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The Following explanations are relevant to both hospitals
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of the Organization:
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Heritage Valley, Beaver
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Heritage Valley, Sewickley
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Pt I Line 3c
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Part 1. Line 3C: The Organization provides charity care to
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qualifying individuals and families based on a sliding scale using
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Federal Health & Human Services Poverty Guidelines. Accounting for family
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size at 300% of the poverty level for free care, a 75% discount for
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families at 350%, a 50% discount for families at 400%
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and a 25% discount for families at 450%
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Pt I Line 6a
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Part 1 Line 6a See below Section VI about Community Benefit Report results.
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Pt I Line 7g
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Part 1 Line 7g Family Medicine & Family Planning Clinic Subsidy
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Pt I Line 7
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The costing methodology used to calculate the amounts reported on
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Part 1, Line 7 was based on the Organization's cost accounting system.
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Pt III Line 2
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Bad debt expense at cost was determined based on the cost to charge ratio under
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Generally Accepted Accounting Principles applied to the bad debt expense for the fiscal year.
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Pt III Line 8
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The Organization believes the entire shortfall of reimbursement
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versus cost ($7,164,406) should be considered community benefit
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since it results in a loss therefore lessening government burden. Costs associated with
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the shortfall were determined from the Organization's cost accounting system.
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Pt III Line 9b
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Within the Organization's bad debt/collection policy, there is
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reference to the fact that patients are provided several options,
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one of which being the application for Charity Care in satisfying the
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outstanding balance of their account. If the patient pursues Charity
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Care, there is a separate policy detailing the steps
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required to qualify for Charity Care.
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Pt V Sec B 3
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The Organization led a comprehensive Community Health Needs Assessment (CHNA)
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to evaluate the health needs of individuals living in the hospital service
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area including Beaver County and the selected municipalities located
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within Allegheny County beginning in 2012. The Organization contracted with
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reputable consulting firms to assist in completing the assessment.
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The purpose of the assessment was to gather information
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about local health needs and health behaviors.
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The assessment examined a variety of indicators including risky health behaviors
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(physical inactivity, tobacco use) and chronic health conditions (diabetes, heart disease).
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The completion of the CHNA enabled The Organization
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to take an in-depth look at its greater community. The findings from
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the assessment were utilized by The Organization to prioritize public health
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issues and develop a community health implementation plan focused on meeting community needs.
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Pt VI Line 2
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The Organization is committed to the people it serves and the communities they live in.
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Healthy communities lead to lower health care costs, robust community partnerships,
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and an overall enhanced quality of life. The CHNA Final Summary Report serves
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as a compilation of the overall findings of each research component.
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Research Components
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*Secondary Statistical Data Profile of Beaver County and the selected municipalities
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located within Allegheny County
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*Household Telephone Survey with 403 Community residents
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*Key Informant Interviews with 10 Community stakeholders
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*Focus Group Discussions with 10 providers and 28 Community residents
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---Key Informant Interviews---
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A survey was conducted by the consultants which included ten "Key Informants"
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from the area. Key informants were defined as Community stakeholders with expert knowledge
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including public health and health care professionals, social service providers, non-profit leaders,
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business leaders, faith-based organizations, and other area authorities.
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A total of 10 telephone interviews were conducted by the consultants during
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November 2012 to January 2013. It is important to note that the results reflect the perceptions of
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some community leaders, but may not necessarily represent all community representatives. To
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supplement the information gathered during the interviews, the consultants also
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conducted two focus group sessions with key informants.
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In April of 2013, 2 focus groups were held with other key informants totaling
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ten people and another group participated in a prioritization of the health needs identified
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through the Needs Assessment process.
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Pt VI Line 3
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The Organization is committed to assisting all self pay
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patients in applying for State Medicaid. Currently the Organization
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engages a third party service to interview and complete the Medicaid
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application on all patients admitted with no health insurance.
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During the application process, patients are made aware of the Charity care
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Program in the event they are denied State Medicaid. the financial
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information obtained during this process is used in determining if the
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patients qualify for the Charity Care Program.
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If the patient is denied for Medicaid, they receive monthly statements
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reflecting the outstanding balance owed. The Organization makes the
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patients aware of the Charity Care Program on the back side of all self pay
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patients statements. The statement directs all inquiries regarding Charity
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Care to the Patient Accounting Department. the patients are provided with
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the guidelines of the program at the point they contact Patient Accounting.
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This phone call usually results in the application along with the current
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guidelines being mailed to the patient for completion.
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In addition, reference to the Charity Care Program is included in the
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"Patient Guide" which is provided to all patients admitted.
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Pt VI Line 4
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The Organization defined their current service area based on an analysis of the
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geographic area where individuals utilizing The Organization health services
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reside. The Organization's primary service area is considered to be the Beaver
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County and the following municipalities located within Allegheny County:
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Aleppo Township
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Bell Acres Borough
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Coraopolis Borough
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Crescent Township
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Edgeworth Borough
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Findlay Township
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Glen Osborne Borough
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Glenfield Borough
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Haysville Borough
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Leet Township
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Leetsdale Borough
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Moon Township
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Neville Township
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North Fayette Township
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Oakdale Borough
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Sewickley Borough
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Sewickley Heights Borough
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Sewickley Hills Borough
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Selected Demographic & Behavioral Risk Factor Findings
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* Beaver County experienced a 5.8% decline in population between 2000
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and 2010, which was the opposite of both state and national trends.
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* In 2010, Beaver County had a higher percentage of individuals that
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were age 45+ than both Pennsylvania and nationwide.
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* Allegheny County has a higher portion of individuals that have received a
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Bachelor's degree or higher when compared to state and national averages.
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* In 2010, a lower percentage of children and families lived in poverty within
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Allegheny County (7.8%) and Beaver County (11.1%) than both the state of
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Pennsylvania (12.4%) and the nation (13.8%).
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* Beaver County has a higher percentage of mothers who smoked
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|
during pregnancy than the state of Pennsylvania.
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* The leading causes of death for both Allegheny and Beaver Counties were heart
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|
disease and cancer in 2010. The top three sites for cancer deaths were Lung &
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Bronchus, Colon & Rectum, and Female Breast.
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* In 2009, over a quarter of the population in Beaver County were obese and /or
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|
physically inactive. Given the higher than state average of persons diagnosed with
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|
diabetes in Beaver County that same year, this statistic is particularly concerning.
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Medically Underserved Areas (MUAs)
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|
MUAs in the Organization's primary service area include:
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* Beaver Falls (part)
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* Bridgewater
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* Aliquippa (part)
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* Coraopolis
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|
Heritage Valley Beaver and Heritage Valley Sewickley conducted the Needs Assessment
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|
|
jointly. Where possible, information about each hospital's service area was described
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|
|
separately. The Implementation Plans for each hospital were separate, but coordinated.
|
|
Pt II
|
|
Executive Summary - During Fiscal 2013, the Organization
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|
|
participated in over one hundred activities providing community benefit.
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|
|
A selection of these activities included:
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|
*Participated in sixty-five (65) major health fairs providing free
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|
|
screenings & health information.
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|
*Presented health & wellness information, including mental health
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|
issues, at various school & community group events.
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|
*Sponsored seven (7) monthly support groups and working with four (4)
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|
|
other monthly support groups.
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|
*Provided manikins to local first responder organizations for CPR
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|
Certification activities.
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|
|
*Day of caring participants - value of donated time - $9,337.
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|
*Participated in local school career days.
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|
|
*Provided free clinical services or donating medical equipment to
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|
|
several community not-for-profit organizations.
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|
|
The organization also subsidizes various programs that benefit both the
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|
|
health and well being of the patients in the communities we serve and the
|
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|
|
students seeking to further their education in the health services field.
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|
Examples of these programs include:
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|
|
* Family Medicine and Family Planning Clinics
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|
|
* School of Nursing
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|
Pt VI Line 5
|
|
COMMUNITY HEALTH EDUCATION & OUTREACH
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|
|
*Maternal & Child health staff at Heritage Valley, Sewickley-conducted
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|
|
over thirty (30) sessions of different prenatal education topics
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|
|
and also provided support groups for pregnancy loss and new mothers.
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|
|
*Staff of the Community Health Services Department participated in
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|
|
fifty-four (54) health fairs/education sessions.
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|
*Car Seats are rented at discounted rates to parents in
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|
|
need for safe transport of newborns.
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|
|
*Family Medicine Residents provided free physicals and provided
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|
|
health education on smoking avoidance and sex education.
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|
|
* The Hospital Division Laboratory provided four hundred eighty six (486) legal alcohol test for area
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|
|
police departments and also assisted with student high school projects and community health fairs.
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|
|
*Womens's Health Center staff performed approximately seven-hundred twenty-five
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|
|
(725) osteoporosis health screenings at twenty two (22) community
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|
|
events or for patients and visitors at the Women's Health Center.
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|
|
*The Sterile Processing Department lends manikins to local
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|
|
fire departments, EMS units and police for CPR certification activities.
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|
|
*School of Nursing faculty and staff provided over two
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|
|
hundred eighty four (284) hours of community service at
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|
|
twenty-six (26) events.
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|
|
*Management and staff from several departments participated in
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|
|
local school career days.
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|
|
*Heritage Valley-Beaver Laboratory services worked with
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|
|
high school students on science fair projects.
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|
|
*Community groups use the conference center/education center
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|
|
at the hospitals for meetings; the pro-rated facility
|
|
|
|
cost of these meetings was $5,833.
|
|
|
|
COMMUNITY-BASED CLINICAL SERVICES
|
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|
|
*The Family Medicine Clinic (Beaver Falls) conducts free
|
|
|
|
physicals for the foster grandparent program.
|
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|
|
*The Laboratory provided legal alcohol tests for area police departments at a testing cost of
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|
|
$4,617 and also spent $75 in supply costs for assisting with student high
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|
|
|
school projects and community health fairs for a total expense of $4,692.
|
|
|
|
HEALTHCARE SUPPORT SERVICES
|
|
|
|
*The Organization sponsors or works directly with seven (7) support
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|
|
groups that meet monthly at an Organization hospital or in the
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|
|
community; the Organization is involved in another four (4) support groups
|
|
|
|
that meet monthly in various community settings.
|
|
|
|
DONATIONS TO NOT-FOR-PROFIT ORGANIZATIONS
|
|
|
|
*Payments to local municipalities (in lieu of taxes) - $59,838
|
|
|
|
*Donation of a parcel of land on the Beaver Campus for the
|
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|
|
Brighton Township Volunteer Fire Department at a cost of $3,510.
|
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|
|
*The Organization sponsored events held by community
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|
|
|
not-for-profit organizations and donated $70,000 to these
|
|
|
|
organizations (net of value received.)
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|
|
|
* Donation to Cameos of Caring - $2,500.
|
|
|
|
* Donation of two (2) vehicles to the Make a Wish Foundation - $1,975
|
|
|
|
MEDICAL EDUCATION
|
|
|
|
*---SCHOOL OF NURSING SUBSIDY - $441,068
|
|
|
|
The Organization serves as a site for numerous health
|
|
|
|
and adminstrative/professional internships and administrating nursing
|
|
|
|
students from Community College of Beaver County, Robert Morris
|
|
|
|
University and Kent State University who use the Organization as a site for clinical
|
|
|
|
training with no tuition or monetary reimbursement. Coordination
|
|
|
|
of these unpaid internships requires approximately 750 hours
|
|
|
|
of staff time, valued at $28,307.
|
|
|
|
SUBSIDIZED HEALTH SERVICES
|
|
|
|
*Family Medicine Clinic & Family Planning Clinic (Beaver Falls)
|
|
|
|
- $174,765 loss. (excluding estimated Medicaid &
|
|
|
|
Medicare underpayments separately reported)
|
|
|
|
*Nutritional Counseling Services are subsidized - $65,649
|
|
|
|
The Organization is committed to offering a robust range of services to meet community
|
|
|
|
needs; therefore some services such as Emergency Department services &
|
|
|
|
Maternal/Child Health services are operated with significant subsidies.
|
|
|
|
MEDICAL STAFF PRIVILEGES
|
|
|
|
In general, both the Beaver and Sewickley campuses have an open medical staff and
|
|
|
|
privileges are granted to qualified physicians who meet established criteria. There
|
|
|
|
are, however, certain departments and/or services that are closed due to contractual
|
|
|
|
arrangements with third party providers. Four departments are closed. The emergency
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|
|
room department is closed to physicians who are employed by the Organization,
|
|
|
|
and to physicians otherwise contracted by the Organization. For
|
|
|
|
the departments of radiology, pathology and anesthesiology, the Organization
|
|
|
|
has exclusive contracts with the contracting physician groups, and thus,
|
|
|
|
privileges in these departments are limited to those physicians who have a contractual
|
|
|
|
relationship with the group. In addition, the Organization has an exclusive
|
|
|
|
contract with a third party provider for the provision of hospitalist services at the
|
|
|
|
Beaver campus and has exclusive contracts with third party providers for the provision
|
|
|
|
of telemedicine stroke services at each of the campuses.
|
|
|
|
Quality Improvements in Patient Care
|
|
|
|
Quality, Patient Safety, and Customer Satisfaction are defined as strategic
|
|
|
|
imperatives in our the Organization. Compliance with National Patient Safety Goals
|
|
|
|
exceeds 98% and CMS Core Measure compliance exceeds exceeds 99%. Core Measures are actively managed
|
|
|
|
with enhanced reporting and engagement of nursing and physician staff. Performance improvement
|
|
|
|
initiatives are ongoing in the areas of infection control, patient safety, and the
|
|
|
|
customer experience. A renewed focus on service excellence culminated in the
|
|
|
|
recruitment of the Organization's first Manager of Customer Experience.
|
|
|
|
Consistent year-over-year improvement is being demonstrated on the Organizations balanced
|
|
|
|
scorecard across all facets of Quality, Safety, and Customer Satisfaction.
|
|
|
|
INVESTMENTS IN FACILITIES AND EQUIPMENT
|
|
|
|
---The Organization has a significant capital budget, of approximately $30
|
|
|
|
million annually, primarily funded by operating margins.
|
|
|
|
---Both foundations support facility enhancements and equipment purchases.
|
|
|
|
The Sewickley Valley Hospital Foundation supports initiatives
|
|
|
|
such as the purchase of Cardiology and Operating Room equipment.
|
|
|
|
Renovations of the Maternity Ward and educational equipment
|
|
|
|
for the School of Nursing.
|
|
|
|
Heritage Valley Beaver Foundation supports initiatives such as
|
|
|
|
the purchase of cardiology and pediatric equipment.
|
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|
|
Renovations to the Education Center and a Van for the Clinic.
|
|
|
|
MEDICAL EDUCATION
|
|
|
|
The Organization has a Family Practice Residency Program in Beaver Falls,
|
|
|
|
with an associated clinic, and a School of Nursing in Moon Township. Both
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|
|
affiliated foundations offer Nursing School scholarships.
|
|
|
|
COMMUNITY HEALTH SERVICES
|
|
|
|
Community Health Services is a robust set of programs and services that focus
|
|
|
|
on families and individuals suffering from chronic illnesses.
|
|
|
|
The benefits of these programs are demonstrated through
|
|
|
|
clinical outcomes that relate to healthy living and improved functioning:
|
|
|
|
---Pediatric Asthma
|
|
|
|
---Diabetes
|
|
|
|
---Pregnancy Health Services (Designed for high-risk pregnancies)
|
|
|
|
---Community Advanced Illness (Palliative care for end of life services).
|
|
|
|
---Childhood obesity
|
|
|
|
---LifeSmart (pre-diabetes/obesity)
|
|
|
|
---Smoking Cessation
|
|
|
|
---Community Outreach Services
|
|
|
|
---Community Crisis Counseling
|
|
|
|
These services are supported through Grants from the Foundations.
|
|
Pt VI Line 6
|
|
Part VI Line 7: The Organization is a wholly owned subsidiary of
|
|
|
|
Heritage Valley Health System, Inc. and provides inpatient and
|
|
|
|
outpatient health care and related services to the residents of Beaver
|
|
|
|
County, PA, and Northwestern Allegheny County, PA, and the surrounding
|
|
|
|
areas through its two acute care hospitals: Heritage Valley, Beaver
|
|
|
|
and Heritage Valley,Sewickley.
|
|
|
|
The Organization is part of an independent, community-based
|
|
|
|
health system, unaffiliated with any other health care system.
|
|
|
|
The roles of the Organization and its affiliated foundations are
|
|
|
|
documented elsewhere in this form. The contracted physician practices
|
|
|
|
also participate in community health improvement efforts. Several
|
|
|
|
physicians participated in the diabetes clinical program and several
|
|
|
|
have met certain criteria to be identified under the NCQA's diabetes
|
|
|
|
physician recognition program. Also, one of the senior pediatricians
|
|
|
|
in Tri-State Pediatric Associates is a champion for the
|
|
|
|
Organization's childhood obesity program.
|
|
Pt V Sec B 19d
|
|
Uninsured individuals are expected to pay the equivalent
|
|
|
|
of the Medicaid DRG case rate payment for inpatient accounts
|
|
|
|
and 45% of charges for outpatient accounts.
|
|
Pt V Sec B 4
|
|
Heritage Valley Sewickley
|
|
Pt V Sec B 4
|
|
Heritage Valley Beaver
|
|
Pt V Sec B 20d
|
|
Maximum amount charged to Inpatients is Medical Assistance Rates.
|
|
|
|
Maximum amount charged to Outpatients is 45% of total charges.
|
|
Pt V Sec B 7
|
|
RATIONALE FOR COMMUNITY HEALTH NEEDS NOT ADDRESSED
|
|
|
|
It is understood that in order to be the most effective and make the greatest impact,
|
|
|
|
that not all community needs can be addressed at once. The Organization will continue to provide excellent
|
|
|
|
quality of care and health literacy education to meet the wide array of health needs present
|
|
|
|
among county residents. To allocate resources in an effort to impact the most pressing needs,
|
|
|
|
the five key priority areas were identified.
|
|
|
|
It is important to emphasize the criteria-driven approach that went into the selection
|
|
|
|
of the priority issues. While the seriousness of the issue and ability to impact
|
|
|
|
were the primary criteria for the quantitative ratings, additional criteria were
|
|
|
|
included in the group discussion. These included the availability of proven best
|
|
|
|
practices and prevention strategies, existing expertise and resources around
|
|
|
|
any particular issue, and the opportunity for collective community buy-in or support
|
|
|
|
to rally around a health priority. As a result, the Organization and its partners
|
|
|
|
are confident that the prioritization process was a systematic, democratic, and thorough
|
|
|
|
course of action.
|
|
|
|
In total, nine key needs/themes were identified following the interpretation of the CHNA findings.
|
|
|
|
A rationale for exclusion of the four issues not included in the final
|
|
|
|
prioritized list of community needs is detailed below.
|
|
|
|
Behavioral Health: The Organization currently provides both inpatient and
|
|
|
|
outpatient behavioral health services to the community in collaboration with the County and
|
|
|
|
other local providers that specialize in specific community-based supports, such as
|
|
|
|
housing, case management, family support, respite care ,etc.
|
|
|
|
Resource constraints do not permit expansion of these efforts.
|
|
|
|
Drug and Alcohol Abuse: While the Organization will continue to provide supportive services to
|
|
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the community, as appropriate, however other providers specialize in this care and are better
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suited to address the initiatives related to drug and alcohol abuse in the community.
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Maternal Health: The Organization has many successful programs related to prenatal
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and maternal health which will continue to be offered to the community.
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Community Sustainability: The Organization will continue to support environmental
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responsibility and will encourage safe neighborhoods.
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The Organization does not have the resources or expertise needed to influence this need.
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Pt III Line 4
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Differences between amounts reimbursed and normal billing rates are charged to
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provisions for contractual allowances as a reduction to net patient service
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revenue. Accounts receivable are further reduced by an allowance for doubtful
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accounts. In evaluating the collectibiilty of accounts receivable,
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the Organization analyzes its past history and identifies trends for each of its major payor
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sources of patient service revenue to estimate the appropriate allowance for doubtful
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accounts and provision for bad debts. Management regularly reviews data about these major payor
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sources of patient service revenue in evaluating the sufficiency of the allowance
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for doubtful accounts. For receivables associated with services provided to patients
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who have third-party coverage, the Organization analyzes contractually due amounts
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and provides an allowance for doubtful accounts and a provision for bad debts, if
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necessary. For receivables associated with self-pay patients, which includes both
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patients without insurance and patients with deductible and copayment balances due for which
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third-party coverage exists for part of the bill, the Organization records a provision for bad
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debts in the period of service on the basis of its past experience, which
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indicates that many patients are unable or unwilling to pay the portion of
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their bill for which they are financially responsible. The difference between the standard rates
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or the discounted rates according to the Organization's charity care policy and the amounts actually
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collected after all reasonable collection efforts have been exhausted is charged off
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against the allowance for doubtful accounts.
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