Community Benefit Insight - Tax-exempt hospital

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Moses-ludington Hospital

Moses-Ludington Hospital

1019 Wicker Street
Ticonderoga, NY 12883

Bed count	25	Medicare provider number	331306	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 141372647

Display data for year:

Community Benefit Spending- 2018
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

28.51%

Spending by Community Benefit Category- 2018
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2018

Additional data

Community Benefit Expenditures: 2018

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 5,351 0.17 %
Medicaid as % of operating expenses	$ 330,689 10.33 %
Costs of other means-tested government programs as % of operating expenses	$ 5,351 0.17 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 571,005 17.84 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2018

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 131,504 4.11 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 4,078 3.10 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2018

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2018

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 2585259 including grants of $ 0) (Revenue $ 2280323)
MOSES-LUDINGTON HOSPITAL BEGAN PROVIDING HEALTH CARE SERVICES IN JUNE 1908. THROUGH APRIL 2018, THE HOSPITAL WAS A 15 BED CRITICAL ACCESS HOSPITAL WITH A 24-HOUR EMERGENCY ROOM AND HELICOPTER TRANSPORT CAPABILITY, OUTPATIENT CLINIC, PHYSICAL AND OCCUPATIONAL THERAPY CENTERS, CARDIAC REHABILITATION CENTER, OUTPATIENT SURGICAL SERVICES, AND EARLY PREVENTION CENTER.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 2: ON APRIL 10, 2018, THE HOSPITAL SOLD ESSENTIALLY ALL OF ITS OPERATING ASSETS (PRIMARILY ACCOUNTS RECEIVABLE, SUPPLIES,AND PROPERTY AND EQUIPMENT) NET OF OUTSTANDING LIABILITIES (PRIMARILY ACCOUNTS PAYABLE, ACCRUED EXPENSES, ANDESTIMATED THIRD-PARTY PAYOR SETTLEMENTS) TO ELIZABETHTOWN COMMUNITY HOSPITAL, A NEARBY ACUTE CARE CRITICAL ACCESSHOSPITAL LOCATED IN ELIZABETHTOWN, NEW YORK.

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 5: THE 81 QUESTION SURVEY WAS DEVELOPED THROUGH A COLLABORATIVE EFFORT BY A SEVEN-MEMBER SURVEY ARHN SUBCOMITTEE DURING THE SPRING OF 2016. THE SEVEN VOLUNTEER MEMBERS ARE REPRESENTATIVES OF THE COUNTY PUBLIC HEALTH DEPARTMENTS AND HOSPITALS IN THE REGION THAT ARE INVOLVED IN THE ADIRONDACK RURAL HEALTH NETWORK (ARHN). SUBCOMITTEE MEMBERS IDENTIFIED THE BROAD RESEARCH QUESTIONS TO BE ADDRESSED BY THE SURVEY, DRAFTED THE INDIVIDUAL SURVEY QUESTIONS, AND DEVELOPED THE LIST OF RELEVANT HEALTH CARE STAKEHOLDERS THAT RECEIVED THE SURVEY. A MORE DETAILED DESCRIPTION OF THE PROCESS IS INCLUDED IN THE FULL REGIONAL REPORT.THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO AN EMAIL CONTACT LIST OF 658. ULTIMATELY, 217 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 33.9%. OF ALL 217 RESPONSES, 79 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTHCARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION.

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 6A: OTHER HOSPITALS INCLUDE ELIZABETHTOWN COMMUNITY HOSPITAL AND ADIRONDACK MEDICAL CENTER.DATA WAS GATHERED AND ANALYZED BY ARHN - A REGIONAL MULTI-STAKEHOLDER COALITION THAT CONDUCTS COMMUNITY HEALTH PLANNING ACTIVITIES BY PROVIDING THE FORUM FOR LOCAL PUBLIC HEALTH SERVICES, COMMUNITY HEALTH CENTERS, HOSPITALS, COMMUNITY MENTAL HEALTH PROGRAMS, EMERGENCY MEDICAL SERVICES, AND OTHER COMMUNITY-BASED ORGANIZATIONS TO ASSESS REGIONAL NEEDS AND THE EFFECTIVENESS OF THE RURAL HEALTH CARE DELIVERY SYSTEM.

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 6B: ESSEX COUNTY HEALTH DEPARTMENT

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 11: OTHER HIGH RANKING ISSUES IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT WHICH WE WILL NOT BE DIRECTLY ADDRESSING INCLUDE:- MATERNAL AND INFANT HEALTH: AS A SMALL, CRITICAL ACCESS HOSPITAL WITHOUT ONSITE SPECIALTY SERVICES, WE FEEL ILL-EQUIPPED TO ADDRESS THIS IDENTIFIED NEED.- BUILT ENVIRONMENT: WE FEEL THIS ISSUE BETTER ALIGNS WITH THE MISSION OF OTHER ORGANIZATIONS IN THE DEVELOPMENT OF COMMUNITY WALKING PATHS AND COMMUNAL GARDENS.- SUBSTANCE ABUSE AND MENTAL, EMOTIONAL AND BEHAVORIAL HEALTH: ESSEX COUNTY HAS VERY LIMITED MENTAL HEALTH RESOURCES TO HANDLE THE NEEDS OF THE POPULATION. ALTHOUGH IDENTIFIED AS A SIGNIFICANT NEED IN OUR COMMUNITY, MOSES-LUDINGTON CANNOT DEVELOP AND MAINTAIN INTERVENTIONS TO ADDRESS IT. SUBSTANCE ABUSE AND MENTAL HEALTH ARE NOT IN MLH'S CORE MISSION OR SKILL SET.

MOSES-LUDINGTON HOSPITAL
PART V, SECTION B, LINE 24: SELF-PAY PATIENTS ARE CHARGED GROSS CHARGES UNTIL THEY CONTACT THE HOSPITAL FOR A PROMPT PAYMENT DISCOUNT OR FINANCIAL ASSISTANCE. THE HOSPITAL DOES NOT ROUTINELY DISCOUNT SELF-PAY BILLS.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7:
IN CALCULATING LINE 7, COLUMN E, WE USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS FOR THIS SCHEDULE. THE CHARGES AND COSTS THAT WE USED WERE FROM THE COST REPORT AND INCLUDED ALL SERVICES PROVIDED BY THE HOSPITAL. WHERE A COST TO CHARGE RATIO WAS NEEDED, WE USED THE COST TO CHARGE RATIO FROM WORKSHEET C ON THE FILED 2018 MEDICARE COST REPORT.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 278,115.

PART III, LINE 2:
COST-TO-CHARGE RATIO

PART III, LINE 4:
ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, INTER-LAKES HEALTH ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, INTER-LAKES HEALTH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), INTER-LAKES HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 8:
SINCE MOSES-LUDINGTON IS A CRITICAL ACCESS HOSPITAL, WE TOOK THE MEDICARE ALLOWABLE COSTS CALCULATED ON THE COST REPORT AND REPORTED THEM ABOVE ON LINE 6.

PART III, LINE 9B:
PER THE MOSES-LUDINGTON FINANCIAL ASSISTANCE POLICY:1. WHEN A PATIENT HAS COMPLETED AND RETURNED AN APPLICATION FOR FINANCIAL ASSISTANCE, THE CLAIM WILL NOT BE FORWARDED TO A COLLECTION AGENCY, PENDING DETERMINATION OF ELIGIBILITY.2. THE HOSPITAL WILL NOT FORECLOSE, REQUIRE A FORCED SALE OR PLACE A LIEN ON THE APPLICANT'S PRIMARY RESIDENCE.3. PATIENTS WILL BE NOTIFIED AT LEAST 30 DAYS PRIOR TO FORWARDING AN ACCOUNT TO THE COLLECTION AGENCY.4. MOSES-LUDINGTON HOSPITAL WILL PROVIDE WRITTEN CONSENT TO A COLLECTION AGENCY PRIOR TO COMMENCING LEGAL ACTION ON AN ACCOUNT.5. COLLECTION AGENCIES CONTRACTED BY MOSES-LUDINGTON HOSPITAL WILL FOLLOW THE HOSPITAL'S FINANCIAL AID POLICIES AND PROCEDURES, INCLUDING THE MEANS OF APPLYING FOR AID.6. COLLECTIONS ARE PROHIBITED FROM PATIENTS ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.7. A FAVORABLE DETERMINATION STILL ENABLES THE PATIENT TO MAKE INSTALLMENT PAYMENTS AT NO GREATER THAN 10% OF GROSS MONTHLY INCOME. THE PATIENT WILL BE REQUIRED TO SIGN A PAYMENT AGREEMENT IN THIS INSTANCE.

PART VI, LINE 2:
MOSES-LUDINGTON HOSPITAL (MLH) REGULARLY SOLICITS FEEDBACK AND INPUT FROM THE RESIDENTS OF OUR COMMUNITIES REGARDING THEIR HEALTH CARE NEEDS AND PREFERENCES. THIS ALLOWS MLH TO ENSURE THAT ESSENTIAL HEALTH CARE SERVICES ARE PRESERVED AND DEVELOPED AS NEEDED. TO THIS END, MLH SERVES ON THE ADIRONDACK RURAL HEALTH NETWORK (ARHN), COMMUNITY HEALTH PLANNING COMMITTEE (CHPC) AND COMMUNITY HEALTH ASSESSMENT (CHA) TASKFORCE.THE ARHN IS A COMMUNITY PARTNERSHIP OF PUBLIC, PRIVATE AND NON-PROFIT ORGANIZATIONS IN UPSTATE NEW YORK. THE ARHN FACILITATES A COLLABORATIVE PROCESS FOR DEVELOPING STRATEGIES AND FOR IMPLEMENTING, MONITORING AND EVALUATING THE REGIONAL HEALTH CARE SYSTEM. AS A LONG TIME MEMBER OF THE ARHN, MLH ACTIVELY SUPPORTS AND PARTICIPATES IN THIS GATHERING OF INFORMATION FROM A VARIETY OF STAKEHOLDERS. THIS PROCESS IS CONDUCTED REGIONALLY AND IS REPEATED EVERY THREE TO FIVE YEARS.MLH ALSO SOLICITS INDIVIDUAL PATIENT FEEDBACK REGULARLY THROUGH MULTIPLE PATIENT SATISFACTION SURVEYS. THESE SURVEYS ARE DEPARTMENT SPECIFIC AND ARE A VALUABLE METHOD OF MEASURING PUBLIC PERCEPTION OF PATIENT CARE. BOTH IN-PATIENT AND OUT-PATIENT DEPARTMENT DISCHARGES ARE SURVEYED, IN WRITTEN FORM AND BY TELEPHONE.

PART VI, LINE 3:
BY VIRTUE OF ITS EXEMPTION FROM FEDERAL AND STATE TAXES, AND AS PART OF THE HOSPITAL'S MISSION TO SERVE THE HEALTHCARE NEEDS OF THE COMMUNITY, MLH PROVIDES CHARITY CARE TO PATIENTS WITHOUT HEALTH INSURANCE OR THE FINANCIAL MEANS TO PAY FOR HOSPITAL SERVICES. CHARITY CARE IS PROVIDED TO ALL PATIENTS IN NEED IN FULL COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT, WITHOUT REGARD TO RACE, CREED, COLOR OR NATIONAL ORIGIN. CHARITY CARE SERVICES INCLUDE THOSE WHO ARE CLASSIFIED AS FINANCIALLY OR MEDICALLY INDIGENT ACCORDING TO THE HOSPITAL'S ELIGIBILITY SYSTEM.MLH PUBLISHES A FINANCIAL ASSISTANCE SUMMARY, UPDATED ANNUALLY, THAT ANSWERS ELIGIBILITY QUESTIONS AND DESCRIBES THE APPLICATION PROCESS. MLH EMPLOYS PATIENT ACCOUNTING REPRESENTATIVES FOR THIS PURPOSE. REGISTRATION STAFF IS TRAINED TO EDUCATE PATIENTS WHO NEED FINANCIAL ASSISTANCE WHEN THEY PRESENT FOR SERVICES. UNINSURED PATIENTS ARE PROVIDED A PACKET OF INFORMATIONAL MATERIAL, INCLUDING A FINANCIAL ASSISTANCE APPLICATION. SERVICES OF A TRANSLATOR ARE AVAILABLE FOR NON-ENGLISH SPEAKING OR HEARING IMPAIRED PATIENTS.IN THE EVENT THAT IT IS DETERMINED THAT A PATIENT DOES NOT QUALIFY FOR FREE OR LOW-COST INSURANCE, MLH'S FINANCIAL COUNSELOR OR PATIENT ACCOUNTING REPRESENTATIVE WILL ASSIST THEM IN APPLYING FOR A DISCOUNT.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART VI, LINE 4:
MLH'S SERVICE AREA IS DEFINED BY ZIP CODE, AND IS COMPOSED PRIMARILY OF SIX ZIP CODES IN SOUTHEASTERN ESSEX COUNTY AND NORTHEASTERN WARREN AND WASHINGTON COUNTIES. HISTORICALLY, ABOUT 90% OF MLH'S PATIENTS RESIDE WITHIN THIS GEOGRAPHY, WITH THE REMAINING 10% BEING SEASONAL RESIDENTS. MLH SERVES AN INDEFINABLE TOURIST POPULATION AS WELL, SINCE THIS REGION IS A POPULAR NATIONAL VACATION SPOT. MLH IS LOCATED IN CONGRESSIONAL DISTRICT 23, 57 MILES FROM THE NEAREST ACUTE CARE NEW YORK STATE HOSPITAL, AND IS GEOGRAPHICALLY REMOTE FROM THREE COUNTY SEATS. THE TOWN OF TICONDEROGA IS LOCATED WITHIN THE 6 MILLION ACRE ADIRONDACK PARK. THE AREA'S SMALL VILLAGES AND HAMLETS ARE AT RISK FOR COMPLETE ISOLATION DURING ALL SEASONS BECAUSE OF THE SEVERE WEATHER CONDITIONS, FREQUENT POWER OUTAGES, ROAD IMPASSABILITY, AND MOUNTAINOUS TOPOGRAPHY. FOR THESE REASONS, AREA RESIDENTS TEND TO BE PLACE-BOUND AND ISOLATED. PUBLIC TRANSPORTATION IS VIRTUALLY NON-EXISTENT, AND THERE ARE FEW SECONDARY ROADS. THE TOWN OF TICONDEROGA OWNS AND OPERATES A SENIOR BUS AS LOW COST TRANSPORTATION FOR THE OTHERWISE HOME-BOUND ELDERLY.THE ECONOMY IS PRIMARILY GOVERNMENTAL OR SEASONAL, AND INCLUDES LAW ENFORCEMENT, PRISONS, EDUCATION, AND HEALTHCARE. MLH/ILH IS ONE OF THE TOP THREE EMPLOYERS IN THE TICONDEROGA AREA, FOLLOWED BY THE SCHOOL SYSTEM AND INTERNATIONAL PAPER'S TICONDEROGA MILL. MUCH OF THE AREA'S EMPLOYMENT OPPORTUNITIES FOCUS ON SEASONAL TOURISM, ALTHOUGH THIS HAS BEEN THINNING OVER THE YEARS. IT REACHED AN ALL-TIME LOW AFTER RISING GAS PRICES MET THE DWINDLING ECONOMIC CLIMATE NATIONWIDE. SEASONAL EMPLOYMENT USUALLY COMES WITHOUT HEALTHCARE BENEFITS, AND SO EXPANDS THE NUMBER OF WORKING COMMUNITY MEMBERS WITHOUT MEDICAL INSURANCE. LACKING SUBSTANTIAL EMPLOYMENT WITHOUT COMPREHENSIVE BENEFIT PLANS CONTRIBUTES TO THE POVERTY OF THE AREA'S RESIDENTS. IN THIS REGION, CHILDREN BETWEEN THE AGES OF 5 AND 17 LIVE IN POVERTY AT A RATE OF 16.1%.BASED ON THE U.S. CENSUS ESTIMATES, APPROXIMATELY 14,000 PEOPLE LIVE YEAR-ROUND WITHIN MLH'S SERVICE AREA, OF WHICH 50.4% ARE MALE AND 49.6% ARE FEMALE. OF THE TOTAL FEMALE POPULATION, APPROXIMATELY 38% ARE OF CHILDBEARING AGE. PEOPLE OVER THE AGE OF 65 CONSTITUTE 17.3% OF THE POPULATION. ETHNICALLY, NEARLY 100% OF THE POPULATION IS WHITE AND/OR NON-HISPANIC. THE GREATEST POPULATION GROWTH TREND IN OUR SERVICE AREA WILL BE FOR PEOPLE BETWEEN THE AGES 45 AND 75.

PART VI, LINE 5:
MOSES-LUDINGTON HOSPITAL (MLH) AND ITS PARENT INTER-LAKES HEALTH (ILH) ARE GOVERNED BY A VOLUNTEER BOARD MADE UP OF COMMUNITY MEMBERS. MANY MEMBERS OF OUR BOARD SERVE IN A PUBLIC CAPACITY, EITHER AS A MEMBER OR OFFICER ON ANOTHER NOT-FOR-PROFIT BOARD OR COMMITTEE, OR IN A POSITION WITHIN PUBLIC HEALTH, OR AS A MEMBER OF A NON-FOR-PROFIT SERVICE ORGANIZATION WITHIN THE SAME SERVICE AREA.MLH PARTICIPATES IN THE HRSA BIOTERRORISM GRANT PROGRAM, A FEDERAL PROGRAM ADMINISTERED THROUGH THE NYS DEPARTMENT OF HEALTH'S GRANT ADMINISTRATION OFFICES. THIS PROGRAM PROVIDES ONGOING INDIVIDUAL AND GROUP TRAINING IN MANY ASPECTS OF EMERGENCY PREPAREDNESS. MLH'S ENVIRONMENT OF CARE (EOC) MANAGER FACILITATES THE GRANT AND OVERSEES THE HOSPITAL SAFETY PROGRAM AND DECONTAMINATION TEAM. SHE PARTICIPATES IN REGULAR DRILLS IN COOPERATION WITH AREA ORGANIZATIONS, INCLUDING BUT NOT LIMITED TO LOCAL EMS SQUADS, THE VOLUNTEER FIRE DEPARTMENT, LOCAL POLICE AND COUNTY AUTHORITIES.A NUMBER OF NOT-FOR-PROFIT COMMUNITY-BASED ORGANIZATIONS USE SPACE AT MLH TO HOST COMMUNITY SERVICE-ORIENTED MEETINGS, FREE AND OPEN TO THE PUBLIC, INCLUDING BUT NOT LIMITED TO ALCOHOLICS ANONYMOUS AND CELEBRATE RECOVERY.MLH DONATES PRIVATE CONSULTATION SPACE ON CAMPUS FOR THE ESSEX COUNTY MENTAL HEALTH ASSOCIATION TO UTILIZE AS A CLINIC OFFICE TO COUNSEL PATIENTS FROM OUR SERVICE AREA THAT MAY NOT HAVE RELIABLE TRANSPORTATION TO TRAVEL THE 50-MILE TRIP TO THE ASSOCIATION'S ELIZABETHTOWN HEADQUARTERS. WE HOST AN ALZHEIMER SUPPORT GROUP, CONDUCT 4 BLOOD DRIVES PER YEAR, HOST AN ANNUAL HEALTH FAIR AND HELP SUPPORT OTHER CAUSES IN THE COMMUNITY.

Operating expenses	$ 3,200,696
Total amount spent on community benefits as % of operating expenses	$ 912,396 28.51 %