4A (Expenses $ 5268970 including grants of $ 0) (Revenue $ 7432454)
INPATIENT AND ACUTE SERVICES (SEE SCHEDULE O) INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT ACUTE CARE, SWING BED AND ADDICTION TREATMENT SERVICES VIA ITS 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2021 WERE COMPRISED OF 120 ACUTE, 142 SWING BED, AND 65 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 411 PATIENT DAYS, IN ADDITION TO THE 3,116 PATIENT DAYS FOR SWING BED AND 951 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 10,613 LAB TESTS, 7,244 RESPIRATORY TREATMENTS, 88 X-RAYS, 14 ULTRASOUNDS, 44 CT AND 8 MRI EXAMS, 1,934 PHYSICAL THERAPY AND 853 OCCUPATIONAL THERAPY SESSIONS, AND 95 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED 16 ECHO EXAMS, AND 660 DIETARY CONSULTS. TO ENSURE OUR RURAL AREA RESIDENTS HAVE ACCESS TO HIGH QUALITY, EFFICIENT CARE IN A COMFORTABLE AND PRIVATE AREA, THE HOSPITAL'S IMAGING CENTER IS EQUIPPED WITH 3D MAMMOGRAPHY, ULTRASOUND, BONE DENSITY, X-RAY AND A 128-SLICE CT SUITE. MRI SERVICES ARE OFFERED ON SUNDAYS THROUGH AN AGREEMENT WITH A MOBILE VENDOR.IN ORDER TO ADDRESS THE NEED TO FREE UP ICU BEDS, WITHIN BOTH THE UNITED HEALTH SERVICES SYSTEM AND THE REGION, DELAWARE VALLEY HOSPITAL PAUSED ADMISSIONS TO ITS INPATIENT ADDICTION TREATMENT PROGRAM IN OCTOBER 2021. STAFF FROM THE ADDICTION TREATMENT PROGRAM WERE RE-ASSIGNED TO THE INPATIENT MEDICAL UNIT WHICH ENSURED CARE FOR PATIENTS WITH COVID AND OTHER SERIOUS ILLNESSES, WHILE ALLOWING DVH TO CONTINUE TO ACCEPT PATIENTS WHO NEEDED ACUTE CARE, BUT WERE LESS SERIOUSLY ILL.

4B (Expenses $ 3453624 including grants of $ 0) (Revenue $ 3778208)
CLINICS (SEE SCHEDULE O)CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH ITS PRIMARY CARE CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE PRIMARY CARE CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. 2021 INCLUDED 13,009 VISITS IN WALTON, 723 IN ROSCOE, AND 2,003 IN DOWNSVILLE. DELAWARE VALLEY HOSPITAL ALSO PURCHASED A PRIVATE PRACTICE AND BROUGHT ON TWO WELL-KNOWN NURSE PRACTITIONERS, WHICH LED TO AN ADDITIONAL 5,736 PRIMARY CARE VISITS; BRINGING THE GRAND TOTAL TO 21,471.

4C (Expenses $ 14591463 including grants of $ 0) (Revenue $ 17824611)
OUTPATIENT AND AMBULATORY SERVICES (SEE SCHEDULE O) OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC CARDIOPULMONARY, IMAGING, LAB AND TREATMENT SERVICES AT ITS WALTON CAMPUS. THESE INCLUDE A 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE PHYSICAL AND OCCUPATIONAL REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, CARDIAC AND PULMONARY REHABILITATION AND ACCESS TO SPECIALTY SERVICES. IN 2021 THE CARDIOLOGY SPECIALTY CLINIC HAD 757 VISITS, PAIN MANAGEMENT 294; TELE-MENTAL HEALTH AND TELE-DIABETES CONSULTS 422, WHILE GASTROENTEROLOGY HAD 136. THE HOSPITAL ALSO GENERALLY CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS, DIABETES EDUCATION AND CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS. GENERALLY, THESE PROGRAMS ARE CONDUCTED BEGINNING IN THE SPRING AND HELD AGAIN IN THE FALL. HOWEVER, DUE TO THE PANDEMIC GROUP EDUCATION PROGRAMS WERE NOT HELD. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION: 161 IN 2021. IN 2021 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 4,875 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 61,465 TESTS, AND 6,807 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 8,550 X-RAYS, CT SCANS, MRI'S, ULTRASOUNDS, BONE DENSITY TESTS AND MAMMOGRAPHY FOR OUTPATIENT SERVICES. OTHER OUTPATIENT SERVICES PERFORMED IN 2021 INCLUDED 605 AMBULATORY PROCEDURES, 116 ENDOSCOPIES, 1,283 OPIATE ADDICTION TREATMENT SESSIONS, AND 1,072 SERVICES ASSOCIATED WITH CARDIAC AND PULMONARY REHABILITATION. THE CARDIOPULMONARY DEPARTMENT PERFORMED 1,047 TESTS AND/OR TREATMENTS. 1,234 CARDIAC RELATED TESTS WERE PERFORMED: EKGS, ECHOCARDIOGRAMS, CARDIAC HOLTER AND EVENT MONITORS. THERE WERE 182 DIETARY CONSULTS. THE HOSPITAL'S OUTPATIENT RETAIL PHARMACY FILLED 61,712 PRESCRIPTIONS.

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 0)

DELAWARE VALLEY HOSPTITAL
PART V, SECTION B, LINE 5: DELAWARE VALLEY HOSPITAL HAS MEMBERSHIP IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY, AS WELL AS ON ITS WELLNESS COMMITTEE. A STAFF MEMBER ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR PARTICIPATES IN ALL DVH VOLUNTEER MEETINGS AND ACTIVELY SEEKS THEIR INPUT AND FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES INPUT AS TO WHAT THEY HEAR FROM COMMUNITY MEMBERS. PATIENT SATISFACTION SURVEYS ARE ALSO USED IN GAINING INPUT FROM OUR PATIENTS.

DELAWARE VALLEY HOSPTITAL
PART V, SECTION B, LINE 6A: O'CONNOR HOSPITAL, DELHI, NYMARGARETVILLE COMMUNITY HOSPITAL, MARGARETVILLE, NY

DELAWARE VALLEY HOSPTITAL
PART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, DEPARTMENT OF SOCIAL SERVICES, SHERIFF'S DEPT, ALCOHOL AND DRUG ABUSE COUNCIL, PLANNING DEPARTMENT, EMERGENCY SERVICES, DRUG TREATMENT COURT, WATERSHED AFFAIRSHOSPITAL AND HEALTH SERVICES: UHS DELAWARE VALLEY HOSPITAL, BASSETT HEALTHCARE-O'CONNOR HOSPITAL AND CATSKILL AREA HOSPICEEDUCATION: ROXBURY CENTRAL SCHOOLNURSING HOMES: ROBINSON TERRACEALLIANCES: RURAL HEALTH NETWORK OF SOUTH CENTRAL NYOTHER HUMAN SERVICE AGENCIES: CORNELL COOPERATIVE EXTENSION, RURAL 3 FOR TOBACCO FREE COMMUNITIES, CANCER SERVICE PROGRAM OF DELAWARE, OTSEGO AND SCHOHARIE COUNTIES, DELAWARE OPPORTUNITIES, NY CONNECTS, FAMILY RESOURCE NETWORK, CATHOLIC CHARITIES

DELAWARE VALLEY HOSPTITAL
"PART V, SECTION B, LINE 11: DELAWARE VELLEY HOSPITAL 2019-2021 COMMUNITY SERVICE PLAN - 2021 UPDATEPREVENT CHRONIC DISEASEFOCUS AREA 4: PREVENTIVE CARE AND MANAGEMENT DISPARITY: UNLESS OTHERWISE NOTED THE DISPARITY FOR ALL OF THE FOLLOWING WILL BE: DVH PRIMARY CARE PATIENTS FITTING DEMOGRAPHICS AS DESCRIBED IN EACH OBJECTIVEINTERVENTIONS: UNLESS OTHERWISE NOTED THE INTERVENTIONS WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS REMINDERS THROUGH EHR ALERTS, MAIL, PHONE CALLS, EMAIL AND/OR E-CHART NOTIFICATIONSMEASURES: UNLESS OTHERWISE NOTED THE MEASURE WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: PERCENTAGE OF DVH PATIENTS, AS DESCRIBED, WHO COMPLY SCREENING GUIDELINES2021 EXECUTIVE SUMMARY THE COVID PANDEMIC CONTINUED TO AFFECT THE NATION IN MANY AREAS BUT ONE THAT TRULY SUFFERED WAS THE FOLLOW UP WITH PATIENTS FOR ROUTINE AND CHRONIC CARE. THE PUBLIC'S UNWILLINGNESS TO COME TO HEALTH CARE FACILITIES, FOR FEAR OF CATCHING COVID CONTINUED. IN THE SUMMER MONTHS THIS IMPROVED, ONLY TO REGRESS IN THE FALL, WHEN THE PREVALENCE OF COVID ONCE AGAIN SPIKED. THE HOSPITAL CONTINUED VIRTUAL VISITS, SOCIAL DISTANCING AND STAGGERED APPOINTMENTS BUT THE RESULTS REGARDING THE FOLLOWING PRIORITIES STILL SUFFERED. FOR THE MOST PART, THE PLANNED INTERVENTIONS TOOK PLACE. PATIENTS WERE CALLED THROUGH UHS' POPULATION HEALTH PROGRAM STAFF. REMINDERS WERE SENT TO PATIENTS THROUGH THE MAIL, AND THROUGH THE PATIENT PORTAL: MY CHART, FOR THOSE PATIENTS WHO ELECTED TO SIGN UP. PHONE CALLS WERE ALSO COMPLETED THROUGH THE AUTOMATED SERVICE. UNFORTUNATELY, THE ADDED INFLUENCE PROVIDERS CAN BRING TO THE MESSAGE WAS OFTEN LOST AS THEY WERE NOT SEEING THEIR PATIENTS, FACE-TO-FACE, AS OFTEN. AS TIME GOES ON, THE NUMBERS OF PATIENTS (NUMERATOR) WHO FALL WITHIN THE TIME FRAME OF ANY GIVEN OBJECTIVE, INCREASES. IF THE NUMBERS OF PATIENTS MEETING THE OBJECTIVE DOES NOT INCREASE, THE PERCENTAGE OF COMPLIANCE WILL AUTOMATICALLY DECREASE, DUE TO THE NUMERATOR BECOMING STEADILY LARGER. BECAUSE THE COVID-19 PANDEMIC HAS CONTINUED MUCH LONGER THAN ANYONE COULD HAVE IMAGINED, WE WILL BE MAKING A CONCERTED EFFORT TO RE-FOCUS ON DISEASE CONTROL AND WELLNESS STRATEGIES IN 2022, DESPITE COVID-19 CONDITIONS. WE WILL BE TRANSITIONING TO A MORE ""BUSINESS AS USUAL"" EMPHASIS SO THAT WE CAN HELP PATIENTS REFOCUS ON THEIR GENERAL HEALTH AND WELL-BEING. COMMUNITY SERVICE PLAN METRICS- 2019-2021GOAL 4.1 INCREASE CANCER SCREENING RATES4.1.1 OBJECTIVE: DVH PATIENTS, WHO HAD AN INTERACTION WITH DVH WITHIN THE LAST TWO YEARS, AND ARE BETWEEN THE AGES OF 50-75 HAVE HAD APPROPRIATE COLORECTAL SCREENING. IMPROVEMENT STRATEGIES: BECAUSE COVID-19 PANDEMIC HAS CONTINUED MUCH LONGER THAN ANYONE COULD HAVE IMAGINED, WE WILL BE MAKING A CONCERTED EFFORT TO RE-FOCUS ON DISEASE CONTROL IN 2022, DESPITE COVID-19 CONDITIONS. 2019 GOAL % 70 ACTUAL % 64.4 2020 GOAL % 68 ACTUAL % 47 2021 GOAL % 47 ACTUAL % 41 GOAL 4.3 PROMOTE EVIDENCE-BASED CARE TO PREVENT AND MANAGE CHRONIC DISEASES INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES AND PREDIABETES AND OBESITY.4.3.1 OBJECTIVE: DVH PATIENTS, BETWEEN THE AGES OF 50-85 HAVE HAD AN ANNUAL WELL CARE VISIT. IMPROVEMENT STRATEGIES: BECAUSE COVID-19 PANDEMIC HAS CONTINUED MUCH LONGER THAN ANYONE COULD HAVE IMAGINED, WE WILL BE MAKING A CONCERTED EFFORT TO RE-FOCUS ON WELLNESS STRATEGIES IN 2022, DESPITE COVID-19 CONDITIONS.2019 GOAL % 50 ACTUAL % 36.5 2020 GOAL % 50 ACTUAL % 25.5 2021 GOAL % 50 ACTUAL % 26 4.3.2 OBJECTIVE: DVH PATIENTS, BETWEEN THE AGES OF 18-85 WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION, HAVE HAD THEIR BLOOD PRESSURE ADEQUATELY CONTROLLED (<140/90). IMPROVEMENT STRATEGIES: ALTHOUGH THE METRIC WAS MET FOR 2021, WE WILL CONTINUE TO FOCUS ON BLOOD PRESSURE CONTROL IN 2022. 2019 GOAL % 71 ACTUAL % 71.7 2020 GOAL % 72.5 ACTUAL % 76 2021 GOAL % 66 ACTUAL % 72 4.3.3 OBJECTIVE: DVH PATIENTS, 18-75 YEARS OF AGE, WITH DIABETES, WILL HAVE HAD HBA1C TESTING WITHIN A YEAR AND THE RESULT WILL BE <8.0%. IMPROVEMENT STRATEGIES: BECAUSE COVID-19 PANDEMIC HAS CONTINUED MUCH LONGER THAN ANYONE COULD HAVE IMAGINED, WE WILL BE MAKING A CONCERTED EFFORT TO RE-FOCUS ON WELLNESS STRATEGIES IN 2022, DESPITE COVID-19 CONDITIONS.2019 GOAL % 67.2 ACTUAL % 69.9 2020 GOAL % 67.2 ACTUAL % 24 2021 GOAL % 71 ACTUAL % 23 4.3.4 OBJECTIVE: PRESCRIPTIONS, WRITTEN FOR THE CHRONIC CONDITIONS OF PATIENTS WHO HAVE HAD ANY INTERACTION WITH DVH WITHIN THE LAST 2 YEARS, WILL BE WRITTEN FOR A 90 DAY SUPPLY. MEDICATION TYPES INCLUDED IN THE MEASURE: ACE INHIBITOR/ARB MEDICATIONS, DIABETES, BETA-BLOCKER, HIGH AND MODERATE AND LOW INTENSITY STATIN MEDICATIONS. IMPROVEMENT STRATEGIES: THIS METRIC HAS CONSISTENTLY BEEN EITHER MET OR VERY NEARLY MET THROUGHOUT THE UHS SYSTEM. THEREFORE, THE UHS SYSTEM IS DROPPING THIS METRIC IN 2022. 2019 GOAL % 72 ACTUAL % 72.6 2020 GOAL % 72 ACTUAL % 70.7 2021 GAOL % 72 ACTUAL % 74 GOAL 4.4 IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES AND PREDIABETES AND OBESITY.4.4.1 OBJECTIVE: A HEALTHCARE PROVIDER OR HUMAN SERVICE AGENCY WILL HAVE REFERRED MORE PARTICIPANTS TO THE CHRONIC DISEASE SELF- MANAGEMENT WORKSHOP. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE 4.4.2 OBJECTIVE: ACCESS TO CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS WILL CONTINUE. 2021 EXECUTIVE SUMMARY THE CONTINUED COVID PANDEMIC WREAKED HAVOC ACROSS THE NATION IN MANY AREAS BUT ONE THAT GREATLY SUFFERED WAS IN OUR ABILITY TO DELIVER WELLNESS PROGRAMMING. DUE TO SOCIAL DISTANCING CONSTRAINTS, IN-PERSON CLASSES WERE NOT FEASIBLE, OR EVEN PRUDENT. MANY IN OUR AREA EITHER DO NOT HAVE ACCESS TO A COMPUTER AND/OR THE INTERNET OR FIND THE SERVICE TOO COSTLY OR ARE NOT COMPUTER LITERATE. THIS IS ESPECIALLY TRUE OF OUR OLDER RESIDENTS WHO ARE GENERALLY THE PATIENTS WHO BENEFIT FROM THIS INTERVENTION, SO VIRTUAL CLASSES WERE ALSO UNREALISTIC. WE LOST A CERTIFIED TRAINER IN 2020 AND ANOTHER IN 2021.THIS LEFT THE HOSPITAL WITH JUST ONE TRAINER. IT HAD BEEN A STRUGGLE TO FIND ENOUGH PARTICIPANTS TO MAKE THIS A VALUABLE PROGRAM ALREADY - (SUPPOSED TO HAVE AT LEAST 8-10) AND THE COVID PANDEMIC JUST ADDED TO THESE STRUGGLES. THE DECISION WAS MADE TO NO LONGER OFFER THESE CLASSES. WE CONSISTENTLY HAD TOO FEW ATTENDEES FOR THE AMOUNT OF RESOURCES IT TOOK TO GIVE THESE WORKSHOPS. HOWEVER, THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY STILL OFFERS THESE CLASSES AND WE FORWARD THIS INFORMATION ALONG TO OUR PROVIDERS, SOCIAL WORKER AND PATIENT CARE COORDINATOR TO SHARE WITH PATIENTS WHO MAY BENEFIT FROM THE PROGRAM. IN 2020, THE DECISION WAS MADE TO FOCUS OUR EFFORTS ON MOVING OUR COMMUNITY TOWARD BECOMING AN AGE FRIENDLY COMMUNITY, WHICH SHOULD BE MUCH MORE IMPACTFUL IN IMPROVING THE HEALTH AND WELL-BEING FOR RESIDENTS OF ALL AGES. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSFOCUS AREA 1: PROMOTE WELL-BEINGGOAL 1.1: STRENGTHEN OPPORTUNITIES TO BUILD WELL-BEING AND RESILIENCE ACROSS THE LIFESPAN1.1.1 OBJECTIVE: BY DECEMBER 31, 2020 AT LEAST ONE COMMUNITY WITHIN THE DVH SERVICE AREA WILL BE ACTIVELY WORKING TO BECOME AN AGE-FRIENDLY COMMUNITY.INTERVENTIONS: BUILD COMMUNITY WEALTH BY SERVING AS THE CATALYST TO CREATE INCLUSIVE, HEALTHY PUBLIC SPACES AND INTER-GENERATIONAL SOCIALIZATION OPPORTUNITIES2021 UPDATE: ALTHOUGH THE PANDEMIC CUT INTO MUCH OF WHAT WE WANTED TO DO, WORKING WITH THE WALTON CHAMBER OF COMMERCE, THE COMMUNITY'S VETERANS' PLAZA WAS BETTER UTILIZED FOR A VARIETY OF ACTIVITIES. THESE INCLUDED OPEN-AIR CONCERTS, FARMER'S MARKET, AND THE WALK FOR HUNGER. THE PLAZA IS PART OF THE COMMUNITY'S FLOOD MITIGATION PROJECT. IN ADDITION, THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR WROTE A GRANT FOR THE CHAMBER TO COMMISSION A STREET SCAPE PLAN THAT WOULD BENEFIT MERCHANTS AND THE PUBLIC BY MAKING AN ATTRACTIVE AND WALKABLE MAIN STREET. THAT PROJECT WAS FUNDED AND THE PLAN IS BEING DEVELOPED BY THE COUNTY'S LANDSCAPE ARCHITECT. THE DIRECTOR ALSO SPEARHEADED THE PROJECT TO PURCHASE AND PLANT APPROPRIATE EVERGREENS IN DECORATIVE BARRELS ALONG THE MAIN STREET AND NEAR OTHER BUSINESSES THAT CAN BE USED TO MAKE THE STREET MORE INVITING ALL YEAR AND ESPECIALLY DURING THE HOLIDAYS. THESE ACTIVITIES ARE SMALL STEPS TOWARD CREATING OPPORTUNITIES FOR RESIDENTS TO SOCIALIZE, AND WALK IN AN ATTRACTIVE, INVITING ENVIRONMENT. OBJECTIVE 1.1.2 INCREASE ACCESSIBILITY OF PHYSICAL ENVIRONMENT BY 5% (BASELINE TO BE SET IN 2020)INTERVENTION: DEVELOP CONSENSUS ON DEVELOPMENT OF WATER STREET THROUGH FLOOD MITIGATION PROJECT AND OTHER FUNDING"

DELAWARE VALLEY HOSPTITAL
PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE.

PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN (CONTINUED)
2021 UPDATE: THE COUNTY PLANNING DEPARTMENT DID WRITE SEVERAL GRANTS TO BEGIN THE DEVELOPMENT OF THE WATER STREET FLOOD MITIGATION PROJECT TO INCLUDE A RIVERSIDE WALK AND PICNIC AREAS. THE PICNIC AREAS WERE PUT IN PLACE BUT CONSTRUCTION OF THE RIVER WALK HAS NOT YET BEEN FUNDED. OBJECTIVE 1.1.3: BY DECEMBER 31, 2021 DECREASE THE % OF ADULTS WHO REPORT FEELING ANXIETY OR FEAR, DEPRESSION OR SADNESS, HELPLESS OR HOPELESSINTERVENTION: SURVEY COMMUNITY MEMBERS2021 UPDATE: THE GRANTS SOUGHT TO FUND THE SURVEY WERE NOT RECEIVED SO IN LATE 2021 DELAWARE VALLEY HOSPITAL DID MAKE THE COMMITMENT TO FUND THE COST OF THE SURVEY ITSELF. THE DECISION WAS MADE AFTER THE HOSPITAL FELT IT WAS ON FINANCIALLY SOLID GROUND DESPITE THE LOWER THAN EXPECTED VOLUMES CAUSED BY THE PANDEMIC. DISCUSSIONS WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY TOOK PLACE REGARDING DEVELOPMENT, DISTRIBUTION AND TABULATION OF THE SURVEY RESULTS. A CONTRACT WAS DRAFTED AND SENT TO THE LEGAL DEPARTMENT FOR REVIEW. WORK HAS BEGUN ON THE QUESTIONS FOR THE SURVEY. DISCUSSION WITH THE WALTON SCHOOL DISTRICT ALSO SECURED THEIR SUPPORT TO HELP FORMULATE AND DISTRIBUTE A SURVEY FOR THE MIDDLE AND HIGH SCHOOL AGE STUDENTS. DVH ALSO CONTINUED TO SPONSOR ACTIVITIES THAT PROVIDED SOCIALIZATION OPPORTUNITIES TO THE PUBLIC TO HELP OFFSET THE ADDITIONAL ISOLATION AND DEPRESSION THAT SOME MAY HAVE FELT DUE TO THE RESTRICTIONS COVID BROUGHT TO BEAR. THESE INCLUDED A 5K RUN IN DOWNSVILLE, THE HUNGER WALK IN WALTON, THE MUSIC ON THE DELAWARE GROUP THAT HELP SEVERAL VIRTUAL CONCERTS AND THE LOCAL LITTLE LEAGUE AND PROM NIGHT. BECAUSE OF THE PANDEMIC, MUCH EFFORT CENTERED AROUND THE DISTRIBUTION OF THE VACCINE TO AREA RESIDENTS. THE HOSPITAL'S COMMUNITY RELATIONS DEPARTMENT TOOK THE CALLS FROM THOSE WANTING TO BE VACCINATED. THE DEPARTMENT ALSO WORKED CLOSELY WITH THE DELAWARE COUNTY PUBLIC HEALTH AND OFFICE FOR THE AGING DEPARTMENTS TO COORDINATE CLINICS AND COMMUNICATE TO THE PUBLIC. THE HOSPITAL HELD ONGOING CLINICS, WHICH CONTINUE TO THIS DAY. THE HOSPITAL'S DELAWARE COUNTY FAIR BOOTH SPACE WAS UTILIZED BY THE NYS DEPARTMENT OF HEALTH TO GIVE VACCINES ON SITE. HOSPITAL STAFF TRAVELED TO SIDNEY, HANCOCK AND MASONVILLE TO OFFER VACCINATIONS. DELAWARE VALLEY HOSPITAL ALSO PROVIDED WATER BOTTLES TO THE HANCOCK, DOWNSVILLE, LIVINGSTON MANOR, ROSCOE AND FRANKLIN CENTRAL SCHOOLS FOR THEIR KIDS AS THEY TRANSITIONED TO WATER DISPENSERS RATHER THAN WATER FOUNTAINS IN THEIR SCHOOLS.

PART I, LINE 7:
DELAWARE VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) AS DESIGNATED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. UNLIKE NON-CAH'S THAT ARE REIMBURSED BASED ON A PROSPECTIVE REIMBURSEMENT METHODOLOGY, CAH'S ARE REIMBURSED THEIR ALLOWABLE COSTS FOR MEDICARE PURPOSES. THE MEDICARE COST REPORT (CMS 2552) AND THE MEDICAID INSTITUTIONAL COST REPORT (ICR) WAS UTILIZED FOR PURPOSES OF IDENTIFYING COSTS AND NET REVENUE. ADDITIONALLY, THERE IS NO BAD DEBT EXPENSE IN ANY OF THE COSTS USED IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F.

PART I, LN 7 COL(F):
DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $1,143,925 IN PART IX, LINE 24B. THE AFOREMENTIONED BAD DEBT EXPENSE WAS SUBTRACTED IN THE CALCULATIONS OF SCHEDULE H, PART I, LINES 7A THRU 7K.

PART II, COMMUNITY BUILDING ACTIVITIES:
DELAWARE VALLEY HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH ITS MEMBERSHIP AND PARTICIPATION IN THE DELAWARE COUNTY RURAL HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY. THE COMMUNITY RELATIONS DIRECTOR ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. IN 2020, MANY SCHOOLS, AS PART OF THEIR RE-OPENING PLAN, CHANGED OUT THEIR WATER FOUNTAINS FOR WATER BOTTLE FILL STATIONS. DVH ONCE AGAIN, SUPPLIED 5 AREA SCHOOLS WITH NEW WATER BOTTLES FOR THEIR STUDENTS. OVER 1,500 WATER BOTTLES WERE PROVIDED TO 5 SCHOOLS. BOTTLES WERE ORDERED IN EACH SCHOOL'S COLORS AND PRINTED WITH ITS MASCOT AND A PLACE FOR THE CHILDREN TO WRITE THEIR NAMES. THE HOSPITAL MAINTAINS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER) COMMITTEE. HOWEVER, NO MEETINGS WERE HELD IN 2021 DUE TO THE PANDEMIC. DELAWARE COUNTY'S SOLID WASTE MANAGEMENT CENTER CONTINUES TO DISTRIBUTE BROCHURES, PRINTED COURTESY OF DVH, REGARDING SAFE NEEDLE DISPOSAL. WHEN PATIENTS BRING THEIR USED SHARPS TO THE HOSPITAL FOR DISPOSAL, THEY ARE GIVEN AN APPROPRIATELY SIZED SHARP DISPOSAL CONTAINER, FREE OF CHARGE.THE HOSPITAL CONTINUES TO SUPPORT THE TOWN'S VETERAN'S CLUB, CHAMBER OF COMMERCE, THE LITTLE LEAGUE ORGANIZATION, TWO LOCAL TOY BANK DRIVES, ONE 5K, FIRE DEPARTMENTS AND EMS. BECAUSE OF THE PANDEMIC, THE COMMUNITY'S ANNUAL HOLIDAY DINNER WAS NOT HELD BUT THE MUSIC ON THE DELAWARE GROUP HELD SEVERAL VIRTUAL CONCERTS. THE RETIRED PRESIDENT/CEO OF DELAWARE VALLEY WAS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB, WHILE THE CURRENT PRESIDENT/CEO IS ACTIVE ON THE CATSKILL-HUDSON AREA HEALTH EDUCATION BOARD. THE HOSPITAL CFO SERVES ON THE BOARD OF THE CULLMAN CENTER, A DAY CARE CENTER IN SIDNEY, NY. SHE ALSO SERVES AS THE CHAIR OF THE BOARD OF DIRECTORS OF THE UHS EMPLOYEES' CREDIT UNION. BEGINNING IN 2020, THE DIRECTOR OF SUPPORT SERVICES SERVES ON THE DELAWARE COUNTY CHAMBER OF COMMERCE BOARD, WHILE THE COMMUNITY RELATIONS DIRECTOR SITS ON THE WALTON CHAMBER OF COMMERCE BOARD. IN 2015, THE WALTON MINISTERIAL ASSOCIATION BEGAN A HUNGER WALK TO RAISE MONEY FOR THE LOCAL FOOD BANK AND CHILDREN'S NUTRITION PROGRAMS. DELAWARE VALLEY CONTINUES TO BE THE LEADING SPONSOR OF THE EVENT AND STAFF SERVES ON THE PLANNING COMMITTEE. THE HOSPITAL ALSO HELPS RECRUIT ADDITIONAL SPONSORS.DVH CONTINUES TO SUPPLY FREE OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE IS LOCATED IN BINGHAMTON, NY, AT LEAST AN HOUR AWAY FROM DELAWARE COUNTY, ONE OF THEIR TARGET AREAS. BY PROVIDING THEM WITH FREE OFFICE SPACE, THEY HAVE A HOME BASE MORE CENTRALLY LOCATED TO THOSE WHO THEY ARE TRYING TO SERVE. THE ORGANIZATION OFFERS MANY NAVIGATION-TYPE PROGRAMS, MOST ESPECIALLY ACCESS TO TRANSPORTATION SERVICES. THE HOSPITAL ALSO PROVIDES PHONE AND OFFICE SUPPLIES TO THEM AT NO CHARGE. ALTHOUGH THE OFFICE CONTINUED TO BE MAINTAINED IN 2021, THE STAFF CONTINUED WORKING REMOTELY, WITH ONLY OCCASIONAL OFFICE DAYS. DVH ALSO PROVIDES A SPACE FOR THE FAMILY RESOURCE NETWORK, WHICH SERVES FAMILIES DEALING WITH DISABILITIES, TO MEET WITH FAMILIES. THEIR MAIN OFFICE IS LOCATED 45 MINUTES AWAY FROM WALTON AND CLIENTS HAD DIFFICULTY GETTING THERE. WHILE THEY DID NOT UTILIZE THE ROOM IN 2021, DVH MAINTAINS THEIR SPOT ON THE CALENDAR, FOR WHEN THEY REVERT BACK TO IN-PERSON MEETINGS. WHEN THE LOCAL EMERGENCY SQUAD NEEDS TO RE-STOCK ITS AMBULANCE, BUT HAS NOT BROUGHT THE PATIENT TO THE HOSPITAL'S ER, THE HOSPITAL RE-STOCKS THE AMBULANCE FREE OF CHARGE. THIS CAN HAPPEN WHEN THE AMBULANCE PERSONNEL HAVE CALLED FOR A HELICOPTER EVACUATION OF THE PATIENT(S) DIRECTLY FROM THE SCENE OF THE INCIDENT. A PATIENT AND FAMILY ADVISORY COMMITTEE STARTED IN 2018. THE GROUP PROVIDES DVH WITH INVALUABLE INSIGHT AS TO HOW A PATIENT INTERPRETS A MULTITUDE OF HEALTHCARE TOPICS. DVH IS ABLE TO PROVIDE THEM WITH INSIGHT TO SOME OF THE REASONS THAT THINGS ARE DONE THE WAY THEY ARE. DURING 2019, THE GROUP WAS INSTRUMENTAL IN HELPING THE HOSPITAL TO RE-TOOL ITS ADMISSION PACKET, HEALTH HISTORY FORM AND PATIENT EDUCATION MATERIALS. HOWEVER, THIS GROUP DID NOT MEET IN EITHER 2020 OR 2021 DUE TO THE PANDEMIC.DVH ALSO BELIEVES IN ENCOURAGING FAMILY TOGETHERNESS AND ACTIVITIES. SINCE 2016, DELAWARE VALLEY HAS HELD AN ANNUAL SANTA EVENT, TAKING PHOTOS WITH SANTA, DOING A HOLIDAY CRAFT WITH THE CHILDREN AND THEIR PARENTS AND SERVING REFRESHMENTS. UNFORTUNATELY THE EVENT HAS NOT BEEN ABLE TO BE HELD SINCE 2019 DUE TO COVID-19. PLANS ARE TO CONTINUE THE PROGRAM IN 2022, IF POSSIBLE. TO ENCOURAGE YOUNG CHILDREN TO BE SAFE AND NOT TO BE AFRAID OF HEALTHCARE PROVIDERS OR HOSPITALS, DVH GENERALLY HOSTS SECOND GRADERS FROM 5 AREA SCHOOLS AT ITS TEDDY BEAR CLINIC. THEY LEARN LESSONS ABOUT SAFETY HELMETS, SEAT BELTS AND POISON, ALSO HAVE HANDS-ON EXPERIENCE IN THE ER, RADIOLOGY, AND HELP CARE FOR OUR MANNEQUIN PATIENT (A BIKE ACCIDENT PATIENT WHO DID NOT WEAR A HELMET). THEY TOUR AN AMBULANCE, LOOK INSIDE THE MEDICAL HELICOPTER AND GET TO MEET AND LEARN ABOUT WHAT K9 OFFICERS AND THEIR DOGS DO. THE EVENT IS USUALLY HELD IN MAY, HAD TO BE CANCELLED IN 2020 AND 2021. AGAIN, DELAWARE VALLEY HAS EVERY INTENTION OF BRINGING THIS EVENT BACK IN 2022. THE PEDIATRICIAN PARTICIPATES IN THE NATIONAL REACH OUT & READ PROGRAM AND GIVES FREE AND AGE-APPROPRIATE BOOKS TO CHILDREN AT EACH WELLNESS VISIT, BEGINNING AT THE AGE OF 6 MONTHS.

PART III, LINE 3:
THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2021 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2021 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2021, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 15.0% OF THE TOTAL BAD DEBT WRITE-OFFS.

PART III, LINE 4:
AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. PLEASE REFER TO FOOTNOTE 1, PAGE 7 OF THE AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION.

PART III, LINE 8:
BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE HOSPITAL HAS A POLICY TO PROVIDE A COMMUNITY BENEFIT TO UNINSURED PATIENTS THAT CONSISTS OF FEE DISCOUNTS. CERTAIN PATIENTS THAT WERE PROVIDED FEE DISCOUNTS WOULD HAVE LIKELY QUALIFIED UNDER THE CHARITY CARE POLICY. DELAWARE VALLEY HOSPITAL USES THE COST TO CHARGE RATIO METHODOLOGY UTILIZING AMOUNTS FROM THE 2021 MEDICARE COST REPORT FOR ALL PERTINENT CALCULATIONS IN PART III, LINE 6.

PART III, LINE 2:
THE HOSPITAL 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, THE HOSPITAL 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 HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING 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), THE HOSPITAL 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 9B:
UHS HOSPITALS POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.UHS HOSPITALS REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. UHS HOSPITALS PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 240 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. UHS HOSPITALS ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENCING LEGAL ACTION.

PART VI, LINE 2:
"IN 2019, THE HOSPITAL CONTINUED TO WORK HAND IN HAND WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT, O'CONNOR HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL TO DEVELOP THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND OUR INDIVIDUAL COMMUNITY SERVICE PLANS. STAFF FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY AIDED US BY RESEARCHING AREA DEMOGRAPHICS AND COMPILING THE REPORT. THE NEW NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN AND ANNUAL UPDATES ARE LOCATED AT HTTPS://WWW.NYUHS.ORG/WHY-CHOOSE-US/COMMUNITY-SERVICE-REPORTS.RECRUITMENT OF HEALTHCARE PROFESSIONALS IS ALWAYS A CHALLENGE, ESPECIALLY IN OUR RURAL AREA. DELAWARE VALLEY HOSPITAL (DVH) AND 2 OF ITS 3 PRIMARY CARE CENTERS MAINTAIN THEIR STANDING AS APPROVED SITES FOR PROFESSIONALS SEEKING ASSISTANCE THROUGH THE NATIONAL HEALTH SERVICE CORPS. HOWEVER, THE ROSCOE SITE HAD TO BE TEMPORARILY CLOSED ON 9/11/20 DUE TO THE LOSS OF THE PROVIDER BUT WAS RE-OPENED ON 4/26/21. TO GAIN NHSC APPROVAL, MEDICATION ASSISTED TREATMENT NEEDS TO BE AVAILABLE AT EACH SITE FOR SUBSTANCE USERS. ROSCOE'S NEW PROVIDER WILL BE WORKING TO GET HER WAIVER. THE HOSPITAL ALSO HOSTS BOTH RN AND CNA STUDENTS, FROM OUR LOCAL COLLEGE (SUNY DELHI) AND BOARD OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). DUE TO THE PANDEMIC, THE STUDENTS FROM BOCES AND SUNY DELHI WERE UNABLE TO RETURN UNTIL THE SPRING OF 2021. TWO DVH RNS SERVED AS MENTORS TO SUNY DELHI RN AND BSN STUDENTS IN 2020. THE PANDEMIC CONTINUED TO MAKE IT IMPOSSIBLE TO HOST THE ANNUAL MASH CAMP FOR HIGH SCHOOL STUDENTS WHERE THEY LEARN ABOUT HEALTHCARE CAREERS AND ENCOURAGE THEM TO PRACTICE IN OUR RURAL COMMUNITY. THE ANNUAL CAREER DAY AT THE AREA HIGH SCHOOL, WHICH IS ATTENDED EACH YEAR BY ONE OF THE HOSPITALS ER PHYSICIAN ASSISTANTS WAS AGAIN CANCELLED IN 2021. HOWEVER, DVH DID BEGIN TO WORK TO DEVELOP AND IMPLEMENT A STUDENT VOLUNTEER/SHADOW PROGRAM IN 2022, IN ORDER TO BE ABLE TO ACCOMMODATE REQUESTS FROM AREAS THAT STUDENTS INTERESTED IN LEARNING MORE ABOUT RURAL HEALTHCARE AND THE OPPORTUNITIES IT AFFORDS.IN 2021, DVH RESOURCES WERE MORE FOCUSED ON DEVELOPING EVEN MORE STRINGENT SAFETY PROTOCOLS, GIVEN THE PANDEMIC. ACCESS TO THE HOSPITAL CONTINUED TO BE DETOURED TO ONE ENTRANCE, WHERE A SCREENER ASSESSES THE PATIENT/VISITOR/VENDOR FOR COVID-19 SYMPTOMS AND EXPOSURE BEFORE HAVING THEM ENTER. ALL VISITORS/COMPANIONS CONTINUE TO BE PROVIDED INFORMATION ABOUT PROPER WAY TO WEAR MASKS, SOCIAL DISTANCE AND THE IMPORTANCE OF SAFETY AND HAND HYGIENE. FLOOR INSIGNIA DEMARCATE APPROPRIATE SOCIAL DISTANCES. WAITING ROOMS REMAIN CONFIGURED TO ALLOW SOCIAL DISTANCING. APPOINTMENTS CONTINUE TO BE STAGGERED SO LESS PEOPLE WOULD BE IN ANY ONE WAITING ROOM AT A TIME. TELEPHONIC AND VIRTUAL APPOINTMENTS ARE USED WHEN APPROPRIATE, TO HELP REDUCE POTENTIAL EXPOSURE. NURSING STAFF CONTINUES TO CONDUCT DRIVE-THROUGH COVID TESTING. ALWAYS A FOCUS, HAND HYGIENE IS EVEN MORE GREATLY EMPHASIZED. A NEW POSITION WAS CREATED TO ASSURE A SCREENER WOULD BE AVAILABLE FROM 7 AM- 5 PM MONDAY THROUGH FRIDAY. THE ER PATIENT SERVICE REPRESENTATIVE SERVES AS THE SCREENER DURING OFF HOURS, ON WEEKENDS AND HOLIDAYS. BOTH CONTINUE TO USE A BUZZER AND SPEAKER SYSTEM SO THAT SCREENERS CAN COMMUNICATE WITH PEOPLE WAITING TO BE SCREENED. VISITATION OF MEDICAL PATIENTS WAS RESTRICTED OR PAUSED AS NEEDED. IPADS WERE PUT IN PLACE TO ACCOMMODATE VIRTUAL VISITS, ESPECIALLY FOR SWING BED PATIENTS WHO ARE AT DVH FOR A LONGER PERIOD OF TIME. IN 2020, THE MANAGEMENT TEAM WORKED EXTENSIVELY ON A PLAN THAT WOULD ENABLE DVH TO ACCOMMODATE A 50% BED SURGE CAPACITY. THIS INCLUDED WAYS TO ACCOMMODATE EXTRA BEDS AND HOW TO ENSURE THE HOSPITAL WOULD BE ABLE TO STAFF THEM. LPNS FROM THE HOSPITAL'S PRIMARY CARE CENTERS STEPPED UP TO BE CROSS-TRAINED TO WORK ON THE MEDICAL FLOOR IF NEEDED. THE HOSPITAL PURCHASED 10 ADDITIONAL BEDS. BASED ON THAT WORK, IN 2021, THE MAINTENANCE STAFF TRANSFORMED EXISTING ROOMS THAT WERE BEING UTILIZED AS OFFICE OR STORAGE SPACE, BACK INTO PATIENT ROOMS, ALSO WITH NEGATIVE PRESSURE. THIS BROUGHT THE NUMBER OF BEDS, AVAILABLE ON THE MEDICAL UNIT, FROM 15 TO 19. BY DOING THIS DVH HAD GREATER FLEXIBILITY TO ACCEPT MORE PATIENTS, REGARDLESS OF THEIR GENDER AND/OR ISOLATION STATUS, FROM THE UHS SYSTEM OR OTHER AREA HOSPITALS. THEY ALSO INSTALLED PORTABLE NEGATIVE PRESSURE UNITS IN ALL THE ER ROOMS, AND ONE ROOM AT EACH OF THE PRIMARY CARE SITES.THE MAINTENANCE DEPARTMENT STAFF ALSO INSTALLED CLEAR BARRIERS THROUGHOUT THE FACILITY AT ALL PATIENT-FACING REGISTRATION AREAS. THE SEMI-ENCLOSED METAL AND GLASS WALKWAY CANOPY CONTINUED TO HELP PROTECT PATIENTS/VISITORS/VENDORS FROM THE ELEMENTS WHILE WAITING TO BE SCREENED FOR ENTRY. THE ENVIRONMENTAL SERVICES DEPARTMENT, CONTINUED KEEPING A MEMBER OF THEIR TEAM ON-CALL FOR AFTER HOUR TERMINAL CLEANING IF NEEDED BY THE ER, IN ORDER TO BE SURE THAT A FULL COMPLEMENT OF ER BEDS WOULD BE AVAILABLE AT ALL TIMES. UV WANDS AND AIR IONIZERS PURCHASED IN 2020, CONTINUED TO BE USED. HOWEVER, UVC LIGHTS WERE INSTALLED IN 2021 ON ALL THE HOSPITAL'S AIR HANDLERS TO INCREASE THEIR FILTERING CAPABILITIES. EVS STAFF CONTINUED ENHANCED CLEANING THROUGHOUT ALL FACILITIES OF HIGH-TOUCH AND HIGH-USE AREAS, INCLUDING HANDRAILS, DOOR KNOBS, SEATING, AND PUBLIC BATHROOMS. THEY ALSO INSURED THAT ALL DEPARTMENTS HAD ACCESS TO AN AMPLE SUPPLY OF HAND SANITIZER, AND VIREX FOR DISINFECTING SURFACES. THE FOOD SERVICE DEPARTMENT CONTINUED TO FULLY SERVE MENU ITEMS. ALL CONTAINERS, CUPS ETC. ARE SINGLE-USE. THE CAFETERIA SEATING WAS REARRANGED TO ENSURE SOCIAL DISTANCING. EXTENSIVE SIGNAGE, BROCHURES, NEWS ARTICLES WERE DEVELOPED, AS APPROPRIATE, TO HELP THE PUBLIC UNDERSTAND WHAT WAS BEING DONE FOR SAFETY AND WHY. PHONE MESSAGES WERE UPDATED SO THEY COULD MORE EASILY ACCESS THE LATEST INFORMATION. GREAT ATTENTION WAS ALSO PAID TO THE WELL-BEING OF OUR STAFF. TESTING, VACCINATION AND COMMUNICATION CONTINUED. DAILY ""SAFETY HUDDLE"" CALLS, WITH DEPARTMENTAL REPRESENTATION, PROVIDE A TIME FOR SHARING INFORMATION THAT COULD AFFECT THE SAFETY OF PATIENTS, STAFF OR VISITORS. COVID UPDATES ARE INCLUDED WHEN NECESSARY. A MEMBER OF DVH'S SENIOR STAFF THEN PARTICIPATES IN THE DAILY UHS SYSTEM SAFETY HUDDLE. STAFF THAT COULD PERFORM THEIR JOBS REMOTELY WERE ALLOWED TO STAGGER ON-SITE AND REMOTE WORK. MARKET ADJUSTMENTS WERE MADE TO THE SALARIES OF MOST POSITIONS, THROUGHOUT THE FACILITY AND MERIT INCREASES WERE GIVEN AS WELL. RETENTION BONUSES WERE INSTITUTED FOR ALL LABS, NURSING, NURSING ASSISTANT STAFF WHO COMMITTED TO STAYING IN THEIR POSITION FOR 2 YEARS. RECRUITMENT BONUSES WERE ALSO PUT IN PLACE, AS WELL AS, REFERRAL BONUSES. DVH CLINICAL ADMINISTRATIVE STAFF PROVIDED DIRECT PATIENT CARE, WHEN NECESSARY, UNTIL ADDITIONAL STAFF WAS HIRED. FINALLY, MORE STAFF WERE HIRED, IN KEY POSITIONS, TO ADDRESS THE HIGHER INPATIENT VOLUMES. A HOSPITALIST INPATIENT CARE MODEL WAS INSTITUTED. MENTAL HEALTH AND SUBSTANCE USE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. THE DIRECTOR OF COMMUNITY RELATIONS SITS ON A SUB-COMMITTEE OF THE COUNTY'S COMMUNITY SERVICE DEPARTMENT, FOCUSED ON MENTAL HEALTH AND ON THE DELAWARE COUNTY COMMUNITY SERVICES BOARD. THE MOST CHALLENGING BARRIER IN ACCESSING CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. DVH WAS ABLE TO CONTRACT WITH AN OUTSIDE VENDOR TO BEGIN A TELE-MENTAL HEALTH PROGRAM IN JANUARY OF 2019. THE PROGRAM IS MEANT TO HAVE AT LEAST ONE PART-TIME NPP AND 2 PART-TIME LCSWS. BUT MAINTAINING THAT STAFFING RATIO HAS BEEN EXTREMELY CHALLENGING. WHILE THE NPP HAS REMAINED CONSTANT, THE LCSWS HAVE NOT. ONE WENT ON MATERNITY LEAVE, AND DECIDED NOT TO RETURN, ONE DROPPED OUT, AFTER THE COVID PANDEMIC BEGAN BECAUSE FIRST RESPONDERS IN HER COMMUNITY (LONG ISLAND) DESPERATELY NEEDED HELP; AND YET ANOTHER SAW HER PRIVATE PRACTICE SHARPLY INCREASE, DUE TO COVID, AND SHE JUST DID NOT HAVE TIME TO CONTINUE. FINALLY, ANOTHER TWO LCSWS WERE RECRUITED. THE NPP HAS REMAINED CONSTANT.THE HOSPITAL NO LONGER SERVES AS A COLLECTION SITE FOR URINE SPECIMENS FOR THE COUNTY'S DRUG COURT. THE COURT DID NOT RE-OPEN UNTIL LATE 2021 AND IN OCTOBER 2021, DVH MADE THE DECISION TO PAUSE ADMISSIONS TO ITS ADDICTION TREATMENT PROGRAM, AS THE REFERRALS HAD SIGNIFICANTLY DWINDLED AND STAFF WAS DIFFICULT TO RECRUIT. EXISTING STAFF WERE RE-DEPLOYED TO OTHER AREAS WITHIN THE HOSPITAL, OR THEY TOOK POSITIONS ELSEWHERE. A SECOND NEED IS FOR CHRONIC DISEASE MANAGEMENT AND PREVENTION. THERE IS NO LONGER ANY TRAINED STAFF TO HOLD THE STAMFORD UNIVERSITY CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. DVH WILL PROVIDE A VENUE FOR THE PROGRAM, WHICH CAN BE DELIVERED BY RURAL HEALTH NETWORK OF SOUTH CENTRAL NY. HOWEVER, NO REQUESTS WERE MADE IN 2021. THE HOSPITAL STILL PLANS TO RE-START ITS LUNG MATTERS PROGRAM FOR PATIENTS DIAGNOSED WITH LUNG CONDITIONS. HOWEVER, NO IN-PERSON PROGRAMMING WAS HELD IN 2021. AND THE DVH-SPONSORED CHAIR YOGA PROGRAM FOR CARDIAC/PULMONARY REHABILITATION PATIENTS HAS NOT YET RETURNED DUE TO THE PANDEMIC."

PART VI, LINE 3:
DELAWARE VALLEY HOSPITAL IS COMMITTED TO PROVIDING OUR PATIENTS THE KNOWLEDGE THAT WE OFFER FINANCIAL ASSISTANCE. EACH PATIENT CARE REGISTRATION AREA HAS SIGNS TELLING THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO THEM. THERE ARE ALSO BROCHURES REGARDING THE PROGRAM THROUGHOUT THE HOSPITAL'S FACILITIES AND THE INFORMATION IS ALSO POSTED ON THE WEBSITE. IF NEEDED, TRANSLATION SERVICES ARE AVAILABLE. A FINANCIAL ASSISTANCE HELP LINE IS ALSO AVAILABLE AND ADVERTISED ON ALL BILLINGS. IN 2015, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CHANGED TO PROVIDE ALL SELF-PAY PATIENTS AN AUTOMATIC 35% DISCOUNT AT THE TIME OF SERVICE. IF FURTHER ASSISTANCE IS NEEDED, THE PATIENT APPLIES THROUGH THE FINANCIAL ASSISTANCE PROGRAM. DELAWARE VALLEY ALSO OFFERS PATIENTS EASY ACCESS TO A FIDELIS REPRESENTATIVE, BY PROVIDING A SITE FOR THEM TO INTERVIEW AND ENROLL RESIDENTS IN THEIR MEDICAID MANAGED CARE PRODUCT. FIDELIS IS THE ONLY PROVIDER OF THESE SERVICES FOR DELAWARE COUNTY. WHILE THE HOSPITAL MAINTAINED THE SPACE FOR THE FIDELIS REPRESENTATIVE TO COME IN 2021, MOST OF THE WORK CONTINUED TO BE DONE REMOTELY.

PART VI, LINE 6:
DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT MEMBER OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UNITED HEALTH SERVICES IN 1981 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATIONS INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. DVH PARTICIPATES IN THE UNITED HEALTH SERVICES SYSTEM STRATEGIC PLANNING PROCESS. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSES ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND THREE OBJECTIVES: IMPROVE OUR CARE, MANAGE OUR COSTS, AND GROW OUR MARKET SHARE. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE AND DVH FURTHER DEVELOPS OBJECTIVES AS THEY RELATE TO THE HOSPITAL'S SERVICES AND THE NEEDS OF OUR PATIENTS. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES BOTH LOCALLY AND REGIONALLY. THE DVH COMMUNITY SERVICE REPORT IS INCLUDED WITH THE DELAWARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, ALONG WITH THE COMMUNITY SERVICE PLANS OF O'CONNOR HOSPITAL, TRI-TOWN REGIONAL HOSPITAL, AND MARGARETVILLE HOSPITAL, ALL IN ONE DOCUMENT.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART VI, LINE 4:
DELAWARE VALLEY HOSPITAL'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY. USING PERCENTAGES, BASED ON THE NUMBERS OF UNIQUE PATIENTS UTILIZING OUR PRIMARY CARE SITES IN 2021, (AS THAT IS WHERE THE HIGHEST UTILIZATION OCCURS) THE PRIMARY SERVICE AREA ENCOMPASSES WALTON, DOWNSVILLE, ROSCOE, SIDNEY CENTER, DELHI, HAMDEN, EAST BRANCH, HANCOCK AND UNADILLA. THE PRIMARY SERVICE AREA REFLECTS WHERE 80% OF OUR PATIENTS RESIDE. THE SECONDARY SERVICE AREA CONSISTS OF THE COMMUNITIES WHERE THE NEXT 10.4% OF OUR PATIENTS RESIDE. THOSE COMMUNITIES INCLUDE: SIDNEY, DELANCEY, FRANKLIN, DEPOSIT, TROUT CREEK, LEW BEACH, ANDES, FISHS EDDY, BAINBRIDGE AND ONEONTA. DELAWARE COUNTY IS LOCATED ON THE WESTERN EDGE OF THE CATSKILL MOUNTAINS IN RURAL, UPSTATE NEW YORK. ENCOMPASSING 1446.37 SQUARE MILES, THE COUNTY'S SIZE APPROXIMATES THAT OF RHODE ISLAND AND IS THE FOURTH LARGEST OF NEW YORK STATE'S 62 COUNTIES. IN FACT, ITS SIZE IS SO GREAT THAT, SEVEN COUNTIES AND THE STATE OF PENNSYLVANIA BORDER DELAWARE COUNTY. IT ALSO RANKS AS THE FOURTH MOST RURAL COUNTY IN THE STATE WITH JUST 29.78 PERSONS PER SQUARE MILE. ITS TOPOGRAPHY IS CHARACTERIZED BY WINDING, AND TWISTING, TWO-LANE ROADS THAT TRANSVERSE A MOUNTAINOUS TERRAIN, MAKING TRAVEL CHALLENGING, ESPECIALLY DURING THE WINTER MONTHS. TRANSPORTATION IS AN EXTREMELY CHALLENGING BARRIER TO PROVIDING PATIENT CARE. THE AREA DOES NOT HAVE PUBLIC TRANSPORTATION AND WHILE RECENTLY SOME PRIVATE TRANSPORTATION SERVICES HAVE BEGUN, THEY ARE GENERALLY TOO COST PROHIBITIVE FOR MANY TO ACCESS. THE COUNTY IS HOME TO TWO OF THE STATE'S LARGEST RESERVOIRS IN THE NEW YORK CITY WATERSHED, WHICH HAS THE LARGEST UNFILTERED DRINKING WATER SUPPLY IN THE UNITED STATES. APPROXIMATELY 55% OF DELAWARE COUNTY'S POPULATION LIES WITHIN THE WATERSHED. NEW YORK CITY HAS WORKED TO PRESERVE AND SAFEGUARD THE WATERSHED FROM ENVIRONMENTAL DEGRADATION BY MEANS OF RESTRICTIONS AND REGULATIONS ON LAND USE WITHIN AND SURROUNDING THE WATERSHED. THE INITIAL IMPACT OF THE WATERSHED ON DELAWARE COUNTY HAS BEEN TO LIMIT ECONOMIC DEVELOPMENT WHICH PREVENTS EXPANSION OF THE TAX BASE. BECAUSE OF THE ENVIRONMENTAL ECOSYSTEM OF THE WATERSHED, THERE HAVE BEEN STRICT REGULATIONS PERTAINING TO AGRICULTURAL POLLUTION AND BUILDING CONSTRUCTION. MANY PROPERTIES HAVE BEEN PURCHASED BY NYC, TO FURTHER PROTECT ITS WATERSHED. LIMITING INFRASTRUCTURE GROWTH RESULTS IN DECREASED EMPLOYMENT OPPORTUNITIES. THESE UNIQUE CIRCUMSTANCES RESULT IN HEALTH CARE RELATED CHALLENGES FOR THE COUNTY RESIDENTS. THESE LIMITATIONS ALSO IMPACT THE LOCAL HEALTH AND SOCIAL SERVICE AGENCIES AND ORGANIZATIONS AND THE DELIVERY OF CARE AND SERVICES.THESE LIMITATIONS HAVE CAUSED RESIDENTS TO SEEK ALTERNATIVES TO STIMULATE ECONOMIC GROWTH. DELAWARE COUNTY FARMERS HAVE STARTED SPECIALTY INDUSTRIES. THIS IS REFLECTED IN THE INCREASED NUMBER OF SPECIALTY FARMS. OTHER ECONOMIC DEVELOPMENTS ARE TAKING THE FORM OF TOURISM (E.G. BED AND BREAKFAST), RECREATIONAL FACILITIES COMPATIBLE WITH THE ENVIRONMENT (E.G. GOLF, SKIING, HIKING, HUNTING AND FISHING), LOW POLLUTION FARMING, AND PROFESSIONAL/BUSINESS SERVICES COMPANIES.ACCORDING TO THE 2020 AMERICAN COMMUNITY SURVEY 5 YEAR ESTIMATES DATA PROFILES, THE POPULATION OF DELAWARE COUNTY NY IS 43,378. OF THOSE 3.9% ARE UNDER THE AGE OF 5, WHILE 24.5% ARE AGE 65 AND OVER. THE MEDIAN AGE IS 48.3 VERSUS THAT OF NY STATE AT 39. 91.8 % OF THE POPULATION IS CAUCASIAN, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN HOUSEHOLD INCOME IS $ 49,945, WHICH IS $21,172 LESS THAN THAT OF NYS AND APPROXIMATELY 12.8% OF THE POPULATION LIVES IN POVERTY, WHICH IS AN DECREASE OF 3.8%. ACCORDING TO THE SAME SOURCE, THE PERCENTAGE OF RELATED CHILDREN UNDER THE AGE OF 18 LIVE BELOW THE POVERTY LEVEL 60.1% WHILE FOR CHILDREN UNDER THE AGE OF 5, THE RATE IS 54.2% IN DELAWARE COUNTY. WHILE THE PERCENT OF THOSE LIVING IN POVERTY HAS DECREASED, THE PERCENTAGE OF CHILDREN LIVING IN POVERTY HAS INCREASED SUBSTANTIALLY.

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BECAUSE NUTRITION PLAYS A HUGE ROLE IN THE HEALTH OF COMMUNITY MEMBERS, THE HOSPITAL'S DIETITIAN/NUTRITIONIST WORKED IN CONJUNCTION WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY TO PROVIDE 60 PATIENTS WITH COMPLIMENTARY ONE ON ONE DIETARY COUNSELING, OVER 5 MONTHS, AS THEY PROGRESSED THROUGH THE COOPERATIVE EXTENSION'S FRUIT & VEGETABLE PROGRAM. THE HOSPITAL RECOGNIZED THAT UNLESS IT IS ABLE TO ENGAGE THE COMMUNITY IN CONVERSATIONS ABOUT MANY OF THE SOCIAL DETERMINANTS OF HEALTH, A LOT OF PROGRESS CANNOT BE MADE IN THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS. RESEARCH LED TO THE AARP AGE FRIENDLY LIVABLE COMMUNITY PROGRAM, WHICH IS GEARED TO ALL AGES. IN EARLY 2020, LEADERS FROM AROUND THE COUNTY ATTENDED A DAY-LONG PROGRAM FEATURING NATIONALLY RENOWNED SPEAKER, ESTHER GREENHOUSE, AN EXPERT ON AGING IN PLACE AND KAT FISHER FROM THE REGIONAL AARP OFFICE. LEADERS REPRESENTING GOVERNMENT, SERVICE ORGANIZATIONS, HEALTHCARE, SCHOOLS, CHURCHES AND COMMUNITY MEMBERS WERE PRESENT. 50 PEOPLE ATTENDED. BASED ON THIS PROGRAM, AND THE COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS, DVH, WORKING WITH DELAWARE COUNTY PUBLIC HEALTH AND MENTAL HEALTH PLANNED TO CONDUCT A SURVEY ABOUT HOW PEOPLE DO OR DO NOT SOCIALIZE IN THE COMMUNITY OF WALTON NY. WHILE THIS PROJECT IS BEHIND DUE TO THE PANDEMIC, IT IS MOVING FORWARD AND TAKING PLACE IN THE FALL OF 2022.A COMPONENT OF BECOMING AGE FRIENDLY IS TO CREATE SPACES WHERE PEOPLE CAN COME TOGETHER. WALTON HAS A RECLAIMED FLOOD PLAIN THAT BORDERS THE DELAWARE RIVER AND FOR YEARS PLANS HAVE BEEN DISCUSSED BUT NO ACTION HAD OCCURRED. IN 2020, THE FIRST PROJECT, A BOAT RAMP WAS INSTALLED. WITH THIS SPARK, DVH HAD APPLIED FOR SOME FUNDING TO KICK-START THE PROGRAM BUT IT HAD NOT COME THROUGH. DELAWARE COUNTY PLANNING DEPARTMENT ALSO APPLIED FOR FUNDING THAT WAS NOT SUCCESSFUL. HOWEVER, MEETINGS ARE STILL TAKING PLACE AND FUNDING OPPORTUNITIES ARE STILL BEING ASSESSED SO THAT A BEAUTIFUL PLACE WILL BE CREATED FOR FAMILIES AND VISITORS TO ENJOY RECREATION AND SOCIALIZATION.

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DELAWARE VALLEY HOSPITAL, A CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH OUR ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE WE SERVE. OUR INPATIENT SERVICES INCLUDE ACUTE CARE FOR THOSE PATIENTS REQUIRING 96 HOURS OR LESS OF HOSPITALIZATION; LONGER TERM REHABILITATIVE CARE FOR THOSE WHO NEED TIME TO GAIN STRENGTH AND STAMINA AFTER A DEBILITATING ILLNESS OR INJURY OR A SURGICAL PROCEDURE; AND INPATIENT ADDICTION TREATMENT (UNTIL PUT ON PAUSE IN OCTOBER 2021). THE HOSPITAL ALSO PROVIDES 24-HOUR EMERGENCY CARE. DIAGNOSTIC SERVICES INCLUDE LABORATORY, CARDIOPULMONARY, AND IMAGING SERVICES. THE HOSPITAL HAS THE CAPABILITY OF PERFORMING PULMONARY FUNCTION TESTING, EKGS, CARDIAC STRESS TESTING, AND PLACING HOLTER AND EVENT MONITORS. IN THE IMAGING CENTER, X-RAY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS, AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE WEEKLY. NUCLEAR MEDICINE WAS INSTITUTED 2 DAYS A WEEK. THIS WAS A MAJOR IMPROVEMENT FOR PATIENTS, WHO WOULD HAVE HAD TO TRAVEL AT LEAST 45 MINUTES TO AN HOUR TO RECEIVE SUCH DIAGNOSTIC TESTING. OUR OUTPATIENT REHABILITATION DEPARTMENT OFFERS PHYSICAL AND OCCUPATIONAL THERAPY; AACVPR CERTIFIED CARDIAC AND PULMONARY REHABILITATION PROGRAMS ARE ALSO IN PLACE. THROUGH OUR THREE PRIMARY CARE OFFICES LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE NY, PATIENTS OF ALL AGES CAN RECEIVE ACUTE AND PREVENTIVE CARE, AS WELL AS CHRONIC DISEASE MANAGEMENT. A FAMILY PRACTICE PROVIDER, IN WALTON, APPROACHED THE HOSPITAL TO INTEGRATE HIS STAFF AND PRACTICE INTO THE HOSPITAL'S PRIMARY CARE SERVICES. DELAWARE VALLEY AGREED AND THIS BROUGHT TWO ADDITIONAL FAMILY NURSE PRACTITIONERS INTO ITS MEDICAL STAFF.OCCUPATIONAL HEALTH SERVICES INCLUDE PRE-EMPLOYMENT AND DOT PHYSICALS, IMMUNIZATIONS, DRUG TESTING, AND ANNUAL PHYSICALS FOR FIRE DEPARTMENT MEMBERS. VISITING SPECIALISTS INCLUDE A GASTROENTEROLOGIST, CARDIOLOGIST, PODIATRIST AND PAIN MANAGEMENT PROVIDERS: A PHYSICIAN AND PHYSICIAN ASSISTANT. IN DECEMBER, THIS PRACTICE CONVERTED TO 100% VIRTUAL VISITS. THE GASTROENTEROLOGIST FROM UHS CONTINUES PERFORMING ENDOSCOPY AND COLONOSCOPY, AS WELL AS PERFORMING GI CONSULTS WHILE HE IS AT DVH. THE PAIN MANAGEMENT CLINIC BEGAN TO HELP PATIENTS UTILIZE ALTERNATIVE TREATMENT METHODS RATHER THAN USING OPIOIDS. THE CLINIC IS HELD THREE DAYS PER MONTH. DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST GENERALLY OFFERS A VARIETY OF PROGRAMS TO SEVERAL GROUPS. HOWEVER, DUE TO THE PANDEMIC, MANY PROGRAMS WERE UNABLE TO BE HELD. HOWEVER, SHE AND OUR RN CARE COORDINATOR PARTNERED AGAIN WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY IN 2021, TO WORK WITH THEIR CLIENTS WHO WERE ELIGIBLE FOR THE FRUIT AND VEGGIE VOUCHER PROGRAM.THE ANNUAL DELAWARE COUNTY FAIR WAS HELD IN 2021 AND DVH HAD A BOOTH AND BANNERS AND ALL ITS PROGRAMMING PLANNED, WHEN A FEW WEEKS PRIOR TO THE OPENING, THE AREA EXPERIENCED ANOTHER WAVE OF INCREASED COVID CASES. THE DECISION WAS MADE TO NOT GO TO THE FAIR AFTER ALL, AND POTENTIALLY EXPOSE STAFF TO COVID, THEREBY POTENTIALLY REDUCING THE NUMBERS OF STAFF THAT WOULD BE NEEDED SHOULD THERE BE A DRAMATIC UPTICK IN CASES AFTER THE FAIR. DVH STAFF WORKED WITH NY STATE OF HEALTH WHO PROVIDED VACCINATORS AND INFORMATION THROUGHOUT THE WEEK AT THE HOSPITAL'S BOOTH.