TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) HELEN JOHNSTON...................................................................... BOARD MEMBER/BOARD CHAIR	2.00 .................	X	X			0	0	0
(2) JOHN CARRIGG...................................................................... BOARD MEMBER/VICE CHAIR	2.00 ................. 55.00	X	X			0	3,503,410	1,354,855
(3) LARRY LIGHT...................................................................... BOARD MEMBER	2.00 .................	X				0	0	0
(4) EDWARD SNOW...................................................................... BOARD MEMBER/SECRETARY	2.00 .................	X	X			0	0	0
(5) ERIN NEALE...................................................................... BOARD MEMBER	2.00 .................	X				0	0	0
(6) AMANDA HALL...................................................................... BOARD MEMBER/TREASURER	2.00 .................	X	X			0	0	0
(7) DR MICHAEL FREEMAN...................................................................... BOARD MEMBER/MEDICAL STAFF PRESIDENT	57.00 .................	X	X			236,927	0	21,741
(8) DR JOHN GIANNONE...................................................................... CHIEF MEDICAL OFFICER	5.00 .................		X			21,938	0	0
(9) DOTTIE KRUPPO...................................................................... V.P. COMMUNITY RELATIONS	55.00 .................		X			99,906	0	21,951
(10) DEBORAH HITT...................................................................... V.P. QUALITY/SUPPORT SVCS	55.00 .................		X			28,257	0	1,222
(11) VICTORIA CONKLING...................................................................... V.P. PATIENT CARE SERVICES	55.00 .................		X			138,635	0	7,627
(12) LUCINDA RIDER...................................................................... CFO	55.00 .................		X			100,489	0	19,375
(13) KATHLEEN ULMSCHNEIDER...................................................................... STAFF NURSE	55.00 .................			X		113,858	0	22,490
(14) TITO ENDAYA...................................................................... LAB MANAGER	55.00 .................			X		110,210	0	22,868
(15) PATRICIA SVOBODA...................................................................... CLINICAL LAB TECHNOLOGIST	55.00 .................			X		104,774	0	16,581
(16) PAUL SUMMERS...................................................................... FORMER BOARD MEMBER/PRES/CEO 6/30/20	57.00 .................				X	239,801	0	24,966

(A) Name and business address	(B) Description of services	(C) Compensation
SECO PHYSICALOCCUPATIONAL THERAPY 26 CONKY AVE NORWICH,NY13815	PHYSICAL/OCC. THERAPY	658,807
GE HEALTHCARE SERVICE PO BOX 96483 CHICAGO,IL60693	HEALTH TREATMENT SERVICES	476,886
MEDHOST OF TENNESSEE INC 2739 MOMENTUM PLACE CHICAGO,IL60689	MEDHOST PROGRAM MANAGEMENT/FINANCE	418,765
AMN HEALTHCARE PO BOX 56157 LOS ANGELES,CA900746157	MEDICAL STAFFING SOLUTION	371,483
EVANS MECHANICAL INC 314 MAPLE STREET ENDICOTT,NY13760	PLUMBING AND HEATING SOLUTIONS	156,751
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 18

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2020

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization DELAWARE VALLEY HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization DELAWARE VALLEY HOSPITAL INC		Employer identification number 15-0524324

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization DELAWARE VALLEY HOSPITAL INC			Employer identification number 15-0524324
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

1,735

Total. Add lines 1c through 1i ....................................................................................................

1,735

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY (17.97%) AND IROQUOIS HEALTHCARE (39.70%).

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	335,666	330,416	328,445	330,360	324,669
b	Contributions ...	1,179	5,250	1,971	9,996	5,691
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...				11,911
f	Administrative expenses ....
g	End of year balance ......	336,845	335,666	330,416	328,445	330,360

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

94.000 %

Term endowment SchDMd Bullet

6.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .......................

3a(i)

Yes

(ii) Related organizations .......................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	51,202		51,202
b	Buildings ....	13,760,390	6,757,140	7,003,250
c	Leasehold improvements
d	Equipment ....	11,345,386	9,541,063	1,804,323
e	Other .....	1,479,921		1,479,921
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				10,338,696

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	651,124
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2020

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	30,701,072
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	295,317
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-46,913
e	Add lines 2a through 2d .....................			2e	248,404
3	Subtract line 2e from line 1..................			3	30,452,668
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	515,228
c	Add lines 4a and 4b....................			4c	515,228
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	30,967,896

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	24,816,269
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	24,816,269
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	515,228
c	Add lines 4a and 4b.....................			4c	515,228
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	25,331,497

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	PURCHASE OF CAPITAL EQUIPMENT (MEDICAL) AND IMPROVEMENT OF FACILITIES.
PART X, LINE 2:	THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2020 AND 2019, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2017 TO 2020. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	INTEREST RATE SWAP -46,913.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 515,228.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 515,228.

Schedule D (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	152,431		152,431	0.610 %
b	Medicaid (from Worksheet 3, column a) . . . . .	5,511,089	3,847,793	1,663,296	6.700 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	74,971	102,218	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	5,738,491	3,950,011	1,815,727	7.310 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	258,270		258,270	1.040 %
f	Health professions education (from Worksheet 5) . . .	11,799		11,799	0.050 %
g	Subsidized health services (from Worksheet 6) . . . .	13,589,225	10,979,327	2,609,898	10.520 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	13,859,294	10,979,327	2,879,967	11.610 %
k	Total. Add lines 7d and 7j .	19,597,785	14,929,338	4,695,694	18.920 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	6,262	6,262	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	11,014	11,014	0.040 %
7	Community health improvement advocacy	179	179	0 %
8	Workforce development
9	Other
10	Total	17,455	17,455	0.070 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

515,228

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

296,464

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

4,787,213

Enter Medicare allowable costs of care relating to payments on line 5.....

4,759,091

Subtract line 6 from line 5. This is the surplus (or shortfall)........

28,122

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	DELAWARE VALLEY HOSPTITAL 1 TITUS PLACE WALTON,NY13856	X	X	X

Schedule H (Form 990) 2020

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	DELAWARE VALLEY HOSPTITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTP://WWW.NYUHS.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTP://WWW.NYUHS.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	DELAWARE VALLEY HOSPTITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTP://WWW.NYUHS.ORG

The FAP application form was widely available on a website (list url):

HTTP://WWW.NYUHS.ORG

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.NYUHS.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	DELAWARE VALLEY HOSPTITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	DELAWARE VALLEY HOSPTITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
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 VALLEY HOSPITAL - 2020 UPDATEDELAWARE COUNTY 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS(EXCERPTED FROM COMMUNITY HEALTH NEEDS ASSESSMENT 2019-2021)CHALLENGES THE SHEER SIZE, TOPOGRAPHY AND PAROCHIAL NATURE OF THE COMMUNITIES WITHIN DELAWARE COUNTY POSE HUGE CHALLENGES IN THE DELIVERY OF HEALTH CARE. THERE ARE MANY CHALLENGES BUT FOR DELAWARE VALLEY'S PLAN, THE KEY FINDINGS ARE BELOW: KEY FINDINGS FROM THE ASSESSMENT 1. LACK OF TRANSPORTATION 2. AGING POPULATION 3. POVERTY 4. PREVALENCE OF CHRONIC DISEASE 5. PREVALENCE OF MENTAL HEALTH NEEDS ACCESSDVH HAS BEGUN TO ADDRESS MANY OF THESE ISSUES IN A VARIETY OF WAYS. THE HOSPITAL HAS EXPANDED THE HOURS THAT ITS PRIMARY CARE OFFICES ARE OPEN. BOTH THE DOWNSVILLE AND ROSCOE OFFICES ARE NOW OPEN 5 DAYS PER WEEK. THE WALTON OFFICE IS OPEN UNTIL 7 PM, MONDAYS THROUGH THURSDAYS AND UNTIL 5 PM ON FRIDAY. SATURDAY MORNING HOURS HAVE BEEN DISCONTINUED DUE TO THE INCREASED USE OF VIRTUAL VISITS SINCE THE COVID PANDEMIC BEGAN. THE HOSPITAL'S RETAIL PHARMACY IS OPEN 7 DAYS A WEEK. THE IMAGING AND LAB DEPARTMENTS OFFER EVENING AND WEEKEND APPOINTMENTS. THE HOSPITAL'S OUTPATIENT REHABILITATION DEPARTMENT OFFERS EARLY MORNING AND EVENING APPOINTMENTS. BY EXTENDING HOURS, PATIENTS HAVE THE OPPORTUNITY TO RECEIVE CARE WITHOUT HAVING TO TAKE TIME OFF FROM WORK. MANY AGING PATIENTS RELY ON THEIR CHILDREN OR NEIGHBORS/FRIENDS FOR TRANSPORTATION TO HEALTH CARE APPOINTMENTS. THIS ALLOWS THE CAREGIVERS THE ABILITY TO SCHEDULE THOSE APPOINTMENTS AT A MORE CONVENIENT TIME. SINCE THE PANDEMIC, MANY HOURS HAVE HAD TO BE ADJUSTED IN ORDER TO PROMOTE SOCIAL DISTANCING AND PATIENT AND STAFF SAFETY. MANY ACCOMMODATIONS HAVE BEEN MADE INCLUDING THE EXTENSIVE USE OF VIRTUAL VISITS AND TELEPHONIC VISITS. FOR PATIENTS, LIKE THE ELDERLY, WHO WOULD BE AT HIGH-RISK IF THEY WERE TO CONTRACT COVID, DVH PHLEBOTOMISTS WERE GOING OUT TO THEIR CAR TO DRAW BLOOD, RATHER THAN HAVE THEM ENTER THE HOSPITAL. ALL COVID-19 TESTING HAS BEEN DONE WHILE THE PATIENT REMAINS IN THEIR CAR. THE HOSPITAL BUILT A SMALL ADDITION TO THE HOSPITAL TO ACCOMMODATE TESTING SUPPLIES AND ALLOW STAFF PROTECTION FROM THE WEATHER. PATIENTS THEN DRIVE UNDER AN EXISTING OVERHANG TO HAVE THEIR TEST COMPLETED. TRANSPORTATION: DELAWARE VALLEY HAS A REPRESENTATIVE ON THE COUNTY'S TRANSPORTATION COMMITTEE, THROUGH THE OFFICE FOR THE AGING, BUT THERE WAS NO MEETING IN 2020. THE HOSPITAL MAINTAINED AN OFFICE FOR TWO REPRESENTATIVES FROM THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY. THE ORGANIZATION SERVES DELAWARE COUNTY, YET HAS NO PHYSICAL PRESENCE IN THE AREA. THEIR OFFICE IS BASED APPROXIMATELY ONE HOUR AWAY: CENTRAL TO THEIR COVERAGE AREA BUT CHALLENGING WHEN TRYING TO REACH THE FAR CORNERS OF THEIR TERRITORY. BECAUSE THEY HAVE NO BUDGET FOR A SECOND OFFICE, DVH PROVIDES THE SPACE, PHONE, SUPPLIES AT NO CHARGE TO THE ORGANIZATION. THIS HELPS THEM PROVIDE DELAWARE COUNTY RESIDENTS WITH MANY REFERRALS, NAVIGATION, AND SOCIAL SERVICE-TYPE SUPPORTS. HOWEVER, DUE TO THE PANDEMIC, IN 2020, MOST OF THEIR WORK WAS DONE FROM HOME, WITH OCCASIONAL VISITS TO THE OFFICE. PREVALENCE OF CHRONIC DISEASE DVH HAD THREE STAFF MEMBERS WHO WERE CERTIFIED LEADERS OF THE STANFORD UNIVERSITY EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. THE PROGRAM IS GENERALLY OFFERED AT LEAST TWICE PER YEAR AND ALSO IS OFFERED BOTH DURING THE DAY AND IN THE EVENING FOR CONVENIENCE. HOWEVER, IN 2019, WE SAW DECLINING INTEREST. IN 2020, WE DID NOT OFFER THE PROGRAM, AS WE DID NOT HAVE A SPACE LARGE ENOUGH TO ACCOMMODATE SOCIAL DISTANCING. ONE OF THE THREE LEADERS LEFT DVH EMPLOY IN 2020. DVH ALSO HAS A CARE COORDINATOR RN WHO WORKS CLOSELY WITH THE PRIMARY CARE PROVIDERS TO HELP PATIENTS WHO ARE HIGH RISK FOR ADMISSION TO THE HOSPITAL DUE TO THEIR CHRONIC DISEASE. SHE OFFERS ONE- ON- ONE GUIDANCE AND SUPPORT BASED ON THEIR NEEDS. SHE ALSO WORKS VERY CLOSELY WITH THE CERTIFIED DIETITIAN/NUTRITIONIST WHO ALSO OFFERS INDIVIDUALIZED GUIDANCE. THE DIETITIAN ALSO WORKED WITH 30 SNAP RECIPIENTS IN 2020 IN CONJUNCTION WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S FRUIT AND VEGETABLE RX PROGRAM. THE PROVIDERS BEGAN TO TRACK, AND WILL CONTINUE TO TRACK VARIOUS METRICS REGARDING CHRONIC DISEASE THROUGHOUT THIS THREE-YEAR PLAN. SPECIFICS ARE OUTLINED LATER IN THIS DOCUMENT. AS DVH, ALONG WITH THE ENTIRE UHS SYSTEM, WAS PREPARING TO IMPLEMENT THE EPIC ELECTRONIC HEALTH RECORD IN APRIL 2020. IT IS BELIEVED THAT THE PROGRAM'S FEATURES WILL ENHANCE THE PROVIDERS' EFFORTS TO SERVE AS THE PATIENTS' MEDICAL HOME AND GUIDE THEIR CARE. DUE TO THE PANDEMIC, THE IMPLEMENTATION DID NOT TAKE PLACE UNTIL SEPTEMBER 2020. IT IS EXPECTED THAT IN 2021, THE PROVIDERS WOULD BE ABLE TO GUIDE THEIR CARE BETTER, GIVEN TIME TO WORK WITH THE NEW SYSTEM.TELE-ENDOCRINOLOGY WORKING WITH UHS, DVH OFFERS VIDEOCONFERENCING APPOINTMENTS WITH A UHS NURSE PRACTITIONER SPECIALIZING IN DIABETES CARE. THIS NOT ONLY PROVIDES FURTHER CARE FOR ITS DIABETIC PATIENTS BUT ALSO EASES THE ACCESS TO CARE. PREVALENCE OF MENTAL HEALTH NEEDS TELE-MENTAL HEALTH WORKING CLOSELY WITH THE DELAWARE COUNTY MENTAL HEALTH DEPARTMENT OVER SEVERAL YEARS, DELAWARE VALLEY INSTITUTED A TELE-MENTAL HEALTH PROGRAM TO HELP INCREASE ACCESS TO MENTAL HEALTH PROFESSIONALS. PATIENTS SEE PROVIDERS THROUGH VIDEOCONFERENCING AT THE HOSPITAL'S PRIMARY CARE OFFICE IN WALTON. DVH IS CURRENTLY IN THE PROCESS OF REQUESTING AN ADDITIONAL LCSW, AS THERE IS STILL UNMET NEED. THE STIGMA THAT SOME PATIENTS FEEL CAN BE REDUCED BECAUSE THEY ARE COMING TO A PRIMARY CARE FACILITY AS OPPOSED TO A MENTAL HEALTH FACILITY. THE HOSPITAL CONTRACTS WITH A VENDOR WHO SUPPLIES A PSYCHIATRIC NURSE PRACTITIONER AND TWO LICENSED CLINICAL SOCIAL WORKERS. IN 2020, ONE LCSW WENT ON MATERNITY LEAVE AND LEFT THE PROGRAM THEREAFTER. TWO ADDITIONAL LCSWS WERE CONTRACTED, BUT ALMOST IMMEDIATELY ONE OF THEM FOUND THAT THE MENTAL HEALTH NEEDS OF FIRST RESPONDERS AND RESIDENTS OF HER COMMUNITY WERE SO EXCESSIVE DUE TO THE PANDEMIC; SHE FELT COMPELLED TO CONCENTRATE ON HELPING THEM AND THEREFORE LEFT THE PROGRAM. ANOTHER LCSW WAS CONTRACTED TO REPLACE HER BUT IN OCTOBER ALSO HAD TO LEAVE AS HER PRIVATE PRACTICE WAS GROWING, ALSO DUE TO THE PANDEMIC. THE NPP REMAINED CONSTANT. CPEP IN ED WORKING WITH UHS' COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM (CPEP), DVH WAS ABLE TO INSTITUTE VIDEOCONFERENCING IN ITS ER SO THAT UHS' MENTAL HEALTH PROFESSIONALS CAN ACTUALLY SEE THE PATIENTS PRIOR TO THEM BEING SENT TO UHS (1 HOUR AWAY) ONLY TO FIND THEY ACTUALLY DON'T NEED HOSPITALIZATION. THIS WILL REDUCE THE UNNECESSARY USE OF RESOURCES: AMBULANCE AND CREW; A SECOND ER VISIT AND THE NEED TO FIND THE PATIENT A RIDE BACK HOME AFTER THE ASSESSMENT HAS TAKEN PLACE AT UHS. ALTHOUGH THIS SERVICE IS IN PLACE, IT IS NOT WELL-UTILIZED AS YET DUE TO THE SHORTAGE OF PROVIDERS AT THE CRISIS CENTER. RECRUITMENT FOR ALL HEALTHCARE PROFESSIONALS IN RURAL AREAS IS CHALLENGING BUT MENTAL HEALTH PROFESSIONALS ARE EVEN MORE DIFFICULT TO ATTRACT. ASSETS AND RESOURCES DELAWARE VALLEY HOSPITAL HAS CHOSEN TO FOCUS MUCH OF ITS WORK OVER THE NEXT FEW YEARS TO THE WALTON COMMUNITY. WALTON'S POPULATION CONSISTS OF 31.3% OF RESIDENTS AT AGE 65 AND OVER, COMPARED TO THE COUNTY'S 23%. 26% OF THE POPULATION IS DISABLED. OVER THE PAST 12 MONTHS, 25.8% OF ALL HOUSEHOLDS HAVE BEEN BELOW THE POVERTY LEVEL. 59% OF THE HOUSEHOLDS FIT THE DEFINITION OF POVERTY OR OF ALICE (ASSET LIMITED, INCOME CONSTRAINED, AND EMPLOYED). 45.3% OF THE POPULATION HAS PUBLIC INSURANCE COVERAGE AND 6.7% HAVE NO COVERAGE AT ALL.THE WALTON COMMUNITY HAS SUFFERED THROUGH TWO MAJOR FLOODS. ONE HAPPENED IN 1996 AND THE SECOND WAS IN 2006. TWO SMALLER EVENTS, CONSIDERED MODERATE FLOODING, TOOK PLACE IN 2010 AND 2011. THESE EVENTS LED TO A SENSE OF VICTIMIZATION THROUGHOUT THE COMMUNITY AND ITS RESIDENTS. ALL OF THESE FACTORS HAD LED DVH TO BELIEVE THAT TO REALLY MAKE AN IMPACT ON THE HEALTH OF ITS OWN COMMUNITY; IT NEEDS TO ADDRESS MANY OF THE SOCIAL DETERMINANTS OF HEALTH. HOWEVER, IT COULD NOT MAKE MUCH HEADWAY WITHOUT THE COOPERATION OF THE COMMUNITY'S ORGANIZATIONS, SCHOOLS, GOVERNMENT AND RESIDENTS. SOME NEW INITIATIVES FROM A LOCAL 4H CLUB TO BEAUTIFY THE COMMUNITY; THE FORMATION OF A NEW ART GROUP THAT SPONSORED AN ART WALK WITH ACTIVITIES AND A CREATED COMMUNITY MURAL ENTITLED, WALTON RISING; NEW YOUNGER RESIDENTS IN BOTH GOVERNMENT AND CHAMBER OF COMMERCE LEADERSHIP POSITIONS; AND A NEW FOUNDATION THAT WAS CREATED FROM THE ESTATE OF A COUPLE, WHO WERE LONG-STANDING MEMBERS OF THE COMMUNITY HAVE ALL COALESCED INTO A FORCE OF POSITIVITY. THE SCHOOL ADMINISTRATION IS ALSO COMPRISED OF YOUNGER RESIDENTS WHO HAVE GROWN UP IN WALTON AND WANT TO SEE IT THRIVE. THE HOSPITAL IS AN ACTIVE MEMBER OF THE CHAMBER AND THE COMMUNITY COMMITTEE OF THE SCHOOL. IT HAS ALSO ACTIVELY PARTICIPATED IN MANY OF THE ACTIVITIES THAT HAVE BEEN TAKING PLACE.
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)	BASED ON ALL OF THE ACTIVITIES AND RENEWED SENSE OF COMMUNITY AND POSITIVITY AMONG THE RESIDENTS, DVH DISCUSSED THE POSSIBILITY OF PRESENTING A SERIES OF WORKSHOPS (FOR THE ENTIRE COUNTY) BASED ON THE AARP AGE-FRIENDLY COMMUNITIES PROGRAM, WHICH IS BASED ON THE WORLD HEALTH ORGANIZATION'S 8 DOMAINS OF LIVABILITY. THEY INCLUDE:OUTDOOR SPACES AND BUILDINGS TRANSPORTATION OPTIONS HOUSING- APPROPRIATELY DESIGNED OR MODIFIED AND AFFORDABLE SOCIAL PARTICIPATION RESPECT AND SOCIAL INCLUSION CIVIC PARTICIPATION AND EMPLOYMENT COMMUNICATION AND INFORMATION COMMUNITY AND HEALTH SERVICES DISCUSSION WAS HELD WITH THE CARE COMPASS NETWORK EAST REGIONAL PERFORMING UNIT, WHICH IS COMPRISED OF HOSPITALS AND ORGANIZATIONS AND AGENCIES FROM BOTH DELAWARE AND CHENANGO COUNTY. THE IDEA WAS WELL RECEIVED AND CARE COMPASS AGREED TO FUND THE PROGRAM. THE FIRST WORKSHOP WAS HELD ON JANUARY 30TH IN WALTON AND WAS PRESENTED BY ESTHER GREENHOUSE, NATIONALLY RENOWNED EXPERT ON BUILT ENVIRONMENTS. ORGANIZATIONS, AGENCIES AND HEALTHCARE PROVIDERS FROM ACROSS DELAWARE COUNTY, AND THOSE THAT SERVE DELAWARE COUNTY WILL BE INVITED TO ALL THE WORKSHOPS. HOWEVER, DVH AND ITS LOCAL PARTNERS INTEND TO FOCUS OUR EFFORTS TO THE WALTON COMMUNITY. MORE DETAILED INFORMATION REGARDING THIS PROGRAM IS OUTLINED IN SCHEDULE H- SUPPLEMENTAL INFORMATION. COMMUNITY SERVICE PLAN PREVENT CHRONIC DISEASE FOCUS 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 OBJECTIVES. INTERVENTIONS: 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, MAILS, PHONE CALLS, EMAILS AND/OR E-CHART NOTIFICATIONS MEASURES: UNLESS OTHERWISE NOTED THE MEASURE WILL BE AS FOLLOWS FOR ALL OF THE FOLLOWING: PERCENTAGE OF DVH PATIENTS, AS DESCRIBED, WHO COMPLY WITH SCREENING GUIDELINES. GOAL 4.1 INCREASE CANCER SCREENING RATES 4.1.1 OBJECTIVE: BY DECEMBER 31, 2021, THE PERCENTAGE OF ADULTS, AGE 50-75 YEARS OLD, RECEIVING A COLORECTAL SCREENING WILL INCREASE. INTERVENTIONS WORK WITH PRIMARY CARE PROVIDERS AND STAFF TO PUT SYSTEMS IN PLACE TO PROVIDE BOTH PROVIDERS AND PATIENTS' REMINDERS THROUGH ELECTRONIC HEALTH RECORD (EHR) ALERTS, MAILS, PHONE CALLS, EMAILS AND/OR E-CHART NOTIFICATIONS YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019, 64.4% OF DVH PATIENTS, WHO HAD AN INTERACTION WITH DVH WITHIN THE LAST TWO YEARS, AND ARE BETWEEN THE AGES OF 50 AND 75 HAD APPROPRIATE COLORECTAL SCREENING. 70% WAS THE GOAL FOR 2019. THE YEAR ENDED AT 67.2%, AN IMPROVEMENT FROM THE SEPTEMBER PERCENTAGE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 68%IN JUNE 2020 THE RESULT WAS AT 65.1% BUT FELL UNFORTUNATELY TO 47% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE. IN ADDITION, ALL PATIENTS WERE REQUIRED TO HAVE A COVID TEST PRIOR TO ANY PROCEDURE AND THIS REQUIREMENT RESULTED IN PEOPLE OPTING TO WAIT TO BE SCREENED.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.3 PROMOTE EVIDENCE-BASED CARE TO PREVENT AND MANAGE CHRONIC DISEASES INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES AND OBESITY 4.3.1 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 50-85 YEARS OLD, HAVING AN ANNUAL WELL CARE VISIT WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019, 36.5% OF DVH PATIENTS, BETWEEN THE AGES OF 50-85 HAD AN ANNUAL WELL CARE VISIT. 50% WAS THE GOAL FOR 2019. THE YEAR ENDED AT 38%, AN IMPROVEMENT SINCE THE SEPTEMBER MEASURE.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 50%.IN JUNE 2020 THE RESULT WAS AT 39.1%, A SLIGHT IMPROVEMENT FROM YEAR-END 2019 BUT FELL UNFORTUNATELY TO 25.5% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE. YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.2 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-85 YEARS OLD, DIAGNOSED WITH HYPERTENSION WHO HAVE THEIR CONDITION ADEQUATELY CONTROLLED WILL INCREASE. YEAR 1 PROJECTED (OR COMPLETED) INTERVENTION: AS OF SEPTEMBER 2019 71.7% OF DVH PATIENTS, BETWEEN THE AGES OF 18-85 WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION, HAD THEIR BLOOD PRESSURE ADEQUATELY CONTROLLED (<140/90). THE TARGET FOR 2019 WAS 71%. THE YEAR ENDED AT 73.9%, WHICH EXCEEDED THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 WAS 72.5%THIS METRIC ACTUALLY DID IMPROVE OVER 2020 THE RESULT WAS 76%. THIS CAN MOST LIKELY BE BASED ON THE FACT THAT VISITS ARE NECESSARY IN ORDER TO CONTINUE RECEIVING BLOOD PRESSURE MEDICATION, SO COMPLIANCE IS HIGHER. YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.3 OBJECTIVE: BY DECEMBER 31, 2021 THE PERCENTAGE OF ADULTS, AGE 18-75, WITH DIABETES, WHO HAVE HAD HBA1C TESTING WITHIN A YEAR WITH A RESULT OF <8.0% WILL INCREASE. YEAR 1 AS OF SEPTEMBER 2019 AT LEAST 69.5% OF PATIENTS AGE 18-75 YEARS OF AGE, WITH DIABETES, WILL HAVE HAD HBA1C TESTING WITHIN A YEAR AND THE RESULT WILL BE <8.0%. GOAL WAS 67.2% FOR 2019. THE YEAR ENDED AT 68.3%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 67.2% IN JUNE 2020 THE RESULT WAS AT 65.3%, BUT FELL UNFORTUNATELY TO 24% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. 4.3.4 OBJECTIVE: BY DECEMBER 31, 2021 MOST PRESCRIPTIONS FOR CHRONIC DISEASE MANAGEMENT WILL BE WRITTEN FOR 90 DAYS IN ORDER TO FOSTER BETTER PATIENT COMPLIANCE AND CONVENIENCE YEAR 1 AS OF SEPTEMBER 2019, 72.6% OF 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. GOAL WAS 72% FOR 2019. THE YEAR ENDED AT 74.4%, EXCEEDING THE TARGET.YEAR 2 THE 2020 GOAL, AS DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2019 REMAINED THE SAME AT 72%.IN JUNE 2020 THE RESULT WAS AT 74.1%, BUT FELL TO 70.7% BY 12/31/20. THE ONGOING CHALLENGES OF THE PANDEMIC, THE RELUCTANCE OF PATIENTS TO COME FOR CHRONIC CONDITION MANAGEMENT, THE HIGHER VOLUME OF VIRTUAL VISITS AND LESS IN-PERSON VISITS ARE ALL FACTORS THAT CONTRIBUTED TO THE DECLINE.YEAR 3 THIS WILL BE DETERMINED BY THE UHS SYSTEM MEMBERS BASED ON PERFORMANCE IN 2020. GOAL 4.4 IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES, 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 MEASURES: THE PERCENTAGE OF PARTICIPANTS REFERRED BY PRIMARY CARE PROVIDERS OR HUMAN SERVICE AGENCIES INTERVENTIONS: WORK WITH MARKETING STAFF, PRIMARY CARE PROVIDER OFFICES AND LOCAL HUMAN SERVICE AGENCIES TO PUT SYSTEMS IN PLACE TO ASSURE AWARENESS OF THE AVAILABILITY OF THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM. YEAR 1 RECOGNIZED THAT MOST PARTICIPANTS ARE LEARNING OF THE PROGRAM THROUGH ONE SOLE PROVIDER OR THROUGH ADVERTISING. THERE IS A NEED TO CREATE MORE WIDELY-BASED KNOWLEDGE OF THE PROGRAM. YEAR 2 SYSTEMS WILL BE IN PLACE AND UTILIZED BY THE FALL OF 2020.NO ACTION TOOK PLACE ON THIS INITIATIVE. VIRTUALLY ALL THE TARGETED RESOURCES THAT WOULD HAVE WORKED ON THIS WERE OVERWHELMED DEALING WITH COVID-19. IN DVH'S CASE THE CLINICAL STAFF ALSO HAD TO FOCUS ON THE IMPLEMENTATION OF THE NEW EHR IN SEPTEMBER 2020. YEAR 3 AT LEAST 25% OF THE PARTICIPANTS WILL HAVE BEEN REFERRED FROM AN AGENCY OR PROVIDER.
PART V, SECTION B, LINE 11: 2019-2021 COMMUNITY SERVICE PLAN (CONTINUED)	4.4.2 OBJECTIVE: ACCESS TO CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS WILL CONTINUE. DISPARITY: COMMUNITY MEMBERS WITH CHRONIC DISEASE MEASURE: NUMBER OF SERIES OF WORKSHOPS OFFERED INTERVENTIONS: HOLD CHRONIC DISEASE SELF-MANAGEMENT WORKSHOPS YEAR 1 DURING 2019, 2 SERIES OF WORKSHOPS WERE HELD IN THE SPRING. A FALL SERIES WAS OFFERED BUT THERE WERE NOT ENOUGH PARTICIPANTS TO ACTUALLY HOLD THE PROGRAM. YEAR 2 DURING 2020, AT LEAST TWO WORKSHOPS WILL BE HELDNO WORKSHOPS WERE OFFERED DUE TO THE PANDEMIC. YEAR 3 DURING 2021, AT LEAST TWO WORKSHOPS WILL BE HELD. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS FOCUS AREA 1: PROMOTE WELL-BEING GOAL 1.1: STRENGTHEN OPPORTUNITIES TO BUILD WELL-BEING AND RESILIENCE ACROSS THE LIFESPAN 1.1.1 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 OPPORTUNITIES MEASURES: IMPROVEMENT IN ACCESSIBILITY, SOCIALIZATION, AND WELL-BEING MEASURES YEAR 1: RESEARCHED BUILDING AGE FRIENDLY COMMUNITIES THROUGH AARP - DISCUSSED CONCEPT WITH POTENTIAL STAKEHOLDERS INCLUDING LOCAL OFFICIALS, ORGANIZATIONS, AGENCIES, SCHOOLS, POTENTIAL COMMUNITY PARTNERS AND GARNERED SUPPORT TO MOVE PROJECT FORWARD. REQUESTED AND SECURED FUNDING FROM CARE COMPASS NETWORK TO HOLD SERIES OF WORKSHOPS REGARDING AGE FRIENDLY COMMUNITIES - SET DATES, SECURED VENUE, CATERERS AND DEVELOPED INVITE LIST. YEAR 2: HOLD SERIES OF WORKSHOPS BASED ON A BLEND OF AARP'S ROAD TO LIVABILITY PROGRAM AND NY STATE'S LIVABLE NY PROGRAM WHICH INCORPORATES THE IMPORTANCE OF THE SOCIAL DETERMINANTS OF HEALTH. HOLD FOLLOW-UP MEETINGS WITH APPROPRIATE INTERESTED PARTIES FROM WALTON AREA TO CREATE A COALITION OF COMMUNITY MEMBERS TO PRIORITIZE POTENTIAL AGE FRIENDLY COMMUNITY INITIATIVES; IDENTIFY NEXT STEPS AND IDENTIFY POTENTIAL COMMITTEE MEMBERS TO ADDRESS EACH INITIATIVE. MEASURES: TWO COMMITTEES WILL BE FORMED OR EXISTING COMMITTEES, INTEGRATED INTO ADDRESSING AT LEAST TWO COMPONENTS OF THE AGE FRIENDLY COMMUNITY. RECRUIT AND FORM COMMITTEE(S) OF COMMUNITY RESIDENTS, WHICH IS REPRESENTATIVE OF THE POPULATION AND ALSO INCLUDES APPROPRIATE COMMUNITY BASED ORGANIZATIONS, AGENCIES AND GOVERNMENT ENTITIES TO DEVELOP AN ACTION PLAN AND TIMELINE TO ADDRESS AT LEAST TWO COMPONENTS OF BECOMING AN AGE FRIENDLY COMMUNITY.THE WALTON CONTINGENT, WHICH IS DELAWARE VALLEY HOSPITAL'S HOME TOWN, CONTINUED THE MOMENTUM, HOLDING A COMMUNITY FORUM ON MARCH 1 WITH REPRESENTATIVES FROM LOCAL ORGANIZATIONS WHICH WERE ABLE TO TELL ATTENDEES ABOUT THEIR PLANS. DELAWARE VALLEY HOSPITAL SPOKE SPECIFICALLY ABOUT ITS PLANS TO CONDUCT A SURVEY ABOUT HOW PEOPLE SOCIALIZE AND ITS PLAN TO WORK ON HELPING WALTON BECOME AN AGE-FRIENDLY COMMUNITY. SEVEN COMMUNITY MEMBERS VOLUNTEERED TO SERVE ON VARIOUS COMMITTEES TO BEGIN WORK ON BUILDING AN AGE-FRIENDLY COMMUNITY. UNFORTUNATELY, DUE TO THE PANDEMIC AND PEOPLE'S COMMITMENT TO THEIR JOBS, CARING FOR THEMSELVES, THEIR FAMILIES AND RE-STRUCTURING THEIR DAILY LIVES AROUND REMOTE WORK AND SCHOOL, SOME OF THIS WORK HAD TO BE SET ASIDE. HOWEVER, THE COMMUNITY RELATIONS DIRECTOR WROTE A GRANT APPLICATION TO HELP PAY FOR THE SURVEY EXPENSES, BUT WAS TURNED DOWN, AS ALL FUNDING WENT TO FOOD SECURITY. A SECOND APPLICATION WAS ALSO TURNED DOWN AS A BOARD MEMBER FELT THAT THE WORK COULD BE DONE IN CONJUNCTION WITH A BINGHAMTON UNIVERSITY INTERN. UNFORTUNATELY, THAT DID NOT COME TO FRUITION EITHER, AS THE CANDIDATES ALL DECIDED TO DO THEIR INTERNSHIP CLOSER TO THEIR HOMES. AS OF THIS WRITING THE DECISION HAS BEEN MADE TO CONDUCT THE SURVEY AND DVH WILL BE FUNDING THE INITIATIVE. 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, THE DECISION WAS MADE TO APPLY FOR AN AARP GRANT TO CREATE A RIVER WALK AND PICNIC AREA. EXTENSIVE WORK HAD TO TAKE PLACE IN ORDER TO DESIGN THE WALK, THE PARKING AREAS, THE PICNIC AREA, AND DECIDING ON SPECIFIC TABLES ETC. WHILE KEEPING WITHIN THE SCOPE OF WHAT IS ALLOWABLE IN THE FLOOD PLAIN. THE GRANT WAS NOT SUCCESSFUL, HOWEVER ENOUGH WORK HAD BEEN DONE THAT MORE DETAILED DRAWINGS AND PLANS COULD BE MADE UP AND SEVERAL GRANTS ARE BEING WRITTEN IN 2021 FOR THE PROJECT. FUNDING HAD BEEN SECURED FOR PICNIC TABLES, SIGNAGE, CREATION OF NEW WALKING TRAIL MARKERS THAT HAD BEEN DESTROYED IN A FLOOD AND SIGNAGE FOR A BIKE TRAIL UNFORTUNATELY WAS RESCINDED BY THE STATE DUE TO PANDEMIC COSTS. MEASURES: COMMITTEE OBJECTIVES AND TIMELINES WILL BE DEVELOPED COMMITTEES WILL FORMULATE THEIR RESPECTIVE OBJECTIVES, BASED ON AGE FRIENDLY SERIES AND DEVELOP A WORK PLAN AND CREATE A TIMELINE TO ACHIEVE THOSE OBJECTIVES AND CHOOSE A REPRESENTATIVE TO SIT ON THE COMMUNITY COALITION. MEASURES: BEST PRACTICE, CORE MEASURES AND STAKEHOLDER ROLES WILL BE DETERMINED COMMITTEES WILL REACH CONSENSUS ON BEST PRACTICE INTERVENTIONS, CORE MEASURES AND ROLES OF STAKEHOLDERS YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. 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 MEASURES: ACCESSIBILITY OF PHYSICAL ENVIRONMENT YEAR 1: HELD DISCUSSION WITH TOWN SUPERVISOR, VILLAGE MAYOR, AND PROJECT MANAGER FOR WATER STREET PROJECT, AND CHAMBER OF COMMERCE PRESIDENT TO ASSESS FEASIBILITY OF HAVING AN IMPACT ON WATER STREET USE AND DEVELOPMENT. YEAR 2: REVIEW PREVIOUS WALK AUDIT DONE BY RURAL HEALTH GROUP. COMPLETE WALK AUDIT OF WATER STREET AND DELAWARE STREET IN WALTON NY NO ACTION TOOK PLACE ON THIS DUE TO COVID. YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.3: BY DECEMBER 31, 2021 DECREASE THE % OF ADULTS WHO REPORT FEELING ANXIETY OR FEAR, DEPRESSION OR SADNESS, HELPLESS OR HOPELESS INTERVENTIONS: SURVEY COMMUNITY MEMBERS YEAR 1: DELAWARE COUNTY COMMUNITY SURVEY COMPLETED. QUESTION- IN THE PAST YEAR, HAVE YOU OR SOMEONE CLOSE TO YOU EXPERIENCED ANY OF THE FOLLOWING: RESULTS OF THESE MEASURES INCLUDED: ANXIETY OR FEAR 49.6% - DEPRESSION OR SADNESS 55.5% - FEELING HELPLESS OR HOPELESS 30.56% YEAR 2: FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEING BECAUSE THE SURVEY HAS BEEN DELAYED UNTIL LATE 2021, NO FURTHER WORK TOOK PLACE ON THIS INITIATIVE IN 2020.YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS. OBJECTIVE 1.1.4 BY DECEMBER 31, 2021 INCREASES THE % OF ADULTS WHO REPORT ONGOING PARTICIPATION IN AT LEAST ONE SOCIALIZATION OPPORTUNITY OTHER THAN WORK. (BASELINE TO BE SET IN 2020) INTERVENTIONS: SURVEY COMMUNITY MEMBERS MEASURES: NUMBER OF PEOPLE PARTICIPATING AT SOCIALIZATION OPPORTUNITIES. YEAR 1: DISCUSSIONS CENTERED ON CORRELATION OF ISOLATION AND FEELINGS YEAR 2: DEVELOP A SURVEY TO GET SENSE OF SOCIALIZATION ACTIVITIES AND PARTICIPATION THROUGHOUT THE COMMUNITY. FOCUS COMMITTEE WORK ON SOCIALIZATION OPPORTUNITIES TO HELP FOSTER FEELINGS OF WELL-BEINGBECAUSE THE SURVEY HAS BEEN DELAYED UNTIL LATE 2021, NO FURTHER WORK TOOK PLACE ON THIS INITIATIVE IN 2020YEAR 3: TO BE DETERMINED BASED ON 2020 RESULTS/DECISIONS DELAWARE VALLEY HOSPITAL STAFF WILL PLAY AN INTEGRAL ROLE, WITH CARE COMPASS NETWORK STAFF TO ENSURE APPROPRIATE STAKEHOLDERS FROM ACROSS THE COUNTY ARE INVITED TO THE VARIOUS AGE-FRIENDLY WORKSHOPS. DVH STAFF WILL ALSO SECURE THE VENUE AND CATERER FOR EACH WORKSHOP. DELAWARE VALLEY STAFF WILL BE THE CATALYST AND CHAMPION TO ENSURE WALTON COMMUNITY STAKEHOLDERS HOLD FOLLOW-UP MEETINGS AND FORMULATE COMMITTEES TO FOCUS ON SPECIFIC INTERVENTIONS, BASED ON THE CONSENSUS OF THE GROUP. DVH WILL MAINTAIN REPRESENTATION ON THE STEERING COMMITTEE AND ANY OTHER SUB-COMMITTEE THAT IS APPROPRIATE. DVH WILL WORK WITH DELAWARE COUNTY MENTAL HEALTH TO CREATE SURVEY OF SOCIALIZATION ACTIVITIES. IF NECESSARY, DVH WILL ASSIST IN PROVIDING SUPPORT IN WRITING ANY GRANT APPLICATIONS.THE DVH COMMUNITY RELATIONS DIRECTOR WROTE AN AARP GRANT FOR THE VILLAGE OF WALTON TO FUND THE CREATION OF A TRAIL ALONG THE RIVER. SHE ALSO WROTE 2 GRANTS FOR THE FUNDING OF THE SURVEY. UNFORTUNATELY, NONE OF THESE WERE SUCCESSFUL. IN ADDITION, DVH WILL CONTINUE TO MEET REGULARLY WITH DELAWARE COUNTY PUBLIC HEALTH STAFF AND STAFF FROM BOTH O'CONNOR HOSPITAL AND MARGARETVILLE HOSPITAL TO CONTINUE DIALOGUE REGARDING OUR ACTIVITIES SO WE CAN IDENTIFY OPPORTUNITIES TO WORK TOGETHER.ALTHOUGH, DVH HAD A LOT OF INTERACTION WITH DELAWARE COUNTY PUBLIC HEALTH THROUGHOUT 2020, IT WAS FOCUSED ON THE PANDEMIC AND NOT ON THE COMMUNITY SERVICE PLAN.

Schedule H (Form 990) 2020

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address		Type of Facility (describe)
1	1 - WALTON FAMILY HEALTH CENTER 2 TITUS PLACE WALTON,NY13856	OUTPATIENT PHYSICIAN CLINIC
2	2 - DOWNSVILLE FAMILY HEALTH CENTER 28315 STATE HWY 206 DOWNSVILLE,NY13755	OUTPATIENT PHYSICIAN CLINIC
3	3 - ROSCOE FAMILY HEALTH CENTER 1982 OLD ROUTE 17 ROSCOE,NY12776	OUTPATIENT PHYSICIAN CLINIC
4	4 - PHYSICAL AND OCCUPATIONAL THERAPY 121 STOCKTON AVENUE WALTON,NY13856	REHABILITATION CLINIC
5	5 - DVH COMMUNITY PHARMACY 121 STOCKTON AVENUE WALTON,NY13856	COMMUNITY PHARMACY
6
7
8
9
10

Schedule H (Form 990) 2020

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
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 $515,228 IN PART IX, LINE 24C. 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, SHE SERVED ON THE SCHOOL'S RE-OPENING PLANNING COMMITTEE. DURING THESE MEETINGS, THE SCHOOL REPORTED IT HAD CHANGED OUT ALL THE WATER FOUNTAINS TO BOTTLE FILLING STATIONS. THE HOSPITAL OFFERED FREE WATER BOTTLES TO ALL STUDENTS. DVH THEN REACHED OUT TO THE SCHOOLS IN OTHER AREAS AND FOUND THEY ALSO HAD A NEED. 2,400 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). HOWEVER, NO MEETINGS WERE HELD IN 2020 DUE TO THE PANDEMIC. WEEKLY NARCOTICS ANONYMOUS MEETINGS CONTINUED TO BE HELD AT THE HOSPITAL UNTIL MARCH 10, 2020. HOSPITAL STAFF PERFORMED DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG TREATMENT COURT FREE OF CHARGE UNTIL THE COURT CLOSED DUE TO COVID -19. IT DID NOT RE-OPEN IN 2020. THE DELAWARE COUNTY DRUG TREATMENT COURT'S MISSION IS TO HELP CHANGE THE BEHAVIORS OF ADULT NONVIOLENT DRUG AND ALCOHOL USERS THROUGH SUPERVISION AND TREATMENT RATHER THAN JUST SENDING THEM TO JAIL. THE OVERALL GOAL IS TO HELP ADDICTED INDIVIDUALS ACHIEVE LIFELONG RECOVERY AND BECOME RESPONSIBLE AND PRODUCTIVE MEMBERS OF THE COMMUNITY. DELAWARE COUNTY'S SOLID WASTE MANAGEMENT CENTER CONTINUES TO DISTRIBUTE THE BROCHURES, PRINTED COURTESY OF DVH, REGARDING SAFE NEEDLE DISPOSAL. WHEN PATIENTS BRING THEIR USED SHARPS TO THE HOSPITAL FOR DISPOSAL, THEY ARE GIVEN A FREE AND APPROPRIATELY SIZED SHARP DISPOSAL CONTAINER. THE HOSPITAL CONTINUES TO SUPPORT THE TOWN'S VETERAN'S CLUB, CHAMBER OF COMMERCE, THE LITTLE LEAGUE ORGANIZATION, THE LOCAL TOY BANK DRIVE AND TWO 5K RUNS. BECAUSE OF THE PANDEMIC, THE COMMUNITY'S ANNUAL HOLIDAY DINNER WAS NOT HELD AND THE MUSIC ON THE DELAWARE GROUP WAS NOT ACTIVE. THE HOSPITAL CHOSE TO REDIRECT ITS SUPPORT TO TWO LOCAL FOOD BANKS INSTEAD. THE PRESIDENT/CEO OF DELAWARE VALLEY IS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB. THE HOSPITAL CONTROLLER SERVES ON THE BOARD OF THE CULLMAN CENTER, A DAY CARE CENTER IN SIDNEY, NY. 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. OVER THE COURSE OF EACH YEAR, DVH MEMORIALIZES PEOPLE BY DONATING TO NON-PROFIT ORGANIZATIONS RATHER THAN GETTING FLOWERS. 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. DVH CONTINUES TO SUPPLY OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE MOVED TO BINGHAMTON , NY, BUT STILL 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 IS STILL MAINTAINED, THE STAFF HAS BEEN WORKING REMOTELY, WITH ONLY OCCASIONAL OFFICE DAYS. DVH WAS MADE AWARE THAT AN ORGANIZATION, THE FAMILY RESOURCE NETWORK, WHICH SERVES FAMILIES DEALING WITH DISABILITIES, NEEDED A MORE LOCAL PRIVATE PLACE FOR MEETING WITH FAMILIES. THEIR MAIN OFFICE IS LOCATED 45 MINUTES AWAY FROM WALTON AND CLIENTS HAD DIFFICULTY GETTING THERE. DVH HAS AGREED TO LET THEM USE ITS WELLNESS ROOM FOR THOSE MEETINGS. WHILE WE STILL MAINTAIN THEIR SPOT ON THE CALENDAR, THEY DID NOT UTILIZE THE ROOM IN 2020. 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 2020 DUE TO THE PANDEMIC. WE ALSO BELIEVE IN ENCOURAGING FAMILY TOGETHERNESS AND ACTIVITIES. IN 2019, WE HELD OUR THIRD SANTA EVENT BUT THIS TIME WE ADDED A CRAFT ACTIVITY FOR EACH CHILD TO DO WITH HIS/HER PARENTS. APPROXIMATELY 80 KIDS CAME TO THE EVENT WITH THEIR PARENTS. PLANS AND ADVERTISING HAD BEEN DONE WITH EVERY INTENTION OF GOING FORWARD WITH THIS EVENT IN 2020 WITH SOCIAL DISTANCING ARRANGEMENTS. UNFORTUNATELY THE WEEK BEFORE THE EVENT, OUR TOWN EXPERIENCED A SURGE IN COVID-19 CASES AND WE FELT WE NEEDED TO BE PRUDENT AND CANCELLED THE EVENT. 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, BUT HAD TO BE CANCELLED IN 2020.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 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 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 2020 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2020 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2020, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 52.3% 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 8 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 2020 MEDICARE COST REPORT FOR ALL PERTINENT CALCULATIONS IN PART III, LINE 6.
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 120 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:	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 AND THE INABILITY TO RECRUIT ANOTHER PRIOR TO THEIR DEPARTURE. DVH WAS ABLE TO RECRUIT A NEW NURSE PRACTITIONER AND THE OFFICE WAS RE-OPENED ON 4/26/21 AND IS IN THE PROCESS OF APPLYING FOR NHSC APPROVAL. 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 BOTH SCHOOLS WERE ONLY ABLE TO DO THEIR CLINICALS FROM JANUARY TO MARCH 5, WHEN THE HOSPITAL CLOSED DOWN TO THEM. UNFORTUNATELY, THEY WERE UNABLE TO RETURN IN THE FALL. THE ANNUAL EDUCATION OF DIABETES THAT THE HOSPITAL'S DIETITIAN PROVIDES FOR THE NURSING STUDENTS DID NOT TAKE PLACE DUE TO THE PANDEMIC. TWO DVH RNS SERVED AS MENTORS TO SUNY DELHI RN AND BSN STUDENTS IN 2020. THE PANDEMIC ALSO MADE 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 ALSO CANCELLED. 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 ARE LOCATED AT HTTPS://WWW.NYUHS.ORG/WHY-CHOOSE-US/COMMUNITY-SERVICE-REPORTS. IN 2020, DVH RESOURCES WERE MORE FOCUSED ON DEVELOPING EVEN MORE STRINGENT SAFETY PROTOCOLS, GIVEN THE PANDEMIC. ACCESS TO THE HOSPITAL WAS DETOURED TO ONE ENTRANCE, WHERE A SCREENER WAS PUT IN PLACE TO ASSESS THE PATIENT/VISITOR/VENDOR FOR COVID-19 SYMPTOMS AND OTHER RISK FACTORS BEFORE HAVING THEM ENTER. ALL VISITORS/COMPANIONS WERE PROVIDED INFORMATION ABOUT PROPER WAY TO WEAR MASKS, SOCIAL DISTANCE AND THE IMPORTANCE OF SAFETY AND HAND HYGIENE. WAITING ROOMS WERE RECONFIGURED TO ALLOW SOCIAL DISTANCING. APPOINTMENTS WERE STAGGERED SO LESS PEOPLE WOULD BE IN ANY ONE WAITING ROOM AT A TIME. ALL STAFF WERE TRAINED IN THE USE OF TELEHEALTH SO THAT VIRTUAL APPOINTMENTS COULD TAKE PLACE. TELEPHONIC AND VIRTUAL APPOINTMENTS WERE USED WHEN APPROPRIATE, TO HELP REDUCE POTENTIAL EXPOSURE. A TEMPORARY DRIVE-THROUGH WAS CREATED TO ALLOW NURSING STAFF TO CONDUCT COVID TESTING WHILE THE PATIENTS REMAINED IN THEIR CARS. ALL STAFF WORE MASKS, AND APPROPRIATE LEVELS OF PERSONAL PROTECTIVE EQUIPMENT (PPE) WERE ORDERED. PROPER DONNING AND DOFFING TECHNIQUES WERE REVIEWED WITH STAFF. STAFF MEMBERS VOLUNTEERED TO CREATE FACE SHIELDS, WHEN THEY WERE NOT PROCURABLE. ALWAYS A FOCUS, HAND HYGIENE WAS EVEN MORE GREATLY EMPHASIZED. STAFF MEMBERS WERE RE-ASSIGNED TO SERVE AS SCREENERS FOR ANYONE WANTING TO COME INTO THE HOSPITAL. MAINTENANCE STAFF INSTALLED A BUZZER AND SPEAKER SYSTEM SO THAT SCREENERS COULD COMMUNICATE WITH PEOPLE WAITING OUTSIDE THE BUILDING TO BE SCREENED. EVENTUALLY, MAINTENANCE STAFF ALSO BUILT AN OFFICE FOR THE SCREENER TO WORK FROM. THEY ALSO BUILT A TEMPORARY WALL ON THE MEDICAL FLOOR, WHICH IN EFFECT, CREATED A SEPARATE COVID WARD. A SINK WAS INSTALLED IN THE HALLWAY SO STAFF COULD PERFORM HAND HYGIENE MORE EASILY AND EFFICIENTLY. THEY CREATED 5 ADDITIONAL NEGATIVE PRESSURE ROOMS ON THE MEDICAL FLOOR, USING PORTABLE HEPA FILTRATION UNITS AND PERMANENTLY INSTALLED A NEGATIVE AIR PRESSURE SYSTEM THROUGHOUT THE ER. PLEXIGLASS PARTITIONS WERE INSTALLED TO PLACE EXTRA PROTECTION BETWEEN STAFF AND PATIENTS. 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 AND THE MAINTENANCE STAFF TRANSPORTED EXTRA BEDS FROM THE LOCAL BOCES CNA PROGRAM'S CLINICAL TRAINING AREA. AN EXISTING STORAGE AREA WAS EXTREMELY HUMID AND WITHOUT HEATING OR COOLING. THESE CONDITIONS WERE NOT CONDUCIVE FOR STORING EXTRA EQUIPMENT THAT WOULD BE NEEDED IN A SURGE. SO THE ENTIRE AREA WAS CLIMATE-CONTROLLED TO ASSURE THAT ANY STORED EQUIPMENT WILL NOT BE DAMAGED DUE TO EXTREMES IN THE ENVIRONMENT. BY THE END OF NOVEMBER, THE MAINTENANCE CREW ALSO INSTALLED A CUSTOM, PRE-FABRICATED ANNEX TO THE FRONT OF THE HOSPITAL, ADJACENT TO THE ER AMBULANCE FOYER. THE ANNEX IS USED TO STORE SUPPLIES AND PPE NEEDED TO CONDUCT COVID TESTING, CONTAINS A HANDWASHING STATION AND OFFERS PROTECTION FROM THE ELEMENTS FOR NURSING STAFF BETWEEN PATIENT TESTS. BY PLACING IT IN THAT LOCATION, THE PATIENTS CAN STILL REMAIN IN THEIR CAR, BUT ARE UNDERNEATH THE EXISTING OVERHANG AT THE ER. THE CREW ALSO WORKED WITH THE SAME VENDOR TO DEVELOP A CUSTOM SEMI-ENCLOSED METAL AND GLASS WALKWAY OVERHANG TO PROTECT PATIENTS/VISITORS/VENDORS FROM THE ELEMENTS WHILE WAITING TO BE SCREENED FOR ENTRY. SOME LANDSCAPING WAS REMOVED, TO ACCOMMODATE A WIDENED SIDEWALK SO BENCHES COULD BE PROVIDED WHILE MAINTAINING SOCIAL-DISTANCING GUIDELINES. THE FINAL OVERHANG WAS INSTALLED IN JANUARY 2021. THE ENVIRONMENTAL SERVICES DEPARTMENT, REVIEWED THEIR TERMINAL CLEANING PROTOCOLS, AND A MEMBER OF THE EVS STAFF WAS PUT ON CALL FOR AFTER HOUR TERMINAL CLEANING IF NEEDED BY THE ER, IN ORDER TO BE SURE A FULL COMPLEMENT OF ER BEDS WOULD BE AVAILABLE AT ALL TIMES. UV WANDS WERE PURCHASED TO DISINFECT ELECTRONIC AND OTHER EQUIPMENT THAT CANNOT BE SPRAYED. AIR IONIZERS WERE ALSO PURCHASED TO ADD ANOTHER LAYER OF PROTECTION AS WELL AS TO REDUCE THE TURNAROUND TIME TO PERFORM A TERMINAL CLEANING. THE AIR IONIZERS WORK TO CHANGE THE ELECTRICAL CHARGE OF THE GERM MOLECULES SO THEY ARE TAKEN OUT OF THE AIR AND FALL TO THE GROUND, ALLOWING THEM TO BE WIPED AWAY, ONCE THE VIREX FOG HAS BEEN DISPERSED. EVS STAFF ALSO ENHANCED THE 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. SOCIAL DISTANCE MARKERS WERE PLACED ON THE FLOORS TO HELP PEOPLE MAINTAIN THE PROPER 6 FEET DISTANCE.THE FOOD SERVICE DEPARTMENT WAS RECONFIGURED FROM SELF-SERVE TO FULLY SERVED ITEMS. ALL CONTAINERS, CUPS ETC. ARE SINGLE-USE. THE CAFETERIA SEATING WAS REARRANGED TO ENSURE SOCIAL DISTANCING. EXTENSIVE SIGNAGE, BROCHURES, NEWS ARTICLES WERE DEVELOPED TO HELP THE PUBLIC UNDERSTAND WHAT WAS BEING DONE AND WHY. PHONE MESSAGES WERE DEVELOPED SO THEY COULD MORE EASILY ACCESS THE LATEST INFORMATION. GREAT ATTENTION WAS ALSO PAID TO THE WELL-BEING OF OUR STAFF. WEEKLY COMMUNICATION WAS DISTRIBUTED THROUGH A GROUP EMAIL. UPDATES ON VISITATION, WHAT SERVICES WERE OPENED OR CLOSED, INFO ABOUT DONATIONS BEING MADE TO THE STAFF, SUCH AS MASKS, GIFTS OF FOOD, PEOPLE MAKING HONOR SIGNS SO THEY WOULD KNOW THEIR EFFORTS WERE NOT GOING UNNOTICED. THERE WAS ALSO INFORMATION ON VARIOUS RESOURCES THAT HAD USEFUL INFORMATION FOR THEM AND THEIR FAMILIES. FINALLY, NON-COVID RELATED NEWS WAS ALSO INCLUDED TO HELP THEM REALIZE THERE WAS SOME NORMALITY WAS STILL OCCURRING. A NEW FOUNDATION WAS CREATED IN WALTON NY THAT FOCUSES ON HOSTING "RETREATS FOR GROUPS SEEKING RENEWAL, LEARNING, AND GROWTH." ITS RESTORATIVE CARE PROGRAMS AND OFFERINGS ARE MEANT FOR GROUPS WHOSE MISSION IS TO SERVE OTHERS, INCLUDING HEALTH CARE PROVIDERS, EDUCATORS, FIRST RESPONDERS AND SOCIAL SERVICE PROVIDERS. ONE OF THE FOUNDATION'S MAJOR INITIATIVES IS HAVING A SEVERAL ACRE GARDEN AND SHARING THE PRODUCE WITH THE COMMUNITY THROUGH DONATIONS TO THE FOOD BANK, CHURCHES AND A ROAD SIDE STAND. WORKING TOGETHER, IT WAS RECOGNIZED THAT MANY OF THE PEOPLE BENEFITING FROM THE BOUNTY, REALLY DID NOT KNOW HOW TO COOK THE VEGETABLES, WHEN THEY WOULD COME IN SEASON, OR HOW THEY WOULD TASTE. THE PANDEMIC MEANT WE COULD NOT COOK AT THE COMMUNITY'S FARMER'S MARKET SO TASTE TESTING COULD NOT BE OFFERED, BUT WE WORKED TOGETHER TO CREATE TWO-SIDED CARDS, EACH SIDE DISPLAYING A VEGETABLE. INFORMATION INCLUDED WHEN THE VEGETABLE IS GENERALLY HARVESTED, NUTRITIONAL INFORMATION AND THE VARIOUS WAYS THE VEGETABLE CAN BE USED AND COOKED. THE CARDS WERE TAKEN TO THE FARMER'S MARKET FOR DISTRIBUTION. SINCE THEN, THEY HAVE BEEN UTILIZED AT THE UHS SYSTEM LEVEL AS WELL.
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 2020, MOST OF THE WORK WAS DONE REMOTELY.
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 2019, (AS THAT IS WHERE THE HIGHEST UTILIZATION OCCURS) THE PRIMARY SERVICE AREA ENCOMPASSES WALTON, DOWNSVILLE, ROSCOE, SIDNEY CENTER, DELHI, HAMDEN, EAST BRANCH AND HANCOCK. THE PRIMARY SERVICE AREA REFLECTS WHERE 42.02% OF OUR PATIENTS RESIDE. THE SECONDARY SERVICE AREA CONSISTS OF THE COMMUNITIES WHERE THE NEXT 5.32% OF OUR PATIENTS RESIDE. THOSE COMMUNITIES INCLUDE: SIDNEY, UNADILLA, DELANCEY, LIVINGSTON MANOR, FRANKLIN, 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 SIXTH MOST RURAL COUNTY IN THE STATE WITH JUST 33 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 2019 AMERICAN COMMUNITY SURVEY 5 YEAR ESTIMATES DATA PROFILES, THE POPULATION OF DELAWARE COUNTY NY IS 44,995. OF THOSE 3.9% ARE UNDER THE AGE OF 5, WHILE 24% ARE AGE 65 AND OVER. 94.7 % OF THE POPULATION IS CAUCASIAN, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN HOUSEHOLD INCOME IS $ 49,544 AND APPROXIMATELY 16.6% OF THE POPULATION LIVES IN POVERTY, WHICH IS AN INCREASE OF 2.5%. ACCORDING TO THE SAME SOURCE, THE PERCENTAGE OF RELATED CHILDREN UNDER THE AGE OF 18 LIVE BELOW THE POVERTY LEVEL 30.1% WHILE FOR CHILDREN UNDER THE AGE OF 5, THE RATE IS 33.1% IN DELAWARE COUNTY.
PART VI, LINE 5:	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. 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. 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. ON SEPTEMBER 11, 2020, THE ROSCOE PRIMARY CARE SITE WAS TEMPORARILY CLOSED DUE TO THE LOSS OF ITS PROVIDER AND NURSE. THE TEMPORARY CLOSURE PLAN WAS FORMULATED AND APPROVED BY THE NYS DEPARTMENT OF HEALTH. THE CLOSURE WAS TO GIVE US A 6-MONTH WINDOW TO TRY AND RECRUIT NEW STAFF TO THIS LOCATION. WE WERE ABLE TO RE-OPEN THE SITE ON APRIL 26, 2021. 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 THREE PAIN MANAGEMENT PROVIDERS: A PHYSICIAN, PHYSICIAN ASSISTANT AND A CHIROPRACTOR. THE GENERAL SURGEON, WHO HAD BEEN COMING FOR CONSULTS AND TO PERFORM ENDOSCOPY PROCEDURES, RETIRED. DVH WAS ABLE TO RECRUIT A GASTROENTEROLOGIST FROM UHS TO CONTINUE PERFORMING THE ENDOSCOPIES AND HE ALSO RUNS A GI CLINIC WHILE HE IS AT DVH. THIS BRINGS A NEW SERVICE TO THE COMMUNITY. 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, THIS WAS NOT THE CASE IN 2020 DUE TO THE PANDEMIC. SHE AND OUR RN CARE COORDINATOR PARTNERED AGAIN WITH THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY IN 2020, TO WORK WITH THEIR CLIENTS WHO WERE ELIGIBLE FOR THE FRUIT AND VEGGIE VOUCHER PROGRAM. THE DIETITIAN AND FOOD SERVICE MANAGER HELD A CELEBRATORY EVENT AT THE END OF THE YEAR, CREATING A BUDDHA BOWL DINNER FOR ALL OF THE PARTICIPANTS. SHE ALSO WAS EXTREMELY INSTRUMENTAL IN THE DEVELOPMENT OF THE VEGETABLE CARDS FOR THE LOCAL FARMER'S MARKET AUDIENCE. THE ANNUAL DELAWARE COUNTY FAIR WAS CANCELLED DUE TO COVID-19. HOWEVER, THE HOSPITAL LET THE FAIR, A NON-PROFIT GROUP, KEEP THE FUNDS THAT WE PAID FOR OUR BOOTH AS A DONATION. SEVERAL WELLNESS INITIATIVES ALSO SUFFERED DUE TO THE PANDEMIC. THE LACK OF FACILITATORS HAMPERED THE FRESH START SMOKING CESSATION PROGRAM, BUT NO CLASSES WOULD HAVE BEEN HELD IN PERSON ANYWAY. THE HOSPITAL PLANNED TO CONTINUE THE LUNG MATTERS GROUP FOR PATIENTS AND CAREGIVERS DEALING WITH LUNG CONDITIONS. THEY TOOK A HIATUS IN WINTER, BUT RETURNED IN MARCH. THE PROGRAM WAS ADVERTISED AND READY TO BE HELD WHEN DVH HAD TO SHUT DOWN TO VISITORS. IN 2020, THE HOSPITAL ALSO PLANNED TO OFFER CHAIR YOGA AGAIN, BUT IT HAD TO BE POSTPONED DUE TO THE PANDEMIC. THE STANFORD UNIVERSITY, EVIDENCED-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, MARKETED AS 'HAPPY HEALTHY AND WISE WORKSHOPS' WAS NOT OFFERED. FURTHER COMPLICATING THE ABILITY TO PRESENT THIS PROGRAM IS THAT A FACILITATOR HAS LEFT THE HOSPITAL'S EMPLOY. OTHER AVENUES OF POSSIBLY OFFERING THIS PROGRAM IN THE FUTURE ARE BEING EXPLORED.
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 2 CONTINUED:	MENTAL HEALTH AND SUBSTANCE USE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2020, MEETINGS WERE CONTINUED WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. THE DIRECTOR OF COMMUNITY RELATIONS SAT ON A SUB-COMMITTEE OF THE COUNTY'S COMMUNITY SERVICE DEPARTMENT, FOCUSED ON MENTAL HEALTH. IN SEPTEMBER, SHE WAS ASKED TO SIT ON THE COUNTY COMMUNITY SERVICES BOARD. THE MOST CHALLENGING BARRIER IN ACCESSING CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. IN 2017, DVH BEGAN A TELE PSYCHIATRY PROGRAM WITH A PRIVATE PRACTICE PSYCHIATRIST. UNFORTUNATELY, DUE TO THE PHYSICIAN'S LIMITED PARTICIPATION WITH INSURANCE CARRIERS, MANY PATIENTS IN NEED COULD NOT BE REFERRED. IN 2018, DVH WAS ABLE TO CONTRACT WITH AN OUTSIDE VENDOR TO BEGIN A TELE-MENTAL HEALTH PROGRAM. THE PROGRAM OFFICIALLY BEGAN IN JANUARY 2019. AN NPP AND LCSW ARE AVAILABLE TO SEE PATIENTS THROUGH THIS TECHNOLOGY. IN 2020, THE LCSW WENT ON MATERNITY LEAVE AND LEFT THE PROGRAM THEREAFTER. TWO ADDITIONAL LCSWS WERE CONTRACTED, BUT ALMOST IMMEDIATELY ONE OF THEM FOUND THAT THE MENTAL HEALTH NEEDS OF FIRST RESPONDERS AND RESIDENTS OF HER COMMUNITY WERE SO EXCESSIVE DUE TO THE PANDEMIC; SHE FELT COMPELLED TO CONCENTRATE ON HELPING THEM AND THEREFORE LEFT THE PROGRAM. ANOTHER LCSW WAS CONTRACTED TO REPLACE HER BUT IN OCTOBER, ALSO HAD TO LEAVE AS HER PRIVATE PRACTICE WAS GROWING, ALSO DUE TO THE PANDEMIC. THE NPP REMAINED CONSTANT. THE HOSPITAL CONTINUES TO SERVE AS THE COLLECTION SITE FOR URINE SPECIMENS FOR THE COUNTY'S DRUG COURT. IN 2020, SERVICES WERE PROVIDED FREE OF CHARGE UNTIL MARCH, WHEN THE DRUG COURT CLOSED AND DID NOT REOPEN UNTIL 2021. A SECOND NEED IS FOR CHRONIC DISEASE MANAGEMENT AND PREVENTION. IN 2020, THE HOSPITAL STAFF TRAINED TO PROVIDE THE CLASSES WAS REDUCED TO TWO; ONE LEFT FOR A POSITION OUTSIDE OF THE HEALTHCARE FIELD. HOWEVER, NO CLASSES WERE HELD IN 2020 DUE TO THE PANDEMIC. THE HOSPITAL PLANNED TO CONTINUE ITS LUNG MATTERS PROGRAM FOR PATIENTS DIAGNOSED WITH LUNG CONDITIONS. IN FACT, ITS MARCH SESSION HAD BEEN ADVERTISED, WHICH WAS ITS FIRST FOR 2020 AFTER A WINTER HIATUS, BUT IT ULTIMATELY HAD TO BE CANCELLED DUE TO COVID. DVH SPONSORED CHAIR YOGA FOR CARDIAC/PULMONARY REHABILITATION PATIENTS WAS ALSO NOT CONTINUED IN 2020 DUE TO THE PANDEMIC. 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 30 PATIENTS WITH COMPLIMENTARY ONE ON ONE DIETARY COUNSELING AS THEY PROGRESSED THROUGH THE COOPERATIVE EXTENSION'S FRUIT & VEGETABLE PROGRAM. A CELEBRATORY DINNER WAS HELD OUTDOORS IN EARLY OCTOBER FOR PARTICIPANTS IN THE PROGRAM TO RECOGNIZE THE GAINS THEY MADE. THE HOSPITAL ALSO ACTIVELY PARTICIPATED IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR WAS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS UNTIL THE FOCUS OF ITS PROGRAMS CHANGED TO COMMUNITY BASED ORGANIZATIONS. SHE CONTINUES TO SERVE IN AN AD-HOC CAPACITY WHEN APPROPRIATE.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. WORKING WITH THE CARE COMPASS NETWORK, WHICH AGREED TO FUND AN EVENT, LEADERS FROM AROUND THE COUNTY WERE INVITED TO ATTEND A DAY-LONG PROGRAM FEATURING NATIONALLY RENOWNED SPEAKER, ESTHER GREENHOUSE, WHO IS CONSIDERED AN EXPERT ON AGING IN PLACE. KAT FISHER FROM THE REGIONAL AARP OFFICE SPOKE ABOUT AARP'S PROGRAM. INVITATIONS WERE SENT TO LEADERS IN VARIOUS GOVERNMENT AGENCIES, SERVICE ORGANIZATIONS, SCHOOLS, CHURCHES AND COMMUNITY MEMBERS. THE PROGRAM WAS SCHEDULED FOR LATE JANUARY, 2020. THIS FULL-DAY WORKSHOP TOOK PLACE ON 1/30/20, WITH 50 PEOPLE IN ATTENDANCE. PARTICIPANTS INCLUDED REPRESENTATION FROM ALL THREE HOSPITALS SERVING DELAWARE COUNTY, COMMUNITY BASED ORGANIZATIONS INCLUDING HOSPICE AND PALLIATIVE CARE, ALCOHOL AND DRUG ABUSE, REHABILITATIVE SUPPORT, FAMILY PLANNING, NAMI, RURAL HEALTH NETWORK OF SOUTH CENTRAL NY, COOPERATIVE EXTENSION, ACTION FOR OLDER PERSONS, WALTON CHAMBER OF COMMERCE AND WEST BRANCH ARTISTS. THREE SCHOOL DISTRICTS WERE REPRESENTED. TWO COMMUNITIES' LOCAL GOVERNMENT BOARD MEMBERS ATTENDED. DELAWARE OPPORTUNITIES, THE AREA'S LEAD AGENCY FOR MANY COMMUNITY PROGRAMS SUCH AS HEAD START, WIC, HOUSING, SENIOR DINING, TRANSPORTATION AND MORE, HAD THREE ATTENDEES. DEPARTMENT HEADS OF DELAWARE COUNTY WERE VERY WELL REPRESENTED; THESE INCLUDED OFFICE FOR THE AGING, PUBLIC HEALTH, COMMUNITY SERVICES (BEHAVIORAL AND ADDICTION SERVICES), PLANNING AND WATERSHED AFFAIRS, CHAMBER OF COMMERCE, AND SOIL AND WATER CONSERVATION. THE PRESENTERS WERE VERY IMPRESSED WITH NOT ONLY THE NUMBER OF ATTENDEES, ESPECIALLY IN SUCH A SMALL COMMUNITY, BUT ALSO THE WIDE RANGE AND SCOPE OF THE ATTENDEES. ALL PARTICIPANTS RECEIVED A SET OF THE AARP AGE FRIENDLY COMMUNITY GUIDES.

Schedule H (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

Yes

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2020

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOHN CARRIGG BOARD MEMBER/VICE CHAIR	(i) (ii)	0 ------------- 823,311	0 ------------- 133,369	0 ------------- 2,546,730	0 ------------- 1,333,289	0 ------------- 21,566	0 ------------- 4,858,265	0 ------------- 0
2PAUL SUMMERS FORMER BOARD MEMBER/PRES/CEO 6/30/20	(i) (ii)	214,777 ------------- 0	25,024 ------------- 0	0 ------------- 0	8,334 ------------- 0	16,632 ------------- 0	264,767 ------------- 0	0 ------------- 0
3DR MICHAEL FREEMAN BOARD MEMBER/MEDICAL STAFF PRESIDENT	(i) (ii)	234,927 ------------- 0	2,000 ------------- 0	0 ------------- 0	12,336 ------------- 0	9,405 ------------- 0	258,668 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 6	THE EXECUTIVE COMPENSATION INCENTIVE PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2020 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS.
FORM 990, PART VII, SECTION A, LINE 5, UNRELATED PARTY DETAIL:	INDIVIDUAL: MICHAEL FREEMAN, MEDICAL STAFF PRESIDENT COMPENSATION RECEIVED FROM UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES (UMA) COMPENSATION: WAGES & NON-TAXABLE BENEFITS $258,668.
PAYMENT IN 2020 FROM A NON-QUALIFIED PLAN:	JOHN CARRIGG $2,546,730 RE: SCHEDULE J, PART II, LINE 1, BIII - OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $2,536,832 INCLUDES THE TRIGGERING EVENT OF A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. "SERP" AMOUNTS INCLUDED AS COMPENSATION FOR MR. CARRIGG RELATED TO THE RECOGNITION OF THAT PLAN. EARLY SERP DISTRIBUTIONS WERE RELATED TO INCOME TAX PAYMENTS. THE REMAINING AMOUNTS ARE DEFERRED UNTIL SUBSEQUENT TRIGGERING EVENTS. THESE TAX RELATED PROCEEDS AND DEFERRALS WERE REPORTED BY UNITED HEALTH SERVICES HOSPITALS, INC, ONLY, A RELATED ORGANIZATION. RE: SCHEDULE J, PART II, LINE 1, C - RETIREMENT AND OTHER DEFERRED COMPENSATION IN THE AMOUNT OF $1,285,207 ALSO INCLUDES THE DEFFERRAL AMOUNT FOR THE SUPPLYMENTAL EXECUTIVE RETIREMENT PLAN NOTED IN BIII.

Schedule J (Form 990) 2020

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
DELAWARE VALLEY HOSPITAL INC

Employer identification number
15-0524324

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY	16-1137407	245867AA4	06-29-2007	5,805,000	CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	5,805,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	250,826
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	5,554,174
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...	X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......
b Exception to rebate? ........
c No rebate due? .........
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MILA KATANIC-TUCKER	STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS	32,051	EMPLOYEE WAGES		No
(2) NANCY VOLLKOMMER	SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO	33,909	EMPLOYEE WAGES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2020

Additional Data

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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7A	UHS, INC., THE ORGANIZATION'S SOLE CORPORATE MEMBER, APPOINTS THE VOTING BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE DELAWARE VALLEY HOSPITAL, INC. (DVH) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF FORM 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATIONAL PURPOSES.
FORM 990, PART VI, SECTION B, LINE 12C	DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15A	PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY THE BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. THE COMMITTEE USES SULLIVAN-COTTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS THE BASIS FOR ESTABLISHING AN ACCEPTABLE COMPENSATION RANGE TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 5,236,696. MANAGEMENT AND GENERAL EXPENSES 1,207,271. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,443,967.
FORM 990, PART XI, LINE 9:	INTEREST RATE SWAP -46,913.
FORM 990, PART XII, LINE 2C	NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT HAS CHANGED DURING THE YEAR. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

DELAWARE VALLEY HOSPITAL INC

Employer identification number

15-0524324

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)UNITED HEALTH SERVICES HOSPITALS INC 10-42 MITCHELL AVENUE BINGHAMTON,NY13903 16-1165049	HOSPITAL	NY	501(C)(3)	3	UNITED HEALTH SERVICES INC		No
(2)PROFESSIONAL HOME CARE 601 RIVERSIDE DRIVE JOHNSON CITY,NY13790 16-1261977	HOME HEALTH CARE	NY	501(C)(3)	10	UNITED HEALTH SERVICES INC		No
(3)IDEAL SENIOR LIVING CENTER 508 HIGH AVENUE ENDICOTT,NY13760 22-2902896	SENIOR LIVING CENTER	NY	501(C)(3)	3	UNITED HEALTH SERVICES INC		No
(4)IDEAL SENIOR LIVING CENTER HOUSING 508 HIGH AVENUE ENDICOTT,NY13760 22-2902899	SENIOR HOUSING	NY	501(C)(3)	10	UNITED HEALTH SERVICES INC		No
(5)CHENANGO MEMORIAL HOSPITAL 179 NORTH BROAD STREET NORWICH,NY13815 15-0532180	HOSPITAL	NY	501(C)(3)	3	UNITED HEALTH SERVICES INC		No
(6)UNITED HEALTH SERVICES INC 20-40 MITCHELL AVENUE BINGHAMTON,NY13903 22-2682421	PARENT COMPANY	NY	501(C)(3)	10	BOARD OF DIRECTORS UHS INC		No
(7)TWIN TIER HOME HEALTH INC 601 RIVERSIDE DRIVE JOHNSON CITY,NY13790 22-2438211	HOME HEALTH CARE	NY	501(C)(3)	10	UNITED HEALTH SERVICES INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2020

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2020

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2020

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2020

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OTO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE,PRIMARY CARE AND WELLNESS SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	240
6	Total number of volunteers (estimate if necessary) .............	6	32
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,208,797	7,270,845
9	Program service revenue (Part VIII, line 2g) .........	24,990,075	23,357,978
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	161,825	195,421
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	391,936	143,652
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	26,752,633	30,967,896
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	10,341,924	10,449,295
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 215,085
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	14,429,311	14,882,202
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	24,771,235	25,331,497
19	Revenue less expenses. Subtract line 18 from line 12.......	1,981,398	5,636,399
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	23,538,078	30,737,711
21	Total liabilities (Part X, line 26).............	5,893,763	7,208,593
22	Net assets or fund balances. Subtract line 21 from line 20.....	17,644,315	23,529,118

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 5,004,806 including grants of $ ) (Revenue $ 4,742,868 )
	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 2020 WERE COMPRISED OF 89 ACUTE, 121 SWING BED, AND 72 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 254 PATIENT DAYS, IN ADDITION TO THE 2,177 PATIENT DAYS FOR SWING BED AND 1,116 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 5,654 LAB TESTS, 8,994 RESPIRATORY TREATMENTS, 111 X-RAYS, 11 ULTRASOUNDS, 58 CT AND 2 MRI EXAMS, 1,250 PHYSICAL THERAPY AND 716 OCCUPATIONAL THERAPY SESSIONS, AND 45 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED 6 ECHO EXAMS, AND 540 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.

4b	(Code: ) (Expenses $ 3,326,843 including grants of $ ) (Revenue $ 2,157,254 )
	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. 2020 INCLUDED 10,276 VISITS IN WALTON, 425 IN ROSCOE, AND 1,740 IN DOWNSVILLE.

4c	(Code: ) (Expenses $ 12,465,715 including grants of $ ) (Revenue $ 16,457,856 )
	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 2020 THE CARDIOLOGY SPECIALTY CLINIC HAD 568 VISITS, PAIN MANAGEMENT 405; TELE-MENTAL HEALTH AND TELE-DIABETES CONSULTS 890, WHILE GASTROENTEROLOGY HAD 72. 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: 198 IN 2020. IN 2020 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 4,107 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 56,278 TESTS, AND 5,853 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,526 X-RAYS, CT SCANS, MRI'S, ULTRASOUNDS, BONE DENSITY TESTS AND MAMMOGRAPHY FOR OUTPATIENT SERVICES. OTHER OUTPATIENT SERVICES PERFORMED IN 2020 INCLUDED 198 AMBULATORY PROCEDURES, 49 ENDOSCOPIES, 1,614 OPIATE ADDICTION TREATMENT SESSIONS, AND 542 SERVICES ASSOCIATED WITH CARDIAC AND PULMONARY REHABILITATION. THE CARDIOPULMONARY DEPARTMENT PERFORMED 973 TESTS AND/OR TREATMENTS. 1,047 CARDIAC RELATED TESTS WERE PERFORMED: EKGS, ECHOCARDIOGRAMS, CARDIAC HOLTER AND EVENT MONITORS. THERE WERE 213 DIETARY CONSULTS. THE HOSPITAL'S OUTPATIENT RETAIL PHARMACY FILLED 58,260 PRESCRIPTIONS.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ 143,652 )


4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ 143,652 )
4e	Total program service expenses20,797,364

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,194,795	3,503,410	1,513,676

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	7,263,720

f	All other contributions, gifts, grants, and similar amounts not included above		1f	7,125

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		7,270,845

		Business Code
2a	OUTPATIENT SERVICES	621400	16,457,856	16,457,856
b	INPATIENT AND ACUTE SERVICES	621990	4,742,868	4,742,868
c	CLINICS	621110	2,157,254	2,157,254
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		23,357,978

3 Investment income (including dividends, interest, and othersimilar amounts) ......			191,321			191,321
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	4,100		7a
b	Less: cost or other basis and sales expenses	0		7b
c	Gain or (loss)	4,100		7c
d	Net gain or (loss).........			4,100			4,100
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	DSRIP PROJECT REVENUE		900099	80,656	80,656
b	MISC REVENUE		900099	13,328	13,328
c
d	All other revenue ....			49,668	49,668
e	Total. Add lines 11a–11d ......			143,652
12	Total revenue. See instructions.....			30,967,896	23,501,630	0	195,421

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,232,263	851,751	258,655	121,857
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	7,417,940	6,064,241	1,319,123	34,576
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	241,800	200,694	38,688	2,418
9	Other employee benefits .......	956,339	754,300	192,476	9,563
10	Payroll taxes ...........	600,953	463,375	127,463	10,115
11	Fees for services (non-employees):
a	Management ......	113,297		113,297
b	Legal .........	12,317		12,317
c	Accounting ...........	88,226		88,226
d	Lobbying ...........	1,735		1,735
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	4,708		4,708
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	6,443,967	5,236,696	1,207,271
12	Advertising and promotion ....	594			594
13	Office expenses .......	1,433,488	799,495	621,389	12,604
14	Information technology ......	107,515		107,515
15	Royalties ..
16	Occupancy ...........	199,533	47,790	151,743
17	Travel ............	21,030	13,086	7,613	331
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	30,583	7,121	435	23,027
20	Interest ...........	118,469	87,289	31,180
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	930,553	930,553
23	Insurance ...	124,784	89,570	35,214
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS	3,934,638	3,934,638
b	MEDICAL SUPPLIES	558,067	558,067
c	BAD DEBT EXPENSE	515,228	515,228
d	EQUIPMENT	174,521	174,521
e	All other expenses	68,949	68,949
25	Total functional expenses. Add lines 1 through 24e	25,331,497	20,797,364	4,319,048	215,085
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,628,167	1	3,734,558
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			2,176,087	4	2,608,965
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			504,567	8	382,713
9	Prepaid expenses and deferred charges ......			550,450	9	780,361
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	26,636,899
b	Less: accumulated depreciation	10b	16,298,203	9,919,860	10c	10,338,696
11	Investments—publicly traded securities .			5,046,374	11	11,408,064
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			318,209	13	318,209
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,394,364	15	1,166,145
16	Total assets. Add lines 1 through 15 (must equal line 33)...			23,538,078	16	30,737,711

17	Accounts payable and accrued expenses .....	1,535,695	17	1,103,340
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	2,148,852	20	1,831,430
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	222,663	23	166,045
24	Unsecured notes and loans payable to unrelated third parties ..	1,516,651	24	3,456,654
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	469,902	25	651,124
26	Total liabilities. Add lines 17 through 25..	5,893,763	26	7,208,593

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	17,308,649	27	23,192,273
28	Net assets with donor restrictions ...........	335,666	28	336,845
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	17,644,315	32	23,529,118
33	Total liabilities and net assets/fund balances ........	23,538,078	33	30,737,711