE ACCOUNTED FOR UNDER CHARITY CARE RATHER THAN BAD DEBT.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
FOOTNOTE ON AUDITED FINANCIALS THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 21-26 OF NUVANCE HEALTH AND SUBSIDIARIES CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE IN EXCESS OF THE COMPANY'S COSTS FOR THE PATIENTS IN THE COMMUNITY. THE COSTING METHODOLOGY USED TO CALCULATE THE SHORTFALL WAS THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
"IT IS THE POLICY OF NORTHERN DUTCHESS HOSPITAL TO PROVIDE ""FINANCIAL ASSISTANCE"" (EITHER FREE CARE OR REDUCED PATIENT OBLIGATIONS) TO PERSONS OR FAMILIES WHERE: (I) THERE IS LIMITED OR NO HEALTH INSURANCE AVAILABLE; (II) THE PATIENT FAILS TO QUALIFY FOR GOVERNMENTAL ASSISTANCE (FOR EXAMPLE MEDICARE OR MEDICAID); (III) THE PATIENT COOPERATES WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION; (IV) THE PATIENT DEMONSTRATES FINANCIAL NEED; AND (V) NORTHERN DUTCHESS HOSPITAL MAKES AN ADMINISTRATIVE DETERMINATION THAT FINANCIAL ASSISTANCE IS APPROPRIATE. AFTER THE HOSPITAL DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE AVAILABLE TO THE PATIENT BY UTILIZING THE CHARITABLE ASSISTANCE GUIDELINES, WHICH ARE BASED UPON THE MOST RECENT FEDERAL POVERTY GUIDELINES. NORTHERN DUTCHESS HOSPITAL SHALL REGULARLY REVIEW THIS FINANCIAL ASSISTANCE POLICY TO ENSURE THAT AT ALL TIMES IT: (I) REFLECTS THE PHILOSOPHY AND MISSION OF THE HOSPITAL; (II) EXPLAINS THE DECISION PROCESSES OF WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND IN WHAT AMOUNTS; AND (III) COMPLIES WITH ALL APPLICABLE STATE AND FEDERAL LAWS, RULES, AND REGULATIONS CONCERNING THE PROVISION OF FINANCIAL ASSISTANCE TO INDIGENT PATIENTS. CONSISTENT WITH THIS MISSION, NORTHERN DUTCHESS HOSPITAL RECOGNIZES ITS OBLIGATION TO THE COMMUNITY IT SERVES TO PROVIDE FINANCIAL ASSISTANCE TO INDIGENT PERSONS WITHIN THE COMMUNITY. IN FURTHERANCE OF ITS CHARITABLE MISSION, NORTHERN DUTCHESS HOSPITAL WILL PROVIDE BOTH (I) EMERGENCY TREATMENT TO ANY PERSON REQUIRING SUCH CARE; AND (II) ESSENTIAL, NON-EMERGENT CARE TO PATIENTS WHO ARE PERMANENT RESIDENTS OF ITS PRIMARY SERVICE AREA WHO MEET THE CONDITIONS AND CRITERIA SET FORTH IN THIS POLICY, WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SUCH CARE. ELECTIVE PROCEDURES GENERALLY WILL NOT BE CONSIDERED ESSENTIAL, NON-EMERGENT CARE AND USUALLY WILL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. NORTHERN DUTCHESS HOSPITAL WILL COLLECT FROM INDIVIDUALS ON FINANCIAL ASSISTANCE IF THEY RECEIVED A PARTIAL CHARITABLE DISCOUNT. ALL PATIENTS CAN APPLY FOR CHARITABLE CARE ON BALANCES THEY FEEL THAT THEY CANNOT AFFORD."

Schedule H, Part V, Section B, Line 16a FAP website
- NORTHERN DUTCHESS HOSPITAL: Line 16a URL: HTTPS://WWW.NUVANCEHEALTH.ORG/FINANCIALASSISTANCE;

Schedule H, Part V, Section B, Line 16b FAP Application website
- NORTHERN DUTCHESS HOSPITAL: Line 16b URL: HTTPS://WWW.NUVANCEHEALTH.ORG/FINANCIALASSISTANCE;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- NORTHERN DUTCHESS HOSPITAL: Line 16c URL: HTTPS://WWW.NUVANCEHEALTH.ORG/FINANCIALASSISTANCE;

Schedule H, Part VI, Line 2 Needs assessment
IN ADDITION TO THE CHNAS CONDUCTED EVERY THREE YEARS, THE HOSPITAL HAS A COMMUNITY HEALTH NEEDS COMMITTEE THAT MEETS REGULARLY TO ASSESS ANY ADDITIONAL HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMITTEE PROVIDES OVERSIGHT TO THE HOSPITAL'S COMMUNITY HEALTH PRIORITIES, INCLUDING NEEDS ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS AND OTHER POPULATION HEALTH INITIATIVES. THEY HELP GUIDE PRIORITY ISSUES FOR ACTION TO IMPROVE COMMUNITY HEALTH AND HELP INFORM, GUIDE AND SHARE SUCCESSFUL PROGRAMS AND STRATEGIES THAT ADDRESS HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY.

Schedule H, Part VI, Line 7 State filing of community benefit report
CT, NY

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
THE HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. ALSO, SIGNS ARE POSTED THROUGHOUT THE HOSPITAL AND COUNSELORS ARE AVAILABLE TO PROVIDE FURTHER ASSISTANCE. ALL UNINSURED INPATIENTS ARE INTERVIEWED BY FINANCIAL COUNSELORS AND ASSESSED FOR ELIGIBILITY FOR ASSISTANCE PROGRAMS. THE HOSPITAL PROVIDES INFORMATIONAL HANDOUTS TO ALL UNINSURED PATIENTS AT THE TIME OF REGISTRATION WHICH REFERS THEM TO FINANCIAL COUNSELING IF THEY WOULD LIKE ASSISTANCE WITH THEIR BILLS. FURTHER, THE HOSPITAL MAILS NOTICES TO ALL SELF-PAY ACCOUNTS REFERRING THEM TO FINANCIAL COUNSELING IF THEY NEED ASSISTANCE. THE COLLECTION DEPARTMENT WILL ALSO REFER PATIENTS TO FINANCIAL COUNSELING WHEN A PATIENT INDICATES THAT THEY CANNOT AFFORD THEIR BALANCES; AND FINALLY, SCHEDULERS REFER UNINSURED PATIENTS TO FINANCIAL COUNSELING PRIOR TO THEIR TEST OR PROCEDURE. THE POLICY AND APPLICATIONS FOR ASSISTANCE ARE ALSO AVAILABLE ONLINE, AS WELL AS UPON REQUEST AT THE HOSPITAL.

Schedule H, Part VI, Line 4 Community information
NORTHERN DUTCHESS HOSPITAL (NDH) IS LOCATED IN RHINEBECK, NEW YORK IN DUTCHESS COUNTY. THE HOSPITAL PRIMARILY SERVES RESIDENTS OF 25 ZIP CODES ALONG THE HUDSON RIVER, STRETCHING FROM CATSKILL IN THE NORTH TO HYDE PARK IN THE SOUTH. THE NDH SERVICE AREA POPULATION IS PROJECTED TO INCREASE +6,615 PEOPLE OR 4.4% FROM 2022 TO 2027, ALTHOUGH CONSISTENT WITH NEW YORK STATE TRENDS, THIS GROWTH WILL OCCUR LARGELY AMONG OLDER ADULT POPULATIONS. THE POPULATION AGED 65 OR OLDER WILL INCREASE BY +5,520 PEOPLE OR 15% FROM 2022 TO 2027, WHILE THE CHILD POPULATION UNDER AGE 18 WILL INCREASE BY +14 PEOPLE OR 0.1%. THE NDH SERVICE AREA IS LESS RACIALLY AND ETHNICALLY DIVERSE THAN NEW YORK OVERALL, ALTHOUGH CONSISTENT WITH STATEWIDE TRENDS, PEOPLE OF COLOR ARE THE FASTEST GROWING POPULATIONS WITHIN THE SERVICE AREA. BETWEEN 2022 AND 2027, THE WHITE POPULATION WITHIN THE NDH SERVICE AREA IS PROJECTED TO GROW 1.9%, WHILE ALL OTHER RACIAL AND ETHNIC GROUPS ARE PROJECTED TO GROW 10.9% OR MORE. THE ASIAN POPULATION IS PROJECTED TO BE ONE OF THE FASTEST GROWING DEMOGRAPHICS AT +11.8%. ACCORDING TO THE U.S. BUREAU OF LABOR STATISTICS, THE DUTCHESS COUNTY/PUTNAM COUNTY REGION HAD AN UNEMPLOYMENT RATE OF 4.8% IN DECEMBER OF 2022. APPROXIMATELY 9.7% OF THE POPULATION IN DUCHESS COUNTY ARE LIVING IN POVERTY (CENSUS.GOV). APPROXIMATELY 4% OF NDH'S MARKET ARE UNINSURED, WHILE MEDICAID (27%), MEDICARE (26%) AND PRIVATE DIRECT OR EXCHANGE MAKE UP THE REST OF THE MARKET (43%). (SOURCE: THE CLARITAS COMPANY). ACCORDING TO THE HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA.GOV), BOTH THE EASTERN PART OF DUTCHESS COUNTY AND POUGHKEEPSIE HAVE BEEN IDENTIFIED AS MEDICALLY UNDERSERVED POPULATIONS (MUP) FOR PRIMARY CARE FOR LOW INCOME POPULATIONS.

Schedule H, Part VI, Line 5 Promotion of community health
NORTHERN DUTCHESS HOSPITAL IS AN 84-BED, NONPROFIT HOSPITAL IN PICTURESQUE RHINEBECK, NY, OFFERING QUALITY, CLOSE-TO-HOME CARE. THE HOSPITAL OFFERS A VARIETY OF SERVICES, FROM CANCER AND HEART DISEASE PREVENTION TO BARIATRIC SURGERY AND HEALTHY AGING SERVICES. KNOWN FOR OUR WARM AND WELCOMING ATMOSPHERE, THE STAFF TREAT PATIENTS LIKE NEIGHBORS, USE THE LATEST TECHNOLOGIES AND PROVIDE AWARD-WINNING CARE FOR A WIDE RANGE OF MEDICAL CONDITIONS. FOR MORE THAN A CENTURY, NORTHERN DUTCHESS HOSPITAL HAS BUILT A REPUTATION AS A LEADER IN THE HUDSON VALLEY FOR MATERNITY AND ORTHOPEDIC EXCELLENCE. WE ARE PART OF NUVANCE HEALTH, A NETWORK OF SEVEN COMMUNITY HOSPITAL LOCATIONS AND NUMEROUS OUTPATIENT FACILITIES THROUGHOUT THE HUDSON VALLEY AND ACROSS WESTERN CONNECTICUT. OUR PATIENTS BENEFIT FROM THE VARIOUS SERVICES AND MULTISPECIALTY GROUPS ACROSS THE HEALTH SYSTEM. FEATURED SERVICES INCLUDE A CANCER INSTITUTE, HEART AND VASCULAR INSTITUTE, NEUROSCIENCES INSTITUTE, AND OUR DIGESTIVE HEALTH INSTITUTE. FEATURED SERVICE LINES INCLUDE MATERNAL AND INFANT CARE, BARIATRIC SURGERY AND MEDICAL WEIGHT LOSS AND BREAST HEALTH. NORTHERN DUTCHESS HOSPITAL ALSO OFFERS: * PRIMARY CARE * WOUND CARE AND HYPERBARIC OXYGEN THERAPY * WOMEN'S HEALTH * ORTHOPEDIC SERVICES OUR EFFORT TO IMPROVE THE HEALTH OF OUR COMMUNITITES IS A LONG-TERM AND VERY COLLABORATIVE ONE TO ADDRESS PUBLIC HEALTH ISSUES AND OPPORTUNITIES IN OUR REGION. OUR ROLE IN IMPROVING HEALTH MAY BE AS A LEADER, PARTNER, FACILITATOR, FUNDER, ADVOCATE, CHAMPION, OR OBSERVER. IN THESE ROLES, WE EMBRACE THE SOCIAL DETERMINANTS OF HEALTH AND APPLY STRATEGIES AND TACTICS INCLUDING HEALTH EDUCATION, OUTREACH AND SCREENINGS VIA COLLABORATIONS, DATA COLLECTION AND RESEARCH, HEALTH CLINICS AND FAIRS, SPONSORSHIPS, AND SUBJECT MATTER EXPERT SPEAKER PRESENTATIONS. FOR MORE DETAILED INFORMATION AND EXAMPLES, SEE SCHEDULE H, PART I, LINE 7E. NORTHERN DUTCHESS HOSPITALS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS WHO LIVE AND WORK IN THE COMMUNITY. NORTHERN DUTCHESS HOSPITAL ALSO HAS AN OPEN MEDICAL STAFF. SURPLUS FUNDS ARE USED TO PROVIDE INNOVATIVE TECHNOLOGY TO CLINICAL CARE IN ADDITION TO EXPANDING OUR SERVICE AREA.

Schedule H, Part VI, Line 6 Affiliated health care system
NUVANCE HEALTH IS AN INTEGRATED HEALTH SYSTEM OFFERING CONVENIENT, ACCESSIBLE AND AFFORDABLE CARE TO OUR COMMUNITY MEMBERS. OUR TALENTED TEAM OF MORE THAN 15,000 COMPASSIONATE CAREGIVERS PROVIDE HIGH-QUALITY CARE THROUGH: COMMUNITY HOSPITALS, PRIMARY CARE AND SPECIALTY PRACTICE LOCATIONS, OUTPATIENT SETTINGS, HOME CARE SERVICES, A SKILLED NURSING HOME AND REHABILITATION FACILITY AND TELEHEALTH VISITS. FOR FY2022, THE NETWORK PROVIDED APPROXIMATELY $87,245,319 IN TOTAL CHARITY CARE. DANBURY HOSPITAL, ITS NEW MILFORD HOSPITAL CAMPUS AND NORWALK HOSPITAL PROVIDE MEDICAL SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. SERVICES INCLUDE ROUTINE INPATIENT ANCILLARY AND OUTPATIENT CARE IN SUPPORT OF THE NETWORK'S MISSION STATEMENT, AS NOTED ABOVE, FOR FY2022, CHARITY CARE WAS PROVIDED IN THE FOLLOWING AMOUNTS: NORWALK HOSPITAL, $28,765,372, DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS, $27,799,213. ALL HOSPITALS NOTED ABOVE HAVE OPEN MEDICAL STAFFS. IF AN INDIVIDUAL MEETS THE EDUCATIONAL, EXPERIENTIAL AND LICENSOR REQUIREMENTS THEY CAN JOIN THE MEDICAL STAFF. NUVANCE HEALTH MEDICAL PRACTICE CT, INC. (NHMPCT): THE MISSION of NHMPCT IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND SPECIALTY HEALTH CARE IN THE COMMUNITIES THEY SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO THEIR PATIENTS' NEEDS. THEY SUPPORT A COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THEIR COMMUNITY BY DELIVERING QUALITY CARE, PARTICIPATING IN MEDICAL RESEARCH AND MEDICAL RESIDENCY PROGRAMS AND THE PROVISION OF MEDICAL SERVICES TO PATIENTS. FOR FY2022 THEY PROVIDED APPROXIMATELY $6,300,375 IN CHARITY CARE. DANBURY HOSPITAL & NEW MILFORD HOSPITAL FOUNDATION INC. (DH/NMHF): DH/NMHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS AND OTHER DANBURY NOT-FOR-PROFIT HEALTH CARE AFFILIATES. NORWALK HOSPITAL FOUNDATION (NHF): NHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO NORWALK HOSPITAL AND OTHER NOT-FOR-PROFIT NORWALK HOSPITAL AFFILIATES. WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC. (WCHNA): WCHNA'S PRINCIPAL PURPOSE IS TO PROVIDE OUTPATIENT HEALTH CARE SERVICES IN VARIOUS LOCATIONS AND ALSO PROVIDE AMBULANCE SERVICES TO DANBURY AND SURROUNDING TOWNS, WHILE SERVING THOSE THAT CANNOT AFFORD THE CARE. FOR FY2022, WCHNA PROVIDED APPROXIMATELY $91,583 IN CHARITY CARE. WESTERN CONNECTICUT HOME CARE, INC. (WCHC): WCHC PROVIDES STATE OF THE ART CLINICAL SERVICES RANGING FROM PEDIATRIC PATIENTS TO THE ELDERLY UTILIZING BEST PRACTICE IN HOME CARE TO MEET THE NEEDS OF THEIR PATIENTS. EASTERN NEW YORK MEDICAL SERVICES, P.C. (ENYMS): THE MISSION AT ENYMS IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND GASTROENTEROLOGY HEALTH CARE IN THE COMMUNITIES WE SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO OUR PATIENTS' NEEDS. EASTERN NEW YORK MEDICAL SERVICES, PC. PROVIDED APPROXIMATELY $8,931 IN CHARITY CARE. VASSAR BROTHERS MEDICAL CENTER (VBMC) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF MID-HUDSON VALLEY. VBMC PROVIDED APPROXIMATELY $17,205,786 IN CHARITY CARE. THE FOUNDATION OF VBMC'S PRINCIPAL ACTIVITY IS THE SOLICITATION, RECEIPT, HOLDING, INVESTMENT AND ADMINISTRATION OF CONTRIBUTION ON BEHALF OF VBMC. PUTNAM HOSPITAL CENTER (PHC) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. PHC PROVIDED APPROXIMATELY $2,195,382 IN CHARITY CARE. PUTNAM HOSPITAL CENTER FOUNDATION ACTIVELY SOLICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES. NORTHERN DUTCHESS HOSPITAL (NDH) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. NDH PROVIDED APPROXIMATELY $2,898,598 IN CHARITY CARE. NORTHERN DUTCHESS HOSPITAL FOUNDATION (NDH) FOUNDATION ACTIVELY SOLICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES. VASSAR HEALTH CT, INC DBA SHARON HOSPITAL (SH) PROVIDES GENERAL ACUTE CARE WITH A RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS IN THE NORTHWEST CONNECTICUT COMMUNITY. SH PROVIDED APPROXIMATELY $1,069,468 IN CHARITY CARE. NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY OPERATES AND MAINTAINS A RESIDENTIAL HEALTHCARE FACILITY FOR THE CARE AND TREATMENT OF PERSONS WHO REQUIRE MEDICAL CARE AND RELATED SERVICES. NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY -PROVIDED APPROXIMATELY $164,980 IN CHARITY CARE. NUVANCE HEALTH MEDICAL PRACTICE, PC (HQMP) IS THE BENEFICIAL OWNER OF VARIOUS PHYSICIAN PRACTICES THAT PROVIDE A FULL RANGE OF HOSPITAL-BASED AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY AND IN THE NORTHWEST CONNECTICUT COMMUNITY. NUVANCE HEALTH MEDICAL PRACTICE, PC PROVIDED APPROXIMATELY $924,614 IN CHARITY CARE. HUDSON VALLEY CARDIOVASCULAR PRACTICE (HVCP) PROVIDES INVASIVE AND NONINVASIVE CARDIOVASCULAR, DIAGNOSTIC AND THERAPEUTIC SERVICES AND IS LOCATED THROUGHOUT THE MID-HUDSON VALLEY AND NORTHWEST CONNECTICUT COMMUNITY. HUDSON VALLEY CARDIOVASCULAR PRACTICE PROVIDED APPROXIMATELY $1,017 IN CHARITY CARE. HEALTH QUEST HOME CARE, INC WAS FORMED TO OPERATE A HOME HEALTH CARE SERVICE BUSINESS SERVING RESIDENTS OF THE MID-HUDSON VALLEY. ALAMO AMBULANCE SERVICES, INC'S ASSETS WERE SOLD IN SEPTEMBER 2009; HOWEVER, IT HAS MAINTAINED ITS LICENSE TO PROVIDE TRANSPORT AND EMERGENCY MEDICAL SERVICES TO SICK, DISABLED, OR INJURED PERSONS, GENERALLY WITHIN DUTCHESS, ORANGE, ULSTER AND PUTNAM COUNTIES, NEW YORK.