4A (Expenses $ 65480062 including grants of $ 10072589) (Revenue $ 70785710)
NEWYORK-PRESBYTERIAN/LAWRENCE HOSPITAL PROVIDES MEDICAL, SURGICAL, PEDIATRIC, MATERNITY AND OBSTETRIC, NEWBORN AND LEVEL II NURSERY SERVICES. IN 2017 NEWYORK-PRESBYTERIAN/LAWRENCE HOSPITAL OPENED A CANCER CENTER AND NEW SURGICAL SUITES OFFERING COMPREHENSIVE CARE INCLUDING THE MOST ADVANCED RADIATION THERAPY, AN INFUSION UNIT, STATE-OF-THE-ART OPERATING SUITES, AND ROOFTOP WELLNESS GARDEN. PATIENTS HAVE ACCESS TO THE LATEST CLINICAL TRIALS AND SERVICES PROVIDED IN COLLABORATION WITH CANCER SPECIALISTS FROM THE NATIONAL CANCER INSTITUTE-DESIGNATED HERBERT IRVING COMPREHENSIVE CANCER CENTER AT COLUMBIA UNIVERSITY MEDICAL CENTER. NEWYORK-PRESBYTERIAN/LAWRENCE HOSPITAL IN COLLABORATION WITH THE NEW YORK AND PRESBYTERIAN HOSPITAL AND COLUMBIA PHYSICIANS OPENED A CARDIAC CATHETERIZATION LAB IN MAY 2015 WHICH PERFORMED 122 INPATIENT CARDIAC CATHETERIZATION PROCEDURES IN JAN-MARCH 2018, THE HOSPITAL HAD APPROXIMATELY 3,050 INPATIENT ADMISSIONS AND PERFORMED APPROXIMATELY 444 INPATIENT SURGICAL PROCEDURES. THERE WERE APPROXIMATELY 14,683 PATIENT DAYS IN JAN-MARCH 2018 AND THE AVERAGE LENGTH OF A PATIENT'S STAY WAS 4.8 DAYS. THE HOSPITAL PROVIDES PRENATAL TESTING AND ADVANCED MEDICAL EXPERTISE FOR AT-RISK MOTHERS AND BABIES. THE MATERNITY PROGRAM AT NEWYORK-PRESBYTERIAN/LAWRENCE HOSPITAL DELIVERED 365 BABIES IN JAN-MARCH 2018. IN JAN-MARCH 2018, UNINSURED PATIENTS ACCOUNTED FOR APPROXIMATELY 1.1% AND 0.9% OF THE HOSPITAL'S TOTAL DISCHARGES AND PATIENT DAYS, RESPECTIVELY. SUCH INPATIENTS GENERATED APPROXIMATELY $1.5 MILLION IN CHARGES FOR SERVICES PROVIDED OF WHICH A SIGNIFICANT AMOUNT WILL GO UNCOLLECTED. THE HOSPITAL'S EMERGENCY DEPARTMENT TREATED A TOTAL OF APPROXIMATELY 10,834 PATIENTS FROM WHICH APPROXIMATELY 1,966 WERE ADMITTED TO THE HOSPITAL. BOARD-CERTIFIED EMERGENCY MEDICINE PHYSICIANS WORK IN THE EMERGENCY DEPARTMENT AND PROVIDE EMERGENT CARE 24 HOURS A DAY, 7 DAYS A WEEK. IN THE OUTPATIENT SETTING, THE HOSPITAL OFFERS THE LATEST IN DIAGNOSTIC TESTING AND LABORATORY SERVICES, AMBULATORY SURGERY OPTIONS, AND REHABILITATION AND SPORTS MEDICINE SERVICES. OUR WOMEN'S IMAGING CENTER PROVIDES STATE-OF-THE-ART DIAGNOSTIC SERVICES IN A COMFORTABLE, PRIVATE SETTING AND OUTPATIENT PHYSICAL THERAPY, LYMPHEDEMA THERAPY, SPEECH, AND OCCUPATIONAL THERAPY SERVICES ARE PROVIDED AT FACILITIES IN EASTCHESTER AND SCARSDALE. AS EVIDENCE OF ITS FORWARD THINKING PROGRAM, NEWYORK PRESBYTERIAN/LAWRENCE HOSPITAL HAS ONE OF THE ONLY MULTI-DISCIPLINARY CARDIAC AND PULMONARY REHABILITATION PROGRAMS IN SOUTHERN WESTCHESTER COUNTY. THE DEPARTMENT PROVIDES A STRUCTURED AND SUPPORTIVE ENVIRONMENT IN WHICH MEN AND WOMEN WHO HAVE EXPERIENCED CARDIAC AND PULMONARY ILLNESSES CAN RECOVER THEIR STRENGTH AND ACHIEVE A SENSE OF WELLBEING. NEWYORK PRESBYTERIAN/LAWRENCE HOSPITAL LABORATORY IS A STATE-OF-THE ART, FULL SERVICE, COMPUTERIZED LABORATORY ACCREDITED BY THE COLLEGE OF AMERICAN PATHOLOGISTS (CAP). UNDER RIGOROUS QUALITY STANDARDS, WE HAVE BEEN PROVIDING DIAGNOSTIC LABORATORY SERVICES FOR MORE THAN 90 YEARS, MAKING US THE AREA'S MOST EXPERIENCED AND TRUSTED PROVIDER. THROUGH OUR EXTENSIVE OUTREACH PROGRAM, WE MEET COMMUNITY NEEDS BY PROVIDING LABORATORY SERVICES TO NURSING HOMES, PHYSICIAN OFFICES, COLLEGES AND HOME HEALTH AGENCIES.

Additional Information:
Part V, Line 5: In 2016, NewYork-Presbyterian Lawrence Hospital worked as a member of the Westchester County Health and Hospital Planning Team (WCHHPT) under the guidance of the Westchester County Department of Health to plan and execute a county-wide Community Health Needs Assessment survey, and to collaborate on the identification of priority areas and planned health interventions for 2016-2018. Members of the WCHHPT included the Department of Health and representatives from 12 hospitals and healthcare providers who met seven times throughout the year. As a result of this collaboration, survey results, and internal planning based on our hospitals strengths, resources and local community needs, NewYork-Presbyterian Lawrence Hospital developed its 2016-2018 Community Service Plan. In our efforts to meet the Agendas requirements, the Westchester County Health & Hospital Planning Team (WCHHPT), including NewYork-Presbyterian Lawrence Hospital, conducted a Community Health Needs Assessment Survey to sample residents and providers in the County and each hospitals or agencies service areas to determine which Prevention Agenda initiative(s) it plans to address during this three year period. Surveys yielded 1,318 responses and 733 were from within the subset of NewYork-Presbyterian Lawrence Hospitals primary and secondary service areas. Significant socioeconomic gaps exist among the communities served by NewYork-Presbyterian Lawrence Hospital. Over a series of meetings in 2016, the Westchester County Health & Hospitals Planning Team crafted and disseminated throughout Westchester County community assessment and provider surveys. In addition to surveying the community at large, the team sought to identify a wide and varying range of providers of health care services to ensure that as many areas of health care as possible could be included in the surveys. Surveys were distributed to community members, community agencies and providers both electronically via a Survey Monkey on-line form, and in hard copy paper format. Completed paper surveys were manually entered into the data sets prior to analysis. NewYork-Presbyterian/Lawrence completed a stand alone Community needs assessment report. Part V, Line 7a & Line 10: https://www.nyp.org/documents/lawrence/Community-Service-Plan-2016-2018.pd f Part V, Line 7d: A link to survey was sent to Westchester residents via the Gannett journal news digital subscriber list. The journal news is the county's only regional daily newspaper. The link and hard copies were also distributed through our community partners, for example grace community church of Mount Vernon which collected approximately 80 surveys from their congregants and health ministry members. Part V, Line 11: For 2016-2018, NewYork-Presbyterian Lawrence Hospital will address the following Priority and Focus Areas and Goals as prescribed by the NYS Prevention Agenda. Priority Area: Prevent Chronic Disease Focus Area 1: Reduce Obesity in Children and Adults To expand the role of health service providers in nutritional education and obesity prevention through Community Nutrition Education, Supporting Healthy Eating and Promoting Physical Activity through partnerships and outreach. Focus Area 2: Increase Access to High Quality Chronic Disease Preventive Care and Management in Both Clinical and Community Settings. To increase screening rates for cardiovascular diseases and breast, lung, skin and colorectal cancers, especially among disparate populations by screenings facilitated by Clinical Navigators in collaboration with Physicians, community initiatives including disease focused education campaigns, seminars and outreach events. To address a health care disparity through planned interventions, NewYork-Presbyterian Lawrence Hospital will focus on underserved communities with a focus on African American and Hispanic communities, particularly in its interventions planned for increasing screening for breast cancer. We will continue our diet and nutrition outreach and focus on the prevention and treatment of cancer and heart disease. With the addition of the NewYork-Presbyterian Cardiac Catheterization Laboratory, an expert interventional cardiology team and a dedicated Heart Disease Prevention Committee which meets to plan interventions and outreach, NewYork-Presbyterian Lawrence Hospital clinical team leaders will perform screenings and interventions to educate and reduce the incidence of heart disease and offer treatment to those in need. The Breast Disease Management Team will lead the hospitals intervention to increase the number of women who are screened for breast cancer, with a focus on underserved women who have not traditionally had access to mammography for financial or cultural reasons. Participants in internal and community screening programs will be identified and tracked as part of a new New York State grant funded mammography screening program to begin in 2017. In addition to breast screening, interventions for the area of focus on cancer will also involve nurse navigators working in the community to provide increased education, outreach and screenings for colorectal cancer. Part V, Line 16a, b & C: www.nyp.org/lawrence/pay-my-bill Part V, Line 16J: Summary of the policy is posted on the hospital's website as well as in the emergency room, admitting offices, breast imaging center and offsite physical therapy offices. Notice of financial assistance is included on the patient's billing statement.

Part VI Additional Information:
"PART I, LINE 3C: N/A PART I, LINE 6A: N/A Part I, Line 7, Column F: Bad Debt Expense is offset against revenue and not included in expenses. Part I, Line 7 - The Following is a detail of the sources used for determining the amounts reported on schedule H: Line 7A - Adjusted Ratio of Patient Care Costs to Charges. Line 7B - Adjusted Ratio of Patient Care Costs to Charges. Line 7E - Actual Expenses Part III, Line 2 - Bad Debt Expense: Based on historical bad debt write-off percentages adjusted for actual write-offs and recoveries. Part III, Line 3 - Bad Debt attributable to Charity Care: Based on an estimate that is consistent with prior years. PART III, LINE 4 - Bad Debt Expense Description ""Accounts receivable is recorded at its expected net realizable value. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectibles and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectibles."" PART III, LINE 8: NewYork-Presbyterian Lawrence Hospital costing methodology used to determine the amounts on part iii, line 6 is the cms-2552 Medicare cost report. PART III, LINE 9B - Collection Practices: POLICY AND PURPOSE: The purpose of the Collection Policy (Policy) is to promote patient access to quality health care while minimizing bad debt at NewYork-Presbyterian/Lawrence Hospital (Hospital). This Policy places requirements upon Hospital and those agencies and attorneys undertaking debt collection activities that are consistent with the core mission, values, and principles of Hospital including, but not limited to, Hospitals Charity Care Policy (hereafter Charity Care Policy). PROCEDURE: A. General guidelines 1. Hospital, collection agencies (Agency), and lawyers and law firms (Outside Counsel) will comply with all applicable federal and state laws and accrediting agency requirements governing the collection of debts including, but not limited to, the Fair Debt Collection Practices Act (FDCPA), the Fair Credit Billing Act, the Consumer Credit Protection Acts, Public Health Law Section 2807-k-9-a, Internal Revenue Service Code 501(r), Article 52 of the New York Civil Practice Law and Rules, and the Health Insurance Portability and Accountability Act (HIPAA). Hospital, Agency and Outside Counsel will also comply with Hospitals Charity Care Policy. To the extent that there are any inconsistencies between Hospitals Collection Policy and Charity Care Policy, the Charity Care Policy shall supersede and control. 2. Hospital shall enter legally binding written agreements with any parties (including Agency or Outside Counsel) to which it refers an individuals debt related to care that are reasonably designed to prevent Extraordinary Collection Actions (ECAs) from being taken to obtain payment for the care, until reasonable efforts have been made to determine whether the individual is eligible for Charity Care. Part VI, Line 2- Needs Assessment: The Westchester County Health and Hospital Planning Team (WCHHPT) reviewed survey results from the Westchester County survey of 218 providers and 1097 residents along with results specific to the NewYork-Presbyterian Lawrence Hospital service areas to determine which Prevention Agenda initiative and focus area to pursue. In the community survey results, the top five community health conditions or concerns residents identified were: Obesity/Overweight; Care for the Elderly; Drug Abuse; Mental Health/Depression; Cancer. Questions about what health concerns respondents have about their own health yielded the highest response around (1) nutrition and eating habits and (2) obesity and being overweight, followed by (3) having a healthy environment, (4) womens health, and (5) dental care. Community members identified the top three health information sources they access as being (1) their doctor or healthcare professional, (2) the internet, and (3) family and friends. Providers of healthcare services surveyed identified the following health conditions and concerns they see when treating their clients/patients: Mental Health/Depression; Drug Abuse; Overweight/Obesity; Access to Specialty Care; Heart Disease/Stroke and Care for the Elderly (tied). The survey results were discussed among members of the WCHHPT and reviewed in comparison to data in the Westchester County Department of Health Community Health Assessment Update dated January, 2016. County data indicates that in 2012, heart disease, stroke and other circulator diseases accounted for 39% of all deaths, and cancer accounted for 24% of all deaths. Heart disease is the number one cause of death in Westchester County, followed by cancer. Based on review of health data, survey findings, community feedback, the Prevention Agenda Action Plan provided by New York State Department of Health, and collaboration with other providers, the Westchester County Health & Hospitals Planning Team, including NewYork-Presbyterian Lawrence Hospital, decided to address the Prevention Agenda Priority Group Choice A (GCA): Preventing Chronic Diseases. Hospital representatives came to consensus that choosing two areas of focus under the umbrella of Preventing Chronic Disease was supported by the data collected, and was the best choice and avenue to implement successful programs aligned with the strengths, service lines and priorities of their organizations. Survey results were further reviewed with members of the leadership team of NewYork-Presbyterian Lawrence Hospital and weighed against existing resources, assets and strengths to determine our priorities and two areas of local focus. Data was also discussed at a monthly meeting of the NewYork-Presbyterian Lawrence Hospital Heart Disease Prevention Committee. This committee comprises physicians, clinicians from the hospitals interventional cardiology, emergency medicine and nursing departments, nutrition, and marketing and administrative team members. NewYork-Presbyterian Lawrence Hospital determined that it can best address the Prevention Agenda Item Reducing Chronic Disease and the issue of premature cardiac related deaths by devoting present and future resources to Hands-Only CPR education and interventions that address blood pressure, cholesterol, cardiovascular health, diet, healthy Body Mass Index, and education. This plan of action fits well with survey results which showed that the highest concern among community respondents are around obesity and nutrition. With cancer as the number two cause of death in Westchester County and the fifth highest area of concern cited in our community survey results, addressing this second area of focus fits well with our organizational strengths and assets. In November 2016, NewYork-Presbyterian Lawrence Hospital opened a new, state-of-the-art comprehensive Cancer Center to bring prevention measures, screening, diagnosis, treatment, and return to wellness through survivorship programs all together in one location. To support the Cancer Center, the Hospital recruited and built an experienced and highly regarded team of physicians, surgeons, specialists and clinical providers, and established disease management teams, expanded treatment options and ancillary offerings. The expanded resources and team enhances the hospitals ability to provide education and services out in the community. To address a health care disparity through planned interventions, NewYork-Presbyterian Lawrence Hospital will focus on underserved communities with a focus on African American and Hispanic communities, particularly in its interventions planned for increasing screening for breast cancer. We will continue our diet and nutrition outreach and focus on the prevention and treatment of cancer and heart disease. With the addition of the NewYork-Presbyterian Cardiac Catheterization Laboratory, an expert interventional cardiology team and a dedicated Heart Disease Prevention Committee which meets to plan interventions and outreach, NewYork-Presbyterian Lawrence Hospital clinical team leaders will perform screenings and interventions to educate and reduce the incidence of heart disease and offer treatment to those in need. The Breast Disease Management Team will lead the hospitals intervention to increase the number of women who are screened for breast cancer, with a focus on underserved women who have not traditionally had access to mammography for financial or cultural reasons. Participants in internal and community screening programs will be identified and tracked as part of a new New York State grant funded mammography screening program to begin in 2017. In addition to breast screening, interventions for the area of focus on cancer will also involve nurse navigators working in the community to provide increased education, outreach and screenings for colore"