Community Service Plan - The Healthcare Association of
Transcription
Community Service Plan - The Healthcare Association of
2 0 0 8 C O M M U N I T Y S S T. C A T H E R I N E OF SIENA MEDICAL CENTER M e m be r o f Cathol ic Health Se r vices of Long Isl and 5 0 Route 25A, S mi thtown , Ne w York 1 17 97 ww w.stc athe r inemedi c al center.o rg E R V I H e a l t h C a r e E x c e l2l0e0n8 c e C l o s e t o H o m e C E P L A APPROVED BY BOARD OF TRUSTEES N 2 0 0 8 C O M M U N I T Y S E R V I C E P 2 L A N Table of Contents Letter from St. Catherine’s Executive Vice President & Chief Administrative Officer 3 Introduction and Background 4 Mission Statement 5 Catholic Health Ser vices of Long Island Affliates 6 Catholic Health Ser vices of Long Island Corporate Members, Off icers, Board of Directors & St. Catherine of Siena Medical Center Board of Trustees 7-8 Highlights of Clinical Ser vices 9-15 St. Catherine of Siena Nursing Home 16 Siena Village 17 Public Participation in Progress and Public Notice 18 Plan Development and Adoption 19 Assessment of Community Health Needs and Goals 20 Target Communities and Populations 21 Projects to Address Identified Community Needs 22-23 Public Health Priorities 24-26 Charity Care Policy 27-30 Self-Pay Policy 31-33 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N St. Catherine of Siena Medical Center brings to its community some of the most innovative programs and services. Investing in state-of-the-art equipment and expanding our services ensures that all patients receive the quality of care they deserve. Sharing our accomplishments gives us the opportunity to reflect on our achievements and plan for the future. Sharo n Kennish Executive VP & This year St. Catherine’s unveiled a new colorectal program which provides a full range of consultative, diagnostic and therapeutic services involving minimally invasive surgery for patients with diseases of the small bowel, colon, rectum and anus. St. Catherine’s also welcomed new medical leadership in its Emergency Department. Our new medical leadership CAO team oversees C-Port (primary coronary intervention) and stroke programs. Patients experiencing heart attacks and strokes will have access to the most advanced medical care right in their own neighborhood. The construction of a new Women’s Health and Outpatient Diagnostic Center continues and is scheduled to be completed in 2009. Upgrades and renovations to our cardiac catheterization laboratory are also scheduled for completion in 2009. State-of-the-art equipment will be installed, which will assist our experienced cardiologists in providing the latest medical treatments available to fight heart disease, including primary coronary angioplasty. St. Catherine’s is one of the few community hospitals offering this procedure. Renovations of the interventional radiology room as well as the construction of a new radiology multipurpose room have been completed. With an emphasis on meeting the growing health care needs of our community, St. Catherine’s participates in the Healthy Sunday Program. A team of health care professionals visits local parishes, offering educational material and free health care screenings for blood pressure, glucose, and cholesterol. There is a bright future on the horizon for St. Catherine’s with plans under way to open a new Diabetic and Wound Care Clinic and a commitment to renovate the Maternal/Child Health Unit. Both will add significant value to the services offered to our patients. Plans to construct an addition to our existing structure will house a new OR/PACU, ICU and CCU equipped with the very latest in technological advances to diagnose and treat our patients. Private and semi private rooms will also be integrated in the addition. St. Catherine’s Community Service Plan highlights our continuing commitment to providing state-of-the-art services with a personal touch close to home. Sincerely, Sharon Kennish Executive Vice President & Chief Administrative Officer 3 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N About Us St. Catherine of Siena Medical Center is located on 110 acres on the north shore of Long Island in Smithtown, New York. Our campus is comprised of a 558-bed, not-for-profit hospital (including 240 nursing home beds), 298-unit senior housing facility, and a medical office building. On February 29, 2000, Catholic Health Services of Long Island, (CHS), purchased St. John’s Episcopal Hospital from Episcopal Health Services. The Center was renamed St. Catherine of Siena Medical Center after Catherine Benincasa of Siena of Italy, who was noted for her work as a nurse, mediator and spiritual leader during the 14th century. St. Catherine of Siena Medical Center is the owner and operator of St. Catherine of Siena Hospital and St. Catherine of Siena Nursing Home, which are located on a single campus in Smithtown, New York. The Medical Center is also the sole member of (i) Siena Village, Inc., which owns and operates a 298-unit, subsidized housing facility adjacent to the Medical Center Campus; (ii) Siena Medical Realty, LLC, which is leased from the Medical Center pursuant to a long-term lease. This includes the medical office building located on the Medical Center Campus: and (iii) Siena Retirement Community Realty, LLC, which owns an undeveloped 35-acre parcel adjacent to the Medical Center campus. CHS and the CHS hospitals are the foundation of an integrated delivery system organized to serve Nassau and Suffolk counties under the auspices of the Roman Catholic Diocese of Rockville Centre. In addition to the CHS hospitals, the CHS integrated delivery system includes a number of related organizations representing a full continuum of care throughout Nassau and Suffolk counties. With and through the CHS hospitals, CHS has formed affiliations with Winthrop-South Nassau University Health System, Inc. and the Long Island Health Network. 4 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Catholic Health Services of Long Island MISSION STATEMENT Catholic Health Services of Long Island, as a ministry of the Catholic Church, continues Christ’s healing mission, promotes excellence in care, and commits itself to those in need. CHSLI affirms the sanctity of life, advocates for the poor and underserved, and serves the common good. It conducts its healthcare practice, business, education and innovation with justice, integrity and respect for the dignity of each person. 5 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Catholic Health Services of Long Island St. Catherine of Siena Medical Center is a member of Catholic Health Services of Long Island, which was formed in October 1997 and is comprised of the following entities: H OS P IT A LS: Good Samaritan Hospital Medical Center Mercy Medical Center St. Catherine of Siena Medical Center St. Charles Hospital St. Francis Hospital – The Heart Center N U R SI N G HO M E S: Good Samaritan Nursing Home Our Lady of Consolation Nursing Home St. Catherine of Siena Nursing Home C OM M U N I TY - B AS E D OR G AN I ZA T IO N S: Maryhaven Center of Hope Siena Village H OM E C AR E O R GA N IZ AT I ON S: Good Samaritan Home Care Nursing Sisters Home Care C AT H OL IC H OM E C AR E : CHS at Home H OM E S UP P OR T S E R V IC E S : Home Medical Equipment Pharmacy L O N G - T E R M H O M E H E A L TH C A RE P R O G R A M S : Good Samaritan Our Lady of Consolation H OS P IC E : Good Shepherd Hospice 6 2 0 0 8 C O M M U N I T Y MIS SI ON & MINIS TRY COMMITTEE E R V I C E P 7 L A N Catholic Health Services of Long Island Msgr. Robert Brennan, Chair Charles Bove Sr. Marilyn Breen, OP Joseph Conte Patricia Deeley S. Bernadette Downes Sister Audrey Harsen Louise Spadaro, M.D. James Harden William Allison Dennis Verzi Alan Guerci, M.D. Lewis Grossman Nancy Simmons Sharon Kennish Marianne Gillan Jim O’Connor Mary Ellen Polit Mary T. O’Neill, Staff FINANCE COMMITTEE Thomas Christman, Chairperson William Mullaney Eugene Murphy Kevin Murphy Sal Sodano Richard Schmidt Joseph Tantillo James Harden Joseph Conte, Staff Richard Sarli, Staff Bill Mead, Staff Frank Fox, Staff Bill Armstrong, Staff IN VE ST M E NT COM M IT T EE Patrick J. Scollard, Chairperson Thomas E. Christman J. William Greve Eugene Murphy Peter Quick Richard Sarli, Staff Frank Fox, Staff William Armstrong, Staff PERSONNE L & BE NEFITS COMMITTE E S Patricia Nazemetz, Chair Thomas Edwards James Harden Joseph Conte William Allison Dennis Verzi Patricia Garofalo Richard Sarli, Staff Alan Guerci, Staff GOVERNANCE COMMITTEE Sister Elaine Callahan, Chairperson James Harden Robert Iseman Eugene Murphy Richard J.J. Sullivan, Jr. Patricia Garofalo, Esq. EXE CUT IV E COMPEN SA T ION C O MM I TT E E Richard J.J. Sullivan, Chair Sister Elaine Callahan, Vice Chair Thomas Christman Eugene Murphy Patricia Nazemetz Robert Iseman Jim Harden, ex-officio INSURANCE COMMITTEE Richard J.J. Sullivan, Jr., Chair William C. Armstrong William Chapin Patricia Hajnosz, Esq. Dick Meyer Pat Garofalo, Esq. Fred Landon Joseph Conte RVC I NS URANCE COMPANY James Harden Joseph Conte Richard J.J. Sullivan Richard Meyer Patricia Garofalo, Staff Richard Sarli, Staff PE RF O RM A NC E I M PRO V E M ENT C O MM I TT E E Thomas Dowling, M.D., Chairperson Lionel Barrau, M.D. Phil Bruno, SCSMC Ann Cella, SFH Joseph Conte, CHS Gara Edelstein, SCSMC Nicki Fiore-Lopez, SCH Francis Gleason, SCSNH Patricia Hogan, GSMC Sharon Kennish, SCSMC Renee Mauriello, MMC James O’Connor, SCH John Reilly, M.D., MMC Nancy Simmons, MMC Craig Smestad, MD., SCH Jack Soterakis, M.D., SFH David Suskind, OLC Jerome Weiner, M.D. PERFORMANCE IMPROVEMENT COMMITTEE STAFF MEMBERS Joel Yohai, M.D. Anna ten Napel Anna Baracchini, SFH Barbara Blair-Reade, MMC Pam Kelly, OLC Melena Bowling, Maryhaven Sr. Marilyn Breen, OLC Chris Cardinal, GSNH Helen Carroll, CHC Susan Dries, Good Sam Mary Graf, SCSNC Mary Guararra., CHS Ellen Judson, Hospice Jennifer James, GSNH Dante Latorre, SCH Catherine Magone, MMC Pegeen McGowan, CHS Mary Ellen Polit, CHC Michael Quartararo, SCSNH Theresa Rosenthal, OLC Amanda Ryan, CHS Marie Thayer, SCSMC Corrinne Tramontana, SCH PL AN NING COMMITTEE Richard J.J. Sullivan, Jr., Chair James Harden Lionel Barrau, M.D. Msgr. Robert Brennan Sr. Elaine Callahan Thomas Christman Bernadette Curry, Ph.D. Dan Denihan Thomas Dowling, M.D. Joe Tantillo Sal Sodano Charles Falkner Staff Joseph Conte Joe Loiacono Jessica Wyman C O MP L I AN C E & AU D I T C O M M I T T EE Sister Margaret John Kelly, Chair Ken Daley Frank Kurre Patricia Nazemetz Ben Pollio, Esq. Glen Reed Eugene Souther, Esq. Paul Vitale Joseph Conte Richard Sarli Pegeen McGowan Bob Iseman, Esq. AGEND A COMMITTEE Richard J.J. Sullivan, Jr. James Harden Sister Elaine Callahan S. Margaret John Kelly Patricia Garofalo, Esq. Bob Iseman EX ECUTIVE COMMITTEE Richard J.J Sullivan, Jr., Chair Sister Elaine Callahan Thomas Christman Eugene Murphy James Harden C HS B OAR D OF D IRE CTO R S Richard J.J. Sullivan, Jr., Chair James Harden, President Lionel Barrau, M.D. Msgr. Robert Brennan Sister Elaine Callahan, OP Thomas E. Christman Sister Bernardette Downes, CIJ Thomas Dowling, Jr., M.D. Sister Audrey Harsen Sister Margaret John Kelly, DC Richard Meyer Eugene Murphy Patricia Nazemetz Joseph Tantillo Staff Alan Guerci, M.D. Dennis Verzi William Allison Joseph Conte Patricia Garofalo, Esq. Joel Yohai, M.D. Richard Sarli Pegeen McGowan Bob Iseman, Esq. CHS COR PORATE MEMBE RS Most Rev. William Murphy Msgr. Robert Brennan Most Rev. Peter Libasci, D.D. Most Rev. Paul Walsh, D.D. Sister Ann Gray, D.W. Sister Bernadette Downes, C.I.J. Most Rev. John C. Dunne, D.D. Sister Lois Ann Pereira, FMM CHS OFFIC ERS Richard J.J. Sullivan, Jr., Chair Sister Elaine Callahan, Vice-Chair Eugene Murphy, Secretary Thomas E. Christman, Treasurer James Harden, President & CEO 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Catholic Health Services of Long Island COR PORAT E M EM BERS Most Reverend William F. Murphy Bishop of Rockville Centre Monsignor Robert J. Brennan Most Reverand Peter Libasci, D.D. Most Reverend Paul Walsh, D.D. Sister Ann Gray, D.W. Sister Bernadette Downes, C.I.J. Most Reverend John, C. Dunne, D.D. Sister Lois Ann Pereira, F.M.M. OFFICERS Richard J.J. Sullivan, Jr., Chair Sister Elaine Callahan, O.P., Vice-Chair Eugene F. Murphy, Secretary Thomas E. Christman, Treasurer James Harden, President & Chief Executive Officer Richard J.J. Sullivan, Jr., Chair James Harden, President & Chief Executive Office Lionel Barrau, M.D. Monsignor Robert J. Brennan ST. CATHERINE BOARD OF DI RECT ORS Sister Elaine Callahan, O.P . Thomas E. Christman Sister Bernadette Downes, C.I.J. Thomas Dowling, Jr., M.D. Sister Audrey Harsen, O.P. OF Sister Margaret John Kelly, D.C. Richard Meyer Eugene F. Murphy Patricia Nazemetz Joseph Tantillo, Jr. SI ENA M EDI CAL CENT ER BOA RD OF TR UST EES Reverend Monsignor John Rowan, Chairman Mr. Joseph Tantillo, Jr., Vice Chair Mr. Salvatore F. Sodano, Treasurer Mr. Thomas Reilly, Secretary Mr. William Allison, President & Chief Executive Officer Raymond Borsella, C.P.A. Sylvia Diaz James Dilts Honorable Jeanne Garant Sister Anne Gray, D.W. J. William Greve J. Robert Gross, D.C . John Halleron, III, Esq. Michael C. Lambert, Esq. William A. Mullaney David Paul, M.D. Mr. Jerome Poller Mr. George Rice, Esq. Henry C. Schreiber, Jr. James Umbdenstock John F. Van Bourgondien Matthew Verdone, D.O. Rev. Monsignor James Vlaun 8 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Ambulatory Surgery Unit (ASU) The ASU is designed for patients requiring a one-day stay for surgical procedures. Patients are admitted directly to our private, dedicated unit. Surgery is performed in the hospital operating room. Following surgery, patients recover in the postanesthesia area or are brought back to the ASU. Free, private parking is provided for patients’ convenience. Behavioral Health Psychiatry Department The service consists of 42 adult, inpatient OMH certified beds. A highly qualified and experienced staff provide expert care, with an emphasis on wellness self management. A cognitive behavioral orientation by a interdisciplinary team offers a structured and protected environment that encourages trust and open communication. Patients are given the opportunity to enhance their interpersonal skills, obtain education about their disorder, gain support from staff, family and peers, and build on their strengths. Each patient receives an individual treatment plan. The program focuses on short-term crisis intervention, with the goal of stabilizing the patient and making appropriate referrals to ongoing outpatient treatment or long-term residential treatment if necessary. Patients are approached with kindness, concern and compassion. Cancer Care Unit (Oncology) The Oncology Unit provides compassionate care by highly skilled and experienced registered nurses. Our newly renovated unit is private and discreet. Videotapes providing entertainment and education are available at the bedside. Cardiac Catheterization Lab The Cardiac Catheterization Lab offers a wide range of critical cardiac procedures, caring for the cardiovascular needs of the community we serve. Diagnostic cardiac catheterization examines the coronary arteries supplying blood to the heart muscle, evaluates the function of the heart muscle and measures pressure within the chambers of the heart to assess the valves controlling blood flow through the heart and lungs. Electrophysiology studies test the conduction system of the heart, evaluating slower and faster than normal rhythms and the possibility of a life-threatening arrhythmia, sudden cardiac death. Treatment provided in the Cath Lab includes interventions such as ablation, cardioversion and placing of pacemaker and internal cardioverter defibrillators to maintain normal cardiac rhythms. 9 2 0 0 8 C O M M U N I T Y S E R V I C E P PRIMARY CORON ARY ANGIOPLASTY : L A N Our Cardiac Cath Lab is one of a select few in the state of New York permitted to perform Primary Coronary Intervention, providing immediate treatment to patients experiencing chest pain and preserving heart function with the proven intervention of balloon angioplasty and stent placement. Patients arriving at St. Catherine’s with chest pain are promptly evaluated in the ED and are transferred to the Cath Lab for intervention, in less than 90 minutes. Board certified interventional cardiologists and experienced nursing and technical staff is available 24-hours-a-day, 7-days-a-week, in a soon to be renovated Cardiac Catheterization Lab with state-of-the-art cardiac imaging and hemodynamic acquisition and analysis equipment. Cardiac Services Unit The Cardiac Services Unit provides optimal intermediate cardiac care. Recent expansion and renovation of the Cardiac Services Unit (CSU) includes the Te l e m e t r y Com p u t e r i z e d S y s t em for precise reading and immediate transmission of results. CSU has a room specifically dedicated to echocardiography, transesophogeal echocardiography and electrocardiograms (EKG). The unit’s upgraded facilities reflect 21st century efficiency and comfort. Care Management / Performance Improvement Registered Nurses and Certified Social Workers assist patients and their families with post acute discharge planning and crisis counseling. Assistance with transition into skilled nursing, rehabilitation, assisted living, or subacute facilities is provided. Home care services including nursing care, home medical equipment and respiratory care needs are arranged. Patient Review Instruments (PRIs) are completed in the hospital to determine the appropriate level of post-discharge care for each patient. Colorectal Program St. Catherine’s provides the latest in colorectal surgery using laparoscopic and colonoscopy procedures. Laparoscopic surgery offers more advantages when compared to traditional surgical methods, including less post-surgical pain, less need for pain medication, shorter hospital stays (one to four days on average), quicker recovery times (one to four weeks earlier), fewer small bowel blockages, fewer wound infections and improved cosmetic results. Laparoscopic surgery is used to treat the following: anal, colon and rectal cancer, bleeding, constipation, crohn’s disease, diverticular disease, inflammatory colitis (ulcerative colitis), ostomy (creation of colostomy or ileostomy), polyps of the colon and rectum, rectal prolapse, rectocele and volvulus, to name a few. St. Catherine’s recognizes that problems with a patient ’s colon, rectum and anus can cause immense discomfort, which is why the program has been created and is easily accessible to the surrounding communities. Our specialized physicians diagnose and treat patients in a caring, compassionate and confident environment. 10 2 0 0 8 C O M M U N I T Y Dialysis Unit S E R V I C E P L A N Outpatient dialysis services includes a 12-chair Hemodialysis Unit and a Home Training Peritoneal Dialysis Program. Continuous ambulatory peritoneal dialysis and automated peritoneal dialysis are offered at the center’s ambulatory unit for eligible patients. A multidisciplinary team, including staff from medicine, nursing, social service, and dietary, provides care for the young adult, adult and geriatric patient diagnosed with end stage renal failure. Emergency Department (ED) Each year, 35,000 community members turn to St. Catherine’s Emergency Department (ED) for care. The ED provides a fast track center for minor injuries. The ED consists of cardiac and trauma rooms, a negative pressure room for airborne infections and a private room with bathroom for obstetrics and gynecology patients. St. Catherine’s is a New York State Designated Stroke Center. The ED staff includes highly credentialed board certified emergency physicians, skilled and experienced registered nurses who are certified in advanced cardiac life support and pediatric advanced life support. A team approach decreases waiting time for medical evaluations and ensures that patients move smoothly through their course of treatment. Our ED has a “fast track” area that provides quick and efficient service for treatment of work-related injuries, cuts, sprains, sports injuries and minor medical problems. Endoscopy The Endoscopy Unit is equipped with advanced video imaging systems, providing physicians with endoscopic evaluation and treatment. The video technology boasts superior optics resulting in high performance imaging quality. Caring professionals staff the suite, which contains five procedure rooms, a postprocedure area and a comfortable waiting room. Hospitalist Service At St. Catherine’s, hospitalists (board certified physicians), perform a variety of functions. For patients admitted without a personal physician, hospitalists act as the primary care physician during their stay in the hospital. Hospitalists may also provide consultations and medical clearance for patients undergoing surgery. In addition, hospitalists are trained to respond to life-threatening medical emergencies and in this capacity may assist with providing emergency care and/or resuscitation to critically ill patients in the Intensive Care Unit. Infection Control The Department of Infection Control encourages patients and visitors to be mindful of hand hygiene, to decrease the spread of bacteria and germs. Because doctors, nurses and other health care providers routinely come into contact with bacteria and viruses, they will wash their hands before they treat each patient. We offer and recommend immunizations for certain diseases, such as influenza and pneumonia, to our admitted patients who fall within certain high risk criteria. 11 2 0 0 8 C O M M U N I T Y S E R V I C E P 12 L A N St. Catherine’s is making strides in the fight to prevent infections. In 2005, St. Catherine’s joined with the Greater New York Hospital Association and the Institute for Healthcare Improvement in a collaborative to decrease the risk of infections in patients who had central lines placed in them. Due to our success, the Greater New York Hospital Association and the Institute for Healthcare Improvement asked St. Catherine’s to be a Mentor Hospital for all hospitals, not only in New York State but also across the country. Intensive Care Units (ICU / CCU) Intensive Care Units provide a high level of specialized care for patients whose conditions merit closer than normal attention and supervision. These units are staffed by specially trained nurses and are equipped with advanced monitoring equipment. Laboratory &Pathology The Departments of Laboratory and Pathology at St. Catherine’s are accredited by both the NYS Department of Health and JCAHO every two years. The departments offer a full range of clinical laboratory and anatomic pathology services. The vast majority of testing is performed on site with results being available the same day. These services include: clinical pathology: hematology: coagulation testing and urinalysis; chemistry: clinical chemistry, therapeutic drug testing and endocrinology; blood bank and transfusion services; diagnostic immunology microbiology: bacteriology, parasitology, mycology; and mycobacteriology anatomic pathology: surgical pathology and cytopathology. New York Weight Management Programs The New York Weight Management Programs of St. Catherine of Siena Medical Center was established to provide a comprehensive weight loss center, offering the essential elements for individuals seeking long-term successful weight loss. The two types of weight loss surgery performed at St. Catherine’s are gastric bypass and gastric banding. The program was developed by a multidisciplinary team, which provides extensive education to the nursing staff regarding pre- and post-operative care, bariatric procedures and sensitivity training. All patients receive a “patient-friendly” clinical pathway which explains their daily regimen. On-site support groups provide nursing, social work and nutritional services as well as community resources for the bariatric patient. 2 0 0 8 C O M M U N I T Y S E R V I C E Palliative Care Services P 13 L A N The goal of palliative care at St. Catherine’s is to provide the highest quality of life possible, and to reduce the severity of symptoms for seriously ill patients and to support the patients and their families during treatment, at any stage of their disease. It is offered in conjunction with all other forms of medical treatment. Palliative care patients are given the information they need to address the difficult issues facing them, and have their questions answered by specially trained palliative care health professionals. Members of the expert team include: professionals from medicine, nursing, social work, pastoral care, nutrition, rehabilitation, care management, pharmacy, home care, hospice and others. Palliative care information and support is available to all patients and community members. Parkinson’s Outpatient Program Parkinson’s Disease is a progressive, neurological disorder of the brain. Parkinson’s Disease affects 1.5 million Americans. St. Catherine’s hosts the American Parkinson’s Disease Information and Referral Center (APDA) of Suffolk County. APDA’s goal is to promote a better quality of life for the Parkinson's community and is actualized through its network of information and referral centers, which respond to the needs of those affected by Parkinson’s Disease. The APDA I&R Center educates patients, families and caregivers afflicted with Parkinson’s Disease. The I&R Center offers free literature and referrals regarding the disease. The APDA I&R Center also runs ongoing support groups for people with Parkinson’s Disease, their families and caregivers along with educational lectures and symposia. Perioperative Services St. Catherine’s surgical services include: bariatric surgery, neurosurgery,orthopedic, gynecology, urology, general, podiatry, oral surgery, plastic and reconstructive, vascular, thoracic, ophthalmology, pediatric surgery and colon and rectal surgery. Our dedicated team staffs nine operating room suites and performs more than 10,000 surgeries each year. Our surgeons are highly skilled and offer the latest innovations in health care and surgery. 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N As an example, our orthopedic spine surgeons provide endoscopic discectomies and spinal fusions, which are minimally invasive and require less sedation than traditional spine surgeries. Our plastic surgeons perform concise reconstructive surgery in the safety of the hospital setting. Patients can typically return home the next day. Our neurosurgeons provide image-guided brain surgery, transphenoidal brain tumor removal, and craniotomies. Our team of pain management specialists offer a range of techniques to provide effective pain relief with the least amount of sedation. Physical Therapy The Physical Therapy Department provides daily treatment to inpatients at the bedside or within the department. Physical therapists and physical therapy assistants are available seven days a week. This full service department also offers speech therapy, occupational therapy, and a certified orthotic technician. Radiology / Imaging Services The Radiology Department includes a new, state-of-the-art, MRI, MRI breast coil and MRI breast biopsy system, bone densitometry, digital mammography, stereotactic breast biopsy unit, 64-slice CT scanner. Digital X-ray equipment as well as a new angiography/ interventional radiology suite. Radiology result reporting has been improved by a fully integrated Picture Archiving Computer System (PACS). PACS has eliminated the need to provide X-ray films and provides immediate access to radiology images throughout the hospital and to referring physicians at various locations, and has eliminated repeat images. The acquisition of powerscribe, a voice recognition transcription system, has led to real-time radiology results reporting and improved test turnaround time. Sleep Disorders Center St. Catherine’s Sleep Disorders Center provides comprehensive, individualized evaluation and testing for the diagnosis and treatment of clinical disorders related to sleep. The outpatient facility is in operation 24-hours-a-day, Monday through Saturday. Patients who are undergoing testing, sleep in one of four specially designed bedrooms in the Center. The bedrooms are accessible to the physically challenged and are comfortably equipped with overhead television sets and reading lamps, to help simulate a home-like environment. 14 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Women’s Breast Health Services St. Catherine's provides the latest medical treatment and procedures for breast cancer patients. Experienced surgeons, radiologists and oncologists, who are on staff at St. Catherine's offer all the recommended tests and treatments for breast cancer and breast health. The new digital mammography unit and MRI breast coil, offers the most recent advances in detecting breast cancers. From diagnosis to treatment, we provide compassionate care for our patients. Women & Child Care Center St. Catherine of Siena's Women & Child Care Center provides comprehensive family-centered care for growing families. The serene décor of the unit offers a peaceful and beautiful setting to welcome family and friends visiting the new baby and mother. St. Catherine’s is a “Safe Haven” for newborns as a part of New York State’s Safe Haven network of hospitals. Under the Safe Haven law, a parent, guardian or other legallyresponsible person may surrender a newborn anonymously. Anyone wishing to bring a baby to St. Catherine’s is requested to come to the emergency room. NEO NAT AL IN TEN SIVE CARE U NIT , LEVEL I I In the Special Care Nursery, advanced technology is in place to care for infants with medical complications, such as premature birth and low birth weight. Designed to provide the most comprehensive care and support for the entire family, the center offers an intimate, home-like environment combining privacy with uncompromised care. THE OB STETR ICAL SUITE This suite consists of five birthing rooms where experienced staff assists patients in the birthing process from labor to delivery and through the immediate recovery period. Fathers are welcome to participate in the birthing process and two coaches (friends or family members) may help support the new mother and her baby in the initial bonding phase. Registered nurses staff the postpartum unit and offer new parents their years of experience and knowledge. 15 2 0 0 8 C S P St. Catherine of Siena Nursing Home O M M U N I T Y E R V I C E L A N St. Catherine of Siena Nursing Home is a 240-bed, skilled, hospital-based, nursing facility specializing in long-term residential care, short-term subacute care, and rehabilitation. The Nursing Home has the unique ability to deliver a very home-like environment, and also offers our residents all of the resources of an entire medical center. The Nursing Home provides a state-of-the-art Alzheimer’s/Dementia Care Unit, hemodialysis, hospice care, pain management, respiratory care, physical therapy, occupational therapy, speech therapy and case management. Therapeutic recreation services coordinates social gatherings, group activities, special trips, (Foxwoods Casino, Yankee Stadium, Concerts in the Park, trips to the winery, etc.), daily entertainment and individual bedsidetherapy. In our gala room, residents celebrate birthdays,anniversaries and special occasions. Individualized and special diets are prepared by our culinary trained staff, including kosher foods, enteral feedings and end stage renal disease diets. Dentistry, podiatry, ophthalmology, psychiatric and psychological services are also provided on the premises. Pastoral care and interfaith religious services are offered to all residents. We are also one of the only nursing homes in Suffolk County that provides New York State Department of Health on-site Certified Nursing Assistant Training for our community members who are interested in obtaining a career in health care delivery. In addition, we are the only nursing home on Long Island that has partnered with Suffolk County Community College for Licensed Practical Nursing and Registered Nursing Programs dedicated for the advancement and training of the employees of the facility. Our staff believes family members are a vital part of the caring team. 16 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Siena Village Siena Village is a subsidized senior apartment complex providing affordable housing to low-income seniors and younger disabled adults. Siena Village consists of 298 garden apartments situated on 30 lush acres in suburban Smithtown, New York. It offers its residents secure and affordable housing in a supportive environment. Siena Village includes a spacious community center with auditorium, lounge, library, card and crafts rooms. Residents are provided access to computers with Internet services. Regularly scheduled programs encourage healthful activities and fosters community spirit. Siena Village owns and operates a resident bus for weekday shopping and other trips. Its maintenance staff manages routine repairs and care of buildings and grounds, including repainting apartments and snow removal. Siena Village does not offer direct assistance for activities of daily living. However, many residents utilize the services of home care agencies to assist in maintaining their independence within their apartment. In addition, the social work personnel offer information and referral resources, crisis intervention and short-term counseling. Siena Village is federally subsidized under the United States Department of Housing and Urban Development ’s Housing Assistance Program (HUD). 17 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Public Participation in Progress & Public Notice In order to make the information readily accessible to the public a copy of St. Catherine of Siena Medical Center’s Community Service Plan will be posted on the hospital’s website www.stcatherinemedicalcenter.org after submission to the New York State Department of Health. 18 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Plan Development & Adoption St. Catherine of Siena Medical Center prides itself in identifying the needs of its community through participation with organizations, and through ongoing dialogue with our patients, their families, our medical staff, our employees, our management team and key individuals in our community. Information gathered and data collected includes market area over views and environmental factors. These are evaluated and used to enable St. Catherine’s to address the needs of the community. Add i t i o nal se r vi c e s f o r t h e u pc o m i ng ye ar i nc l u de : • • • . Implementation of new Diabetic and Wound Care Clinic Modernization Plan: A brand new tower with new OR/PACU, ICU/CCU and private and semi-private Rooms Renovation of the Maternal/Child Departments 19 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Assesment of Community Needs and Goals St. Catherine’s provides high quality care with compassion and respect for each patient regardless of age, religion, race, gender or ability to pay. The standard of care is equal for all patients. St. Catherine’s is continuously evaluating the service area needs by reviewing patient surveys, community feedback, demographic data, community health indicators and patient care trends to develop and refine its scope of services and delivery of care. St. Catherine’s is proud of the fact that its year-end, 2008 patient satisfaction scores were among the best scores that St. Catherine’s has ever had. Measuring patient satisfaction and using patient feedback is at the heart of St. Catherine of Siena Medical Center’s strategic plan for improving programs and services. St. Catherine’s provides high quality care with compassion and respect for each patient, regardless of age, religion, race, gender or ability to pay. St. Catherine’s is continuously evaluating the service area needs by evaluating patient surveys, community feedback, demographic data, community health indicators and patient care trends to develop and refine its scope of service and delivery of care. St. Catherine’s solicited comments about the quality of service from 50% of our inpatients utilizing the Press Ganey Patient Satisfaction Survey. These results are reviewed on a monthly basis and quality improvements are implemented when a need is identified. Patient priorities are carefully reviewed; opportunities to improve quality of care and services are then identified and implemented. 20 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Target Communities and Populations St. Catherine’s service area consists of 21 communities located in western Suffolk County. St. Catherine’s primary catchment area has a population of approximately 248,000 and includes: Smithtown, St. James, Hauppauge, Kings Park, Commack, Nesconset, Northport and East Northport. These communities represent approximately 53% of total admissions. Our secondary service area has a population of more than 245,000 and accounts for 3.5% of the Medical Center’s total admissions. The secondary service area comprises, Lake Grove, Centerport, Greenlawn, Huntington Station, Huntington and Cold Spring Harbor. Although the overall service area population is projected to have a small increase from 2004 to 2009, there will be significant increases in the 45-64 and 65+ age groups. The projected 2006 average income levels for households in the service area are largely comparable to the average of $99,889 for Suffolk County as a whole. The population is projected to become more racially and ethnically diverse. 21 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Projects to Address Identified Community Needs S t . C a ther ine of S iena Medic al C e n t e r o f f e r s a w i d e a n d c o m p rehensive ar r ay of commu n i t y s e r v i c e p ro g r a m s t h a t ad d re s s c r i t i c a l health issues to a dive r s i t y o f p a t i e n t s , i n c l u d i n g : Annual Community Health Fair: St. Catherine’s Annual Community Health Fair is a pivotal education portal for the community. The health fair is the primal place where community members can receive free health care education and screenings of the vast scope of services provided by the Medical Center. Auxiliary Volunteer Department: The Auxiliary and volunteers of St. Catherine of Siena Medical Center are a group of dedicated and generous individuals, who offer their time, talent and services to patients and staff on a daily basis. The Auxiliary also donate funds to support the mission of the Medical Center, fundraising activities include: fashion shows, managing the hospital gift shop, plants sales and special events. Charity Care Program: The Charity Care Program is a free or subsidized hospital-based health services provided to low income individuals who are without other means of insurance coverage and are unable to pay for services rendered. In order to apply for charity care, an individual must demonstrate that payment of hospital bills would be a hardship and must apply for Medicaid. Community Blood Drives: St. Catherine’s host three blood drives annually in collaboration with Long Island Blood Services, a division of New York Blood Center. Community Newsletter: St. Catherine’s publishes a quarterly newsletter, The Voice. The Voice is a primary component of educating the community about health-related issues and keeping them inform of upcoming events and hospital services. 22 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Emergency Response Appreciation Dinners: Emergency response personnel are at the forefront of the medical process. They provide immediate medical service and work collaboratively to offer timely care. St. Catherine’s recognizes this fact and has implemented a quarterly emergency response appreciation dinner for local emergency response personnel. The appreciation dinners were implemented in 2008, and have become a highlight for St. Catherine’s and local emergency response teams. Each dinner acts as a reminder of how grateful the hospital is for promptness and efficiency in the field. The dinners offer a forum for special educational programs and an opportunity for emergency response personnel to gain education credits. FACE to FACE: St. Catherine’s is now a partner of FACE TO FACE. FACE TO FACE is a humanitarian program conducted under the auspices of the Educational and Research Foundation for the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS Foundation). The Foundation offers pro-bono consultations and surgeries to victims of domestic violence to enhance their self-esteem and assist in the tremendous effort to rebuild their lives. St. Catherine’s has successfully performed one surgery under this program in 2008. Healthy Sunday Series: The Healthy Sunday Program manifests the commitment of Catholic Health Services of Long Island by proactively helping underserved communities by providing educational seminars and preventive screenings that may be otherwise unavailable. The program reaches out into communities of need to help bridge the gap between the individual and the health provider to provide quality, accessible services to the underserved, ultimately building a link for the coordination of care. Healthy Sundays provides a safe avenue to improve access to vital primary care services. Maternity Education: You and Your Baby Education Series The Maternity Department offers a variety of fee and non-fee support groups and workshops for new mothers and family members as follows: Breast-feeding Support Groups, Childbirth Education, Early Pregnancy Classes, Family and Friends CPR: Infant Only, Grandparents Classes, Infant Care Classes, Prenatal Breast-feeding Classes and Sibling Classes. Medical Community Education: St. Catherine’s is dedicated to educating the community and proudly offers free lectures and presentations on a variety of health and wellness topics to help educate and raise awareness. With the combination of lectures and presentations offered, St. Catherine’s hopes to improve the quality of life, promote wellness and healthy living for all those who live and work in the community. Pastoral Care: Pastoral care service is available for patients for all denominations during their hospital stay. We provide spiritual resources, counsel and prayer, and assist patients with integrating their spiritual beliefs into their healing process. Pastoral care is often called upon for ethical advice with advance directives in collaboration with the patient advocate. Support Groups offered to the Community Bariatric Support Groups Cardiac device Support Groups Diabetes Club (GLAD) Green Seminar Parkinson’s Disease Support Groups Bereavement Support Groups St. Catherine of Siena Medical Center offers use of its facility conference space, upon request, and availability to community-based support Uncompensated Care. 23 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N P U B L I C H E A LT H P R I O R I T I E S In keeping with New York State’s mission to improve the health of all New Yorkers, St. Catherine’s joined a collaborative partnership with the Suffolk County Department of Health, the Nassau-Suffolk Hospital Council and other Suffolk County hospitals (hereafter referred to as the Partnership). The goal of the Partnership was to choose two health initiatives that integrate traditional medical services with public health interventions resulting in positive behavioral changes that ultimately improve the health status of the residents in Suffolk County. The two initiatives chosen by the Partnership are tobacco use and unintentional injury. T O B AC C O U S E Smoking kills 25,500 individuals and secondhand smoke kills 2,500 individuals in New York state each year and almost 570,000 New Yorkers are diagnosed each year with a serious illness that is caused by smoking. The statistics are dire, compelling the local health department and Suffolk County hospitals to initiate a county-wide smoking cessation program. The collaborative process of the Partnership resulted in short-term and long-term goals as follows: Short-Term Goals • Develop a comprehensive tobacco policy using the template developed by the Tobacco Cessation Working Group as a guide. • Provide educational programs for staff, patients, and the community. • Provide tobacco education and cessation programs and resources for patients, staff, and community. • Incorporate into the comprehensive policy the use of resources available through the Suffolk County Department of Health Services, the Center for Tobacco Control and community partners. Long-Term Goals (three-year plan) • • • • Improve the health of Suffolk County residents Reduce the prevalence of tobacco use in Suffolk County Work toward creating a culture of safety by eliminating exposure to Environmental Tobacco Smoke (ETS) Reduce health care costs associated with tobacco use and exposure to ETS The short-term and long-term goals are a product of the collaborative partnership with the Suffolk County Department of Health and the following: • Good Samaritan Hospital • St. Charles Hospital • Stony Brook University Medical Center • Eastern Long Island Hospital • North Shore-Long Island Jewish Health System • John T. Mather Hospital • Southampton Hospital • Southside Hospital • Huntington Hospital • Eastern Suffolk BOCES • Tobacco Action Coalition of Long Island • St. Catherine of Siena • Suffolk County Department of Health Services • Nassau-Suffolk Hospital Council, Inc. • Brookhaven National Laboratory 24 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Steps in Place St. Catherine has long had a focus on smoking cessation and prevention. It has the following programs/steps in place: • Effective January 1, 2009, the 110-acre campus, St. Catherine of Siena Medical Center, Nursing Home, and Siena Village, went 100% smoke-free, including all indoor and outdoor areas. Although the buildings have been smoke-free, we have permitted smoking in designated areas outside the facilities. These smoking areas were eliminated as of January 1, 2009. • All inpatients identified during assessment as smokers at St. Catherine’s receive education on smoking cessation, receive brochures for community education and counseling resources, and are offered medication patches for symptom relief. • St. Catherine’s has participated with the Long Island Health Network in the development of a comprehensive smoking cessation program for patients and community members. • Smoking cessation brochures with community resource lists are available in all outpatient waiting areas. • St. Catherine’s social workers participate in community and school health fairs to offer smoking cessation counseling to the community. • The Social Work Department receives and responds to calls from the community for counseling resources in smoking cessation. • Social Work team members and community educators represent St. Catherine’s on the Suffolk County DOH collaborative partnership. U N I N T E N T I O N A L I N J U RY P R E V E N T I O N Accidents are the fifth leading cause of death in older adults with 30% of the elderly population falling at least once a year. One third of all patients presenting to an emergency department for falls are hospitalized and one half of hospitalized fall patients die within a year. The US cost to care for hospitalizations as a result of a fall totaled $20 billion in 2000 and is projected to increase to $32 billion by 2020. The Suffolk County Department of Health, Suffolk County hospitals and other related organizations agreed to move ahead on the important initiative regarding prevention of unintentional injuries, with a focus on the elderly population, through the establishment of a data subcommittee that will accumulate and analyze data in areas related to unintentional injury. These include: • Geographic distribution • Age-specific factors • Co-morbidities • Racial/ethnic distribution • Relationship between emergency department visits and hospital-specific catchment areas Strategies that will factor into an unintentional injury prevention program include: • Risk factors for falls in the elderly population • Medication-related risks • Effective health education strategies • Motivating factors for target population • Necessary behavior reinforcement • Health literacy • Functional issues • Cost benefit analysis to be presented to health insurers Education will be provided to the targeted elderly population through: • Senior housings facilities • Physicians’ offices • Senior centers • Hospitals 25 2 0 0 8 C • • • • • • O M M U N I T Y S E R V I C E P L A N Home visits by home care nurses and physical therapists Meals on Wheels Peer education Caregiver support groups Pharmacies Public awareness and public relations campaigns The Unintentional Injury Committee included: • Suffolk County Department of Health Services • AARP • Dominican Sisters Family Health Service • Eastern Long Island Hospital • John T. Mather Memorial Hospital • North Shore-LIJ Health System • Pharmacist Judy Beizer, Pharm. D., St. John’s University • St. Catherine of Siena Medical Center • St. Charles Hospital • Good Samaritan Hospital • St. Joseph’s College • Stony Brook University Medical Center • Suffolk County Office for Aging Steps in Place • New initiatives will be put in place to achieve these goals as follows: changing the time vital signs are routinely taken, improving communication between staff regarding particular patient risks, practicing peer pressure to maintain hourly rounds, maintaining a sensitive environment and looking for potential obstacles, encouraging night staff to use nightlights, and aiming to decrease the clutter in patient rooms. • Design and develop health education materials designed to prevent falls among the elderly that: Include ideas from both the target population and from experts and community members; Incorporate strategies known to be effective for those with low literacy skills; Companion booklet, poster, and calendar with prevention strategies outlined each month of calendar). • All patients registering for Joint Replacement surgery receive pre-admission education on falls prevention and safety at home by care managers and physical therapists. • Patients using the St. Catherine’s community hemodialysis programs receive education and physical therapy support. • The Voice, St. Catherine’s community newsletter will include safety recommendations on a variety of topics, including falls prevention. 26 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Charity Care Policy I. OBJECTIVE: Consistent with St. Catherine of Siena Medical Center’s (the Medical Center) mission of providing care to needy persons and underserved persons in a manner that preserves the dignity of the individual, this Charity Care Policy (the Policy) describes the policies and procedures relating to the provision of charity care to persons who are unable to pay for all or a portion of their bill. No individual will be denied medically necessary hospital services based on a demonstrated inability to pay for those services. II. PURP OSE: To describe the Medical Center’s policy related to the provision of charity care to persons who are unable to pay for all or a portion of their bill. No person will be denied medically necessary hospital services based on a demonstrated inability to pay for those services. It is not the intention of the Medical Center to collect amounts that exceed an individual’s ability to pay, as set out in the St. Catherine of Siena Medical Center’s Self-Pay Collection Policy, a copy of which is attached and incorporated herein by reference. III. POLICY: 1. General: The Medical Center offers as part of its mission, medically necessary care to those individuals not covered under a third party insurer or government program or who do not have resources to pay all or a portion of their bills. 2. Charity Care Services: Emergency services are always provided without regard to the patient’s ability to pay. In addition, all non-emergent healthcare services, inpatient and outpatient, shall be available to all individuals under this policy, except as outlined in number 3 below. 3. Specific Exclusions: Charity care will not be available to patients for services that are not medically necessary, including, but not limited to, implants, cosmetic surgery, orthodontics and lens ocular implants. Procedures inconsistent with the Ethical and Religious Directives as interpreted and applied by the Bishop of the Diocese of Rockville Centre are specifically excluded from the Medical Center’s Charity Care Policy. In addition, non-essential services and services that are not appropriate to a hospital setting may also be excluded from this policy. 4. Family Income: Family income includes earnings, unemployment compensation, workers’ compensation, Social Security, supplemental security income, public assistance, veterans’ payments, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Non-cash benefits (such as food stamps and housing subsidies) do not count. Family income is calculated before taxes and excludes capital gains or losses. 5. Patients qualify for 100% charity care if their family income is at or below 300% of the Federal poverty guidelines. (Attached) 6. Patients are responsible for 20% to 80% of their bill if their family income is between 301% and 400% of the Federal poverty guidelines. Please refer to the current charity care income guidelines (attached) for sliding scale eligibility percentages. 7. Except as provided in the next sentence, in cases in which a person is uninsured, not eligible for Medicaid and otherwise qualified for charity care under this Policy, the discounts described in items 5 27 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N and 6 above will be applied to the table of rates from the Medical Center’s lowest paying third party insurer payable. The applicable rates for emergency-related services will be those of the Medical Center’s lowest table of rates of the managed care company. For purposes of this paragraph 7, a person will be deemed to be uninsured to the extent that the person (a) has exhausted his or her insurance benefit, (b) is fully responsible for payment of their bill, and (c) qualifies for charity care under this Policy. This paragraph 7 will not apply to co-payment obligations in cases in which a person is insured. IV. PROCEDU RES: A. Ge nera l : 1. Confidentiality: The need for charity care may be a sensitive and deeply personal issue for recipients. Confidentiality of information and preservation of individual dignity shall be maintained for all who seek charitable services. Orientation of staff and the selection of personnel who will implement this policy and procedure should be guided by these values. No information obtained in the patient’s charity care application may be released unless the patient gives expressed permission for such release, except to bona fide governmental agencies requesting aggregate data. B . P a t i en t N o ti f i c a ti o n : 1. Since it is the duty of the Medical Center to ensure that every patient is made aware of the existence of its Charity Care Policy, all employees in the scheduling, patient access, patient financial services and emergency departments will be fully versed in the Charity Care Policy, have access to the charity care application forms, and be able to direct questions to the appropriate Medical Center representatives. 2. The Medical Center shall post multilingual notices as to any policies on charity care in several prominent locations within the Medical Center including, but not limited to, the emergency department, billing office, waiting rooms for purposes of admissions, and the inpatient and outpatient registration area. Said notices shall be published in at least the following languages: English and Spanish, and shall be clearly visible to the public from the location at which they are posted. 3. The Medical Center shall provide patients, in a timely manner, a summary of its Charity Care Policy upon request. The summary, at a minimum shall provide specific information as to income levels used to determine eligibility and the means of applying for assistance. This summary shall be written at or below a sixth grade reading level. 4. The Medical Center shall post its Charity Care Policy summary on their Internet website. 5. The Medical Center shall provide all patients interpreters to assist them in understanding its Charity Care Program in the language spoken by the patient during any pre-admission, admission, and discharge process. 6. On all bills and statements sent to patients, a statement will be included regarding the availability of various financial assistance programs, including charity care, and a contact number to call to obtain further information. This information will be available at or below a sixth grade reading level. C . A p p l i ca t i on f or F i n a n c ia l As s i s t a n ce : 1. Patients requesting financial relief from their bill will be provided with an application for charity care. Application materials shall include a notice to patients that upon submission of a completed application, including any information or documentation needed to determine eligibility, the patient may disregard any bills until the Medical Center has rendered a decision on the application. 2. Completed charity care applications with supporting documentation will be returned to the Medical Center’s patient access department for verification. Applications for inpatient services should be 28 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N accompanied with a Medicaid denial. Renewal applications for dental and other outpatient recurring services should also be accompanied with a Medicaid denial. 3. Patients who do not provide the requested information necessary to completely and accurately assess their financial situation in a timely manner and/or who do not cooperate with efforts to secure governmental healthcare coverage may not be eligible for charity care. 4. Charity care eligibility will be determined by the attached guidelines and reviewed by the Medical Center’s Chief Financial Officer or other designated individual. 5. The Medical Center may provide discounts for patients who are unable to pay, but the criteria used will apply equally to all patients regardless of payor. However, applications that do not meet all of the established criteria may be approved based upon extraordinary circumstances with the documented approval of the Medical Center’s Chief Financial Officer. 6. The Medical Center will notify the patient of its determination in writing within thirty (30) days of receipt of the application. 7. If the patient has applied and obtained charity care within the last twelve (12) months and the patient’s financial circumstances have not changed, the patient shall be deemed eligible for charity care without having to submit a new charity care application. 8. All applications shall be maintained on file by the Medical Center. D . P a ym e n t o f O u ts t a n d i n g B a l an c e s : 1. Please refer to the attached Medical Center’s Self-Pay Collections Policy for specific policies and procedures regarding acceptable collection practices for self-pay accounts, including but not limited to the upfront collection of deposits and/or co-payments, the establishment of reasonable payment terms, annual collection limits, specific prohibitions and third party collection agent standards. E . A n n u a l R e v ie w , M o n i to r i n g a n d Re p o r ti n g : 1. The Catholic Health Services (CHS) Board of Directors’ Mission & Ministry Committee, as part of an annual mission report, shall review its Charity Care Policy annually and the CHS Board of Directors shall approve all revisions. 2. The Medical Center shall develop a mechanism to measure its compliance with this Policy. 3. Compliance with these policies will be monitored semi-annually by the Medical Center’s Compliance and Audit Committee, and be reported to the CHS Compliance and Audit Committee. 4. The St. Catherine of Siena Medical Center Charity Care Policy shall be provided to the Suffolk County Department of Health Services upon request. 5. The Medical Center shall comply with all governmental reporting requirements. 29 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Charity Care Income Guidelines (2007) The above income levels refer to family income. Family income includes earnings, unemployment compensation, workers’ compensation, Social Security, supplemental security income, public assistance, veterans’ payments, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Non-cash benefits (such as food stamps and housing subsidies) do not count. Family income is calculated before taxes and excludes capital gains or losses. O t h e r A s s e t E x e m p t i o n s : Available assets shall be converted to income for comparison to poverty guidelines, on a dollar for dollar basis, but will exclude from consideration the following assets in considering whether the patient meets the charity care financial criteria: savings accounts and other liquid assets with balances of less than six months of income, assets held in a tax-deferred or comparable retirement savings account, college savings accounts, all personal property, including, but not limited to, household goods, wedding/engagement rings and medical equipment, available business equity below $50,000, automobiles used regularly by a patient or immediate family members, and other assets at our discretion that we may believe are in the patient's best interest to exempt. 30 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Self-Pay Collection Policy I. OBJECTIVE: Consistent with St. Catherine of Siena Medical Center’s (the Medical Center) mission of providing care to needy persons and underserved persons in a manner that preserves the dignity of the individual, this Self-Pay Collections Policy (the Policy) describes the policies and procedures relating to the collection activities of the Medical Center. It is not the Medical Center’s intention to collect amounts that exceed an individual’s ability to pay, as set out in the St. Catherine of Siena Medical Center Charity Care Policy, a copy of which is attached and incorporated herein by reference. It is, however, the intention of the Medical Center to perform collection activities that reflect the highest standards of Christian duty, ethics and integrity, and be consistent with the mission of the Medical Center with respect to the dignity of each individual. I I . PO L I CY : A. E l ig ib il i t y : The Medical Center’s Charity Care Policy describes the policies and procedures relating to the provision of charity care to persons who are unable to pay for all or a portion of their bill. No individual will be denied medically necessary hospital services based on a demonstrated inability to pay for those services. In addition, upon applying for charity care, each patient and patient guarantor’s ability to pay will be assessed. B . S el f - P a y C ol l ec t io n P r a c t ic e s : 1. Collection Practices: All patient and patient guarantor accounts shall be pursued fairly 2. Ethics and Integrity: All collection activities shall consistently reflect the highest standards of ethics and integrity, and be consistent with the mission of the Medical Center with respect to the dignity of each individual. 3. Reasonable Payment Terms: Reasonable payment schedules (installments) and terms (no interest is assessed) shall be offered to each patient and patient guarantor with self-pay balances. 4. Eligibility for Assistance: A reasonable review shall be performed prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (i.e. Medicaid) and do not qualify for coverage through the Medical Center’s Charity Care Policy. After having been turned over to a third-party collection agent, any account that subsequently is determined to meet the charity care criteria shall be returned immediately by the third-party collection agent for appropriate follow-up. C . T h i r d -P ar t y C ol l e c t i on A g e n ts : Third-party collection agents are to follow the following practices: 1. Standards and Scope of Practices: Third-party collection agents shall follow the same standards as the Medical Center’s patient financial services department. 2. Approval Policy: The Medical Center’s Chief Financial Officer shall consider and must first approve any legal actions (i.e. garnishments, liens, etc.) that may be pursued by the third-party collection agent. 31 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N Such approvals shall be reported to the System Chief Financial Officer. 3. Financial Assistance: The third-party collection agent shall advise the patient/guarantor of the Medical Center’s Charity Care Policy and return the account immediately if it is determined that the qualifications are met. 4. 210-Day Limit: Unsettled accounts shall be returned to the Medical Center as uncollectible after 210 days. Under certain circumstances (i.e., when or if a payment or resolution is expected within 60 days), a third-party collection agent may manage an account beyond 210 days from the date assigned to the third-party collection agent. 5. Annual Collection Limits: Annual amounts collected from an uninsured individual shall not exceed ten percent (10%) of that patient’s family income. 6. Annual Adherence Attestation: Each third-party collection agent shall be reviewed at least annually for adherence to these standards. (i.e. rate of success and compliance with these terms and conditions). The patient financial services department shall send the current Self-Pay Collection Policy, and an attestation to each collection agent for them to sign that they will act in compliance with this Policy. D . S p e ci f i c P r o h i b i t io n s : 1. Unemployed Without Significant Income/Assets: No legal action shall be pursued for non-payment of any bills against any patient or patient guarantor who is unemployed and without other significant income or assets. 2. Principal Residence: No legal action against any patient or patient guarantor by seeking a remedy that would involve foreclosing upon the principle residence of a patient or patient guarantor, or taking any other action that could result in the involuntary sale or transfer of such residence or informing any patient or patient guarantor that he/she may be subject to any such action. 3. Other Asset Exemptions: The Medical Center shall convert available assets to income for comparison to poverty guidelines, on a dollar for dollar basis, but will exclude from consideration the following assets in considering whether the patient meets the charity care financial criteria: • • • • savings accounts and other liquid assets with balances of less than six months of income, assets held in a tax-deferred or comparable retirement savings account, college savings accounts, all personal property, including, but not limited to, household goods, wedding/engagement rings and medical equipment, • available business equity below $50,000, • automobiles used regularly by a patient or immediate family members, and • other assets at our discretion that we may believe are in the patient’s best interest to exempt. 4. Cooperating Efforts: No unpaid self-pay account shall be sent to a third-party collection agent as long as the patient and patient guarantor are cooperating to settle the account balance. 5. Collection Tactics: Tactics such as charging interest, requiring patients or patient guarantors to incur debt or loans with recourse to the patient’s or guarantor’s personal or real property assets (recourse indebtedness), or so called ‘body attachments’ (i.e. the arrest or jailing of patients in default on their accounts, such as for missed court appearances) are strictly prohibited. 32 2 0 0 8 C O M M U N I T Y S E R V I C E P L A N I I I . P R O C E D U R E F O R AS S E S S M E N T O F S E L F P A Y BA L A N C E S : A. M e d i ca l C e n t e r P at i e n t A c ce s s / Fi n a n c i al C ou n s e l or s : 1. All employees in the scheduling, patient access, patient financial services and emergency departments will be fully versed in the Medical Center’s Charity Care Policy, have access to the charity care application forms, and be able to direct questions to the appropriate Medical Center representatives. 2. Patient access personnel and financial counselors shall review payment arrangements prior to service for insured patients, self-pay patients and those who have a co-payment/deductible portion that their insurance does not recompense. 3. For elective and scheduled non-urgent services, the Medical Center shall request payment of fifty to one hundred percent (50-100%) of the amount due prior to date of service. Such deposits must be included as part of any financial aid consideration. 4. The Medical Center shall request payment of self-pay portion of service, including co-payments, at time of service. 5. When appropriate, the Medical Center shall establish reasonable payment arrangements with the guarantor on the account. No interest shall be assessed on installment plans. 6. Patient access personnel and financial counselors shall review the Medical Center’s Charity Care Policy and/or other financial assistance available with patient and/or guarantor (outside services are available to assist with the inpatient application process for NYS Medicaid). The Medical Center’s Charity Care Policy describes the policies and procedures related to the provision of charity care, including but not limited to eligibility requirements and the communication and application processes. B . T he P a ti e n t Fi n a n c i al S er v ic e s D ep a r t me n t: 1. After discharge, all primary and secondary insurances shall be billed for covered services. 2. Once all third-party payor transactions are settled, self-pay bills for total charges, deductibles and/or co-payments shall be mailed to the guarantor on the account. 3. All bills and statements sent to patients shall include a statement regarding the availability of various financial assistance programs, including charity care, and a contact number to call to obtain further information. This information will be available at or below a sixth grade reading level. 4. According to the Medical Center’s Charity Care Policy, upon submission of a completed charity care application, including any information or documentation needed to determine eligibility, the patient may disregard any bills until the Medical Center has rendered a decision on the application. 5. A series of two (2) internal data mailers shall be sent thirty (30) days apart, telephone calls shall be made to patients/guarantors for accounts over $500.00 and then a series of three (3) overdue notices shall be sent. 6. After sixty (60) days, if the account is not paid in full or an acceptable payment plan has been arranged, the account will qualify for bad debt. 7. After a reasonable review, delinquent accounts shall be considered bad debts and shall be referred to a third-party collection agent for collection, which shall follow the collection practices described above. 8. Patients shall be notified thirty (30) days before their account is sent to a third-party collection agent. 33 Health Care Excellence Close to Home