4A (Expenses $ 290044549 including grants of $ 0) (Revenue $ 247048363)
FLUSHING HOSPITAL MEDICAL CENTER OPERATES A 299-BED FACILITY THAT PROVIDES HOSPITAL SERVICES, OUTPATIENT CLINIC SERVICES, AND EMERGENCY SERVICES.

FLUSHING HOSPITAL MEDICAL CENTER
PART V, SECTION B, LINE 5: THE EFFECTS OF POVERTY ON HEALTH, INCLUDING DIFFICULTY OBTAINING NUTRITIOUS FOOD, UNEMPLOYMENT, AND THE BURDEN OF HIGH RENTS ARE OBSERVED IN THE COMMUNITIES THAT FLUSHING HOSPITAL SERVES, PARTICULARLY IN FLUSHING-CLEARVIEW AND WEST QUEENS.CHRONIC DISEASES, OBESITY, TOBACCO USE, BEHAVIORAL HEALTH CONCERNS, MATERNAL MORBIDITY, AND LATE OR NO PRENATAL CARE WERE AMONG THE HEALTH ISSUES HIGHLIGHTED IN THE COMMUNITY-LEVEL DATA ANALYSES THAT FLUSHING HOSPITAL CONDUCTED FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE HEALTH CONCERNS WERE ALSO IDENTIFIED BY RESIDENTS OF THE HOSPITAL'S SERVICE AREA WHO RESPONDED TO A HEALTH NEEDS ASSESSMENT SURVEY SPONSORED BY THE HOSPITAL DURING THE SPRING AND SUMMER OF 2019. MANY OF THESE HEALTH PROBLEMS ARE CAUSED IN PART BY OR EXACERBATED BY THE SOCIAL DETERMINANTS OF HEALTH (SDH). THE HOSPITAL HAS BEGUN FOCUSED EFFORTS TO ADDRESS SDH, INCLUDING THE EFFECTS OF DISCRIMINATION, AS PART OF ITS TREATMENT OF THE WHOLE PERSON.BREASTFEEDING, WHICH LOWERS THE RISK OF DEATH FROM INFECTIOUS DISEASES IN A CHILD'S FIRST TWO YEARS OF LIFE, AND CAN ALSO REDUCE THE RISK OF CHILDHOOD OBESITY AS WELL AS THE RISK OF A WOMAN DEVELOPING BREAST OR OVARIAN CANCER, IS STILL NOT PRACTICED AS OFTEN IN PARTS OF THE HOSPITAL'S SERVICE AREA AS IT IS IN NEW YORK CITY OVERALL. FLUSHING HOSPITAL HAS FOCUSED ON IMPROVING RATES OF EXCLUSIVE BREASTFEEDING AMONG THE WOMEN GIVING BIRTH IN THE HOSPITAL AND THOSE ATTENDING ITS AMBULATORY CARE CENTERS WITH THEIR INFANTS, AS WELL AS AMONG MOTHERS IN THE COMMUNITY. THE HOSPITAL IS DESIGNATED AS A BABY FRIENDLY HOSPITAL FOR OFFERING AN OPTIMAL LEVEL OF CARE FOR INFANT FEEDING AND MOTHER/BABY BONDING.TOBACCO USE AND SECONDHAND SMOKE, AS WELL AS HOUSEHOLD/OUTDOOR AIR POLLUTION, WERE IDENTIFIED AS ONGOING COMMUNITY HEALTH CONCERNS THAT ARE CORRELATED WITH CHRONIC DISEASE, SUCH AS ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE AS WELL AS CANCER. RESPONDING TO THE NEEDS OF THE COMMUNITY, FLUSHING HOSPITAL HAS FOCUSED ON IMPROVING TOBACCO CESSATION RATES. THE HOSPITAL WAS AWARDED GOLD STAR STATUS FROM THE NYC DOHMH'S TOBACCO-FREE HOSPITALS CAMPAIGN IN RECOGNITION OF ITS TOBACCO CESSATION PROGRAMMING AND SUCCESSES, AND CONTINUES TO COMPLY WITH THE CAMPAIGN'S STANDARDS.WITH THE BENEFIT OF COMMUNITY INPUT, THE HOSPITAL HAS CHOSEN TO HIGHLIGHT THE PREVALENCE OF THESE TWO HEALTH ISSUES IN ITS SERVICE AREA AS WELL AS THE HOSPITAL'S CONCERTED EFFORTS TO ADDRESS THEM IN ITS THREE YEAR COMPREHENSIVE COMMUNITY SERVICE PLAN AND IMPLEMENTATION PLAN. THESE INITIATIVES ARE IN ALIGNMENT WITH THE NYS PREVENTION AGENDA PRIORITIES AND THE HEALTHY PEOPLE 2021 GOALS.

PART V, SECTION B, LINE 3: PUBLIC PARTICIPATION
DEVELOPED A 4 HOUR PROVIDER EDUCATIONAL PROGRAM FOCUSED ON THE BENEFITS OF BREASTFEEDING AND THE PROVIDER APPROACH TO PROMOTE THIS HEALTH CHOICE BY ALL PATIENTS; MANDATORY FOR OB/GYN, PEDIATRICS, FAMILY MEDICINE AND MEDICINE.DEVELOPED A MANDATORY EDUCATIONAL PROGRAM TO EDUCATE GENERAL STAFF WHO INTERACT WITH PATIENTS (E.G., REGISTRARS, HOUSEKEEPERS, MANAGERS).ACTIVE PARTICIPATION IN LATCH ON NYC, NY STATE'S GREATER BEGINNINGS, AND THE COHORT STUDY.ACTIVITIES ACCOMPLISHED CONTINUE TO MAKE AVAILABLE PRIVATE AREAS FOR BREASTFEEDING IN ALL AMBULATORY CARE LOCATIONS.OFFER TO THE COMMUNITY CHILD BIRTH EDUCATION CLASSES WITH BREASTFEEDING COMPONENT ON CAMPUS TWO TIMES EACH MONTH.PROMOTE BREASTFEEDING VIA POSTERS AT ALL AMBULATORY CARE AND INPATIENT SITES.REMINDERS OF THE EXCLUSIVE BREASTFEEDING GOAL WILL BE MADE AT ALL REGULAR MEETINGS OF DEPARTMENT HEADS AND INDIVIDUAL DEPARTMENTS.CONTINUE TO PARTICIPATE IN COMMUNITY HEALTH FAIRS AND PROVIDE EDUCATIONAL MATERIALS AS WELL AS COUNSELING ON THE BENEFITS OF BREASTFEEDING.CONTINUE PARTNERSHIP WITH WIC BY ENSURING THAT ALL ELIGIBLE PATIENTS ARE REFERRED FOR ADDITIONAL ASSISTANCE.

PART I, LN 7 COL(F):
BAD DEBT EXPENSE IS ESTIMATED BASED ON AGING OF THE ACCOUNTS RECEIVABLE AND GETS ADJUSTED BASED ON ACTUAL WRITE OFF. ACTUAL ACCOUNT WRITE OFF IS AS FOLLOWS: PATIENTS WHO ARE ENTITLED TO FINANCIAL ASSISTANCE ARE GIVEN DISCOUNT BASED ON OUR CHARITY CARE POLICY (MEDICAID RATE). IF THE PATIENT DOESN'T PAY THE BALANCE OF THEIR ACCOUNT AFTER RECEIVING 3 BILLS THEN THE ACCOUNT BALANCE GETS TRANSFER TO THE COLLECTION AGENCY. IF THE COLLECTION AGENCY CAN'T COLLECT AFTER EXHAUSTING THEIR EFFORTS THEN THE ACCOUNT GETS RETURNED AS UNCOLLECTIBLE AND THE HOSPITAL WRITES OFF THE ACCOUNT AS BAD DEBT. BAD DEBT RELATED TO LINE 3: BAD DEBT EXPENSE IS ALLOCATED TO THE PATIENTS WHO ARE ENTITLED TO FINANCIAL AID BASED ON CHARITY CARE VOLUME PATIENTS.

PART II, COMMUNITY BUILDING ACTIVITIES:
"FLUSHING HOSPITAL PROGRAMS SUPPORT THE CITY OF NEW YORK'S TAKE CARE NEW YORK (TCNY) PROGRAM IN THE FOLLOWING WAYS:1. HAVE A REGULAR DOCTOR OR OTHER HEALTH CARE PROVIDER: FLUSHING'S AMBULATORY CARE SERVICES ARE DESIGNED TO PROMOTE CONTINUITY OF CARE BYALLOWING PATIENTS TO CHOOSE A PHYSICIAN WHO WILL BE DESIGNATED AS THEIRPRIMARY CARE PROVIDER. THE DESIGNATED PROVIDER IS RESPONSIBLE FOR ENSURING THAT HIS/HER PATIENTS ARE GIVEN AGE APPROPRIATE SCREENING, IMMUNIZATION AND EDUCATION.2. BE TOBACCO-FREE: SMOKING CESSATION IS ONE OF THE HOSPITAL'S PREVENTION PRIORITIES AND WAS DISCUSSED IN THE PREVIOUS SECTION.3. KNOW YOUR HIV STATUS: THE HOSPITAL PROVIDES HIV COUNSELING AND TESTING WITH STAFF THAT ROUTINELY PERFORMS THIS FUNCTION IN BOTH THE EMERGENCY DEPARTMENT AND CLINICS. IF REQUIRED, PATIENTS ARE REFERRED FOR SERVICES TO JAMAICA HOSPITAL'S INFECTIOUS DISEASE CLINIC OR TO OTHER COMMUNITY PROGRAMS.4. GET HELP FOR DEPRESSION: FLUSHING HOSPITAL'S MEDICAL PROVIDERS INCORPORATE DEPRESSION SCREENING DURING ROUTINE MEDICAL EXAMINATIONS AND ONGOING CARE. CHILDREN AND ADULTS NEEDING FURTHER SERVICES ARE REFERRED TO FLUSHING?S FULL SERVICE PSYCHIATRY DEPARTMENT OR OTHER COMMUNITY PROGRAMS.5. LIVE FREE OF DEPENDENCE ON ALCOHOL AND DRUGS: DURING ROUTINE MEDICAL EXAMINATIONS PATIENTS HAVE THE OPPORTUNITY TO RECEIVE SCREENING FOR ALCOHOL AND DRUG USE. AS NECESSARY, PATIENTS WILL BE GIVEN PREVENTIVE COUNSELING AND TREATMENT OPTIONS, INCLUDING FLUSHING HOSPITAL'S IN-PATIENT AND OUT-PATIENT TREATMENT PROGRAMS FOR CHEMICAL DEPENDENCY. 6. GET CHECKED FOR CANCER: FLUSHING HOSPITAL IS A MEMBER OF THE STATE'S HEALTHY LIVING PARTNERSHIP PROGRAM, WHICH PROVIDES COVERAGE FOR CERVICAL, BREAST, AND COLON CANCER SCREENINGS TO UNINSURED AND UNDERINSURED PATIENTS WHO MEET THE ELIGIBILITY AND SCREENING CRITERIA. THE HOSPITAL RECEIVES GRANT FUNDING FOR BREAST HEALTH CARE FROM THE AVON FOUNDATION AND KOMEN FOUNDATION TO HELP SUPPORT CASE MANAGEMENT, OUTREACH AND BREAST CARE SERVICES TARGETED TO THE ASIAN AND SOUTH ASIAN POPULATIONS. FLUSHING HOSPITAL WAS PRIVILEGED TO BE PART OF THE ""COLONOSCOPY SCREENING NAVIGATOR PROGRAM,"" WHICH RECEIVED ONE YEAR SEED FUNDING BY THE NYCDOH. THE PROGRAM HAS BEEN SHOWN TO BE EFFECTIVE AND THE HOSPITAL HAS MADE A COMMITMENT TOCONTINUE THE PROGRAM WITHOUT GRANT FUNDING.7. THE HOSPITAL PARTICIPATES IN THE NYC'S VACCINE FOR CHILDREN PROGRAM (VFC) PROVIDING IMMUNIZATIONS TO CHILDREN UP TO 19 YEARS OF AGE AGAINST CHILDHOOD DISEASES AND INFLUENZA TO ELIGIBLE CHILDREN INCLUDING THOSE WITHOUT HEALTH COVERAGE SEEN IN OUR AMBULATORY CARE NETWORK. INFLUENZA VACCINE IS OFFERED TO ADULTS DURING RECOMMENDED VACCINATION MONTH.8. HAVE A SAFE AND HEALTH HOME: ANTICIPATORY GUIDANCE ON SAFETY IN THE HOME IS PROVIDED BY THE HOSPITAL'S PEDIATRIC, FAMILY MEDICINE AND REHABILITATION PROFESSIONALS. AT HEALTH FAIRS IN THE COMMUNITY, FIRE, HOME AND AUTOMOTIVE SAFETY INFORMATION IS ROUTINELY MADE AVAILABLE TO ATTENDEES. 9. HAVE A HEALTHY BABY: THE HOSPITAL FOLLOWS PRENATAL CARE GUIDELINES ADOPTED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THESE PROGRAMS ASSIST PREGNANT WOMEN AND THEIR FAMILIES TO OBTAIN NECESSARY MEDICAL CARE AND SUPPORTIVE SERVICES, WITH THE GOAL OF IMPROVING BIRTH OUTCOMES AND REDUCING CHILD ABUSE.10. WE ARE WORKING CLOSELY WITH THE NYCDOH BY EDUCATING AND ENCOURAGING THE IMMUNIZATION OF ALL HEALTHCARE PERSONNEL THAT ARE IN CONTACT WITH WOMEN OF CHILDBEARING AGE, NEWBORNS AND CHILDREN WITH TDAP TO PREVENT THE TRANSMISSION OF PERTUSSIS. ALL PREGNANT AND POSTPARTUM WOMEN ARE OFFERED THE VACCINE AS A STANDING ORDER AND IAS OF DECEMBER 31, 2021 20% OF OUR FLUSHING HOSPITAL MEDICAL CENTER 11-1631781 POSTPARTUM PATIENTS RECEIVED THE VACCINE. ADDITIONALLY, ALL FAMILY MEMBERS ARE INSTRUCTED ON THE IMPORTANCE OF RECEIVING THE VACCINE."

PART III, LINE 4:
FINANCIAL STATEMENTS BAD DEBT & CHARITY CARE FOOTNOTE:FLUSHING HOSPITAL PROVIDES CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A MATTER OF POLICY, FLUSHING HOSPITAL PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED AS CHARITY CARE. FLUSHING HOSPITAL PROVIDES CHARITY CARE IN THE AMOUNT OF THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. SINCE PAYMENT OF THIS DIFFERENCE IS NOT SOUGHT, CHARITY CARE ALLOWANCES ARE NOT REPORTED AS REVENUE. REMAINING UNCOLLECTED BALANCES AFTER CHARITABLE ALLOWANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. THE ESTIMATED COSTS OF PROVIDING CHARITY SERVICES ARE BASED ON A CALCULATION WHICH APPLIES A RATIO OF COST TO CHARGES TO THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. TOTAL FOREGONE CHARGES FOR CHARITY CARE WERE $6.9 MILLION AND $9.4 MILLION FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY. THIS EQUATES TO AN APPROXIMATE COST OF $5.3 MILLION AND $6.6 MILLION FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY.

PART III, LINE 8:
ALLOWABLE COSTS ARE FROM THE HOSPITAL COST REPORT THAT GETS FILED WITH MEDICARE EVERY YEAR. COST METHODOLOGY THAT IS USED TO CALCULATE MEDICARE ALLOWABLE COST IS RATIO OF COST TO CHARGES BASED ON MEDICARE GUIDELINES. MEDICARE ALLOWABLE COST ON LINE 6 DOESN'T INCLUDE COST OF RESIDENCY PROGRAM AND SUPERVISORY PHYSICIAN COST WHICH IS OVER $37 MILLION. EXCLUSION OF THESE COSTS RESULTED IN A SURPLUS ON LINE 7.

PART VI, LINE 6:
AFFILIATED HEALTH CARE: MEDISYS HEALTH SYSTEM

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART III, LINE 9B:
THE HOSPITAL OFFERS INSTALLMENT PLANS FOR THE PAYMENT OF OUTSTANDING BALANCES FOR PATIENTS APPROVED FOR FINANCIAL AID. THE HOSPITAL DOES NOT MANDATE THAT THE MONTHLY INSTALLMENT PAYMENT ARRANGEMENT EXCEED 10% OF THE APPLICANT'S GROSS MONTHLY INCOME. THERE IS NO ACCELERATOR OR SIMILAR CLAUSE UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED WHEN A PATIENT MISSES MAKING A PAYMENT.THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 40 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTIONS AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTIONS AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING A LEGAL ACTION.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPOLICY: TO PROVIDE ACCESS TO GOVERNMENT ASSISTANCE APPLICATIONS AND/OR FINANCIAL AID FOR THE QUALIFIED UNINSURED.PURPOSE: TO PROVIDE ACCESSIBLE AND AFFORDABLE CARE TO UNINSURED PATIENTS AND TO IDENTIFY METHODS BY WHICH PATIENTS AND/OR FAMILY MEMBERS ARE NOTIFIED OF THE FLUSHING HOSPITAL FINANCIAL AID POLICY.PROCEDURE: NOTIFICATION TO PATIENTS:FLUSHING HOSPITAL DEVELOPED AND HAS PUBLICLY AVAILABLE A CLEAR AND UNDERSTANDABLE WRITTEN SUMMARY OF ITS FINANCIAL ASSISTANCE POLICIES AND ENSURES THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE POLICIES. THE HOSPITAL HAS A 24-HOUR EMERGENCY DEPARTMENT AND NOTIFIES PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE DURING THE INTAKE AND REGISTRATION PROCESS THROUGH THE POSTING OF CONSPICUOUS AND LANGUAGE APPROPRIATE INFORMATION AND THROUGH INFORMATION ON ALL BILLS AND STATEMENTS SENT TO PATIENTS.

PART VI, LINE 4:
"NEW YORK CITY (NYC) HAS DIFFERENT WAYS OF DESCRIBING AND CATEGORIZING NEIGHBORHOODS, WHICH IS RELEVANT TO HOW COMMUNITY HEALTH DATA ARE ANALYZED AND PRESENTED. NEIGHBORHOODS ARE TYPICALLY DEFINED ACCORDING TO EITHER NYC COMMUNITY DISTRICTS OR UNITED HEALTH FUND NEIGHBORHOODS (AN INDEPENDENT, NONPROFIT, HEALTH SERVICES RESEARCH AND PHILANTHROPIC ORGANIZATION). THERE ARE 59 NYC COMMUNITY DISTRICTS, WHICH WERE ESTABLISHED BY LOCAL LAW IN 1975. UNITED HEALTH FUND (UHF) NEIGHBORHOODS CONSIST OF 34 NEIGHBORHOODS, MADE UP OF ADJOINING ZIP CODE AREAS, DESIGNATED TO APPROXIMATE NYC COMMUNITY PLANNING DISTRICTS. FHMC'S PRIMARY SERVICE AREA (""PSA"") HAS TRADITIONALLY BEEN DEFINED AS COVERING THE QUEENS NEIGHBORHOODS OF FLUSHING-CLEARVIEW AND WEST QUEENS. THESE NEIGHBORHOODS, AS DEFINED BY THE UHF, DO NOT CORRESPOND EXACTLY TO DISTINCT COMMUNITY DISTRICTS. THE TWO PRIMARY PSA SERVICES AREA'S COVERS TO UFH NEIGHBORHOODS FLUSHING-CLEARVIEW (403), AND WEST QUEENS (402). FHMC'S SERVICE AREA WAS DETERMINED BY ANALYZING STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS) 2017 DISCHARGE DATA AT THE ZIP CODE LEVEL. THE UHF NEIGHBORHOODS WITH THE HIGHEST VOLUMES OF PATIENTS WERE DETERMINED TO BE THE PSA. UHF NEIGHBORHOODS WITH AT LEAST 3% OF INPATIENT CASES WERE CONSIDERED THE HOSPITAL'S SECONDARY SERVICE AREA (SSA) THE PSA AND SSA TOGETHER ACCOUNT FOR APPROXIMATELY 84% OF THE HOSPITAL'S TOTAL INPATIENT CASES, WITH THE PSA ACCOUNTING FOR 57% AND THE SSA ACCOUNTING FOR 27%. THE FHMC CHNA FOCUSES ON THE HOSPITAL'S PSA."

PART VI, LINE 5:
BASED UPON AN ANALYSIS OF COMMUNITY HEALTH STATISTICS AND THE RESULTS OF ITS CONSUMER HEALTH NEEDS SURVEY, AND ITS RESOURCES AND CAPABILITIES THE HOSPITAL DECIDED TO CONTINUE TO IMPLEMENT AND TO GATHER OUTCOMES DATA FOR ITS COMPREHENSIVE PROGRAMS OF EVIDENCE-BASED PRACTICES RELATED TO DECREASING TOBACCO USE WITHIN THE COMMUNITY, AND INCREASING RATES OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN THE SERVICE AREA. THE OPINION OF THE COMMUNITY AND HOSPITAL LEADERSHIP WERE CONSIDERED IN THIS DECISION.FHMC ELECTED TO HIGHLIGHT THESE TWO PARTICULAR PROGRAMS USING THE FOLLOWING CRITERIA:ALIGNMENT WITH NYS PREVENTION AGENDA PRIORITIES- PREVENT CHRONIC DISEASE, FOCUS AREA 3: - TOBACCO PREVENTION, GOAL 3.2: PROMOTE TOBACCO USE CESSATION; AND- PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN, FOCUS AREA 3: PERINATAL AND INFANT HEALTH; GOAL 2.2: INCREASE BREAST FEEDING; ALIGNMENT WITH HEALTHY 2020 GOALS AND OBJECTIVES:- GOAL: REDUCE ILLNESS, DISABILITY, AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE.-- OBJECTIVE: REDUCE CIGARETTE SMOKING BY ADULTS.- GOAL: IMPROVE THE HEALTH AND WELL-BEING OF WOMEN, INFANTS, CHILDREN, AND FAMILIES.-- OBJECTIVE: INCREASE THE PROPORTION OF INFANTS WHO ARE BREASTFED. ALIGNMENT WITH SURVEY RESULTS- SMOKING/TOBACCO USE/VAPING RATED AS VERY/EXTREMELY IMPORTANT BY 47% OF ALL SURVEY RESPONDENTS IN PSA AND 54% OF BLACK/AFRICAN AMERICAN PSA RESPONDENTS;- CONNECTION BETWEEN SMOKING/TOBACCO USE/VAPING AND CANCER AND HEART DISEASE (BOTH RATED VERY/EXTREMELY IMPORTANT BY 49%);- WOMEN'S HEALTH AND INFANT CARE RATED BY 51% BY ALL PSA RESPONDENTS AND BY 57% OF FEMALES AS VERY/EXTREMELY IMPORTANT. EXCLUSIVE BREASTFEEDING IS A VERY IMPORTANT PRACTICE IN ENSURING GOOD HEALTH FOR WOMEN AND THEIR INFANTS. ALIGNMENT WITH HOSPITAL'S PRIORITIES- CONTINUING RECOGNITION FOR FOLLOWING BEST PRACTICES FOR TOBACCO CESSATION AS EVIDENCED BY EARNING A GOLD STAR FROM NYC'S TOBACCO-FREE HOSPITAL CAMPAIGN AND CONTINUING TO ADHERE TO STANDARDS AND RETAIN THE DESIGNATION AS A BABY FRIENDLY HOSPITAL.- RESOURCES ALREADY COMMITTED AND WORK GROUPS ALREADY WORKING TO IMPLEMENT COMPREHENSIVE HOSPITAL-WIDE PROGRAMS FOR THESE TWO PREVENTION PRIORITIES;- ADDRESSES A DISPARITY OF IMPACT/BURDEN ON PEOPLE LIVING IN POVERTY, AS MEASURED BY THE PROPORTION OF PEOPLE AFFECTED WHO ARE COVERED BY MEDICAID.- POTENTIAL FOR SIGNIFICANT IMPROVEMENT IN INDIVIDUAL AND COMMUNITY HEALTH AND QUALITY OF LIFE BY DECREASING TOBACCO USE AND INCREASING BREASTFEEDING.THE HOSPITAL PLACES A HIGH VALUE ON THE IMPORTANT WORK OF PREVENTION, COMMUNITY OUTREACH AND EDUCATION. THESE ACTIVITIES WILL NOT ONLY REDUCE DISEASE AND DISABILITY WITHIN OUR COMMUNITY, BUT WILL ALSO ENABLE THE HOSPITAL TO PROSPER UNDER VALUE-BASED PAYMENT ARRANGEMENTS.

PART VI, LINE 2:
A SURVEY OF COMMUNITY RESIDENTS WAS PERFORMED SO THAT THE HOSPITAL WOULD HAVE DIRECT INPUT FROM RESIDENTS ABOUT THE HEALTH OF THE COMMUNITIES IT SERVES AND THE MAIN HEALTH AND HEALTH SERVICE CHALLENGES FACING THESE COMMUNITIES. THIS REPORT DESCRIBES THE PRIMARY DATA COLLECTION (SURVEY) METHODOLOGY AND ANALYSIS OF SURVEY RESULTS. GREATER NEW YORK HOSPITAL ASSOCIATED (GNYHA) DEVELOPED A MODEL SURVEY TOOL THAT MEDISYS TAILORED FOR ITS COMMUNITIES. THE SURVEYS, WHICH WERE TRANSLATED INTO SPANISH AND MANDARIN TO PROVIDE ADDITIONAL ACCESS TO THE SURVEY, WERE LOADED INTO A HIPAA PROTECTED WEB-BASED SURVEYMONKEY PLATFORM. FROM APRIL THROUGH MID-SEPTEMBER 2019, THE HOSPITAL SENT THE SURVEY TO COMMUNITY RESIDENTS BY EMAIL AND ALSO DISTRIBUTED IT AT NUMEROUS GATHERINGS OF LOCAL COMMUNITY BASED ORGANIZATIONS, INCLUDING THE HOSPITAL'S COMMUNITY ADVISORY BOARD, THE HOSPITAL'S AMBULATORY CARE CENTER, THREE COMMUNITY BOARDS, ONE NYPD PRECINCT COUNCIL, AND TWO CIVIC ASSOCIATIONS. THE HOSPITAL RECEIVED 245 COMPLETED SURVEYS, OF WHICH 196 WERE FROM RESIDENTS OF THE HOSPITAL'S PRIMARY SERVICE AREA (PSA), WHICH ENCOMPASSES FLUSHING-CLEARVIEW AND WEST QUEENS. SURVEYS COMPLETED ONLINE WERE CAPTURED DIRECTLY IN THE SURVEYMONKEY PLATFORM. PAPER SURVEYS WERE ENTERED INTO THE PLATFORM BY HOSPITAL STAFF AND VOLUNTEERS. DATA WERE ANALYZED BY GNYHA STAFF ACCORDING TO STANDARD STATISTICAL METHODS, USING MICROSOFT EXCEL. MEANS AND PROPORTIONS WERE GENERATED, OVERALL AND BY NEIGHBORHOOD. ALTHOUGH THE SURVEY SAMPLE CANNOT BE CONSIDERED REPRESENTATIVE OF THE CATCHMENT AREAS IN A STATISTICAL SENSE, AND GAPS ARE UNAVOIDABLE, THE COMBINATION OF HOSPITAL CLINIC BASED AND ORGANIZATIONAL OUTREACH FACILITATED THE ENGAGEMENT OF A TARGETED YET DIVERSE POPULATION, INCLUDING BOTH INDIVIDUALS CONNECTED AND UNCONNECTED TO SERVICES.POPULATION CHARACTERISTICSSURVEY RESPONDENTS CAME FROM ALL QUEENS NEIGHBORHOODS. FOR ALL RESPONDENTS - SOCIO-DEMOGRAPHIC CHARACTERISTICS INCLUDED: 63% FEMALE, 34% WHITE, 15% ASIAN, 7% BLACK/AFRICAN AMERICAN, 51% OF HISPANIC OR LATINO DESCENT, 69% HAD HEALTH INSURANCE, 8% WERE 65-74 YEARS OLD, 18% WERE 55-64, 34% WERE 35-54 AND 18% WERE 25-34 YEARS OLD. TWENTY-TWO PERCENT OF SURVEY RESPONDENTS REPORTED HAVING FAIR OR POOR PHYSICAL HEALTH, AND 11% FAIR OR POOR MENTAL HEALTH.FOR PSA RESPONDENTS - SOCIO-DEMOGRAPHIC CHARACTERISTICS INCLUDED: 65% FEMALE, 28% WHITE, 16% ASIAN, 7% BLACK/AFRICAN AMERICAN, 63% OF HISPANIC OR LATINO DESCENT, 63% HAD HEALTH INSURANCE, 7% WERE 65-74 YEARS OLD, 13% WERE 55-64, 37% WERE 35-54 AND 19% 25-34. TWENTY-SEVEN PERCENT OF SURVEY RESPONDENTS REPORTED HAVING FAIR OR POOR PHYSICAL HEALTH, AND 12% FAIR OR POOR MENTAL HEALTH. IN MARCH 2020 THROUGH JUNE 2020 THE FLUSHING HOSPITAL MEDICAL CENTER WAS IN THE EPICENTER OF THE COVID PANDEMIC AND THE HOSPITAL EXPERIENCED AN EXTREMELY LARGE SURGE OF COVID POSITIVE PATIENTS.FLUSHING HOSPITAL MEDICAL CENTER UNDER THE EMERGENCY MANAGEMENT DEPARTMENT FORMED A COVID TASK FORCE TO OVERSEE THE RESPONSE TO THE PANDEMIC TO ENSURE THAT RESOURCES WERE AVAILABLE AND MOBILIZED TO DEAL WITH THE TREMENDOUS INFLUX OF PATIENTS. COMMITTEES WERE CREATED TO ADDRESS AND RESPOND TO THE WIDE-RANGING IMPACT ON THE HOSPITAL INCLUDING CLINICAL LEADERSHIP, OPERATIONS, SUPPLY CHAIN, AND HUMAN RESOURCES. THE COVID TASK FORCE WAS CONSTANTLY MONITORING AND OR IN TOUCH WITH THE MANY FEDERAL, STATE AND CITY AGENCIES TO ENSURE PROPER PROTOCOLS/PROCEDURES WERE DEVELOPED IN RESPONSE TO THE SIGNIFICANT AMOUNT OF INFORMATION CIRCULATING AND REGULATIONS DEVELOPED AS WELL AS ACCESSING AVAILABLE SUPPORT.THE HOSPITAL DEVELOPED SURGE CAPACITY TO PROVIDE 150% OF PRE-COVID BED CAPACITY. INPATIENT HOSPITAL UNITS WERE CONVERTED TO DEDICATED COVID UNITS AND THE NUMBER OF DEDICATED UNITS INCREASED AS THE NUMBER OF COVID PATIENTS INCREASED. FLUSHING HOSPITAL ALSO WAS UTILIZED TO CARE FOR PEDIATRIC AND PSYCHIATRIC PATIENTS FROM JAMAICA HOSPITAL MEDICAL CENTER WHICH UTILIZED SPACE THAT HOUSED THESE SERVICES FOR SURGE CAPACITY. THE OUTPATIENT SITE WAS CONVERTED TO SERVE AS AN EXTENSION OF THE EMERGENCY DEPARTMENT CARING FOR NON-URGENT PATIENTS SUSPECTED OF HAVING COVID AND STAFF WERE REDEPLOYED TO THE MAIN HOSPITAL TO SUPPORT INPATIENT OPERATIONS INCLUDING CLINICAL SUPPORT, PPE DISTRIBUTION, PATIENT FAMILY COMMUNICATION. OTHER AREAS OF THE HOSPITAL WERE USED TO PROVIDE FOR OUTPATIENT INFANT, CHILD AND ADULT CARE AND TELEHEALTH SERVICES WERE GREATLY EXPANDED. THE HOSPITAL HAS CONTINUED TO CARE FOR PATIENTS WITH COVID AFTER THE INITIAL WAVE AND THROUGH 2021.THE HOSPITAL IMPLEMENTED SEVERAL PROGRAMS TO ASSIST OUR PATIENTS AND COMMUNITY RECEIVE HEALTH CARE:1. EMR SYSTEM MODIFICATIONS AND WORKFLOWS WERE DEVELOPED TO ALLOW FOR TELEHEALTH APPOINTMENTS FOR BOTH MEDICAL AND MENTAL HEALTH CARE.2. FAMILY VISITATION DURING HIGH LEVELS OF COVID IN THE COMMUNITY WERE CURTAILED, AND IN RESPONSE THE HOSPITAL DEVELOPED A PROGRAM FOR VIRTUAL VISITATION AND FOR CONTACT WITH FAMILY MEMBERS REGARDING PATIENT STATUS FOR THOSE PATIENTS WITH AND WITHOUT COVID.3. INFORMATION WAS INCLUDED IN SOCIAL MEDIA POSTS. SOCIAL MEDIA ARTICLES ON COVID-19- COVID-19 AND MENTAL HEALTH- COVID-19 AND WARM WEATHER ACTIVITIES- COVID-19 WHEN IS IT SAFE TO RETURN TO WORK?- COVID-19 CAN YOU GET IT MORE THAN ONCE?- COVID-19 CAN IT LEAD TO A STROKE?- COVID-19 AND LARGE HOLIDAY GATHERINGS PRECAUTIONS- COVID-19 AND THANKSGIVING FESTIVITIES- COVID-19 AND HOLIDAY SHOPPING SUGGESTIONS- COVID-19 VERSUS ALLERGIES - COVID-19 POST INFECTION CARE- COVID-19 LONG HAUL CENTER IN HOLLIS- COVID-19 AND CDC GUIDELINES 4. THE HOSPITAL'S WEBSITE WAS UPDATED TO INCLUDE A COVID-19 RESOURCE PAGE- INFORMATION ON WHERE TO GET TESTED- INFORMATION ON HOW TO SCHEDULE AN APPOINTMENT FOR THE VACCINE5. IMMEDIATE ISOLATION OF THOSE WITH SUSPECTED COVID, PPE, SOCIAL DISTANCING, FREQUENT CLEANING AND DISINFECTION AND MASK WEARING. THESE ITEMS WERE CONTINUED THROUGHOUT 2020 AND 2021.6. OUR CARE MANAGEMENT DEPARTMENT REACHED OUT TO HIGH RISK AND DISCHARGED PATIENTS PERFORMING THE FOLLOWING SERVICES:- ONGOING CARE MANAGEMENT SERVICES, TELEPHONICALLY, TO ALL ELIGIBLE COVID AND NON-COVID PATIENTS (AT-HOME VISITS SUSPENDED)- COVID AND STAY-SAFE EDUCATION PROVIDED TO ALL PATIENTS BASED ON CURRENT FEDERAL, STATE AND CITY GUIDANCE- EDUCATION AND GUIDANCE TO TELEHEALTH SERVICES IN ADDITION TO ONGOING CARE COORDINATION WITH PATIENT PCPS AND SPECIALISTS- ONGOING COMMUNITY-BASED RESOURCE REFERRALS, PROPERLY VETTED FOR AVAILABILITY. THIS INCLUDED BOTH COVID AND NON-COVID RESOURCES- TARGETED OUTREACH TO VULNERABLE PATIENTS TO ASSESS STATUS AND NEEDS- IDENTIFICATION AND REFERRAL FOR MENTAL HEALTH SERVICES- IMPLEMENTATION OF COVID SCREENING FOR ALL PATIENTS UPON ENGAGEMENT AND WITH EACH SUBSEQUENT CONTACT/INTERACTION. THIS INCLUDED APPROPRIATE REFERRAL TO TESTING SITES IF INDICATED7. OUR WOMEN'S HEALTH CENTER CONDUCTED PRE-NATAL CENTERING PROGRAM TELE VIDEO SESSIONS.DURING THE SUMMER OF 2020 WHILE THE PANDEMIC WANED, OUTREACH TO PATIENTS WITH CHRONIC CONDITIONS AND PEDIATRIC PATIENTS DUE FOR VACCINATIONS AND WELL CHILDCARE WHO DID NOT SEEK CARE DURING THE COVID SURGE WERE ENCOURAGED TO COME INTO THE OUTPATIENT CLINICS TO BE SEEN. THE SECOND WAVE TOOK PLACE FROM MID-NOVEMBER 2020 THROUGH THE END OF THE YEAR AND BEYOND AND WHILE LESS INTENSIVE DID REQUIRE A HIGH LEVEL OF OVERSIGHT AND RESPONSE. DURING THE SECOND WAVE MANY OF THE ENHANCEMENTS FROM THE FIRST WAVE WERE REESTABLISHED. ADDITIONAL WAVES OF COVID TOOK PLACE THROUGH 2021 AND DURING THOSE WAVES, A HIGH LEVEL OF RESPONSE MEASURES WERE ACTIVATED AS THE SITUATION REQUIRED.