4A (Expenses $ 6733812 including grants of $ 0) (Revenue $ 8981109)
INPATIENT DEPARTMENTS (MED/SURG AND SWING REHAB) & AMBULATORY SURGERY (OR):IN 2021, THE HOSPITAL AND THE FOUNDATION GAVE EDUCATION AWARDS RELATED TO HEALTH CARE SERVICES. THIS GENEROUS ASSISTANCE ALLOWED SEVEN STAFF MEMBERS TO PURSUE HIGHER DEGREES IN HEALTHCARE- RELATED FIELDS.ERH TAKES PRIDE IN SERVING AS A TEACHING HOSPITAL AND HOSTING STUDENTS FROM MANY SCHOOLS. ERH HAS HOSTED STUDENTS FROM SUNY SULLIVAN, SUNY ULSTER, SUNY ORANGE, BOCES NEW VISIONS PROGRAM, LE MOYNE COLLEGE, TOURO MEDICAL COLLEGE, CLARKSON UNIVERSITY, UNIVERSITY AT BUFFALO, ALBANY COLLEGE OF PHARMACY, RHODE ISLAND UNIVERSITY COLLEGE OF PHARMACY, ANTIGUA MEDICAL UNIVERSITY, MARIA COLLEGE, PACE UNIVERSITY, SACRED HEART UNIVERSITY, EASTWICK COLLEGE, LONG ISLAND UNIVERSITY, SUNY EMPIRE, ADELPHI UNIVERSITY, RUSSEL SAGE COLLEGE, MARIST COLLEGE, STONY BROOK UNIVERSITY, AND BAY PATH UNIVERSITY.IN 2021, WHILE MANAGING THE DISRUPTION CAUSED BY THE PANDEMIC, ERH COLLABORATED WITH THESE SCHOOLS TO PROVIDE CLINICAL ROTATIONS, INCLUDING HOSTING STUDENTS FROM TWO LOCAL COMMUNITY COLLEGES. THESE STUDENTS BENEFITED FROM WORKING WITH OUR SKILLED AND COMPASSIONATE CLINICAL TEAM. THEY OBSERVED THE DELIVERY OF EXCEPTIONAL CARE IN OUR INPATIENT, EMERGENCY DEPARTMENT, OPERATING ROOM, AND SPECIALTY SERVICES AS PART OF THEIR CLINICAL ROTATION. AS IN PAST YEARS, ERH PROVIDED THESE SERVICES WITHOUT REQUIRING ANY MONETARY COMPENSATION.PATIENT SATISFACTION AND POSITIVE OUTCOMES REMAIN SIGNIFICANT QUALITY INDICATORS. IN 2021, PATIENT SATISFACTION SCORES REACHED 95% FOR INPATIENT SERVICES. IN THE SUB-ACUTE REHABILITATION UNIT, ERH SAW A SUBSTANTIAL INCREASE IN ACUITY AND THE NUMBER OF COMPLEX CASES; NEVERTHELESS, ERH'S NURSING HOME PLACEMENT RATE WAS AT 9.8%. THESE STELLAR RESULTS ARE THE PRODUCT OF A MULTIDISCIPLINARY COLLABORATIVE EFFORT AMONG NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH-LANGUAGE PATHOLOGY, RESPIRATORY THERAPY, SOCIAL ACTIVITIES, CASE MANAGEMENT, AND REGISTERED DIETITIAN SERVICES.BY COMBINING QUALITY CARE, EVIDENCE-BASED RESEARCH, EXCELLENT NURSING SKILLS, AND EXPANDING OUR CLINICAL EDUCATION PROGRAMS, THE INPATIENT UNIT AT ELLENVILLE REGIONAL HOSPITAL MADE IT THEIR GOAL TO IMPROVE PATIENT OUTCOMES ACROSS THE CARE SPECTRUM. SOME OF THE MITIGATION STRATEGIES IMPLEMENTED DURING THE ONSET OF THE PANDEMIC ALLOWED ERH TO OFFER MUCH-NEEDED SERVICES IN OUR COMMUNITY.OUR NEGATIVE PRESSURE ROOMS EMPOWERED US TO HELP LARGER FACILITIES BALANCE THEIR PATIENT LOADS. PATIENTS READY TO LEAVE THE ACUTE CARE SETTING, STILL TESTING POSITIVE FOR COVID-19, COULD NOT RETURN TO LONG TERM CARE FACILITIES FOR REHABILITATION; HENCE, THEY TRANSFERRED TO ERH TO RECEIVE THE CARE NEEDED AND REGAIN THE STAMINA THEY HAD LOST.THESE PATIENTS WERE REHABILITATED AND TRANSFERRED BACK TO LTC FACILITIES AFTER THEY TESTED NEGATIVE FOR COVID-19.IN 2021, OUR FACILITY HELD STEADFAST, COLLABORATING WITH OTHER AGENCIES TO PROVIDE QUALITY, COMPASSIONATE CARE AND GENERATE POSITIVE OUTCOMES.IN 2021, WE CONTINUED TO SERVE PATIENTS NEEDING MEDICAL MANAGEMENT DURING DRUG AND ALCOHOL WITHDRAWAL BEFORE TRANSITIONING TO EITHER AN INPATIENT OR OUTPATIENT REHAB PROGRAM. ERH WORKS HARD TO HAVE PROTOCOLS IN PLACE TO FACILITATE A SEAMLESS TRANSITION FOR THIS POPULATION OF PATIENTS. ADDITIONALLY, THERE WERE PROTOCOLS INSTITUTED FOR VIVITROL ADMINISTRATION IN OUR SPECIALTY SERVICES CLINIC. THIS NEW PROTOCOL, ESTABLISHED IN COLLABORATION WITH A LOCAL INPATIENT REHABILITATION PROGRAM, HELPED MANY INDIVIDUALS TRANSITION SAFELY FROM REHABILITATION TO HOME.IN 2021, SAFETY WILL CONTINUE TO BE PARAMOUNT IN OUR FACILITY. WE TRACKED AND REPORTED COMPLIANCE WITH MEDICATION SCANNING. THIS PRACTICE ENHANCES SAFE MEDICATION ADMINISTRATION BY HELPING VERIFY PATIENT IDENTIFICATION AND CORRECT MEDICATION, ENSURING PROPER MEDICATION ADMINISTRATION, AND MITIGATING POTENTIAL ERRORS. WE SIGNIFICANTLY BOOST OUR SCORES AND COMPLIANCE FROM LAST YEAR TO ABOVE 85%.ERH'S SAFE PATIENT HANDLING COMMITTEE REVIEWED AND MAINTAINED SUCCESSFUL PRACTICES THAT MAXIMIZED A SAFE ENVIRONMENT FOR OUR PATIENTS AND STAFF. THE FOCUS OF THIS INITIATIVE IS TO ENSURE THAT OUR STAFF IS INJURY FREE. THE COMMITTEE HAS MADE A TREMENDOUS EFFORT TO DELIVER GUIDANCE AND TRAINING STAFF ON TRANSFERS, BODY MECHANICS, AND THE USE OF ASSISTIVE DEVICES. THEY HAVE EFFECTIVELY INCORPORATED EVIDENCE-BASED PRACTICES IN OUR EVERYDAY TASKS AND ROUTINES, LIKE THE BMAT MODEL (BED SIDE MOBILITY ASSESSMENT TOOL). THE SAFE PATIENT HANDLING COMMITTEE REGULARLY DISCUSSES EDUCATIONAL NEEDS AND PROVIDES HANDS-ON TRAINING TO ALL CLINICAL STAFF. ADDITIONALLY, OUR BEDS ARE EQUIPPED WITH ALARMS AND SPECIALTY MATTRESSES TO ENSURE SAFETY AND MAINTAIN SKIN INTEGRITY. WE ALSO IMPLEMENTED A VIDEO MONITORING SYSTEM TO HELP INCREASE SAFETY MEASURES FOR OUR PATIENTS IN ISOLATION.STAFF EDUCATION IS ALSO AN ESSENTIAL ELEMENT IN MAINTAINING AND PROMOTING CLINICAL COMPETENCY. ONE HUNDRED PERCENT OF OUR REGISTERED NURSES HOLD BASIC AND ADVANCED LIFE SUPPORT CERTIFICATION THROUGH THE AMERICAN HEART ASSOCIATION AND TELEMETRY. OUR NURSE EDUCATOR PROVIDES EDUCATION OPPORTUNITIES VIA IN-SERVICES, WEBINARS, LECTURES, AND SCHOLARLY ARTICLES. THE HANDS-ON TRAINING AND ACADEMIC OFFERINGS ENSURE OUR CLINICAL STAFF IS KNOWLEDGEABLE ON CURRENT TRENDS AND STANDARDS OF CARE. WE LINK ALL NEW HIRES WITH AN EXPERIENCED PRECEPTOR AND ADJUST THE ORIENTATION PROCESS TO MEET THE NEEDS OF EACH INDIVIDUAL. IN OUR FACILITY, EDUCATION DELIVERY INVOLVES EVERYONE. THE NURSE EDUCATOR COLLABORATES WITH THE NURSING LEADERSHIP TEAM, DIRECTOR OF PHARMACY, DIRECTOR OF REHABILITATION SERVICES, CLINICAL IT APPLICATIONS SPECIALIST, AND THE MANAGER OF RESPIRATORY SERVICES TO OFFER COMPREHENSIVE ANNUAL EDUCATION FOR ALL NURSING STAFF.

4B (Expenses $ 6566690 including grants of $ 0) (Revenue $ 5068270)
EMERGENCY DEPARTMENT:ELLENVILLE REGIONAL HOSPITAL COMPLETED AN EMERGENCY ROOM DEPARTMENT PROJECT IN 2021. WE EXPANDED THE CURRENT SPACE BY ADDING STATE-OF-THE-ART CARDIAC MONITORS AND NEGATIVE PRESSURE ISOLATION ROOMS. ERH'S EMERGENCY DEPARTMENT OFFERS A VITAL SERVICE TO OUR COMMUNITY. A RURAL SETTING CAN MAKE IT DIFFICULT FOR RESIDENTS TO ACCESS HIGH-QUALITY EMERGENCY CARE. BY COMBINING QUALITY CARE, EVIDENCE-BASED RESEARCH, EXCELLENT NURSING SKILLS, AND EXPANDING OUR CLINICAL EDUCATION PROGRAMS, THE EMERGENCY DEPARTMENT AT ERH FOCUSED ON IMPROVING PATIENT OUTCOMES ACROSS THE CARE SPECTRUM. AS A RESULT, OUR FACILITY COLLABORATES WITH OTHER AGENCIES AND PROVIDES QUALITY, COMPASSIONATE CARE.IN 2021, 11,624 PATIENTS RECEIVED TREATMENT IN THE EMERGENCY DEPARTMENT AT ELLENVILLE REGIONAL. WE CONTINUED TO PROVIDE EXCELLENT CARE MORE EXPEDIENTLY THAN OTHER EMERGENCY DEPARTMENTS ACROSS THE COUNTRY. OUR 2021 AVERAGE FOR ARRIVAL TO TRIAGE WAS A STELLAR THIRTEEN (13) MINUTES.ADDITIONALLY, THE AVERAGE LENGTH OF STAY WAS 122 MINUTES. THESE REMARKABLE TURNAROUND TIMES DERIVE FROM OUR MULTIDISCIPLINARY TEAM OF DEDICATED ED PROVIDERS, NURSES, PATIENT CARE TECHNICIANS, AND REGISTRATION, LAB, AND RADIOLOGY DEPARTMENTS STAFF. THE TEAM'S PRIMARY DRIVER IS TO PRIORITIZE AND ADDRESS PATIENT NEEDS IN THE COMMUNITY TO OPTIMIZE OUTCOMES.WHILE MANAGING THE LASTING EFFECTS OF THE COVID PANDEMIC, WE CONTINUE FOCUSING ON THE OPIOID CRISIS. OUR EMERGENCY DEPARTMENT'S RESCUE INITIATIVE HAS REMAINED IN EFFECT AND GENERATES VERY POSITIVE OUTCOMES. THE ED PROVIDERS ARE CERTIFIED TO PROVIDE MAT (MEDICATION ASSISTED TREATMENT). MAT HAS DRAMATICALLY FACILITATED THE TREATMENT OF PATIENTS PRESENTING TO THE ED AFTER AN OVERDOSE. WE HAVE CONTINUED OUR COLLABORATION EFFORTS WITH THE ULSTER COUNTY SHERIFF'S DEPARTMENT IN THE ORACLE PROGRAM AND UTILIZE THE SERVICES OF OUR IN-HOUSE SUBSTANCE USE DISORDER (SUD) PROGRAM. OUR COLLABORATIVE EFFORTS HAVE HELPED WITH THE INDUCTION OF MAT AND SECURING INPATIENT AND OUTPATIENT REHABILITATION SERVICES FOR THOSE IN NEED.WE ALSO CONTINUED TO WORK CLOSELY WITH OUR LOCAL EMS AGENCIES. IN 2021, ERH PROVIDED LOCAL EMS PROFESSIONALS WITH MEDICAL EDUCATION ACTIVITIES RELATED TO THE MANAGEMENT OF PEDIATRIC EMERGENCIES.TO CONTINUE TO MITIGATE COVID- 19 RISKS, WE ENGAGED OUR STAFF VIA ZOOM MEETINGS. WE HELD EDUCATION SESSIONS PERIODICALLY TO ENSURE ALL STAFF WAS UP-TO-DATE ON EMERGING ISSUES AND TREATMENT REQUIREMENTS.

4C (Expenses $ 1426692 including grants of $ 0) (Revenue $ 2302508)
RADIOLOGY:IN 2021, ERH'S RADIOLOGY & CARDIOLOGY DEPARTMENTS STARTED THE YEAR WITH OUTPATIENT MODALITIES OVER-EXCEEDING OUR USUAL NUMBERS FROM THE PAST SEVERAL YEARS. EVEN WITH THE SPIKES IN COVID-19, WHICH WOULD FLUCTUATE RAPIDLY, WE CONTINUED TO HOLD CONSISTENT WITH OUR VOLUMES. MANY STAFF MEMBERS WOULD CONTRACT COVID PERIODICALLY, MAKING IT CHALLENGING TO OPERATE. STILL, ULTIMATELY, WE HELD STRONG AND WERE ABLE TO KEEP UP WITH OUR PATIENT DEMAND AND CONTINUE TO PROVIDE SERVICES WITHOUT INTERRUPTION OR DELAY.MAMMOGRAPHY HAD ITS ANNUAL MQSA INSPECTION COMPLETED WITH NO CITATIONS. WE CONTINUED OUR REDUCED X-RAY REPEAT/REJECT RATE, WHICH AVERAGED ABOUT 3% OVER THE YEAR. THIS CONTINUED REDUCTION IN RECURRENCES ALLOWED US TO PROVIDE OUR PATIENTS WITH THE HIGHEST LEVEL OF CARE.FOR NUCLEAR MEDICINE, ERH PURCHASED A NEW STATE-OF-THE-ART NUCLEAR CAMERA THAT ALLOWED US TO OFFER A HIGHER LEVEL OF NUCLEAR IMAGING, WHICH GROSSLY BENEFITS OUR PATIENTS AND THE COMMUNITY.WE ALSO ACQUIRED A NEW ECHO MACHINE TO IMAGE PATIENTS' HEARTS WITH MORE CLARITY AND IMPROVED DIAGNOSTIC ABILITIES. THESE NEW MACHINES ARE TIED TOGETHER WITH CERTAIN EXAMS AND ARE A HUGE ASSET TO OUR OUTPATIENT SERVICES. THE PURCHASE OF THESE MACHINES HAS ELEVATED OUR OUTPATIENT OFFERINGS TO A HIGHER STANDARD. ADDITIONALLY, WE HAVE SERVICE CONTRACTS, WHICH INCLUDE APPLICATION SUPPORT ON ALL OF OUR EQUIPMENT. IF A TECHNOLOGIST HAS ANY ISSUE WITH THE EQUIPMENT, THEY HAVE IMMEDIATE SERVICE ACCESS, INCLUDING GUIDANCE ON NEW PROTOCOLS OR EVEN USING SPECIAL FEATURES ON THE MACHINES.ERH CONTINUED TO EXPAND ON THE SERVICES PROVIDED BY THE QUALITY IMPROVEMENT GRANT, AWARDED TWO YEARS PRIOR. WITH THIS GRANT, ERH PERFORMED AN OUTSTANDING 590 EXAMS IN 2021. OFFERING THE EXAMS AT NO OUT-OF-POCKET COST TO PATIENTS HAS BEEN SUCCESSFUL, WITH MANY PATIENTS RECEIVING CRUCIAL FOLLOW-UP CARE BASED ON THE TEST RESULTS. MANY OF THE CALCIUM SCORE PATIENTS HAVE BEENFIRST-TIME PATIENTS AT ERH. MANY PATIENTS HAVE RETURNED FOR OTHER OUTPATIENT SERVICES DUE TO THE HIGH LEVEL OF CARE AND REMARKABLE EXPERIENCE.OVERALL, RADIOLOGY AND CARDIOLOGY POSITIONED THEMSELVES TO HAVE A STRONG 2022 WHILE KEEPING PATIENTS AND STAFF HEALTHY AND SAFE. WE WILL CONTINUE TO OFFER THE HIGHEST LEVEL OF CARE AND OBTAIN THE NEWEST EQUIPMENT TO PROVIDE THE BEST SERVICE TO OUR COMMUNITY.

4D (Expenses $ 4808850 including grants of $ 0) (Revenue $ 9258656)
THE HOSPITAL ALSO PROVIDES OUR PATIENTS WITH AMBULATORY SURGERY, LAB SERVICES, IV THERAPY, PHYSICAL THERAPY, CARDIAC REHAB, AND PRESCRIPTION DRUGS.

WESTCHESTER-ELLENVILLE HOSPITAL, INC.
PART V, SECTION B, LINE 5: AS REQUIRED BY THE NEW YORK STATE DEPARTMENT OF HEALTH AND IRS, ELLENVILLE REGIONAL HOSPITAL (ERH) MUST CONDUCT A THOROUGH COMMUNITY HEALTH ASSESSMENT (CHA) EVERY THREE YEARS. THE INFORMATION IS UTILIZED TO DEVELOP A COMMUNITY SERVICE PLAN (CSP) OUTLINING INTERVENTIONS DESIGNED TO IMPROVE HEALTH OUTCOMES IN THE SERVICE AREA. IN RECENT YEARS, THE NEW YORK STATE DEPARTMENT OF HEALTH HAS ENCOURAGED LOCAL HOSPITALS AND HEALTH DEPARTMENTS TO COLLABORATE IN CREATING JOINT COMMUNITY HEALTH IMPROVEMENT (CHIP)/CSP DOCUMENTS. ULSTER COUNTY DEPARTMENT OF HEALTH (UCDOH) HOSTED A SERIES OF MEETINGS WITH KEY STAKEHOLDER ORGANIZATIONS IN ULSTER COUNTY TO DISCUSS THE SELECTION OF HEALTH IMPROVEMENT PRIORITIES. ERH, WITH ITS PARTNERS UCDOH AND HEALTHALLIANCE HOSPITAL: MARY'S AVE CAMPUS (HA), JOINTLY SELECTED PREVENTING CHRONIC DISEASES AND PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AS THE TWO PRIORITY AREAS FOR THE 2019-2021 CHIP/CSP. COMMUNITY-BASED ORGANIZATIONS, HEALTH CARE PROVIDERS, SEVERAL COUNTY OF ULSTER DEPARTMENTS, AND ULSTER COUNTY COALITIONS WERE ALSO INVOLVED IN THE DECISION-MAKING PROCESS AND WORKED TO SUPPORT THE SELECTED INITIATIVES. THIS COLLABORATION HAS CONTINUED TO INCLUDE MANY SERVICE AGENCIES IN ULSTER COUNTY AS THE UCDOH IS CURRENTLY WORKING TO FINALIZE THE COUNTY'S PRIORITY AREAS FOR 2022-2024.IN 2017, THE SEVEN LOCAL HEALTH DEPARTMENTS OF THE MID-HUDSON REGION, INCLUDING DUTCHESS, ORANGE, PUTNAM, ROCKLAND, SULLIVAN, ULSTER, AND WESTCHESTER COUNTIES, CREATED THE HUDSON VALLEY PUBLIC HEALTH COLLABORATIVE WITH THE ENDEAVOR OF CREATING THE FIRST REGIONAL CHA FOR THE MID-HUDSON REGION. THE COLLABORATIVE CONTRACTED THE SIENA COLLEGE RESEARCH INSTITUTE (SCRI) TO CONDUCT A RANDOM DIGIT DIAL REGIONAL COMMUNITY HEALTH SURVEY TO SUPPLEMENT THE REG CHA AND TO GAUGE THE PERCEPTION OF RESIDENTS SURROUNDING HEALTH AND RESOURCES IN THEIR COMMUNITIES. TO FURTHER INCREASE THE DATA COLLECTED FROM THE COMMUNITY, COLLABORATIVE MEMBERS HELD FOCUS GROUPS WITH SERVICE PROVIDERS TO FURTHER UNDERSTAND THE NEEDS OF SPECIFIC COMMUNITIES AND POPULATIONS AND THE BARRIERS THEY FACE TO ACHIEVING OPTIMAL HEALTH. IN 2022, ELLENVILLE REGIONAL RURAL HEALTH NETWORK (ERRHN), WHICH SERVES AS THE POPULATION HEALTH DEPARTMENT OF ELLENVILLE REGIONAL HOSPITAL (CREATED IN 2017), ASSISTED WITH THE REJOINING OF THIS GROUP TO MAKE ANOTHER REGIONAL CHA FOR 2022. SCRI WAS AGAIN CONTRACTED, AND 5,699 SURVEYS WERE COLLECTED FROM THE MID-HUDSON REGION'S POPULATION, WITH AN AVERAGE OF 814 SURVEYS COLLECTED FOR EACH OF THE SEVEN COUNTIES. ERRHN ALSO REQUESTED SCRI RESPONSES SPECIFIC TO THE ZIP CODES WITHIN ERH'S SERVICE AREA AND RECEIVED THE RESPONSES FROM 313 SURVEYS. AS A REGULAR PART OF THE MANY GRANT PROJECTS RUN BY ERRHN, GAP ANALYSES ARE PERFORMED ON POPULATION-LEVEL DATA TO UNDERSTAND BETTER THE COMMUNITY'S NEEDS THAT NEED TO BE ADDRESSED TO ENSURE A COMPREHENSIVE PUBLIC HEALTH PROGRAM.ADDITIONALLY, THE HEALTHY ULSTER COUNCIL, A BROAD-BASED COALITION FORMED BY REPRESENTATIVES FROM VARIOUS ORGANIZATIONS AND AGENCIES IN 2010, HAS BEEN ONGOING IN ITS FOCUS ON HEALTH PROBLEMS IN ULSTER COUNTY AND WAYS TO IMPROVE HEALTH OUTCOMES. REGULAR MEETINGS OF THE COALITION, ALONG WITH PRESENTATIONS AND DISCUSSIONS, HAVE KEPT THE LARGER COMMUNITY INVOLVED IN TRACKING HEALTH CONCERNS AND SOLUTIONS, INCLUDING ELLENVILLE AND THE TOWN OF WAWARSING.

WESTCHESTER-ELLENVILLE HOSPITAL, INC.
PART V, SECTION B, LINE 6B: 1) HEALTH ALLIANCE OF THE HUDSON VALLEY2) ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH3) THE INSTITUTE FOR FAMILY HEALTH4) DUTCHESS COUNTY DEPARTMENT OF HEALTH5) ORANGE DEPARTMENT OF HEALTH6) PUTNAM DEPARTMENT OF HEALTH7) ROCKLAND DEPARTMENT OF HEALTH8) SULLIVAN DEPARTMENT OF HEALTH9) WESTCHESTER DEPARTMENT OF HEALTH

WESTCHESTER-ELLENVILLE HOSPITAL, INC.
"PART V, SECTION B, LINE 11: FOR ERH SPECIFICALLY, THE FOCUS AREAS CHOSEN WITHIN THE TWO PREVENTION AGENDA PRIORITIES FOR THE YEARS 2022-2024 ARE:1) PREVENT CHRONIC DISEASES FOCUS AREA 4: PREVENTIVE CARE AND MANAGEMENT2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. FOCUS AREA 2: PREVENT MENTAL AND SUBSTANCE USER DISORDERSPREVENT CHRONIC DISEASES FOCUS AREA 4, THE ELLENVILLE REGIONAL RURAL HEALTH NETWORK (ERRHN) WELLNESS PROGRAM, AND ITS EDUCATIONAL PROGRAMMING WILL BE CONTINUALLY DEVELOPED AND IMPLEMENTED. THE COLLABORATIVE WILL WORK TO INCREASE PARTICIPATION IN LIFESTYLE CHANGES, INCLUDING INCREASED PHYSICAL ACTIVITY, IMPROVED DIET, AND IMPROVED HEALTH AND WELL-BEING AWARENESS, UTILIZING THE EVIDENCE-BASED COMMUNITY HEALTH WORKER (CHW) MODEL.INTERVENTION 1 SUMMARY: ERH HAS IDENTIFIED OVER 40 FAMILIES WORKING WITH A COMMUNITY HEALTH WORKER TO PRACTICE HEALTHY GOAL SETTING, INCREASING PHYSICAL ACTIVITY, AND BUILDING MOTIVATION. THE FAMILIES MAY ALSO ACCESS THE ERRHN NUTRITIONIST AT NO COST TO THEM. ALL OF THIS IS DONE TO DECREASE THE RISK OF DEVELOPING CHRONIC DISEASE. INTERVENTION 2 SUMMARY: ERH UTILIZES COLLABORATIVE EFFORTS BETWEEN DIFFERENT HOSPITAL DEPARTMENTS AND OTHER COMMUNITY-BASED ORGANIZATIONS TO OFFER SERVICES TO THE COMMUNITY THAT AIMS TO HELP OVERCOME SOCIAL DETERMINANT-RELATED HEALTH BARRIERS. THE PROGRAMS INCLUDE PHYSICAL ACTIVITY CLASSES, COOKING CLASSES, GARDENING CLASSES, AND EVEN A FREE PRODUCE HANDOUT ALL OF THESE ACTIVITIES ARE PROVIDED TO THE COMMUNITY AT NO DIRECT COST.INDIVIDUALS AND FAMILIES IDENTIFIED AS AT RISK IN THE COMMUNITY, AT THE ERH ED, OR A LOCAL PCP ARE REFERRED TO THE RHN WELLNESS PROGRAM. INDIVIDUALS WHO ACCEPT THE REFERRAL ARE ENROLLED INTO THE COHORT AND COMPLETE AN INTAKE ASSESSMENT WITH A COMMUNITY HEALTH WORKER (CHW) THAT INCLUDES COLLECTING CLINICAL METRICS, AN SDOH SCREENING (PRAPARE), AND HEALTH KNOWLEDGE AND BEHAVIOR ASSESSMENTS. THE CHW WORKS WITH THE INDIVIDUAL TO DEVELOP AN ACTION PLAN TO BEGIN MAKING LIFESTYLE CHANGES THAT REDUCE THEIR RISK OF CHRONIC DISEASE. THE CHW SUPPORTS THE COHORT BY OFFERING MEETINGS AT THEIR HOUSE, COMMUNITY LOCATION, LOCAL STORES, OR HOSPITAL. PROGRAMS INCLUDE:-ELIMINATING TRANSPORTATION BARRIERS.-ARRANGING MEDICATION RECONCILIATION AND BLISTER PACKAGING WITH THE ERH PHARMACIST.-GROCERY SHOPPING EDUCATION AT THE LOCAL GROCERY STORE.ADDITIONALLY, THE COHORT CAN MEET WITH A NUTRITIONIST ONSITE OR AT A SITE OF THEIR CHOOSING (TO OVERCOME TRANSPORTATION) TO MAKE MEAL PLANS AND HAVE NUTRITION COUNSELING. IN ADDITION, TO THE SUPPORT PROVIDED BY THE CHW AND NUTRITIONIST, THERE ARE MANY NO-COST HEALTH PROGRAMS COHORT MEMBERS CAN ATTEND THAT FOCUS ON HEALTH EDUCATION, NUTRITION (COOKING DEMONSTRATIONS, SUPPORT GROUP, ETC.), AND PHYSICAL ACTIVITY CLASSES.TO PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS FOCUS AREA 2, ERH WILL CONTINUE TO IMPLEMENT AND EXPAND PROJECT RESCUE (24/7 BUPRENORPHINE INDUCTION WITH A WARM HANDOFF TO A PEER AND TREATMENT PROVIDER). THE PROGRAM WILL CONTINUE TO SUPPLY HARM REDUCTION SUPPLIES AND EDUCATION ON HARM REDUCTION TO INDIVIDUALS SEEN IN THE ED AND THE COMMUNITY. ADDITIONALLY, ERH STAFF WILL CONTINUE TO SUPPORT THE ULSTER COUNTY SHERIFF'S ORACLE PROGRAM (OPIOID RESPONSE AS COUNTY LAW ENFORCEMENT), WHICH AIMS TO DIVERT INDIVIDUALS FROM POTENTIAL INCARCERATION TO DETOX AND TREATMENT SERVICES.INTERVENTION 1 SUMMARY: IMPLEMENT PROJECT RESCUE, A COLLABORATIVE PARTNERSHIP BETWEEN ERH AND CATHOLIC CHARITIES OF ORANGE, SULLIVAN, AND ULSTER. MEDICATION ASSISTED RECOVERY (MAR) (BUPRENORPHINE) WILL BE AVAILABLE IN THE ED FOR INDUCTION 24/7 (WITH ASSESSMENT FOR WITHDRAWAL SYMPTOMS) WITH A WARM HANDOFF TO A CERTIFIED RECOVERY PEER ADVOCATE (CRPA) AND A REFERRAL TO START TREATMENT. MAR IS AVAILABLE FOR UP TO THREE DAYS IN THE ED, WITH A GUARANTEE TO START TREATMENT WITH PARTNERING AGENCIES ON DAY FOUR. CONTINUE TO LINK INDUCTED PATIENTS TO THE MAT CARE MANAGER AS NECESSARY.INTERVENTION 2 SUMMARY: PROVIDE NECESSARY HARM REDUCTION SUPPLIES AND GUIDANCE TO PREVENT FATAL OVERDOSES AND THE OCCURRENCE AND TRANSMISSION OF INFECTIOUS COMPLICATIONS (I.E., HEPC, HIV, ENDOCARDITIS).INTERVENTION 3 SUMMARY: SUPPORT OF THE ULSTER COUNTY SHERIFF'S PROJECT ORACLE FACILITATE LAW ENFORCEMENT-ASSISTED DIVERSION FOR SUBSTANCE USE DISORDER BY PARTICIPATING IN THE COUNTYWIDE ""HIGH-RISK MITIGATION TEAM,"" A CARE-COORDINATION MODEL THAT AIMS TO REDUCE RATES OF RELAPSE, OVERDOSE, AND DEATH."

PART V, LINE 7, CHNA REPORT WEBSITE:
HTTPS://ULSTERCOUNTYNY.GOV/HEALTH/RESEARCH-AND-REPORTSPLEASE NOTE THAT THERE'S A POSSIBILITY THAT THE LINK COULD CHANGE AFTER THE RETURN IS FILED.

PART V, LINE 10, IMPLEMENTATION STRATEGY WEBSITE:
HTTPS://ERHNY.ORG/ABOUT-US/ PLEASE NOTE THAT THERE'S A POSSIBILITY THAT THE LINK COULD CHANGE AFTER THE RETURN IS FILED.

PART V, SECTION B, LINE 16A:
HTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2022/08/2022-ERH-FINANCIAL-ASSISTANCE-POLICY-PROCEDURE-ENGLISH.PDFHTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2020/03/2020-ERH-FA-APP-ENGLISH-AND-SPANISH.PDFPLEASE NOTE THAT THERE'S A POSSIBILITY THAT THE LINK COULD CHANGE AFTER THE RETURN IS FILED.

PART V, SECTION B, LINE 16B&C:
HTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2020/03/2020-ERH-FA-APP-DIRECTIONS-ENGLISH.PDFHTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2020/03/2020-ERH-FA-APP-DIRECTIONS-SPANISH.PDFHTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2022/08/2022-ERH-FA-SUMMARY-ENGLISH.PDFHTTPS://ERHNY.ORG/WP-CONTENT/UPLOADS/2022/08/2022-ERH-FA-SUMMARY-SPANISH.PDFPLEASE NOTE THAT THERE'S A POSSIBILITY THAT THE LINK COULD CHANGE AFTER THE RETURN IS FILED.

PART I, LINE 5:
ERH DID NOT BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE PROVIDED UNDER ITS FINANCIAL ASSISTANCE POLICY. THE HOSPITAL IS PREPARED TO PROVIDE FREE OR DISCOUNTED CARE FOR ALL ELIGIBLE PATIENTS. THE IMPACT OF FREE AND DISCOUNTED CARE IS NOT PREDICTABLE FOR THE HOSPITAL IN ORDER TO ESTIMATE THIS AMOUNT FOR BUDGETING PURPOSES.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE BOARD OF TRUSTEES OF ERH IS COMPRISED OF ELEVEN MEMBERS; TEN OF THESE MEMBERS ARE VERY VISIBLE IN THE COMMUNITY AND ARE A DIRECT LINK FOR PATIENTS TO THE HOSPITAL ADMINISTRATION. ELLENVILLE REGIONAL HOSPITAL PARTNERS WITH CATSKILL HUDSON AREA HEALTH EDUCATION CENTER AND THE INSTITUTE FOR FAMILY HEALTH TO RECRUIT PRIMARY CARE PHYSICIANS. ELLENVILLE REGIONAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVING THE QUALITY OF CARE FOR ALL PATIENTS AN EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED LICENSED MEDICAL PROVIDERS IN THE COMMUNITY.

PART III, LINE 2:
THE AMOUNT REPORTED IN PART III, SECTION B, LINE 2 IS BASED ON THE AMOUNTS OF PATIENT ACCOUNTS WRITTEN OFF DUE TO BAD DEBT.

PART III, LINE 3:
THE AMOUNT REPORTED IN PART III, SECTION B, LINE 3 IS ESTIMATE OF ACCOUNTS MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON THE KNOWLEDGE OF THE HOSPITAL PATIENTS AND THE COMMUNITY THAT THE HOSPITAL SERVES.

SCHEDULE H, PART II:
"ELLENVILLE REGIONAL HOSPITAL IS AN INTER-AGENCY MEMBER OF THE WAWARSING COUNCIL OF AGENCIES. THE COUNCIL'S MISSION IS TO WORK IN PARTNERSHIP WITH ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS BY IDENTIFYING AND ADDRESSING GAPS IN SERVICES, PROVIDING INFORMATION AND EDUCATION, AND BRINGING SERVICES TOGETHER FOR THE WAWARSING/ELLENVILLE COMMUNITY. AS A MEMBER OF THE COUNCIL, WE HELP TO PLAN AND IMPLEMENT COMMUNITY PROJECTS PRESENTED BY THE COUNCIL. THESE EVENTS PROMOTE WELLNESS AND PROVIDE ACCESS TO HEALTH AND SOCIAL SERVICES FOR THE TARGET GROUP.THE POPULATION HEALTH PROGRAM IS BASED ON A BELIEF IN FOUR PILLARS FOR IMPROVED HEALTH:1) PROPER DIET2) MODERATE EXERCISE3) RISK REDUCTION4) STRESS MANAGEMENTA PROPER DIET IS BASED ON A BALANCED NUTRITIONAL PROGRAM AND EDUCATION TO COMMUNITY MEMBERS TO CONNECT THEM TO THE FOOD THEY EAT AND MAKE BETTER CHOICES.MODERATE EXERCISE IS ESSENTIAL FOR GOOD HEALTH AND FITNESS.RISK REDUCTION REFERS TO CONTROLLABLE RISKS, INCLUDING ALCOHOL, TOBACCO, SALT, SUGAR, EXCESS FAT, RISKY SEX, OPIATE, AND OTHER DRUG USE, DANGEROUS DRIVING, AND OTHER ACTIVITIES THAT INCREASE RISKS TO HEALTH.STRESS MANAGEMENT REFERS TO OUR RESPONSE TO THE SOCIAL DETERMINANTS OF HEALTH; THESE INCLUDE INSECURITIES RELATED TO HOUSING, FOOD, RELATIONSHIP, JOB, FINANCES, AND RELATED FACTORS. WE REALIZE WE MAY NOT BE ABLE TO CHANGE THESE DYNAMICS; HOWEVER, WE MAKE EVERY EFFORT TO HELP OUR COMMUNITY MEMBERS COPE WITH THEIR CHALLENGES. OUR POPULATION HEALTH PROGRAMS ARE TAILORED TO ADDRESS ONE OR MORE OF THESE PILLARS.WE ALSO WORK IN CONCERT WITH THE INSTITUTE FOR FAMILY HEALTH (INSTITUTE), A FEDERALLY QUALIFIED HEALTH CENTER LOCATED ON THE HOSPITAL'S CAMPUS, ON SUCH WELLNESS INITIATIVES AS OUR ANNUAL HARVEST HEALTH FAIR. THE HARVEST HEALTH FAIR IS A FREE COMMUNITY HEALTH EVENT ON OUR CAMPUS THAT PROVIDES HEALTH SCREENINGS FOR ADULTS, SUCH AS BLOOD PRESSURE, GLUCOSE, AND MENTAL HEALTH SCREENINGS. CHILDREN'S RESOURCES INCLUDE ASTHMA AWARENESS ACTIVITIES. DIABETES EDUCATION AND PHARMACY CONSULTATIONS ARE ALSO AVAILABLE. IN ADDITION TO MEDICATION RECONCILIATION, STAFF FROM THE POPULATION HEALTH DEPARTMENT ALSO OFFER NARCAN TRAINING AND MEDICATION DISPOSAL TRAINING, WITH THE ONSITE PHARMACIST ABLE TO COLLECT OLD AND UNUSED MEDICATIONS. IN ADDITION, WE COLLABORATE WITH THE ELLENVILLE/ WAWARSING YOUTH COMMISSION, ELLENVILLE POLICE DEPARTMENT, ELLENVILLE, AND NAPANOCH FIRE DEPARTMENTS, ULSTER COUNTY SHERIFF'S DEPARTMENT, ELLENVILLE RESCUE SQUAD, AND ELLENVILLE SCHOOL DISTRICT PARENT TEACHER ORGANIZATION (PTO). THESE AGENCIES WORK TOGETHER TO PROVIDE FREE YOUTH ACTIVITIES, FREE CAR SAFETY SEAT CHECKS, AND FREE BIKE HELMETS AT THE FAIR.MEMBERS OF THE WAWARSING COUNCIL ARE ALSO INVITED TO PARTICIPATE AND SHARE THEIR RESOURCES WITH THE ATTENDEES. SINCE THE START OF THE COVID-19 PANDEMIC, PUBLIC EVENTS HAVE BEEN ON HOLD. THE HOSPITAL WILL BRING BACK THE HARVEST HEALTH FAIR IN 2023.TO HELP TO REDUCE AND PREVENT CHRONIC DISEASES, INCLUDING DIABETES AND HYPERTENSION, THE POPULATION HEALTH DEPARTMENT COMPLETES OUTREACH EFFORTS, INCLUDING FREE BLOOD PRESSURE AND HEART AGE SCREENINGS AND FREE HEALTH EDUCATION AND EDUCATIONAL MATERIALS. WE ALSO PARTICIPATE IN OR HOST VARIOUS HEALTH FAIRS THROUGHOUT THE YEAR. IN ADDITION, WE PROVIDE A LOVE YOUR HEART DAY EVENT AROUND VALENTINE'S DAY, INCLUDING A FREE ROUNDTABLE DISCUSSION WITH OUR CARDIOLOGIST OVER LUNCH AND PRESENTATIONS BY OUR DIRECTOR OF REHAB AND REGISTERED DIETITIAN. FREE HEALTH SCREENINGS ARE PROVIDED, AS WELL AS WELLNESS BROCHURES, ETC. THE POPULATION HEALTH DEPARTMENTNUTRITIONIST COORDINATES COOKING AND NUTRITION DEMONSTRATIONS AT VARIOUS EVENTS AND OFFERS FOLLOW-UP CONSULTATIONS WITH INDIVIDUALS.OUR EMERGENCY DEPARTMENT PROVIDERS REFER PATIENTS WHO NEED FOLLOW-UP CARE AND DO NOT HAVE A PRIMARY CARE PROVIDER TO THE INSTITUTE FOR CARE. PATIENTS SEEN IN THE EMERGENCY DEPARTMENT WITH MENTAL HEALTH SYMPTOMS ARE REFERRED TO THE BEHAVIORAL HEALTH STAFF AT THE INSTITUTE, WHO PROVIDE A WARM HANDOFF FOR PATIENTS WHO SCREENED POSITIVE FOR DEPRESSION OR SUICIDAL INDICATORS AND DO NOT REQUIRE IMMEDIATE INTERVENTION.ERH CONTINUES TO WORK COLLABORATIVELY WITH THE WAWARSING COUNCIL OF AGENCIES AND ULSTER COUNTY DEPARTMENT OF HEALTH TO ADDRESS TEEN PREGNANCY, SEXUAL ACTIVITY, AND SEX EDUCATION. OUR PARTNER, THE INSTITUTE, SITUATED ON OUR CAMPUS, OFFERS TEEN SERVICES. SINCE 2020, THE POPULATION HEALTH DEPARTMENT HAS PROVIDED COMPREHENSIVE SEXUAL EDUCATION TO TEENS IN THE ELLENVILLE CENTRAL SCHOOL DISTRICT THROUGH A PARTNERSHIP WITH PLANNED PARENTHOOD OF GREATER NEW YORK, UTILIZING FUNDING FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION.WE ARE IMPROVING THE OUTCOMES FOR OUR INPATIENTS THROUGH OUR SWING BED OUTCOMES IMPROVEMENT PROJECT, WHICH HAS BEEN DEVELOPED TO QUANTIFY OUR SUB-ACUTE REHAB (SWING BED) PATIENTS' FUNCTIONAL OUTCOMES FROM ADMISSION TO DISCHARGE. THIS PROJECT INVOLVES MULTIPLE DISCIPLINES, INCLUDING NURSING AND REHAB. ONE OF THE MAIN GOALS OF THE PROJECT IS TO IMPROVE THE FUNCTIONAL INDEPENDENCE OF OUR SWING BED PATIENTS SO THAT THEY ARE DISCHARGED TO HOME, NOT A NURSING HOME. THIS PROJECT HAS BECOME A STATEWIDE MODEL FOR CAH FACILITIES. THE UNIVERSITY OF MINNESOTA IS CURRENTLY BUILDING ON THIS FOUNDATION, MEASURING QUALITY OUTCOMES IN A NATIONAL PROJECT SPONSORED BY HRSA. NYS OUTCOMES WERE SIGNIFICANTLY HIGHER THAN ANY OTHER STATE IN PRELIMINARY RESULTS.ERH PARTICIPATED IN THE WESTCHESTER DSRIP, AND OUR PROJECT FOCUSED ON REDUCING THE USE OF OPIOIDS BY CHRONIC PAIN PATIENTS SEEN IN OUR EMERGENCY DEPARTMENT. THE LEADERSHIP STAFF OF ELLENVILLE REGIONAL HOSPITAL AND THE INSTITUTE FOR FAMILY HEALTH DEVELOPED NEW AND INNOVATIVE PROTOCOLS TO ADDRESS CHRONIC PAIN PATIENTS, WHO OFTEN PRESENT IN THE EMERGENCY DEPARTMENT, SEEKING PAIN RELIEF. CHRONIC PAIN PATIENTS, IN MANY CASES, HAVE DEVELOPED AN ADDICTION TO OPIATE- BASED PAIN RELIEVERS. THE MODEL INCLUDES A COMPLETE REDESIGN OF TREATMENT PROTOCOLS IN THE EMERGENCY DEPARTMENT UTILIZING NON-ADDICTIVE PAIN MEDICATIONS. THE RESULT HAS DRAMATICALLY REDUCED OPIATE PRESCRIBING IN THE EMERGENCY DEPARTMENT. THE PROTOCOL ALSO INCLUDES A ""WARM"" HANDOFF/REFERRAL TO A PATIENT CARE NAVIGATOR WHO HELPS THE PATIENT GET INTO PRIMARY CARE AT THE INSTITUTE OR OTHER COMMUNITY-BASED PROVIDERS. THE PRIMARY CARE TREATMENT PLAN INCLUDES FOUR PATHWAYS TO ADDRESS:- MEDICAL ISSUES WITH A FOCUS ON TRANSITIONING AWAY FROM OPIATES -A PSYCHIATRIC PATHWAY TO ADDRESS ADDICTION -AN INTERVENTION PATHWAY TO ADDRESS PAIN AT ITS SOURCE -A PSYCHO/SOCIAL PATHWAY TO ADDRESS THE NUMEROUS OTHER PROBLEMS OF CHRONIC PAIN PATIENTS.THE DSRIP OPIATE REDUCTION PROJECT RESULTS HAVE BEEN A 97% REDUCTION IN THE ADMINISTRATION OF OPIATES IN THE EMERGENCY DEPARTMENT AND AN 84% REDUCTION IN EMERGENCY DEPARTMENT VISITS FOR THIS POPULATION. IN ADDITION, THERE HAS BEEN A SUCCESS IN TRANSITIONING PATIENTS TO SAFER PAIN REGIMENS AND IMPROVED HEALTH. (SEE PART V, SECTION B, LINE 11 FOR ADDITIONAL INFORMATION).AS A RESULT OF THE SUCCESSES OF THE DSRIP PROJECT, ERH TOOK THE NEXT STEP AND LAUNCHED PROJECT RESCUE IN APRIL 2019. PROJECT RESCUE AIMED TO REDUCE MORBIDITY AND MORTALITY OF SUBSTANCE USE AND OVERDOSE THROUGH EXPANDED ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT). THROUGH THIS PROJECT, INDIVIDUALS IN ACTIVE OPIOID WITHDRAWAL CAN PRESENT TO THE EMERGENCY DEPARTMENTFOR EVALUATION BY CLINICAL STAFF. IF THEIR SYMPTOMS REGISTER AS OPIOID WITHDRAWAL, THE INDIVIDUAL CAN RECEIVE MAT (BUPRENORPHINE) WITH A WARM HANDOFF TO A CERTIFIED PEER RECOVERY ADVOCATE (CRPA) FROM CATHOLIC CHARITIES AND A WARM HANDOFF TO THE ERH SUBSTANCE USE DISORDER COORDINATOR. THE ED AT ERH WILL PROVIDE MAT FOR UP TO 72 HOURS, WHILE THE SUD COORDINATOR AND CRPA ARRANGE FOR THE CLIENT TO START TREATMENT WITH AN EXTERNAL PROVIDER NO LATER THAN DAY FOUR.SINCE THE IMPLEMENTATION OF PROJECT RESCUE, SERVICES HAVE EXPANDED TO INCLUDE LINKING PATIENTS TO A MAT CARE MANAGER THROUGH THE INSTITUTE FOR FAMILY HEALTH. THIS CARE MANAGER PROVIDES EXTRA INDIVIDUAL SUPPORT WHILE TRANSITIONING TO THE INSTITUTE'S MAT PROGRAM. THE INDIVIDUAL HAS DIRECT PHONE ACCESS TO THE MAT CARE MANAGER, WHO CAN HELP RESOLVE MEDICATION ISSUES AND SCHEDULE TRANSPORTATION IF NECESSARY. FURTHERMORE, PROJECT RESCUE EXPANDED TO INCLUDE THE ULSTER COUNTY FAMILY ADVOCATE, ALSO THE SUD PROGRAM COORDINATOR IN ASSISTING FAMILIES AND INDIVIDUALS TO OVERCOME BARRIERS TO TREATMENT AND LINKING THEM TO SERVICES THROUGH THE COUNTY. IN 2020, 56 PEOPLE SUCCESSFULLY CONNECTED WITH SUBSTANCE USE TREATMENT. THE TREATMENT SERVICES INCLUDED DETOXICATION, INPATIENT AND OUTPATIENT SERVICES, AND BRIDGE PRESCRIPTIONS FOR BUPRENORPHINE OR METHADONE."

SINCE THE IMPLEMENTATION OF PROJECT RESCUE, SERVICES HAVE EXPANDED TO
INCLUDE LINKING PATIENTS TO A MAT CARE MANAGER THROUGH THE INSTITUTE FOR FAMILY HEALTH. THIS CARE MANAGER PROVIDES THE INDIVIDUAL WITH EXTRA SUPPORT WHILE THEY TRANSITION TO THE INSTITUTE'S MAT PROGRAM. THE INDIVIDUAL HAS DIRECT PHONE ACCESS TO THE MAT CARE MANAGER, WHO CAN HELP RESOLVE MEDICATION ISSUES AND SCHEDULE TRANSPORTATION, IF NECESSARY. FURTHERMORE, PROJECT RESCUE EXPANDED TO INCLUDE THE ULSTER COUNTY FAMILY ADVOCATE, WHO IS ALSO THE SUD PROGRAM COORDINATOR, IN ASSISTING FAMILIES AND INDIVIDUALS OVERCOME BARRIERS TO TREATMENT, AS WELL AS LINK THEM TO SERVICES THROUGH THE COUNTY. IN 2020, 56 PEOPLE WERE SUCCESSFULLY CONNECTED WITH SUBSTANCE USE TREATMENT, WHICH INCLUDES DETOXICATION, INPATIENT AND OUTPATIENT SERVICES, AS WELL AS BRIDGE PRESCRIPTIONS FOR BUPRENORPHINE OR METHADONE.NOTICING THE HESITANCY AND AMBIVALENCE EXPERIENCED BY THOSE WHO USE SUBSTANCES, ERH IMPLEMENTED A HARM REDUCTION APPROACH TO SUBSTANCE USE DISORDER, AIMING TO RESPECT INDIVIDUAL AUTONOMY AND PROTECT THOSE WHO USE ALCOHOL AND ILLICIT SUBSTANCES FROM THE DANGERS OF USING. INDIVIDUALS HAVE ACCESS TO LIFE-SAVING SUPPLIES THROUGH THE EMERGENCY DEPARTMENT AND TEXT-LINE, WHICH INCLUDE NALOXONE (NARCAN), FENTANYL TEST STRIPS, SAFE USE KITS, SAFE SNORTING KITS, SAFE SEX KITS, MEDICATION LOCK BAGS, AND MEDICATION DISPOSAL BAGS.ERH IS A LEAD AGENCY IN THE DISTRIBUTION OF NALOXONE (NARCAN), A LIFE-SAVING MEDICATION USED TO REVIVE INDIVIDUALS FROM OPIOID OVERDOSE, AND DISTRIBUTED 194 NARCAN KITS TO THE WAWARSING-ELLENVILLE AREA IN 2020. BEING THE FIRST ULSTER COUNTY ORGANIZATION TO LAUNCH VIRTUAL NARCAN TRAININGS, ERH HAS IMPROVED AND EXPANDED ACCESSIBILITY TO HARM REDUCTION SUPPLIES IN THE MIDST OF A NATIONAL CRISIS. DURING THIS TIME, ERH PARTNERED WITH ORGANIZATIONS ACROSS THE HUDSON VALLEY, WHICH FORMED THE MID-HUDSON EDUCATION AND PREVENTION COLLABORATIVE (MHEPC). THIS COLLABORATION UTILIZED THE VIRTUAL FORMAT OF ERH'S FIRST NARCAN TRAINING AND HAS DISTRIBUTED AN ADDITIONAL 340 NALOXONE (NARCAN) KITS TO INDIVIDUALS SINCE LAUNCHING IN MAY OF 2020.DURING THE COVID-19 PANDEMIC, ERH LAUNCHED A PROJECT RESCUE TEXT-LINE WHICH ALLOWS FOR THE CONFIDENTIAL AND SECURE ACCESS TO HARM REDUCTION SUPPLIES. THROUGH AN ONLINE FORM, HARM REDUCTION SUPPLIES CAN BE REQUESTED, AS WELL AS, A REQUEST FOR ASSISTANCE WITH LOCATING A SUBSTANCE USE TREATMENT PROGRAM AND INFORMATION REGARDING THE HOSPITAL'S BUPRENORPHINE PROGRAM. ERH HAS ASSISTED 27 INDIVIDUALS SINCE LAUNCHING THE TEXT-LINE. ELLENVILLE REGIONAL HOSPITAL ALSO IS A CHAMPION OF EDUCATING THE PUBLIC ON PROPER MEDICATION DISPOSAL. PARTICIPATING IN NATIONAL PRESCRIPTION DRUG TAKE BACK DAY, ERH COLLECTED 25 POUNDS OF UNUSED OR EXPIRED MEDICATION FROM THE COMMUNITY. ERH ALSO PROVIDED 332 MEDICATION DISPOSAL PACKETS TO COMMUNITY MEMBERS, ALLOWING FOR PROPER MEDICATION DISPOSAL IN THE PRIVACY OF ONE'S OWN HOME. ERH CONTINUES TO OFFER SERVICES FOR INPATIENT AND OUTPATIENT MEDICATION RECONCILIATION AND EDUCATION REGARDING SAFE USE OF MEDICATIONS. ERH HAS A ROBUST SYSTEM TO IDENTIFY AND REPORT ANY MEDICATION ERRORS AND NEAR MISSES. SOURCES AND PROBABLE CAUSES OF THE ABOVE ARE IDENTIFIED THROUGH A FOCUSED REVIEW BY AN INTERDISCIPLINARY COMMITTEE. ERH HAS BEEN ABLE TO ESTABLISH A SEAMLESS PROCESS OF MEDICATION MANAGEMENT FOR PATIENTS TRANSITIONING FROM THE HOSPITAL TO ANOTHER CARE SETTING WITHIN OR OUTSIDE THE HOSPITAL. PROVIDERS USE OUR MEDICATION RECONCILIATION FORMS AS A TRUSTED SOURCE WITH UP TO DATE MEDICATIONS FOR THEIR PATIENTS. PLEASE SEE BELOW FOR PROGRESS. IN FEBRUARY 2017, WE IMPLEMENTED A NEW HOUSE-WIDE ELECTRONIC HEALTH RECORDS SYSTEM TO HELP US DELIVER HIGH QUALITY CARE TO OUR PATIENTS. THIS SINGLE PLATFORM ELECTRONIC HEALTH SYSTEM ALLOWS STAFF SEAMLESS ABILITIES TO ACCESS INFORMATION FROM ALL PATIENT VISITS AT ELLENVILLE REGIONAL HOSPITAL. THUS ALLOWING FOR MORE PRODUCTIVE VISITS AND STAFF TIME AS THEY NO LONGER NEED TO SIFT THROUGH CHARTS OR OTHER ELECTRONIC MEDICAL RECORD PROGRAMS TO OBTAIN PERTINENT PATIENT DATA. WE ALSO HAVE PARTNERED WITH HIXNY, A REGIONAL HEALTH INFORMATION EXCHANGE PLATFORM, WHICH ALLOWS FOR HOSPITAL STAFF TO ACCESS PERTINENT MEDICAL DATA FROM OUTSIDE PROVIDERS TO ENABLE US TO PROVIDE THE MOST EFFECTIVE AND EFFICIENT CARE TO OUR PATIENTS AS POSSIBLE. IF PATIENTS CONSENT TO ALLOWING THE HOSPITAL ACCESS, OUR STAFF ARE ABLE TO LOOK AT HISTORIC MEDICAL HISTORY AND VISITS OUTSIDE OF ELLENVILLE REGIONAL HOSPITAL, MEDICATION HISTORY, AND HISTORIC LABORATORY AND RADIOLOGY RESULTS. BEING ABLE TO UTILIZE SUCH A PROGRAM ENHANCES THE OVERALL QUALITY AND SAFETY OF CARE THAT OUR PATIENTS ARE ABLE TO RECEIVE AT ELLENVILLE REGIONAL HOSPITAL.

PART III, LINE 4:
EFFECTIVE JANUARY 1, 2019, THE HOSPITAL ADOPTED NEW U.S. GAAP REVENUE RECOGNITION GUIDANCE ACCOUNTING STANDARD UPDATE. AS A RESULT, UPON THE HOSPITAL'S ADOPTION OF ASC 606, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS THE PROVISION FOR BAD DEBTS IN THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS NOW REFLECTED AS IMPLICIT PRICE CONCESSIONS AND THEREFORE IS INCLUDED AS A REDUCTION TO PATIENT SERVICE REVENUE IN 2021. BAD DEBT EXPENSE IS $1,512,036. THE AMOUNT REPORTED IN PART III, SECTION B, LINE 2 IS BASED ON THE AMOUNTS OF PATIENT ACCOUNTS WRITTEN OFF DUE TO BAD DEBT. THE AMOUNT DOES NOT INCLUDE WRITE OFF DUE TO DISCOUNT OR ALLOWANCE.

PART III, LINE 8:
$20,478, WHICH IS 50% OF THE SURPLUS REPORTED ON PART III, SECTION B, LINE 7, PERTAINS TO PATIENTS THAT COULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE AND BE TREATED AS COMMUNITY BENEFIT.THE AMOUNT ON LINE 6 WAS DERIVED BY USING THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE HOSPITAL'S NYS INSTITUTIONAL COST REPORT AND OTHER APPLICABLE ADJUSTMENTS.

PART III, LINE 9B:
NO COLLECTION PROCESS IS UNDERTAKEN FOR KNOWN PATIENT WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ONCE A PATIENT IS QUALIFIED OR DESIGNATED FOR FINANCIAL ASSISTANCE, STATEMENTS WILL STOP BEING SENT UNTIL A DETERMINATION IS MADE THAT THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART II CONTINUATION:
NOTICING THE HESITANCY AND AMBIVALENCE EXPERIENCED BY THOSE WHO USE SUBSTANCES, ERH IMPLEMENTED A HARM REDUCTION APPROACH TO SUBSTANCE USE DISORDER, AIMING TO RESPECT INDIVIDUAL AUTONOMY AND PROTECT THOSE WHO USE ALCOHOL AND ILLICIT SUBSTANCES FROM THE DANGERS OF USING.INDIVIDUALS CAN ACCESS LIFE-SAVING SUPPLIES THROUGH THE EMERGENCY DEPARTMENT AND A CONFIDENTIAL TEXT LINE (DISCUSSED LATER). SUPPLIES INCLUDE NALOXONE (NARCAN), FENTANYL TEST STRIPS, SAFE USE KITS, SAFE SNORTING KITS, SAFE SEX KITS, MEDICATION LOCK BAGS, AND MEDICATION DISPOSAL BAGS.ERH IS A LEAD AGENCY IN DISTRIBUTING NALOXONE (NARCAN), A LIFE-SAVING MEDICATION USED TO REVIVE INDIVIDUALS FROM OPIOID OVERDOSE, AND DISTRIBUTED 659 NARCAN KITS TO THE WAWARSING-ELLENVILLE AREA IN 2021. BEING THE FIRST ULSTER COUNTY ORGANIZATION TO LAUNCH VIRTUAL NARCAN TRAINING, ERH HAS IMPROVED AND EXPANDED ACCESS TO HARM REDUCTION SUPPLIES AMID A NATIONAL CRISIS. DURING THIS TIME, ERH PARTNERED WITH ORGANIZATIONS ACROSS THE HUDSON VALLEY, WHICH FORMED THE MID- HUDSON EDUCATION AND PREVENTION COLLABORATIVE (MHEPC). THIS COLLABORATION UTILIZED THE VIRTUAL FORMAT OF ERH'S FIRST NARCAN TRAINING AND HAS DISTRIBUTED OVER 400 NALOXONE (NARCAN) KITS TO INDIVIDUALS SINCE LAUNCHING IN MAY 2020.DURING THE COVID-19 PANDEMIC, ERH LAUNCHED A PROJECT RESCUE TEXT LINE WHICH ALLOWS FOR CONFIDENTIAL AND SECURE ACCESS TO HARM REDUCTION SUPPLIES. THROUGH AN ONLINE FORM, HARM REDUCTION SUPPLIES CAN BE REQUESTED, AS WELL AS A REQUEST FOR ASSISTANCE WITH LOCATING A SUBSTANCE USE TREATMENT PROGRAM AND INFORMATION REGARDING THE HOSPITAL'S BUPRENORPHINE PROGRAM.ELLENVILLE REGIONAL HOSPITAL ALSO CHAMPIONS EDUCATING THE PUBLIC ON PROPER MEDICATION DISPOSAL. IN MONTHLY SHARPS AND MEDICATION COLLECTION AND DISPOSAL, ERH HAS COLLECTED OVER 50 POUNDS OF MEDICATION FROM THE COMMUNITY FOR SAFE DISPOSAL. ERH ALSO PROVIDED 456 MEDICATION DISPOSAL PACKETS TO COMMUNITY MEMBERS, ALLOWING FOR PROPER MEDICATION DISPOSAL IN THE PRIVACY OF ONE'S HOME.ERH CONTINUES TO OFFER INPATIENT AND OUTPATIENT MEDICATION RECONCILIATION SERVICES AND EDUCATION REGARDING THE SAFE USE OF MEDICATIONS. ERH HAS A ROBUST SYSTEM TO IDENTIFY AND REPORT MEDICATION ERRORS AND NEAR MISSES. SOURCES AND PROBABLE CAUSES OF THE ABOVE ARE IDENTIFIED THROUGH A FOCUSED REVIEW BY AN INTERDISCIPLINARY COMMITTEE. ERH HAS ESTABLISHED A SEAMLESS MEDICATION MANAGEMENT PROCESS FOR PATIENTS TRANSITIONING FROM THE HOSPITAL TO ANOTHER CARE SETTING WITHIN OR OUTSIDE THE HOSPITAL. PROVIDERS USE OUR MEDICATION RECONCILIATION FORMS AS A TRUSTED SOURCE OF DATE MEDICATIONS FOR THEIR PATIENTS.IN FEBRUARY 2017, WE IMPLEMENTED A NEW HOUSE-WIDE ELECTRONIC HEALTH RECORDS SYSTEM TO HELP US DELIVER HIGH-QUALITY CARE TO OUR PATIENTS. THIS SINGLE-PLATFORM ELECTRONIC HEALTH SYSTEM ALLOWS STAFF SEAMLESS ACCESS TO INFORMATION FROM ALL PATIENT VISITS AT ELLENVILLE REGIONAL HOSPITAL. THUS ALLOWING FOR MORE FORMATIVE EVALUATIONS AND STAFF TIME AS THEY NO LONGER NEED TO SIFT THROUGH CHARTS OR OTHER ELECTRONIC MEDICAL RECORD PROGRAMS TO OBTAIN PERTINENT PATIENT DATA. WE ALSO PARTNERED WITH HIXNY, A REGIONAL HEALTH INFORMATION EXCHANGE PLATFORM THAT ALLOWS HOSPITAL STAFF TO ACCESS RELEVANT MEDICAL DATA FROM OUTSIDE PROVIDERS TO PROVIDE OUR PATIENTS WITH THE MOST EFFECTIVE AND EFFICIENT CARE. IF PATIENTS CONSENT TO ALLOWING THE HOSPITAL ACCESS, OUR STAFF CAN LOOK AT HISTORIC MEDICAL HISTORY AND VISITS OUTSIDE ELLENVILLE REGIONAL HOSPITAL, MEDICATION HISTORY, AND LANDMARK LABORATORY AND RADIOLOGY RESULTS. UTILIZING SUCH A PROGRAM ENHANCES THE OVERALL QUALITY AND SAFETY OF CARE OUR PATIENTS CAN RECEIVE AT ELLENVILLE REGIONAL HOSPITAL.

PART VI, LINE 2:
ELLENVILLE REGIONAL HOSPITAL USES VARIOUS METHODS TO ASSESS THE COMMUNITY'S HEALTH NEEDS. ELLENVILLE REGIONAL HOSPITAL SEEKS THE VIEWS OF COMMUNITY MEMBERS TO GAIN THEIR THOUGHTS REGARDING THEIR COMMUNITY'S HEALTH CARE AND FEEDBACK REGARDING ERH SERVICES. THE BOARD OF TRUSTEES OF ERH IS COMPRISED OF TEN MEMBERS; NINE ARE VERY VISIBLE IN THE COMMUNITY AND ARE A DIRECT LINK FOR PATIENTS TO THE HOSPITAL ADMINISTRATION. THE 10TH MEMBER IS THE CEO OF THE INSTITUTE FOR FAMILY HEALTH, THE LARGEST FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER IN NY STATE. COMMUNITY FEEDBACK IS A TOPIC OF DISCUSSION AT MOST BOARD MEETINGS. THE PRESIDENT AND CEO OF ERH, STEVEN L. KELLEY, IS A PROMINENT COMMUNITY MEMBER. MR. KELLEY AND OTHER ADMINISTRATIVE TEAM MEMBERS BELONG TO NUMEROUS ORGANIZATIONS, SERVE ON OTHER NOT-FOR-PROFIT BOARDS, AND ARE ACTIVE PARTICIPANTS. ALL CLINICAL DEPARTMENTS DO PATIENT SATISFACTION QUESTIONNAIRES. IN 2021, ERH RECEIVED 3,735 PATIENT SATISFACTION SURVEYS. THESE QUESTIONNAIRES PROVIDE VALUABLE FEEDBACK FROM THE POPULATION THAT UTILIZES THE HOSPITAL SERVICES. IN ADDITION, STATISTICAL DATA FROM STATE AND COUNTY DATABASES ARE CONTINUALLY ANALYZED, LOOKING FOR TRENDS AND CHANGES IN THE DEMOGRAPHIC MAKEUP OF OUR PATIENTS. IN ADDITION, THE ERRHN OFTEN HOSTS COMMUNITY FORUMS TO GATHER MORE INFORMATION ON THE HEALTH TOPICS THAT THE COMMUNITY FEELS ARE PERTINENT. THESE FORUMS HAVE BEEN THE BASIS FOR CHANGES TO THE POPULATION HEALTH PROGRAM. FOR EXAMPLE, FORUMS HELD IN EARLY 2019 POINTED OUT A NEED FOR EASIER ACCESS TO NUTRITION EDUCATION. FOLLOWING THIS, ERRHN HIRED A FULL-TIME NUTRITIONIST WHO COULD WORK WITH COMMUNITY MEMBERS AT NO COST. WE ALSO MONITOR THE TOP TEN INPATIENT DIAGNOSES ANNUALLY TO PLAN OUR SERVICES AROUND THE DISEASES MOST PREVALENT IN OUR LOCAL COMMUNITY. ERH WORKS CLOSELY WITH AN FQHC ON OUR CAMPUS. THE CEOS OF ERH AND FQHC PARTICIPATE ON THE BOARD OF DIRECTORS FOR BOTH ORGANIZATIONS. THIS COLLABORATIVE WORKING ARRANGEMENT HAS BEEN INVALUABLE IN ASSESSING THE NEEDS OF THE MEDICAL PROVIDERS AND THE PATIENTS IN THE COMMUNITY. AS A MEMBER OF THE WESTCHESTER DSRIP, WE ALSO PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT.

PART VI, LINE 4:
ELLENVILLE REGIONAL HOSPITAL (ERH), A 25-BED CRITICAL ACCESS HOSPITAL BUILT IN 1964(-1966), IS LOCATED IN THE TOWN OF WAWARSING, IN ULSTER COUNTY. ERH IS A NON-PROFIT SOLE PROVIDER HOSPITAL FOR ELLENVILLE AND ITS SURROUNDING COMMUNITIES LOCATED BETWEEN SHAWANGUNK RIDGE AND THE CATSKILL MOUNTAIN RANGE. THE ERH SERVICE AREA, DEFINED AS THE TOP TEN ZIP CODES OF PATIENT RESIDENCY TO WHICH ERH PROVIDES CLINICAL SERVICES EACH YEAR, HAS A POPULATION OF 28,000. THESE ZIP CODES COVER TOWNS AND VILLAGES IN ULSTER COUNTY AND INTO PARTS OF SULLIVAN AND ORANGE COUNTIES, INCLUDING ELLENVILLE, KERHONKSON, NAPANOCH, ACCORD, PINE BUSH, WAWARSING, GRAHAMSVILLE, SUNDOWN, DENNING, WOODBOURNE, WOODRIDGE, WURTSBORO, WURTSBORO HILLS, PHILLIPSPORT, SUMMITVILLE, HAVEN, AND YANKEE LAKE. ERH IS GEOGRAPHICALLY ISOLATED, WITH ITS POPULATION CENTER CONSISTING OF A 37% NON-WHITE POPULATION AND A 20% BELOW-POVERTY LEVEL, ACCORDING TO THE US CENSUS BUREAU. THE NEAREST HOSPITAL IS OVER 25 MILES AWAY ON PRIMARILY SECONDARY ROADS, AND DUE TO THE RURAL GEOGRAPHICAL ISOLATION, ERH SERVES A CRUCIAL NEED FOR THE COMMUNITY. IN 2020 AND 2021, THE EMERGENCY DEPARTMENT (ED) PATIENT VOLUME AT ELLENVILLE REGIONAL HOSPITAL (ERH) WAS 10,435 AND 12,827, RESPECTIVELY. IN 2021, THE HOSPITAL SERVED 11,681 UNIQUE PATIENTS WHO MADE 28,278 VISITS. IT IS ALSO A TEACHING HOSPITAL WITH EDUCATIONAL PROGRAMS FOR RESIDENTS, MEDICAL STUDENTS, PHARMACISTS, PHYSICAL THERAPISTS, PHYSICAL THERAPIST ASSISTANTS, OCCUPATIONAL THERAPISTS, OCCUPATIONAL THERAPY ASSISTANTS, RADIOLOGY TECHNICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, PHYSICIAN ASSISTANTS, PHLEBOTOMISTS, HIGH SCHOOL NEW VISION STUDENTS AND MORE.ERH WAS GRANTED CRITICAL ACCESS HOSPITAL (CAH) STATUS IN 2004 AND HAD 25 INPATIENT BEDS. THESE BEDS CAN BE USED FOR ACUTE CARE OR SWING BUT MAY NOT EXCEED 25. THE RULING IS SIGNIFICANT SINCE THE HOSPITAL IS LOCATED IN A FEDERALLY DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND MEDICALLY UNDERSERVED AREA (MUA). THERE WOULD BE A SUBSTANTIAL PROBLEM WITH UNINSURED AND UNDERINSURED HAVING ACCESS TO QUALITY HEALTHCARE WITHOUT ERH.THE TOWN OF WAWARSING IS LOCATED WITHIN ULSTER COUNTY IN THE MID-HUDSON VALLEY, APPROXIMATELY 90 MILES NORTHWEST OF NEW YORK CITY. THE TOWN OF WAWARSING, A RURAL TOWN DESIGNATED AS HAVING A MEDICALLY UNDER-SERVED POPULATION (MUP ID# 07223), HAS A POPULATION OF APPROXIMATELY 13,004, OF WHICH 4,097 RESIDE WITHIN THE VILLAGE OF ELLENVILLE, THE LARGEST POPULATION CENTER IN THE TOWN (ACS 2018). THE TOWN INCLUDES 11,091 HOUSEHOLDS AND 2,946 FAMILIES.CENSUS DATA INDICATES THAT OF THE WAWARSING POPULATION, 69.8% IDENTIFY AS WHITE, 9.9% IDENTIFY AS BLACK, 2.3% AS ASIAN, 0.5% AS NATIVE AMERICAN (OR ALASKAN NATIVE) AND 9.7% IDENTIFY AS TWO OR MORE RACES; WITH 22.6% OF RESIDENTS IDENTIFYING AS LATINX, AND 14% OF INDIVIDUALS SPEAKING SPANISH AT HOME. THE MEDIAN AGE IS 41.5 YEARS IN WAWARSING, WITH 37% OF ADULTS OVER 50.CHILDREN <18 ARE 18.8% OF THE POPULATION, 18-64 ARE 66%, AND FEMALES OF ALL AGES ACCOUNT FOR 44% OF THE POPULATION. IN THE TOWN OF WAWARSING, 17.9% OF INDIVIDUALS LIVE BELOW THE POVERTY LINE, INCLUDING 23% OF CHILDREN UNDER 18. ELLENVILLE CENTRAL SCHOOL DISTRICT HAD 1,516 STUDENTS ENROLLED FOR THE 2019-20 SCHOOL YEAR, 71% ECONOMICALLY DISADVANTAGED. ROUGHLY 16% OF RESIDENTS HAVE LESS THAN A HIGH SCHOOL EDUCATION.THE UNEMPLOYMENT RATE FOR THE CIVILIAN LABOR FORCE IN WAWARSING IS 9.6%, WITH A SIGNIFICANTLY HIGHER UNEMPLOYMENT RATE FOR INDIVIDUALS 20-24 (32%) AND A SUBSTANTIALLY LOWER RATE FOR INDIVIDUALS 25-29 YEARS OLD (1.9%). IN THE TOWN OF WAWARSING, 17.9% OF INDIVIDUALS LIVE BELOW THE POVERTY LINE, INCLUDING 23% OF CHILDREN UNDER 18 AND 18.8% OF SENIORS. 47.9% OF INDIVIDUALS BELOW THE POVERTY LEVEL DID NOT WORK IN THE PAST 12 MONTHS. 83.8% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA (OR EQUIVALENT). HOWEVER, RATES DIFFER SIGNIFICANTLY FOR MALES AND FEMALES, WITH ONLY 3% OF 25+ FEMALES HAVING LESS THAN A HIGH SCHOOL DIPLOMA BUT 18% OF 25+ MALES HAVING LESS THAN A HIGH SCHOOL DIPLOMA. 18.2% OF THE POPULATION HAS A BACHELOR'S DEGREE OR HIGHER.WAWARSING HAS A TOTAL OF 6,299 HOUSING UNITS, 65% OF WHICH ARE SINGLE UNITS, 71.9% OF WHICH ARE OCCUPIED, AND 28.1% VACANT. OF THE 4,530 OCCUPIED HOUSEHOLDS, 60% ARE DEFINED AS 'FAMILY HOUSEHOLDS' (2,719); 29.1% (1,319) HAVE RELATED CHILDREN UNDER 18 YEARS OLD, AND 9.3% (421) ARE SINGLE FEMALES WITH CHILD(REN) HOUSEHOLDS. ABOUT 44% OF THE POPULATION IS MARRIED. THE AVERAGE HOUSEHOLD SIZE WAS 2.4, AND THE AVERAGE FAMILY SIZE 2.96.IN THE VILLAGE OF ELLENVILLE, THE LARGEST POPULATION CENTER (4,000) IN THE TOWN OF WAWARSING, THE MEDIAN AGE IS 37 YEARS, WITH 41.5% OF THE POPULATION UNDER 25. THE POPULATION IS 52% MALE. ETHNIC AND RACIAL DEMOGRAPHICS INCLUDE 58.4% WHITE, 7.9% BLACK, AND 4% TWO OR MORE RACES, WITH 29.4% OF THE POPULATION IDENTIFYING AS LATINO. JUST OVER 16% OF THE POPULATION SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME, PREDOMINANTLY SPANISH. ACCORDING TO THE 2010 CENSUS, THERE WERE 4,135 PEOPLE IN THE VILLAGE OF ELLENVILLE, INDICATING THE POPULATION HAS CONTINUED TO DECREASE.OVER 12% OF RESIDENTS IN THE VILLAGE ARE UNEMPLOYED, AND ROUGHLY 18% HAVE LESS THAN A HIGH SCHOOL EDUCATION. THE UNEMPLOYMENT RATE FOR INDIVIDUALS 30-34 IS HIGHER THAN THE VILLAGE RATE, AT 21.2%. THE RATE IS EVEN HIGHER FOR INDIVIDUALS WITHOUT A HIGH SCHOOL DEGREE, AT 25.5%. VETERANS REPRESENT 3.4% OF THE POPULATION. IN THE 12428 ZIP CODE AREA, INCLUDING THE VILLAGE OF ELLENVILLE, OVER 40% OF RESIDENTS ARE LOW-INCOME, MORE THAN 18.9% LIVE BELOW THE POVERTY LINE, 24% OF CHILDREN LIVE IN POVERTY, AND 37% OF SENIORS LIVE IN POVERTY.IN THE 2017 ACS 5-YEAR ESTIMATES, 1,841 HOUSEHOLDS IN THE VILLAGE, 53% OF WHICH ARE SINGLE UNITS, AND 85.1% (1,566) OF WHICH ARE OCCUPIED. 39.9% OF HOMEOWNERS AND 54.3% OF RENTERS HAVE MONTHLY HOUSING COSTS THAT EXCEED 35% OF THE HOUSEHOLD INCOME. OF OCCUPIED UNITS, 63% ARE CONSIDERED 'FAMILY HOUSEHOLDS (50% OF WHICH ARE ESTIMATED TO BE SINGLE-PARENT HOUSEHOLDS), AND 21.9% OF OCCUPIED UNITS WERE DEFINED AS FEMALE HOUSEHOLDERS WITH NO MALE PRESENT. ABOUT 50% OF THE POPULATION IS MARRIED. OF OCCUPIED UNITS, 29.1 % HAD RELATED CHILDREN UNDER 18 LIVING WITH THEM, AND 24.8% OF HOUSEHOLDS HAD INDIVIDUALS AGED 65 OR OLDER: AVERAGE HOUSEHOLD SIZE 2.6 AND AVERAGE FAMILY SIZE 3.4.ERH'S CATCHMENT AREA INCLUDES A SUBSTANTIAL IMPOVERISHED POPULATION. FOR EXAMPLE, ELLENVILLE AND WAWARSING HAVE MEDIAN HOUSEHOLD INCOMES (TOWN $46,889 AND VILLAGE $45,531) THAT ARE SUBSTANTIALLY LOWER THAN (ABOUT THREE-QUARTERS) THE ULSTER COUNTY MEDIAN HOUSEHOLD INCOME OF $61,652 AND THE NYS MEDIAN HOUSEHOLD INCOME OF $62,765 (ACS 2017).IT IS ESSENTIAL TO NOTE THE ELLENVILLE FAMILY HEALTH CENTER (IFH), A PRIMARY CARE HEALTH CENTER OPERATED BY THE INSTITUTE FOR FAMILY HEALTH, IS ONE OF THE LARGEST FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) IN NEW YORK STATE. THE FQHC IS ALSO LOCATED ON THE ERH CAMPUS. THE INSTITUTE IS COMMITTED TO PROVIDING HIGH-QUALITY, AFFORDABLE HEALTH CARE FOR ALL. IT STRIVES FOR EXCELLENCE AT ITS 26 PRACTICES WHILE ACCEPTING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE ELLENVILLE IFH OFFERS PRIMARY CARE, MENTAL HEALTH CARE, DENTAL, AND SOCIAL WORK SERVICES, ALONG WITH MANY OTHER HEALTH SERVICES FOR PATIENTS OF ALL AGES. AS PART OF A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER NETWORK, IT MEETS NATIONAL STANDARDS FOR AFFORDABLE, ACCESSIBLE, AND COMPREHENSIVE HEALTH CARE SERVICES. THE CENTER IS ACCREDITED BY THE JOINT COMMISSION AND RECOGNIZED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AS A LEVEL 3 PATIENT-CENTERED MEDICAL HOME; THE HIGHEST RECOGNITION AVAILABLE. THE IFH SEES APPROXIMATELY 3,600 PATIENTS PER YEAR AND OFFERS SAME-DAY APPOINTMENTS. ACCORDING TO THE INSTITUTE OF FAMILY HEALTH, A FEDERALLY QUALIFIED HEALTHCARE CENTER'S ELLENVILLE SITE DATA, NEARLY 59% OF HEALTH CENTER PATIENTS RESIDING IN THE 12428 ZIP CODE RECEIVE MEDICAID OR OTHER PUBLIC INSURANCE, AND 7.6% ARE UNINSURED. FURTHERMORE, ROUGHLY 10% OF ADULTS IN THE ZIP CODE HAVE NO USUAL SOURCE OF CARE. THE SAME PERCENTAGE OF ADULTS HAVE DELAYED OR NOT SOUGHT CARE DUE TO HIGH COSTS.WAWARSING AND THE VILLAGE OF ELLENVILLE WERE PREVIOUSLY HOME TO SEVERAL MANUFACTURING BUSINESSES, INCLUDING IMPERIAL SCHRADE AND HYDRO ALUMINUM, WHICH EMPLOYED MANY RESIDENTS. THE SURROUNDING AREA ALSO BOASTED SEVERAL LARGE RESORT HOTELS. DUE TO THESE BUSINESSES CLOSING THEIR DOORS AND A SIGNIFICANT DECLINE IN THE AREA'S TOURIST INDUSTRY, THE ELLENVILLE COMMUNITY HAS LOST OVER 2,000 JOBS SINCE THE 1990S. THE TOWN AND VILLAGE STRUGGLE WITH THE ISSUES THAT ACCOMPANY POVERTY AND UNEMPLOYMENT IN RURAL AREAS. OVER 12% OF RESIDENTS IN THE VILLAGE ARE UNEMPLOYED. MAJOR EMPLOYERS SUPPORTING THE REGION'S RESIDENTS ARE THE NYS DEPARTMENT OF CORRECTIONS, ELLENVILLE CENTRAL SCHOOL DISTRICT, AND ELLENVILLE REGIONAL HOSPITAL.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART VI, LINE 4, CONTINUATION:
AN AFFORDABLE SENIOR HOUSING PROJECT, A JOINT VENTURE BETWEEN THE HOSPITAL AND WARWICK PROPERTIES, INC., IS LOCATED ON THE ELLENVILLE REGIONAL HOSPITAL CAMPUS. ALL THREE PHASES OF THE PROJECT REMAIN FULLY OCCUPIED, WITH APPROXIMATELY 156 SENIOR CITIZENS LIVING INDEPENDENTLY IN ONE-BEDROOM APARTMENTS. THE PROJECT COLLABORATORS SECURED FUNDING FOR THE COMPLEX FROM THE NEW YORK STATE DIVISION OF HOUSING'S COMMUNITY RENEWAL HOUSING TRUST FUND. THE PARTNERSHIP SPONSORING THE HOUSING PROJECT IS DEVELOPING PLANS TO BUILD ADDITIONAL AFFORDABLE HOUSING CLOSE TO THE HOSPITAL, TARGETING SENIORS, SPECIAL NEEDS POPULATIONS, AND POSSIBLY RETURNING VETS.

PART VI, LINE 3:
BY ITS EXEMPTION FROM FEDERAL AND STATE TAXES AND AS PART OF THE HOSPITAL'S MISSION TO SERVE THE COMMUNITY'S HEALTHCARE NEEDS, ERH PROVIDES CARE TO ALL PATIENTS IN NEED WITHOUT REGARD FOR THEIR ABILITY TO PAY. ELLENVILLE REGIONAL HOSPITAL (ERH) INFORMS ITS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN SEVERAL WAYS. SIGNS ARE POSTED IN REGISTRATION, AND INFORMATION ON FINANCIAL AID IS LOCATED ON OUR WEBSITE. THESE SIGNS DIRECT THE PATIENTS TO SPEAK WITH DESIGNATED PATIENT FINANCIAL SERVICES REPRESENTATIVES. ALL PATIENTS WITHOUT INSURANCE ARE GIVEN A PACKET THAT INCLUDES A CHARITY CARE APPLICATION AND IS AVAILABLE UPON REQUEST BY THE PATIENT AND ON OUR WEBSITE. PATIENT STATEMENTS ALSO INCLUDE CONTACT INFORMATION REGARDING FINANCIAL ASSISTANCE. IN ADDITION, THE REGISTRATION STAFF DIRECTS PATIENTS TO A DESIGNATED PATIENT FINANCIAL SERVICES REPRESENTATIVE FOR MEDICAID APPLICATIONS.HTTPS://ERHNY.ORG/PATIENT-GUESTS/FINANCIAL-ASSISTANCE-PROGRAM/