4A (Expenses $ 50577367 including grants of $ 0) (Revenue $ 59701785)
INPATIENT SERVICES - BLYTHEDALE CHILDREN'S HOSPITAL, FOUNDED IN 1891, IS A LICENSED ACUTE CARE FREE-STANDING CHILDREN'S HOSPITAL THAT SPECIALIZES IN THE CARE OF CHILDREN REQUIRING REHABILITATIVE, RESPIRATORY AND COMPLEX MEDICAL CARE. BLYTHEDALE IS DESIGNATED BY CMS AS A PPS EXEMPT, FREESTANDING CHILDREN'S HOSPITAL. WITHIN BLYTHEDALE CHILDREN'S HOSPITAL, WE PROVIDE A COMPREHENSIVE RANGE OF SERVICES WHICH INCLUDE BUT ARE NOT LIMITED TO GENERAL PEDIATRICS, ADOLESCENT MEDICINE, PEDIATRIC PULMONOLOGY, CHILD NEUROLOGY, PSYCHIATRY, ORTHOPEDICS, PHYSICAL MEDICINE, REHABILITATION OF MULTIPLE PEDIATRIC SPECIALTIES (SUCH AS CARDIOLOGY, INFECTIOUS DISEASE, ENT, OPHTHALMOLOGY, ETC.) BLYTHEDALE MAINTAINS A CORE GROUP OF FULL-TIME SPECIALTY COVERAGE IN PEDIATRICS, PULMONOLOGY, ADOLESCENT MEDICINE, NEUROLOGY, AND PSYCHIATRY. OTHER SUBSPECIALTY COVERAGE IS MAINTAINED AND UTILIZED AS NEEDED THROUGH A VARIETY OF CONTRACTUAL RELATIONSHIPS WITH THE AREA'S LEADING ACADEMIC MEDICAL CENTERS. BLYTHEDALE ALSO PROVIDES OTHER VITAL CLINICAL SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, PSYCHOLOGY, CHILD LIFE, RESPIRATORY, SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY, THERAPEUTIC RECREATION, SOCIAL WORK AND CASE MANAGEMENT. THE INPATIENT SERVICES ARE PRIMARILY COMPOSED OF 5 MAJOR PROGRAMS, PHYSICAL MEDICINE AND REHABILITATION SERVICES, VENTILATOR WEANING, TRAUMATIC BRAIN INJURY, FEEDING THERAPY, AND MEDICAL THERAPIES FOR COMPLEX AND CHRONIC HEALTH CONDITIONS.IN 2021, THE HOSPITAL OPERATED 94 LICENSED ACUTE BEDS, AND 24 PEDIATRIC LONG TERM CARE BEDS FOR A TOTAL OF 118 LICENSED BEDS. IN 2021 THE HOSPITAL ADDED 8 ACUTE TBI BEDS, MAKING BLYTHEDALE THE LARGEST INPATIENT POST-ACUTE TBI PROGRAM IN THE REGION. THE HOSPITAL PROVIDED CARE TO OVER 353 INPATIENTS THROUGHOUT 2021. THE HOSPITAL RAN AN AVERAGE DAILY CENSUS OF 80.3 IN 2021. BLYTHEDALE RECEIVED OVER 848 REGIONAL REFERRALS IN THE YEAR AND HAD 397 ADMISSIONS. OVER 79% OF OUR SERVICES WERE REIMBURSED THROUGH THE MEDICAID PROGRAM IN 2021. 100% OF BLYTHEDALE'S INPATIENT POPULATION IS REFERRED IN FROM OTHER ACUTE CARE HOSPITALS IN THE REGION, OF WHICH 56% ARE REFERRED DIRECTLY FROM INTENSIVE CARE UNITS (ICU'S). THIS SPEAKS TO THE HIGH ACUITY OF THE PATIENT POPULATION MANAGED AT BLYTHEDALE. IN 2021 ALMOST 71% OF PATIENTS TREATED WERE BELOW THE AGE OF 6 YEARS. THIS FACT PRESENTS MANY UNIQUE CHALLENGES TO THE DELIVERY OF CARE AS THE HOSPITAL PROVIDES HIGH QUALITY TO BOTH THE PATIENTS AND THE FAMILY. WE ARE PROUD THAT BLYTHEDALE DISCHARGES OVER 91% OF OUR KIDS BACK TO THEIR HOME AFTER ADMISSION. BLYTHEDALE CHILDREN'S HOSPITAL DOESN'T OPERATE PRIMARY CARE CLINICS, AN EMERGENCY DEPARTMENT OR OBSTETRICAL SERVICES. THESE SERVICES ARE OFTEN THE PRIMARY DRIVERS OF UNINSURED PATIENTS AT ACUTE CARE HOSPITALS. SECONDLY, CHILDREN, MORE SO THAN ADULTS HAVE GREATER ACCESS TO MEDICAID & CHILD HEALTH PLUS (CHP) REIMBURSEMENT AS A PAYER OF LAST RESORT IN NEW YORK STATE. THESE TWO FACTORS SIGNIFICANTLY IMPACT THE REPORTED AMOUNT OF CARE CLASSIFIED AS TRUE CHARITY CARE RELATIVE TO FULL SERVICE ACUTE CARE HOSPITALS.

4B (Expenses $ 14969706 including grants of $ 0) (Revenue $ 13828914)
THE STEVEN AND ALEXANDRA COHEN PEDIATRIC LONG TERM CARE PAVILION, WHICH OPENED IN FALL 2016, IS A UNIQUE 24-BED FACILITY DEDICATED TO THE HIGHLY SPECIALIZED NEEDS OF INFANTS AND CHILDREN WHO REQUIRE EXTENDED MEDICAL CARE AND REHABILITATION. IN 2021, THE HOSPITAL CARED FOR 27 CHILDREN AND RAN AN AVERAGE OCCUPANCY OF 99%. 45% OF THE CHILDREN WERE UNDER THE AGE OF 6, 100% WERE REIMBURSED THROUGH THE MEDICAID PROGRAM AND 100% REQUIRED VENTILATOR-RESPIRATORY SUPPORT. THE PAVILION SERVES CHILDREN WITH COMPLEX MEDICAL NEEDS, INCLUDING THOSE WHO REQUIRE A LONGER PERIOD OF TIME TO BE WEANED FROM THE VENTILATOR, AND PREMATURE INFANTS WITH FEEDING DIFFICULTIES, CONGENITAL CONDITIONS OR NEUROLOGICAL DISORDERS. THE PAVILION IS STAFFED BY A FULL-TIME PEDIATRICIAN WHO WORKS IN CONSULTATION WITH A VARIETY OF PEDIATRIC SUBSPECIALISTS INCLUDING PEDIATRIC PULMONOLOGY, PEDIATRIC PHYSICAL MEDICINE AND REHABILITATION, AND PEDIATRIC NEUROLOGY. THE COMPREHENSIVE TEAM ALSO INCLUDE REGISTERED NURSES, CERTIFIED RESPIRATORY THERAPISTS, PHYSICAL/OCCUPATIONAL/SPEECH THERAPISTS, RECREATIONAL THERAPISTS, CHILD PSYCHOLOGISTS, CHILD LIFE SPECIALISTS AND A DEDICATED SOCIAL WORKER. FEATURES OF THE PAVILION INCLUDE 11 DOUBLE-BEDDED ROOMS AND TWO PRIVATE ROOMS, ALL WITH PIPED-IN OXYGEN, A SPACIOUS DINING AND RECREATION AREA, DEDICATED THERAPY SPACE, AN INFANT PLAYROOM AND TEEN LOUNGE. AN ATTRACTIVE COURTYARD INCLUDES PLAY AREAS, WALKING PATHS AND SITTING AREAS FOR RESIDENTS AND THEIR FAMILIES. CHILDREN IN THE PEDIATRIC LONG TERM CARE UNIT HAVE ACCESS TO EDUCATION THROUGH THE ON-SITE MT. PLEASANT-BLYTHEDALE SCHOOL AND EARLY CHILDHOOD CENTER, AND RECREATIONAL PROGRAMMING ON EVENINGS, WEEKENDS AND HOLIDAYS. FAMILY INVOLVEMENT IS A KEY COMPONENT OF CARE AT BLYTHEDALE, AND PROGRESS TOWARD GOALS (ESTABLISHED UPON ADMISSION) WILL BE REVIEWED DURING PERIODIC FAMILY CONFERENCES. AN INTERDISCIPLINARY APPROACH TO TREATMENT IS A HALLMARK OF BLYTHEDALE, AND EACH PATIENT'S CLINICAL CARE TEAM WILL MEET EVERY TWO WEEKS TO DISCUSS THE INDIVIDUALIZED PLAN FROM EVERY PERSPECTIVE: MEDICAL, SOCIAL, PSYCHOLOGICAL, AND EDUCATIONAL.

4C (Expenses $ 8772178 including grants of $ 0) (Revenue $ 10238178)
THE DAY HOSPITAL PROGRAM - BLYTHEDALE OFFERS A DAY HOSPITAL PROGRAM FOR THOSE CHILDREN WHO ARE ABLE TO LIVE AT HOME, BUT STILL REQUIRE A LEVEL OF MEDICAL AND REHABILITATIVE CARE THAT CANNOT BE MET BY THEIR SCHOOL OR OUTPATIENT PROGRAM. IN 2021, BLYTHEDALE TREATED 195 CHILDREN IN THE PROGRAM. THE PROGRAM CONTINUED TO BE IMPACTED BY COVID THROUGH 2021, BUT THE HOSPITAL MANAGED TO CONTINUE TREATING OUR MEDICALLY FRAGILE CHILDREN THROUGH A MIX OF ON-SITE THERAPY AND TELETHERAPY. ROUGHLY 30+ % OF THE PROGRAM COMES DIRECTLY FROM BLYTHEDALE'S INPATIENT SETTING, WHILE THE BALANCE COME DIRECTLY FROM REFERRALS IN THE COMMUNITY AND THROUGH THE EARLY INTERVENTION/CPSE PROGRAMS THROUGHOUT THE REGION. IN 2021, THE DAY HOSPITAL SERVED ON AVERAGE OF 94 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 16,995 VISITS. OVER 80+% OF THESE PATIENTS WERE REIMBURSED BY THE MEDICAID PROGRAM. THE DAY HOSPITAL PROGRAM PROVIDES A NURTURING ENVIRONMENT WHERE CHILDREN WITH VARIOUS SPECIAL MEDICAL NEEDS CAN RECEIVE DAILY MEDICAL SUPERVISION, NURSING CARE, AND HAVE THEIR NEEDS FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES MET, ALL WHILE RETURNING HOME AT THE END OF THE DAY. EACH CHILD'S PROGRAM IS INDIVIDUALIZED TO ADDRESS THEIR UNIQUE MEDICAL, PSYCHOLOGICAL AND THERAPEUTIC NEEDS. IN ADDITION, EVERY CHILD IS ASSIGNED A SOCIAL WORKER TO PROVIDE FAMILY SUPPORT AND CASE MANAGEMENT. AS NECESSARY, ONGOING PSYCHOSOCIAL SUPPORT AND COUNSELING, AND CASE MANAGEMENT ARE PROVIDED. SERVICES FOR SCHOOL-AGE CHILDREN ARE PROVIDED IN CONJUNCTION WITH A FULL ACADEMIC PROGRAM UNDER THE AUSPICES OF THE MOUNT PLEASANT-BLYTHEDALE UNION FREE SCHOOL DISTRICT.THE CPSE PROGRAM - COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE PROGRAM): BLYTHEDALE CHILDREN'S HOSPITAL PROVIDES EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN BETWEEN THE AGES OF 3 TO 5 YEARS WHO ARE REFERRED THROUGH THEIR LOCAL COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE). THESE PATIENTS ARE ELIGIBLE FOR ASSESSMENT AT NO COST TO THEIR FAMILIES. THE NEW YORK STATE EDUCATION DEPARTMENT OVERSEES A STATEWIDE PRESCHOOL SPECIAL EDUCATION PROGRAM WITH SCHOOL DISTRICTS, MUNICIPALITIES, APPROVED PROVIDERS, AND PARENTS. EVALUATIONS AND SERVICES ARE PROVIDED TO ELIGIBLE CHILDREN WHO HAVE A DISABILITY THAT AFFECTS THEIR LEARNING. FUNDING FOR EVALUATIONS AND SERVICES IS PROVIDED BY MUNICIPALITIES AND THE STATE. IN 2021, THE PROGRAM SERVED 34 PATIENTS FOR A TOTAL OF 3,449 VISITS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTIDISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, SPECIAL EDUCATION TEACHERS, AUDIOLOGISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS.

4D (Expenses $ 1280603 including grants of $ 0) (Revenue $ 2565340)
IN 2021, THE HOSPITAL PROVIDED 4,328 OUTPATIENT THERAPY, TELETHERAPY, AND SPECIALTY CLINIC VISITS TO 869 CHILDREN IN THE REGION. BLYTHEDALE CHILDREN'S HOSPITAL IS WELL SUITED TO PROVIDE EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN. AS THE REGION'S PREMIERE HOSPITAL OFFERING REHABILITATIVE SERVICES TO CHILDREN, WE HAVE THE LARGEST DEPARTMENTS OF SPEECH THERAPY, OCCUPATIONAL THERAPY AND PHYSICAL THERAPY. THE EXPERTISE OF OUR HIGHLY SKILLED, MULTIDISCIPLINARY STAFF ENABLES US TO PROVIDE COORDINATED, COMPREHENSIVE, INDIVIDUALIZED PROGRAMS FOR THE CHILDREN AND FAMILIES WE SERVE. PARENTS AND STAFF WORK CLOSELY TOGETHER TO DEVELOP GOALS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTI-DISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SPECIAL EDUCATION, TEACHERS, AUDIOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. WHILE NOT LIMITED TO THE FOLLOWING, THE PROGRAM TREATS A WIDE ARRAY OF ISSUES AND DIAGNOSES INCLUDING DELAYS OR LAGS IN REACHING THEIR DEVELOPMENTAL MILESTONES, CONGENITAL OR ACQUIRED ABNORMALITIES SUCH AS VISION OR HEARING IMPAIRMENTS, DIAGNOSED MEDICAL CONDITIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OR OTHER NEUROLOGICAL DISORDERSBLYTHEDALE CHILDREN'S HOSPITAL IS A DOWNSTREAM CARE MANAGEMENT AGENCY FOR MEDICALLY FRAGILE CHILDREN UNDER THE UMBRELLA OF NEW YORK STATE'S HEALTH HOME SERVING CHILDREN PROGRAM. OUR PROACTIVE CARE COORDINATION MODEL PROVIDES MEMBERS AND THEIR FAMILIES WITH THE SUPPORT NEEDED TO PROMOTE MORE CONSISTENT MEDICAL CARE, A REDUCTION IN UNNECESSARY HOSPITALIZATIONS, AND THE ACHIEVEMENT OF MEDICAL AND THERAPEUTIC GOALS. THE MODEL INCLUDES MONTHLY IN-HOME VISITS WITH THE CHILD AND FAMILY, 24 HOUR/7 DAYS A WEEK ACCESS TO CARE MANAGEMENT SUPPORT, AND COORDINATION OF CARE AND SERVICES ACROSS THE MEDICAL, BEHAVIORAL HEALTH, EDUCATIONAL, AND SOCIAL SPECTRUM. SOCIAL DETERMINANTS OF HEALTH INCLUDING ACCESS TO TRANSPORTATION, FOOD SECURITY, AND HEALTH LITERACY ARE ALSO CONSIDERED BY THE CARE MANAGER. WE ARE CURRENTLY PARTNERED WITH MONTEFIORE HEALTH HOME TO PROVIDE SERVICES IN THE BRONX AND WITH SKYWARD HEALTH TO PROVIDE SERVICES IN WESTCHESTER COUNTY, 2 OF OUR LARGEST REGIONAL CATCHMENT AREAS. MEMBER CAPACITY IS CURRENTLY BETWEEN 40 AND 45 MEMBERS BUT WILL INCREASE TO AT LEAST 65-70 BY 2023. OUR CARE MANAGERS ARE BILINGUAL TO ALLOW FOR BETTER SERVICE FOR OUR SPANISH-SPEAKING MEMBERS.

BLYTHEDALE CHILDREN'S HOSPITAL
"PART V, SECTION B, LINE 5: THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH) CONVENED A WORKGROUP OF LOCAL HOSPITALS TO SELECT PRIORITIES FROM THE STATE'S PREVENTION AGENDA AND COLLABORATIVELY DEVELOP PLANS TO ADDRESS THESE PRIORITIES AS PART OF WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH)'S COMMUNITY HEALTH ASSESSMENT. THE WESTCHESTER COUNTY WORKGROUP DISTRIBUTED COMMUNITY AND PROVIDER SURVEYS TO COLLECT EXTENSIVE DATA ABOUT THE PARAMOUNT HEALTH CARE NEEDS WITHIN THE COMMUNITY AND COMPARED THAT DATE WITH THE CURRENT STATE OF AFFAIRS WITHIN THE COUNTY TO DESIGNATE SPECIFIC AGENDA ITEMS. IN ADDITION TO ITS REFERRING HOSPITALS, BLYTHEDALE WORKS CLOSELY WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH) TO IDENTIFY COMMUNITY HEALTH PRIORITIES RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES.THE PURPOSE OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN IS THREEFOLD:1. ASSIST IN IDENTIFYING PRIORITY HEALTH NEEDS OF THE AREA SERVED BY BLYTHEDALE CHILDREN'S HOSPITAL;2. COMPLY WITH THE REQUIREMENTS AND GUIDELINES OF THE NYS DEPARTMENT OF HEALTH FOR A COMMUNITY SERVICE PLAN; AND3. COMPLY WITH THE REQUIREMENTS PROMULGATED BY THE INTERNAL REVENUE SERVICE (IRS) BASED ON THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT ENACTED MARCH 23, 2010 THAT ALL 501(C)(3) HOSPITAL ORGANIZATIONS CONDUCT A ""COMMUNITY HEALTH NEEDS ASSESSMENT AND PREPARE A CORRESPONDING IMPLEMENTATION STRATEGY ONCE EVERY THREE TAXABLE YEARS.""AS DIRECTED BY THE STATE HEALTH DEPARTMENT, BLYTHEDALE'S 2019-2021 COMMUNITY SERVICE PLAN ADDRESSES HEALTH IMPROVEMENT PRIORITIES FROM THE STATE'S PREVENTION AGENDA, INCLUDING THOSE SELECTED BY A COALITION OF LOCAL COMMUNITY HOSPITALS AND OTHER COMMUNITY REPRESENTATIVES CONVENED BY THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH. AS A SPECIALTY HOSPITAL SERVING ONLY CHILDREN AND ADOLESCENTS, BLYTHEDALE HAS SELECTED PRIORITIES FROM THE STATE'S PREVENTION AGENDA WHICH ADDRESS ISSUES OF CONCERN TO BLYTHEDALE'S LOCAL COMMUNITY AND ITS COMMUNITY OF REFERRING HOSPITALS IN THE NEW YORK CITY METROPOLITAN AREA. IT ALSO IDENTIFIED TARGET OBJECTIVES FOR MEASURING FUTURE ACHIEVEMENTS MADE IN ADDRESSING THE SELECTED PRIORITIES."

BLYTHEDALE CHILDREN'S HOSPITAL
PART V, SECTION B, LINE 6B: WESTCHESTER COUNTY DEPARTMENT OF HEALTHREGIONAL BEHAVIORAL HEALTH WORKGROUPA LARGE COLLECTION OF AGENCIES AND HOSPITALS FROM ACROSS THE MID-HUDSON REGION HAVE JOINED TOGETHER TO CREATE A MONTHLY BEHAVIORAL HEALTH WORKGROUP THAT EVALUATES THE MENTAL AND BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. COMMUNITY PARTNERS OF OSSINING, CENTERS FOR DISEASE CONTROL/NHSN, AND WESTCHESTER MEDICAL CENTER

BLYTHEDALE CHILDREN'S HOSPITAL
PART V, SECTION B, LINE 11: BLYTHEDALE'S COMMUNITY SERVICE PLAN FOR 2019-2021 IDENTIFIED A NUMBER OF HEALTH INDICATORS AS A BASIS FOR SELECTING PRIORITIES. AS NOTED ABOVE, IN ADDITION TO PUBLIC INPUT, A VARIETY OF DATA FROM THE NYS DEPARTMENT OF HEALTH, WESTCHESTER COUNTY COMMUNITY HEALTH ASSESSMENTS, AND OTHER SOURCES WERE USED TO IDENTIFY THE HEALTH PRIORITIES. THE FOLLOWING GOALS WERE SELECTED AS STATE AND COUNTY-WIDE PRIORITIES: PREVENT COMMUNICABLE DISEASES PREVENT CHRONIC DISEASES PROMOTE A HEALTHY AND SAFE ENVIRONMENT PROMOTE ACCESS FOR PHYSICAL ACTIVITY PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE ABUSE DISORDERSAS NOTED ABOVE, SEVERAL OF THE PRIORITY INITIATIVES IDENTIFIED BY THE COUNTY WERE NOT WITHIN BLYTHEDALE'S SCOPE OF PRACTICE. THEREFORE, IT HAD FOCUSED ON THOSE PRIORITIES THAT FELL WITHIN THE HOSPITAL'S MISSION.THE PURPOSE OF BLYTHEDALE'S ANTIMICROBIAL STEWARDSHIP PROGRAM (ASP) IS TO ADVANCE THE HOSPITAL'S ANTIMICROBIAL PRESCRIBING PRACTICES THAT ASSIST IN REDUCING THE RISK OF ANTIMICROBIAL RESISTANCE IN THE COMMUNITY ONCE A PATIENT IS DISCHARGED.BY 2021, BLYTHEDALE WILL MEET THE FOLLOWING OBJECTIVES:1. REDUCE THE STANDARDIZED ANTIMICROBIAL ADMINISTRATION RATIO (SAAR) BY 5%. THE SAAR FOR 2021 IS 0.29. AN SAAR OF LESS THAN ONE IS CONSIDERED TO BE OPTIMUM.2. MONITOR ANTIMICROBIAL PRESCRIBING PRACTICES IN THE HOSPITAL AND REPORT TO THE PRESCRIBERS AND THE CHIEF MEDICAL OFFICER.3. MONITOR CHANGING PATTERNS OF ANTIMICROBIAL RESISTANCE BASED ON THE HOSPITAL'S ANTIBIOGRAM AND REPORT TREATMENT RECOMMENDATIONS TO THE PRESCRIBERS.BLYTHEDALE INCREASED THE PERCENTAGE OF SCHOOL STAFF MEMBERS EDUCATED ON TRAUMA-INFORMED, RESILIENCE FOCUSED PRACTICES TO ADDRESS ACES. THE WELLNESS PROGRAM WILL ALSO IMPLEMENT SCHOOL-BASED PROGRAMS, PARTICIPATE IN COMMUNITY EVENTS AND FORM COMMUNITY PARTNERSHIPS AIMED TO IMPROVE CHILDREN'S MENTAL HEALTH.INTERVENTIONS AND ACTIVITIES1. INFORM AND IMPROVE SCHOOL WELLNESS PROGRAMS & PROTOCOLS:SCHOOLS ARE IN A UNIQUE POSITION TO IMPROVE BOTH THE DETRIMENTAL IMPACTS OF ADVERSE CHILDHOOD EXPERIENCES (ACES) AND THE HEALTH STATUS OF YOUNG PEOPLE ACROSS THE NATION. WE WILL SUPPORT SCHOOLS IN CUSTOMIZING AN APPROACH TO HEALTH BASED ON A MULTIDIMENSIONAL- MODEL WELLNESS PROGRAM, THE FOCUS OF WHICH WOULD BE COORDINATING POLICY, STRATEGIES AND CURRICULUM RELATED TO SIX KEY COMPONENTS (NUTRITION AND HEALTHY EATING, PHYSICAL EDUCATION AND PHYSICAL ACTIVITY, HEALTH EDUCATION, HEALTH SERVICES, PSYCHOLOGICAL AND SOCIAL SERVICES, AND EMPLOYEE WELLNESS). THESE COMPONENTS SERVE THE DIRECT HEALTH NEEDS OF THE STUDENTS AND STAFF, WHICH RESULTS IN IMPROVED HEALTH OUTCOMES AND LEARNING. OUR MISSION IS TO INSPIRE AND GUIDE SCHOOLS TO EVALUATE THEIR CURRENT STATUS, OFFER EDUCATION TO THE KEY STAKEHOLDERS, ENCOURAGE SHORT AND LONG-TERM GOAL-SETTING, INFORM ON ENDORSED POLICY AND STRATEGIES; AND SERVE AS A RESOURCE FOR EVIDENCE-BASED HEALTH EDUCATION AND PREVENTION-BASED PROGRAMS.BLYTHEDALE HAS PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT PROGRAMS, AS EVIDENCED THROUGH A VARIETY OF PROGRAMS AND SERVICES, INCLUDING:CARE MANAGEMENT: BLYTHEDALE BEGAN WORKING WITH HUDSON RIVER HEALTHCARE'S COMMUNITY CARE COLLABORATIVE HEALTH HOME SERVING CHILDREN PROGRAM AS A CMA (CARE MANAGEMENT AGENCY) FOR MEDICALLY FRAGILE CHILDREN. OUR CARE MANAGER SERVES AN AVERAGE OF 15 MEDICALLY FRAGILE CHILDREN AND THEIR FAMILIES IN WESTCHESTER COUNTY THROUGH THIS IMPORTANT NYSDOH INITIATIVE.CPR TRAINING CENTER: BLYTHEDALE HAS BEEN A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR (CARDIO-PULMONARY RESUSCITATION), HEARTSAVER AED (AUTOMATED EXTERNAL DEFIBRILLATOR) AND HEARTSAVER FIRST AID. IN ADDITION TO BLYTHEDALE STAFF, THOSE TRAINED INCLUDE HEALTH CARE PROFESSIONALS, MEMBERS OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. BLYTHEDALE HAS ALSO OFFERED PEDIATRIC CPR TRAINING FOR THE COMMUNITY AND HEALTH CARE PROFESSIONALS, AND IS A CERTIFIED PEDIATRIC ADVANCED LIFE SUPPORT (PALS) TRAINING CENTER.FIRST RESPONDER TRAINING PROGRAM: BLYTHEDALE, IN COORDINATION WITH THE WESTCHESTER REGIONAL EMS OFFICE, WESTCHESTER COUNTY DEPARTMENT OF ENVIRONMENTAL SERVICES, AND THE NYS EMS FOR CHILDREN PROGRAM, HAS DEVELOPED A SPECIAL PEDIATRIC CONTINUING MEDICAL EDUCATION SERIES FOR FIRST RESPONDERS OF THE WESTCHESTER EMS REGION. THE SERIES COVERS SUBJECTS VITAL TO FIRST RESPONDERS, INCLUDING TRAUMATIC BRAIN INJURY, AUTISM, TECHNOLOGY AND CARE OF THE INFANT OR CHILD, CHILD ABUSE/NEGLECT AND CHILD/INFANT SAFETY DURING TRANSFER. THE COURSES ARE PRESENTED BY BLYTHEDALE CLINICAL EXPERTS, INCLUDING PHYSICIANS, NURSES, AND THERAPISTS.

BLYTHEDALE CHILDREN'S HOSPITAL
PART V, SECTION B, LINE 16J: BLYTHEDALE CHILDREN'S HOSPITAL IS A LONG-TERM, REFERRAL-BASED, CHILDREN'S HOSPITAL. ALL PATIENTS ARE PROVIDED INFORMATION REGARDING BLYTHEDALE'S POLICIES UPON THEIR REFERRAL TO THE HOSPITAL.

BLYTHEDALE CHILDREN'S HOSPITAL
PART V, SECTION B, LINE 21D: HOSPITAL IS A REGIONAL SPECIALTY CHILDREN'S HOSPITAL, AND DOES NOT HAVE AN EMERGENCY ROOM.

PART I, LINE 3C:
NA

PART I, LINE 7:
NYS ICR EXHIBIT 46 / 53 ALLOWABLE COST TO CHARGES SCHEDULES.

PART II, COMMUNITY BUILDING ACTIVITIES:
AS A RESULT OF THE COVID-19 CONTINUATION IN 2021, THE ORGANIZATION'S ABILITY TO PHYSICALLY INTERACT WITH MANY COMPONENTS OF THE COMMUNITY AT PREVIOUS REPORTED SERVICE LEVELS WAS HAMPERED. BLYTHEDALE STILL PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT PROGRAMS, AS EVIDENCED THROUGH A VARIETY OF PROGRAMS AND SERVICES, INCLUDING:BLYTHEDALE HOSPITAL, BECAUSE OF THE UNIQUE NATURE OF OUR PATIENT POPULATION & MISSION, PROVIDES OUTPATIENT SERVICES TO MEDICAL FRAGILE CHILDREN UNDER THE EARLY INTERVENTION PROGRAM. THE HOSPITAL ALSO PROVIDES OUTPATIENT TELETHERAPY SERVICES TO PATIENTS UNABLE TO ATTEND THE BLYTHEDALE SCHOOL AS A RESULT OF COVID19 OR OTHER HEALTH RELATED ISSUES PREVENTING THEM FROM ATTENDING IN PERSON. THE COST TO PROVIDE THESE SERVICES IS HISTORICALLY UNDER/UNREIMBURSED.BLYTHEDALE HOSPITAL, BECAUSE OF THE UNIQUE NATURE OF OUR PATIENT POPULATION & MISSION, PROVIDES SIGNIFICANT TRAINING TO MEDICAL PROFESSIONALS THROUGHOUT THE REGION THROUGH COLLABORATIONS WITH SEVERAL INSTITUTIONS OF HIGHER EDUCATION. BLYTHEDALE HOSPITAL PROVIDED ON-SITE TRAINING FOR STUDENTS FREE OF CHARGE ACROSS THE MULTIPLE SPECIALTIES INCLUDING; NURSING, PHARMACY, SOCIAL WORK, ASSISTIVE TECHNOLOGY, INFORMATION TECHNOLOGY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY. IN 2021, BLYTHEDALE COLLABORATED WITH 10 SCHOOLS OF NURSING, PROVIDING ALMOST 30,000 HOURS OF TRAINING AND PRECEPTORSHIP TO THE NEXT GENERATION OF PEDIATRIC NURSES IN THE REGION. OUR CHILD LIFE DEPARTMENT PROVIDED OVER 740 HOURS OF EXPERIENCE THROUGH VARIOUS INTERNSHIPS PROVIDING STUDENTS WITH BED-SIDE EXPERIENCE. SOCIAL WORK PROVIDED OVER 800 HOURS OF INTERNSHIP EXPERIENCE IN 2021.OUR PHARMACY DEPARTMENT COLLABORATED WITH 2 COLLEGES AND PROVIDED ROUGHLY 900 HOURS OF TRAINING TO STUDENTS IN 2021. THE STUDENTS LEARNED TO LOOK UP RESEARCH FOR NEW DRUG THERAPIES, HELP COUNSEL PATIENTS BEING DISCHARGED (IN CONJUNCTION WITH A PHARMACIST), PERFORM ORAL LIQUID COMPOUNDING, CALL MANUFACTURERS FOR DRUG QUESTIONS, CALL VENDORS TO FIND REPLACEMENTS FOR DRUG SHORTAGES, AND TO GO ON DELIVERIES WITH OUR TECHNICIANS.BLYTHEDALE HAS THE LARGEST STAFF OF PEDIATRIC THERAPISTS IN THE REGION AND CONSIDERS IT A PART OF THEIR MISSION TO TRAIN THE NEXT GENERATION OF THERAPIST WHO WILL PROVIDE THE CARE TO OUR MEDICALLY FRAGILE POPULATION. WE PROVIDED OVER 1,100 HOURS OF CLINICAL PRECEPTORSHIP ACROSS ALL OUR THERAPY DEPARTMENTS INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES.BLYTHEDALE HAS PARTNERED WITH THE NEW YORK LEGAL ASSISTANCE GROUP (NYLAG) TO CREATE A FREE LEGAL CLINIC OPEN TO ALL BLYTHEDALE PATIENTS, RESIDENTS, HEALTH HOME SERVING CHILDREN MEMBERS, AND THEIR FAMILIES. THE CLINIC IS HELD TWICE EACH MONTH IN A VIRTUAL FORMAT AND THE ATTORNEY ASSISTS FAMILIES WITH ISSUES INCLUDING ENTITLEMENTS, HOUSING, IMMIGRATION, LEGAL GUARDIANSHIP, AND EDUCATIONAL CONCERNS. THESE SOCIAL DETERMINANTS OF HEALTH CAN HAVE A GREAT IMPACT ON A MEDICALLY FRAGILE CHILD'S STABILITY AND THE ABILITY OF A FAMILY TO PROVIDE TIMELY CARE AND SUPPORT, SO THIS CLINIC IS AN INVALUABLE WAY TO PROVIDE ASSISTANCE AND SUPPORT TO THOSE MOST IN NEED. THE CLINIC SERVED NEARLY 50 FAMILIES IN 2021. CARE MANAGEMENT: BLYTHEDALE BEGAN WORKING WITH HUDSON RIVER HEALTHCARE'S COMMUNITY CARE COLLABORATIVE HEALTH HOME SERVING CHILDREN PROGRAM AS A CMA (CARE MANAGEMENT AGENCY) FOR MEDICALLY FRAGILE CHILDREN. OUR CARE MANAGER SERVES AN AVERAGE OF 15 MEDICALLY FRAGILE CHILDREN AND THEIR FAMILIES IN WESTCHESTER COUNTY THROUGH THIS IMPORTANT NYSDOH INITIATIVE.CPR TRAINING CENTER: BLYTHEDALE HAS BEEN A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR (CARDIO-PULMONARY RESUSCITATION), HEARTSAVER AED (AUTOMATED EXTERNAL DEFIBRILLATOR) AND HEARTSAVER FIRST AID. IN ADDITION TO BLYTHEDALE STAFF, THOSE TRAINED INCLUDE HEALTH CARE PROFESSIONALS, MEMBERS OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. BLYTHEDALE HAS ALSO OFFERED PEDIATRIC CPR TRAINING FOR THE COMMUNITY AND HEALTH CARE PROFESSIONALS AND IS A CERTIFIED PEDIATRIC ADVANCED LIFE SUPPORT (PALS) TRAINING CENTER.FIRST RESPONDER TRAINING PROGRAM: BLYTHEDALE, IN COORDINATION WITH THE WESTCHESTER REGIONAL EMS OFFICE, WESTCHESTER COUNTY DEPARTMENT OF ENVIRONMENTAL SERVICES, AND THE NYS EMS FOR CHILDREN PROGRAM, HAS DEVELOPED A SPECIAL PEDIATRIC CONTINUING MEDICAL EDUCATION SERIES FOR FIRST RESPONDERS OF THE WESTCHESTER EMS REGION. THE SERIES COVERS SUBJECTS VITAL TO FIRST RESPONDERS, INCLUDING TRAUMATIC BRAIN INJURY, AUTISM, TECHNOLOGY AND CARE OF THE INFANT OR CHILD, CHILD ABUSE/NEGLECT AND CHILD/INFANT SAFETY DURING TRANSFER. THE COURSES ARE PRESENTED BY BLYTHEDALE CLINICAL EXPERTS, INCLUDING PHYSICIANS, NURSES, AND THERAPISTS.

PART III, LINE 2:
IN 2021 THE HOSPITAL RECORDED $0 IN THE BAD DEBT EXPENSE ON THE IRS 990. THIS WAS A RESULT OF THE HOSPITAL ADOPTING NEW ACCOUNTING STANDARD ASU 2014-09 WHICH NEGATES THE WAY BAD DEBT WAS DISCLOSED IN PRIOR YEARS. THE HOSPITAL DID RECOGNIZE $535,730 OF IMPLICIT PRICE CONCESSIONS IN 2021 RELATED TO DENIED REIMBURSEMENT FROM THIRD PARTY INSURERS WHERE CARE WAS PROVIDED.

PART III, LINE 8:
BLYTHEDALE IS A CHILDREN'S HOSPITAL AND SERVES A PEDIATRIC POPULATION TYPICALLY NOT ELIGIBLE FOR THE MEDICARE PROGRAM.BLYTHEDALE, AS A CHILDREN'S HOSPITAL RECEIVED IMMATERIAL AMOUNTS OF MEDICARE REIMBURSEMENT. IN 2021 THE HOSPITAL FILED A LOW/NO COST UTILIZATION REPORT WITH CMS.

PART VI, LINE 7, REPORTS FILED WITH STATES
NY

PART III, LINE 3:
AS A RESULT OF IMPLEMENTING ASU 2014-09, CERTAIN PATIENT ACTIVITY WHERE COLLECTION IS UNCERTAIN PREVIOUSLY REPORTED AS NET PATIENT SERVICE REVENUE AND BAD DEBT EXPENSE IN THE HOSPITAL'S CONSOLIDATED STATEMENTS OF OPERATIONS NO LONGER MEETS THE CRITERIA FOR REVENUE RECOGNITION AND, ACCORDINGLY, BAD DEBT EXPENSE AFTER THE ADOPTION DATE IS SIGNIFICANTLY REDUCED WITH A CORRESPONDING REDUCTION TO NET PATIENT SERVICE REVENUE. FOR THE YEAR ENDED DECEMBER 31, 2021, THE HOSPITAL RECORDED $535,730 OF IMPLICIT PRICE CONCESSIONS AS A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE THAT WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE PRIOR TO THE ADOPTION OF ASU 2014-09. ADDITIONALLY, BAD DEBT EXPENSE AFTER DECEMBER 31, 2019 IS NOW PRESENTED AS AN EXPENSE ITEM (INCLUDED AS A COMPONENT OF SUPPLIES AND OTHER EXPENSES) RATHER THAN A REDUCTION TO NET PATIENT SERVICE REVENUE.THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE IS NOT PURSUED, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF IDENTIFIED CHARITY CARE PROVIDED AT COST NET OF ANY REIMBURSEMENTS DURING THE YEARS ENDED DECEMBER 31, 2021 AND 2020, WAS $12,464 AND $131,669, RESPECTIVELY. THE ESTIMATED COST OF THESE CHARITY CARE SERVICES WAS DETERMINED USING A RATIO OF COST TO GROSS CHARGES AND APPLYING THAT RATIO TO THE GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS FOR THE PERIOD.

PART III, LINE 4:
ACCOUNTS RECEIVABLE FOR SERVICES TO PATIENTS AND PATIENT SERVICE REVENUE ACCOUNTS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHER INSURERS TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. MANAGEMENT PERIODICALLY REVIEWS THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. FOR THE YEAR ENDED DECEMBER 31, 2021, CHANGES IN THE HOSPITAL'S ESTIMATES OF EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEAR ENDED DECEMBER 31, 2021, WAS NOT SIGNIFICANT.

PART III, LINE 9B:
1. BLYTHEDALE WILL SEEK PAYMENT ON ACCOUNTS WITH BALANCES IN SELF-PAY (I.E., PATIENT LIABILITY). BLYTHEDALE DOES NOT TAKE PART IN EXTRAORDINARY COLLECTION ACTIONS (ECA) BEFORE MAKING REASONABLE EFFORTS TO DECIDE WHETHER FINANCIAL ASSISTANCE IS AVAILABLE AND/OR COLLECTION EFFORTS HAVE BEEN PURSUED. ANY ITEMIZED STATEMENT REQUESTED BY A GUARANTOR WILL BE GIVEN WITHIN TEN (10) DAYS OF SUCH REQUEST, IN COMPLIANCE WITH NEW YORK LAW.2. BLYTHEDALE WILL MAKE REASONABLE EFFORTS TO NOTIFY PATIENTS AND FAMILIES ABOUT THE FAP THROUGH THE FOLLOWING METHODS:A. ORALLY NOTIFY INDIVIDUALS ABOUT THE FAP AND HOW TO OBTAIN ASSISTANCE WITH THE APPLICATION PROCESS.B. BLYTHEDALE WILL REFRAIN FROM INITIATING ECAS UNLESS AUTHORIZED BY THE CFO.C. BLYTHEDALE WILL SEND AT LEAST THREE MONTHLY BILLING NOTICES IN A THIRTY (30) DAY PERIOD, FOR AT LEAST 3 MONTHS OR CYCLES, TO THE GUARANTOR OF AN ACCOUNT INFORMING OF A BALANCE DUE.1) FIRST NOTICE INFORMS THE GUARANTOR THAT THERE IS AN UNPAID BALANCE DUE ON AN ACCOUNT;2) SECOND NOTICE REMINDS THE GUARANTOR OF CONTINUED UNPAID BALANCE;3) FINAL NOTICE OF THE PAST DUE ACCOUNT NOTIFIES THE GUARANTOR THAT HE/SHE HAS THIRTY (30) DAYS TO RESOLVE THE DEBT, OR ECAS MAY BE TAKEN ON THE DEBT AND WILL SPECIFY THE ECAS THAT BLYTHEDALE INTENDS TO TAKE AND INCLUDE A COPY OF THE PLAIN LANGUAGE SUMMARY.NOTE: THE ACCOUNT CAN EITHER BE PAID IN FULL, SET UP ON A PAYMENT PLAN, REFERRED TO FINANCIAL COUNSELING, OR MORE INSURANCE INFORMATION OBTAINED DURING THIS TIMELINE. A PLAIN LANGUAGE NOTICE OF BLYTHEDALE'S FAP IS PROVIDED IN BOTH ENGLISH AND SPANISH ON EVERY BILLING STATEMENT.D. AFTER THREE (3) BILLING NOTICES HAVE BEEN SENT AND NO PAYMENT HAS BEEN RECEIVED WITHIN SIXTY (60) DAYS OF THE FINAL NOTICE, THE ACCOUNT MAY BE CONSIDERED BAD DEBT AND ECAS MAY BE TAKEN.1) ACCOUNTS QUALIFY FOR BAD DEBT WHEN PATIENT BALANCES (I.E., SELF-PAY) HAVE NOT BEEN PAID AND THE HOSPITAL HAS MADE REASONABLE EFFORTS, THAT INCLUDE BUT ARE NOT LIMITED TO PHONE CALLS, STATEMENTS OR LETTERS, TO DECIDE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.2) THE BAD DEBT AGENCY WILL REPORT TO THE CREDIT BUREAU SIXTY (60) DAYS AFTER AN ACCOUNT IS PLACED WITH SUCH BAD DEBT AGENCY IF NO ACTION IS TAKEN BY THE GUARANTOR TO RESOLVE THE BALANCE EITHER BY MAKING A PAYMENT OR BY SUBMITTING ADDITIONAL DISPUTE INFORMATION.3) IF ALL OTHER OPTIONS TO COLLECT PAYMENT HAVE BEEN TAKEN AND AN ACCOUNT IN BAD DEBT HAS AGED MORE THAN SIXTY (60) DAYS WITHOUT CONTACT FROM THE GUARANTOR OR THE GUARANTOR REFUSES TO RESOLVE THE BALANCE, LEGAL ACTION MAY BE TAKEN.E. INITIATION OF A FINANCIAL ASSISTANCE APPLICATION1) THE APPLICATION PERIOD FOR FINANCIAL ASSISTANCE WILL END NO EARLIER THAN 240 DAYS FROM THE FIRST POST-VISIT BILL.F. ALL PARTIES ENGAGED IN COLLECTION ACTIONS FOR BLYTHEDALE WILL FOLLOW TO THIS POLICY.

PART VI, LINE 2:
SINCE THE VAST MAJORITY OF ADMISSIONS TO BLYTHEDALE COME BY REFERRAL FROM OTHER HOSPITALS, PARTICULARLY THE LARGE MEDICAL CENTERS IN THE METROPOLITAN NEW YORK AND HUDSON VALLEY AREA, BLYTHEDALE'S SENSE OF NEED FOR CLINICAL SERVICES LARGELY EMANATES FROM REFERRING HOSPITALS AND THEIR PHYSICIANS. BLYTHEDALE CONTINUOUSLY REVIEWS WITH REFERRING HOSPITALS AND PHYSICIANS THEIR NEEDS FOR SERVICES.HOWEVER, IN ADDITION TO ITS REFERRAL HOSPITALS, BLYTHEDALE ALSO WORKS CLOSELY WITH A VARIETY OF LOCAL AGENCIES, NOTABLY THE WESTCHESTER, ROCKLAND AND PUTNAM COUNTY DEPARTMENTS OF HEALTH TO IDENTIFY COMMUNITY HEALTH PRIORITIES THAT ARE RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES. PARTICIPANTS IN THESE COALITIONS INCLUDE THE MAJOR CHILD AND ADOLESCENT HEALTH-FOCUSED COMMUNITY-BASED ORGANIZATIONS IN WESTCHESTER. BLYTHEDALE ALSO HAS CLOSE WORKING RELATIONSHIPS WITH MANY OF THE SCHOOL DISTRICTS IN WESTCHESTER COUNTY, THROUGH ITS NUTRITION EDUCATION ACTIVITIES, AND THROUGH ARRANGEMENTS WHEREBY BLYTHEDALE STAFF ARE CONTRACTED TO PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES TO CHILDREN IN THE SCHOOLS.

PART VI, LINE 3:
CONSISTENT WITH ITS MISSION AND STATE REQUIREMENTS (NEW YORK STATE PUBLICHEALTH LAW 2807(K) (9-A), BLYTHEDALE HAS DEVELOPED GUIDELINES THAT DELINEATE THE CIRCUMSTANCES AND PROCEDURES UNDER WHICH FREE OR REDUCED COST CARE IS AVAILABLE. THESE GUIDELINES ARE MADE AVAILABLE TO ALL FAMILIES UPON REGISTRATION, AND HOSPITAL STAFF PROVIDE COUNSELING AS NECESSARY. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH. PATIENTS ARE ALSO NOTIFIED OF BLYTHEDALE'S CHARITY CARE FINANCIAL ASSISTANCE POLICIES THROUGH NOTICES IN ENGLISH AND SPANISH POSTED IN THE HOSPITAL'S LOBBY AND IN PATIENT REGISTRATION AND WAITING AREAS. IN ADDITION, BLYTHEDALE'S PATIENT ASSISTANCE FUNDS HELPS PROVIDE CHILDREN WITH VARIOUS ITEMS (I.E., EQUIPMENT, CLOTHING, ETC.) WHERE FAMILY RESOURCES ARE LIMITED AND INSURANCE DOES NOT COVER.

PART VI, LINE 4:
AS A SPECIALTY CHILDREN'S HOSPITAL SERVING CHILDREN WITH A BROAD RANGE OF DIAGNOSES, BLYTHEDALE'S SERVICE AREA IS WIDESPREAD, WITH INPATIENT POPULATIONS COMING FROM THE ENTIRE SOUTHERN PORTION OF NEW YORK STATE AS WELL AS ADJACENT AREAS OF CONNECTICUT, NEW JERSEY AND UPSTATE NEW YORK. NEW YORK CITY (54%), WESTCHESTER & THE HUDSON VALLEY (35%), AND 11% FROM OUT OF STATE AND UPSTATE NEW YORK. BLYTHEDALE ATTRACTS 87% OF ITS OUTPATIENT PROGRAMS FROM BRONX, WESTCHESTER-HUDSON VALLEY REGION. THE HOSPITAL IS LOCATED IN SUBURBAN WESTCHESTER COUNTY THAT IS PART OF THE GREATER NEW YORK METROPOLITAN AREA. BLYTHEDALE'S PATIENT POPULATION REFLECTS THE ETHNIC AND RACIAL DIVERSITY OF ITS LARGE SERVICE AREA, AS ILLUSTRATED BY ITS PATIENT POPULATION THAT SELF-IDENTIFIES AS 81% MINORITIES AND PEOPLE OF COLOR. TO ADDRESS THIS DIVERSITY, THE HOSPITAL PROVIDES STAFF TRAINING IN CULTURAL DIVERSITY, INTERPRETER SERVICES, DIETARY VARIETY AND OTHER ACCOMMODATIONS TO SUPPORT FAMILIES FROM DIFFERENT CULTURAL BACKGROUNDS WHILE THEIR CHILDREN ARE PATIENTS AT BLYTHEDALE.

PART VI, LINE 5:
AS A MEANS TO ADDRESS THE COLLECTIVE TRAUMA AND STRESSES THE COVID-19 CRISIS HAS CAUSED CHILDREN AND FAMILIES IN OUR COMMUNITY, BLYTHEDALE CHILDREN'S HOSPITAL SERVED AS THE CLINICAL LEADER AND SPONSOR OF WESTCHESTER COUNTY'S FIRST-EVER TRAUMA-INFORMED SYSTEMS' CHANGE LEARNING COLLABORATIVE, FACILITATED BY UNIVERSITY AT BUFFALO'S INSTITUTE ON TRAUMA & TRAUMA-INFORMED CARE (ITTIC). THIS TRAINING WAS MADE POSSIBLE THROUGH A GRANT FROM KOHL'S DEPARTMENT STORES AND ITS KOHL'S CARES PROGRAM. THE BLYTHEDALE/ITTIC TRAINING PROGRAM TOOK PLACE OVER SIX MONTHS (MARCH TO AUGUST) AND INCLUDED 37 PARTICIPANTS, COMPRISING SENIOR-LEVEL LEADERSHIP AT 24 DIFFERENT ORGANIZATIONS IN WESTCHESTER AND ROCKLAND COUNTIES, INCLUDING BLYTHEDALE CHILDREN'S HOSPITAL, WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH, WESTCHESTER COUNTY DEPARTMENT OF SOCIAL SERVICES, MHA OF WESTCHESTER, WESTCHESTER LIBRARY SYSTEM, MY SISTER'S PLACE, SISTER TO SISTER INTERNATIONAL, INC., WJCS GREENBURGH ELEVEN UFSD, HENDRICK HUDSON SCHOOL DISTRICT, OSSINING SCHOOL DISTRICT, PUBLIC SCHOOLS OF THE TARRYTOWNS, NYACK PUBLIC SCHOOLS, SLEEPY HOLLOW MIDDLE SCHOOL, ST. VINCENT'S WESTCHESTER, WESTCHESTER INSTITUTE FOR HUMAN DEVELOPMENT, WHITE PLAINS YOUTH BUREAU, YWCA WHITE PLAINS & CENTRAL WESTCHESTER, FAMILY TIES OF WESTCHESTER, INC., GUIDANCE CENTER OF WESTCHESTER, INC., HUMAN DEVELOPMENT SERVICES OF WESTCHESTER, MOUNT PLEASANT COTTAGE SCHOOL, OPEN DOOR FAMILY MEDICAL CENTER, AND STUDENT ASSISTANCE SERVICES CORPORATION.TIBBETTS BROOK PARK IS A 161-ACRE COUNTY PARK LOCATED IN THE LINCOLN PARK SECTION OF YONKERS IN WESTCHESTER COUNTY, NEW YORK THAT GETS MORE THAN 80,000 VISITORS EACH YEAR. BLYTHEDALE PARTNERS WITH KOHL'S DEPARTMENT STORES AND WESTCHESTER COUNTY OPENED A NEW OUTDOOR FITNESS PARK IN YONKERS. THE COMPLETION AND OPENING OF THE SEVEN-STATION FITNESS CENTER AT TIBBETTS BROOK PARK WAS CELEBRATED WITH AN OFFICIAL RIBBON CUTTING CEREMONY IN 2021. THE PROJECT WAS THE CULMINATION OF TWO YEARS OF PLANNING, DEVELOPMENT AND CONSTRUCTION. THE NEW FITNESS PARK, DESIGNED FOR INDIVIDUALS AGED 14 AND UP, INCLUDES A ROWING MACHINE, A LOWER BODY COMBO STATION, A LAT PULL-DOWN AND VERTICAL PRESS STATION, BACK AND ARMS STATION, AND OTHER EQUIPMENT. EACH STATION HAS A QR CODE THAT PEOPLE CAN SCAN WITH THEIR SMARTPHONES TO ACCESS A VIDEO THAT SHOWCASES A VARIETY OF EXERCISES THAT CAN BE PERFORMED, THE MUSCLES BEING USED AND DETAILED INSTRUCTIONS ON HOW TO UTILIZE THE EQUIPMENT PROPERLY. THE PURCHASE AND GIFTING OF THE FITNESS EQUIPMENT WAS MADE POSSIBLE BY A GENEROUS GRANT FROM KOHL'S DEPARTMENT STORES AND ITS KOHL'S CARES PROGRAM. SITE CONSTRUCTION AND EQUIPMENT INSTALLATION WAS COORDINATED WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH, DEPARTMENT OF PARKS, RECREATION AND CONSERVATION AND THE DEPARTMENT OF PUBLIC WORKS AND FUNDED BY THE COUNTY. GREENFIELDS OUTDOOR FITNESS, INC., THE CALIFORNIA CORPORATION AND MANUFACTURER OF THE EQUIPMENT, ALSO MADE A DONATIONS TOWARDS THE PROJECT.BLYTHEDALE OFFERS A NUMBER OF COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SPECIAL PROGRAMS FOR DEVELOPMENT OF THE PEDIATRIC PROFESSIONAL COMMUNITY: NUTRITION EDUCATION: IN A MAJOR INITIATIVE TO HELP REDUCE THE PREVALENCE OF CHILDHOOD OBESITY AND PREVENT ITS LONG TERM NEGATIVE HEALTH EFFECTS, BLYTHEDALE IS REACHING OUT TO SCHOOL DISTRICTS THROUGHOUT WESTCHESTER AND SURROUNDING COUNTIES WITH ITS EAT WELL BE WELL SCHOOL BASED NUTRITION EDUCATION PROGRAM. THE EAT WELL, BE WELL PROGRAM, WITH SUPPORT FROM KOHLS DEPARTMENT STORES, IS DESIGNED TO PROVIDE SCHOOL STAFF AND STUDENTS WITH THE TOOLS NECESSARY TO HELP CHILDREN DEVELOP HEALTHY EATING HABITS THROUGH A COMPREHENSIVE CURRICULUM DEVELOPED BY BLYTHEDALE'S REGISTERED DIETICIANS. AS OF 2020, THIS PROGRAM HAS REACHED MORE THAN 125,000 STUDENTS, AS WELL AS OVER 6,000 PARENTS AND SCHOOL STAFF IN SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUTNAM COUNTIES, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME. THE PROGRAM FOCUSED ON AT-RISK SCHOOL DISTRICTS IN WESTCHESTER COUNTY, INCLUDING OSSINING AND YONKERS. A COLLABORATION WITH FEEDING WESTCHESTER ENABLED US TO REACH FAMILIES WITH DIETARY INFORMATION TRANSLATED IN SPANISH, RELATED TO FOOD PANTRY OFFERINGS. IN ADDITION TO OUR OFF-SITE PROGRAMMING, WE HAVE AN EXTENSIVE PAID SOCIAL MEDIA CAMPAIGN PROMOTING OUR EAT WELL, BE WELL PROGRAM, AND A RADIO CAMPAIGN ON WCBS. AS OF 2021, THIS PROGRAM HAS REACHED MORE THAN 125,000 STUDENTS, AS WELL AS OVER 6,000 PARENTS AND SCHOOL STAFF IN SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUTNAM COUNTIES, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME.