| PROGRAM SERVICE STATEMENT |
FORM 990, PART III, LINE 4A |
YALE NEW HAVEN HEALTH SYSTEM (YNHHS) IS CONNECTICUT'S LEADING HEALTHCARE SYSTEM. YNHHS WAS FORMED IN 1996 TO ENHANCE THE QUALITY AND SCOPE OF HEALTHCARE SERVICES FOR RESIDENTS OF CONNECTICUT AND BEYOND. YNHHS INCLUDES THREE DELIVERY NETWORKS: BRIDGEPORT HOSPITAL, GREENWICH HOSPITAL AND YALE-NEW HAVEN HOSPITAL, AND A PHYSICIAN FOUNDATION, NORTHEAST MEDICAL GROUP (NEMG). YNHHS HAS CLINICAL RELATIONSHIPS WITH SEVERAL OTHER HOSPITALS IN CONNECTICUT AND NUMEROUS OUTPATIENT LOCATIONS THROUGHOUT THE STATE. YNHHS IS AFFILIATED WITH YALE UNIVERSITY IN SUPPORT OF PATIENT CARE, MEDICAL EDUCATION AND CLINICAL RESEARCH. SAFETY, QUALITY AND OPERATIONAL EFFECTIVENESS SAFETY AND QUALITY OVER THE PAST DECADE, YALE NEW HAVEN HEALTH SYSTEM HAS ENHANCED PATIENT CARE SAFETY AND CLINICAL QUALITY WHILE SIMULTANEOUSLY MAKING IT MORE EFFICIENT AND COST-EFFECTIVE. YNHHS'S WORK TO IMPROVE PATIENT SAFETY, MEASURE AND REPORT HEALTHCARE OUTCOMES, AND REALIZE COST EFFICIENCIES HAS BEEN INSTRUMENTAL TO PROVIDING HIGH-VALUE CARE TO THE PATIENTS AND COMMUNITIES WE SERVE. IN 2013, EACH DELIVERY NETWORK SUCCESSFULLY IMPLEMENTED HEALTHCARE PERFORMANCE IMPROVEMENT'S SERIOUS SAFETY EVENT INITIATIVE AT LEVEL 2 AND EXCEEDED ESTABLISHED TARGETS FOR HAND HYGIENE COMPLIANCE AND VALUE-BASED PURCHASING METRICS SET BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. IN ADDITION, EACH DELIVERY NETWORK IMPLEMENTED MORNING SAFETY ROUNDS AT WHICH CLINICAL AND ADMINISTRATIVE STAFF ADDRESSED QUESTIONS, DISCUSSED ADVERSE EVENTS AND IDENTIFIED EXISTING OR POTENTIAL PATIENT SAFETY ISSUES AND SOLUTIONS. ALL THREE HOSPITALS PARTICIPATED IN THE GREAT CATCH, A MONTHLY AWARDS PROGRAM RECOGNIZING EMPLOYEES WHO PROACTIVELY DETECT POTENTIAL PATIENT SAFETY ISSUES. OPERATIONAL IMPROVEMENT: COST AND VALUE POSITIONING IN 2012, YNHHS INITIATED A COST AND VALUE POSITIONING (CVP) INITIATIVE TO PRODUCE BETTER QUALITY OUTCOMES WHILE REDUCING UP TO $125 MILLION IN EXPENSE REDUCTION A YEAR AND A CUMULATIVE FIVE-YEAR PROJECTED SAVINGS OF $550 MILLION. THROUGH A SYSTEMIZED APPROACH, ANNUAL EXPENSE REDUCTION OPPORTUNITIES WERE IDENTIFIED IN WORKFORCE PRODUCTIVITY, SUPPLY CHAIN MANAGEMENT, BENEFIT PLANS AND CLINICAL REDESIGN, AND IN 2013 YNHHS EXCEEDED ITS CVP TARGET BY MORE THAN $20 MILLION. IN ADDITION, THE ACQUISITION OF THE HOSPITAL OF SAINT RAPHAEL HAS CONTINUED TO GENERATE ECONOMIES OF SCALE. TO HELP TRACK PROGRESS ON SAFETY AND QUALITY IMPROVEMENT, YNHHS ADOPTED A SCORECARD METHOD THAT MEASURES HOW THE SYSTEM IS DOING ON CORE MEASURES, READMISSIONS, MORTALITY AND INFECTION RATES, TRANSITION OF CARE AND SERIOUS SAFETY EVENTS. SUPPLY CHAIN / NON-LABOR AS A PART OF COST AND VALUE POSITIONING, THE FOCUS AREA OF NON-LABOR IMPLEMENTED $20.9 MILLION IN COST REDUCTION, WELL AHEAD OF TARGETS. THIS COST REDUCTION WAS A RESULT OF A SYSTEM-WIDE REORGANIZATION OF THE LEADERSHIP AND ENGAGEMENT PROCESS NEEDED TO REDUCE COSTS WHILE ENSURING QUALITY REMAINED HIGH. MANY PHYSICIANS AND OTHER CLINICIANS PARTICIPATED WITH STRONG LEADERSHIP PRESENCE. INITIATIVES INCLUDED A COMBINATION OF YALE NEW HAVEN HEALTH SYSTEM AS WELL AS NORTHEAST PURCHASING COALITION, LLC, COMMITMENTS TO BUY COMMON SUPPLIES AND/OR UTILIZE A COMMON CONTRACT METHOD. THE MOST SIGNIFICANT COST REDUCTIONS OCCURRED IN THE AREAS OF PHARMACY, GENERAL MEDICAL SUPPLIES AND SERVICES, AND SURGICAL SERVICES. CLINICAL AND INFORMATION TECHNOLOGY THE IMPLEMENTATION OF EPIC, YNHHS'S $290 MILLION ELECTRONIC MEDICAL RECORD (EMR) INITIATIVE, WAS COMPLETED IN 2013, ON TIME AND UNDER BUDGET. GREENWICH HOSPITAL WENT LIVE IN APRIL 2012. YALE-NEW HAVEN HOSPITAL IMPLEMENTED EPIC ON ITS YORK STREET CAMPUS IN FEBRUARY 2013 AND ITS SAINT RAPHAEL CAMPUS IN JUNE 2013. BRIDGEPORT HOSPITAL FOLLOWED IN SEPTEMBER 2013. EPIC NOW LINKS ALL THREE HOSPITALS, NORTHEAST MEDICAL GROUP, YALE MEDICAL GROUP AND MANY COMMUNITY PHYSICIANS, INCLUDING OVER 1,220 PHYSICIANS AND PROVIDERS AT 267 YNHHS-AFFILIATED AMBULATORY SITES. YNHHS IS NOW A NATIONAL LEADER FOR CONTINUUM OF CARE TECHNOLOGY AND IS ABLE TO USE ITS INTEGRATED EMR TO IDENTIFY QUALITY INDICATORS AND BEST PRACTICES ACROSS ALL PARTS OF THE HEALTH SYSTEM. YNHHS WAS AGAIN SELECTED AS ONE OF THE MOST WIRED HEALTH SYSTEMS IN THE NATION BY HOSPITALS AND HEALTH NETWORK MAGAZINE. YNHHS WAS ALSO RECOGNIZED BY FAIRWARNING, AN INTERNATIONAL PATIENT PRIVACY MONITORING COMPANY, FOR ITS COMMITMENT TO PROTECTING PATIENT INFORMATION THROUGH ONGOING MONITORING AND BEST PRACTICES AND FOR INTEGRATING DIFFERENT CLINICAL SYSTEMS, ENABLING THE DETECTION OF POTENTIAL PRIVACY BREACHES IN THESE APPLICATIONS. PROVIDER OF CHOICE SERVICE GROWTH AND ACCESS IMPROVEMENT YALE NEW HAVEN HEALTH SYSTEM CONTINUED TO PROVIDE CARE TO MORE PATIENTS IN 2013. WHILE THE STATES INPATIENT DISCHARGES DECLINED BY 1.3 PERCENT, YNHHS INCREASED ITS VOLUME BY 22.5 PERCENT THIS YEAR, INCREASING STATEWIDE SHARE TO 27.1 PERCENT, COMPARED WITH 21.7 PERCENT IN 2012. THIS GROWTH IS PRIMARILY DUE TO THE ACQUISITION OF THE HOSPITAL OF SAINT RAPHAEL AND A NOTABLE INCREASE IN TRANSFERS TO YALE-NEW HAVEN HOSPITAL THROUGH ITS INNOVATIVE Y ACCESS LINE, AS WELL AS CONTINUED INVESTMENT IN CLINICAL PROGRAMS AND SERVICES ACROSS THE SYSTEM. ADDITIONALLY, YNHHS EXPANDED ACCESS TO MORE PATIENTS IN 2013 BY DEVELOPING CLINICAL RELATIONSHIPS WITH OTHER HOSPITALS THROUGHOUT THE STATE AND OPENING OR ACQUIRING OUTPATIENT COMMUNITY-BASED LOCATIONS, INCLUDING SMILOW CANCER CARE CENTERS, PEDIATRIC NETWORKS, BLOOD DRAW STATIONS, RADIOLOGY SITES AND TELESTROKE ARRANGEMENTS. THE ONGOING SHIFT FROM INPATIENT TO OUTPATIENT CARE CONTINUED THIS YEAR. SEVERAL PRACTICES, INCLUDING PRIMARY CARE, CARDIOLOGY, ONCOLOGY AND UROLOGY, JOINED YNHHS, AND NEMG EXPERIENCED TREMENDOUS GROWTH, ADDING 63 NEW PROVIDERS IN 2013. IN AUGUST 2013, YNHHS SIGNED A LETTER OF INTENT WITH TENET TO CREATE AN INNOVATIVE NEW PARTNERSHIP BLENDING THE STRENGTHS OF THE TWO NATIONALLY RECOGNIZED ORGANIZATIONS. THE STRATEGIC ALLIANCE WILL ENHANCE PATIENT CARE ACCESS TO YNHHS SERVICE LINES, SUPPORT BROADER CLINICAL INTEGRATION AND IMPROVE CARE EFFICIENCY. PATIENT EXPERIENCE / SERVICE EXCELLENCE YNHHS AND ITS DELIVERY NETWORKS EMBRACED A COMMON COMMITMENT TO EXCELLENCE IN PATIENT CARE AND PRACTICING THE VALUES OF PUTTING PATIENTS AND FAMILIES FIRST, BEING RESPONSIBLE, EMPATHETIC AND ALWAYS DOING THE RIGHT THING. YNHHS CONTINUED ITS EFFORTS TO RAISE ITS PATIENT SATISFACTION SCORES, AS MEASURED BY PRESS GANEY, WITH SPECIAL AREAS OF FOCUS BEING OUTPATIENT, AMBULATORY SURGERY, EMERGENCY DEPARTMENT, PEDIATRIC INPATIENT, PSYCHIATRIC INPATIENT AND COMMUNITY. THE YNHHS SERVICE EXCELLENCE COUNCIL, ORGANIZED IN 2012, EXPANDED ITS FOCUS ON SERVICE EXCELLENCE OPPORTUNITIES ACROSS THE CONTINUUM OF CARE. THE COUNCIL ROUTINELY SHARED SERVICE EXCELLENCE BEST PRACTICES ACROSS THE SYSTEM, WHICH PROVIDED LEARNING OPPORTUNITIES TO ENHANCE PATIENT AND FAMILY ENGAGEMENT AND SATISFACTION WITH THEIR EXPERIENCES. THE YNHHS 2012 SERVICE EXCELLENCE CONFERENCE DREW MORE THAN 900 ATTENDEES AND 55 PRESENTATIONS ON PROJECTS THAT STAFF DEVELOPED TO IMPROVE THE OVERALL PATIENT EXPERIENCE. THE COUNCIL ALSO CREATED AN ELECTRONIC SYSTEMS SUBCOMMITTEE TO EXAMINE MOBILE TECHNOLOGIES DESIGNED TO ENGAGE AND ENHANCE THE EXPERIENCE OF PATIENTS AND FAMILIES. YNHHS HOSPITALS WERE NAMED "LEADERS IN LGBT HEALTHCARE EQUALITY" BY THE NATIONAL HUMAN RIGHTS CAMPAIGN FOUNDATION, IN 2013, FOR COMMITMENT TO EQUITABLE, INCLUSIVE CARE FOR LESBIAN, GAY, BISEXUAL AND TRANSGENDER PATIENTS AND THEIR FAMILIES. POPULATION HEALTH MANAGEMENT RECOGNIZING THE IMPORTANCE OF UNDERSTANDING HOW AND WHEN TO BEGIN THE TRANSITION FROM VOLUME-BASED TO VALUE-BASED CARE DELIVERY, YNHHS FOCUSED ON THREE ESSENTIAL COMPONENTS OF ITS POPULATION HEALTH MANAGEMENT INITIATIVE: CLINICAL INTEGRATION, CARE MANAGEMENT AND DISEASE MANAGEMENT. THE CLINICAL INTEGRATION STEERING COMMITTEE COLLABORATED WITH PHYSICIANS ACROSS YNHHS TO ENHANCE THE COORDINATION OF CARE FOR PATIENTS WITH DIABETES AND CARDIOVASCULAR DISEASE AND ESTABLISHED PRIORITIES FOR IMPROVING TRANSITIONS OF CARE ACROSS SETTINGS. A SYSTEM-WIDE CARE MANAGEMENT PLAN WAS DEVELOPED TO MORE FULLY INTEGRATE ITS CARE MANAGEMENT SYSTEMS, PROCESSES AND RESOURCES TO SUPPORT CARE ACROSS YNHHS. NORTHEAST MEDICAL GROUP IS CENTRAL TO YNHHS'S DEVELOPMENT OF A POPULATION HEALTH MANAGEMENT PROGRAM, IN PARTICULAR WITH ITS FOCUS ON PATIENT-CENTERED MEDICAL HOME DEVELOPMENT. |
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YNHHS'S DISEASE MANAGEMENT EMPLOYEE INITIATIVE EXPANDED THE LIVINGWELL CARES ON-SITE CARE COORDINATION DIABETES PROGRAM, WITH OVER 340 EMPLOYEES CURRENTLY ENROLLED. PATIENT SATISFACTION WITH THE PROGRAM IS EXCEPTIONAL, AND THE PROGRAM WILL EXPAND TO INCLUDE ASTHMA, CARDIOVASCULAR DISEASE AND MUSCULOSKELETAL CONDITIONS. THIS PROGRAM IMPROVED COMPLIANCE WITH EVIDENCE-BASED CARE BY 10 PERCENT, BROUGHT RISK-ADJUSTED PER-MEMBER PER-MONTH SPENDING IN LINE WITH THE GENERAL EMPLOYEE POPULATION, RESULTED IN ZERO PERCENT READMISSIONS AND AVOIDABLE ADMISSIONS FOR PROGRAM PARTICIPANTS, AND CONSISTENTLY HAD 95 PERCENT OR BETTER PARTICIPANT SATISFACTION RATINGS. COMMUNITY BENEFITS EACH YEAR YNHHS DELIVERY NETWORKS PROVIDE OVER $489 MILLION (AT COST) IN COMMUNITY BENEFIT AND COMMUNITY-BUILDING ACTIVITIES. AS PART OF THE SYSTEM-WIDE COMMITMENT TO SERVE AS STRONG COMMUNITY PARTNERS, EACH YNHHS DELIVERY NETWORK PROVIDED NUMEROUS HEALTH SCREENINGS, COMMUNITY EDUCATION SESSIONS, COMMUNITY-BUILDING EVENTS, COMMUNITY LEADERSHIP ACTIVITIES AND GRANTS AND ASSISTANCE TO IMPROVE AND ENHANCE THE HEALTH OF ITS LOCAL COMMUNITY. IN ADDITION, THE AREA OF COMMUNITY BENEFITS ALSO INCLUDES COSTS ASSOCIATED WITH HEALTH PROFESSIONS EDUCATION, UNCOMPENSATED AND UNDER-COMPENSATED CARE. EMPLOYER OF CHOICE HUMAN RESOURCES YNHHS REMAINED COMMITTED TO RECRUITING AND RETAINING A HIGH-QUALITY, ENGAGED WORKFORCE THROUGH A RANGE OF HUMAN RESOURCE INITIATIVES, INCLUDING COMPETITIVE SALARIES AND BENEFITS, EXTENSIVE TRAINING AND DEVELOPMENT OPPORTUNITIES. RESULTS FROM THE EMPLOYEE ENGAGEMENT SURVEY SHOWED THAT EMPLOYEES ACROSS YNHHS ARE ALIGNED WITH THE SYSTEMS MISSION, ARE COMMITTED TO HELPING THE ORGANIZATION SUCCEED, AND VIEW THE ORGANIZATION AS A VALUED EMPLOYER. AS A LEADER IN HEALTHCARE EXCELLENCE, YNHHS HAS A RESPONSIBILITY TO HELP KEEP ITS EMPLOYEES PHYSICALLY HEALTHY. TO SUPPORT EMPLOYEES IN MANAGING THEIR HEALTH AS WELL AS HELP CONTAIN EMPLOYEES' MEDICAL COSTS, YNHHS LAUNCHED KNOW YOUR NUMBERS, A WELLNESS PROGRAM THAT HELPS EMPLOYEES HEIGHTEN THEIR HEALTH AWARENESS, IMPROVE THEIR HEALTH AND RECEIVE A $500 CREDIT TOWARD THE COST OF THEIR 2014 ANNUAL MEDICAL PREMIUM UPON COMPLETION OF SPECIFIC CRITERIA. TO QUALIFY FOR THE CREDIT, EMPLOYEES NEEDED TO HAVE A HEALTH SCREENING AND COMPLETE AN ONLINE HEALTH RISK ASSESSMENT. MORE THAN 9,200 EMPLOYEES, WHICH WAS 65 PERCENT OF BENEFITS-ENROLLED YNHHS EMPLOYEES, COMPLETED BOTH COMPONENTS OF THE PROGRAM. ADDITIONALLY, EXTENDING THE CARE PROVIDED DIRECTLY TO EMPLOYERS AND THEIR EMPLOYEES CONTINUES TO BE THE FOCUS OF THE HEALTH SYSTEM. SERVING NEARLY 1,500 COMPANIES, YNHHS'S OCCUPATIONAL HEALTH SERVICES WORKS TO KEEP EMPLOYEES OF LOCAL BUSINESSES AND ORGANIZATIONS HEALTHY. INSTITUTE FOR EXCELLENCE YNHHS REMAINED COMMITTED TO SUPPORTING EMPLOYEE CAREER DEVELOPMENT. IN 2013, THE INSTITUTE FOR EXCELLENCE (IFE) PROVIDED MORE THAN 17,000 HOURS OF CLASSROOM INSTRUCTION FOR NEARLY 2,600 EMPLOYEES AND SAW AN INCREASE IN THE NUMBER OF MANAGERS AND DIRECTORS WHO REQUESTED PROFESSIONAL DEVELOPMENT SUPPORT. THE IFE ALSO COLLABORATED WITH THE YALE SCHOOL OF MANAGEMENT TO PROVIDE A LEADERSHIP DEVELOPMENT PROGRAM FOR 25 PATIENT SERVICES MANAGERS AT YALE-NEW HAVEN HOSPITAL. THROUGH IFE'S E-LEARNING DEPARTMENT, MORE THAN 19,000 YNHHS EMPLOYEES COMPLETED NEARLY 381,000 COURSES THROUGH HEALTHSTREAM AND OTHER PROGRAMS AS E-LEARNING CONTINUES TO EVOLVE AS AN IMPORTANT STRATEGY FOR BLENDING TECHNOLOGY WITH CLASSROOM LEARNING. THE IFE'S SIMULATION AT YALE NEW HAVEN: ADVANCING PATIENT SAFETY AND EDUCATION CENTER (SYN:APSE) PROVIDED MORE THAN 21,000 HOURS OF SIMULATION-ENHANCED EDUCATION TO OVER 5,000 EMPLOYEES ACROSS YNHHS, AS WELL AS 1,090 HOURS OF SUPPORT FOR EPIC IMPLEMENTATION. SYN:APSE WAS ALSO SELECTED AS ONE OF ONLY 8,000 GLOBAL TEST RECIPIENTS OF GOOGLE GLASS, AS PART OF THE GOOGLE EXPLORER PROGRAM. OVERALL FINANCIAL PERFORMANCE YNHHS CONTINUED TO FOCUS ON MAXIMIZING FINANCIAL PERFORMANCE WHILE INVESTING IN KEY INITIATIVES TO STRENGTHEN AND GROW THE SYSTEM, AS WELL AS PREPARING FOR REIMBURSEMENT CHANGES. AS THE LARGEST PROVIDER OF MEDICAID SERVICES IN THE STATE, YNHHS MODIFIED ITS OPERATING PLANS TO ABSORB NEARLY $40 MILLION IN MEDICAID PAYMENT REDUCTIONSINCLUDING $35.8 MILLION AT YALE-NEW HAVEN HOSPITAL, $2.3 MILLION AT BRIDGEPORT HOSPITAL AND $1.8 MILLION AT GREENWICH HOSPITAL. ADDITIONAL CUTS ARE INCLUDED IN THE STATE'S BIENNIAL BUDGET. STRONG EXPENSE MANAGEMENT HELPED YNHHS ACHIEVE MORE THAN $47.7 MILLION IN COST SAVINGS AND AVOIDANCE THIS YEAR, INCLUDING $27 MILLION RELATED TO SUPPLY CHAIN MANAGEMENT AND $14.7 MILLION IN CORPORATE COST SAVINGS. BRIDGEPORT DELIVERY NETWORK BRIDGEPORT HOSPITAL AND HEALTHCARE SERVICES INCLUDES THE ENTITIES OF BRIDGEPORT HOSPITAL, SOUTHERN CT HEALTH SYSTEM PROPERTIES AND THE BRIDGEPORT HOSPITAL FOUNDATION, INC. BRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 383-BED URBAN TEACHING HOSPITAL SERVING NEARLY 18,500 INPATIENTS AND MORE THAN 240,000 OUTPATIENT ENCOUNTERS IN 2013. A MEMBER OF THE YALE NEW HAVEN HEALTH SYSTEM SINCE 1996, BRIDGEPORT HOSPITAL IS THE SITE OF THE CONNECTICUT BURN CENTER; THE JOEL E. SMILOW HEART INSTITUTE THE NORMA F. PFRIEM CANCER INSTITUTE AND BREAST CARE CENTER, THE WOMENS CARE CENTER, CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE, AND AHLBIN CENTERS FOR REHABILITATION MEDICINE. BRIDGEPORT HOSPITAL IS ALSO HOME TO THE SECOND INPATIENT CAMPUS OF YALE-NEW HAVEN CHILDRENS HOSPITAL. DURING FISCAL YEAR 2013, BRIDGEPORT HOSPITAL PROVIDED APPROXIMATELY $71.8 MILLION DOLLARS IN COMMUNITY BENEFITS. THIS FIGURE INCLUDES $47.3 MILLION DOLLARS IN CHARITY CARE (AT COST) AND UNDER REIMBURSED MEDICAID (AT COST), $19.5 MILLION IN HEALTH PROFESSIONS EDUCATION, AND OVER $4.9 MILLION IN COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ACTIVITIES, SUBSIDIZED SERVICES, RESEARCH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. AN ADDITIONAL $91,000 DOLLARS WAS PROVIDED IN THE AREA OF COMMUNITY BUILDING ACTIVITIES, WHICH INCLUDED SUPPORT FOR ECONOMIC DEVELOPMENT, ENVIRONMENTAL IMPROVEMENTS, WORKFORCE DEVELOPMENT, ADVOCACY AND COALITION BUILDING. BRIDGEPORT HOSPITAL HAS INVESTED A SIGNIFICANT AMOUNT OF TIME AND RESOURCES IN THE DEVELOPMENT AND IMPLEMENTATION OF PUBLIC HEALTH PROJECTS TO IMPROVE HEALTH AND INCREASE ACCESS. GREENWICH HOSPITAL DELIVERY NETWORK GREENWICH HOSPITAL, FOUNDED IN 1903, IS A 206-BED COMMUNITY TEACHING HOSPITAL THAT HAS EVOLVED INTO A PROGRESSIVE REGIONAL HEALTHCARE CENTER, AVERAGING MORE THAN 12,000 INPATIENT DISCHARGES AND NEARLY 300,000 OUTPATIENT ENCOUNTERS LAST YEAR. THE HOSPITAL OFFERS A WIDE RANGE OF MEDICAL, SURGICAL, DIAGNOSTIC, INTEGRATIVE MEDICINE AND WELLNESS PROGRAMS. SPECIALIZED SERVICES INCLUDE THE BENDHEIM CANCER AND BREAST CENTERS, ENDOSCOPY CENTER, LEONA M. AND HARRY B. HELMSLEY AMBULATORY MEDICAL CENTER, THE RICHARD R. PIVIROTTO CENTER FOR HEALTHY LIVING, AND THE GREENWICH HOSPITAL DIAGNOSTIC CENTER IN STAMFORD. DURING FISCAL YEAR 2013, GREENWICH HOSPITAL PROVIDED APPROXIMATELY $31.6 MILLION IN COMMUNITY BENEFITS. THIS FIGURE INCLUDES $24.7 MILLION DOLLARS IN CHARITY CARE (AT COST) AND UNDER REIMBURSED MEDICAID (AT COST), $3.1 MILLION IN HEALTH PROFESSIONS EDUCATION AND $3.8 MILLION IN COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ACTIVITIES, SUBSIDIZED SERVICES, RESEARCH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. AN ADDITIONAL $279,000 WAS PROVIDED IN THE AREA OF COMMUNITY BUILDING ACTIVITIES, WHICH INCLUDED SUPPORT FOR ECONOMIC DEVELOPMENT, ENVIRONMENTAL IMPROVEMENTS, WORKFORCE DEVELOPMENT, COALITION BUILDING AND PHYSICAL IMPROVEMENT AND HOUSING. GREENWICH HOSPITAL HAS INVESTED A SIGNIFICANT AMOUNT OF TIME, MONEY AND RESOURCES IN THE DEVELOPMENT AND IMPLEMENTATION OF PUBLIC HEALTH PROJECTS TO IMPROVE HEALTH AND INCREASE ACCESS. |
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YALE-NEW HAVEN DELIVERY NETWORK YALE-NEW HAVEN HOSPITAL, FOUNDED IN 1826 AS THE FIRST HOSPITAL IN CONNECTICUT, IS A 1,541-BED ACUTE AND TERTIARY CARE HOSPITAL. WITH TWO INPATIENT CAMPUSES IN NEW HAVEN, YALE-NEW HAVEN HOSPITAL IS THE PRIMARY TEACHING HOSPITAL FOR YALE SCHOOL OF MEDICINE AND IS A MAJOR TERTIARY CARE CENTER FOR ACUTELY ILL OR INJURED PATIENTS, RECEIVING REGIONAL, NATIONAL AND INTERNATIONAL REFERRALS. YALE-NEW HAVEN HOSPITAL DISCHARGED MORE THAN 80,500 INPATIENTS AND HANDLED MORE THAN ONE MILLION OUTPATIENT ENCOUNTERS LAST YEAR. YALE-NEW HAVEN HOSPITAL INCLUDES SEVERAL OUTPATIENT CENTERS IN NEW HAVEN, NORTH HAVEN, EAST HAVEN AND GUILFORD AND DOZENS OF RADIOLOGY AND BLOOD-DRAWING SERVICES THROUGHOUT THE STATE. DURING FISCAL YEAR 2013, YALE-NEW HAVEN HOSPITAL PROVIDED APPROXIMATELY $383.2 MILLION DOLLARS IN COMMUNITY BENEFITS. THIS FIGURE INCLUDES $280.3 MILLION DOLLARS IN CHARITY CARE (AT COST) AND UNDER REIMBURSED MEDICAID (AT COST), $79.7 MILLION IN HEALTH PROFESSIONS EDUCATION, AND $23.2 MILLION IN COMMUNITY HEALTH IMPROVEMENT AND EDUCATION ACTIVITIES, SUBSIDIZED SERVICES AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. AN ADDITIONAL $2.6 MILLION DOLLARS WAS PROVIDED IN THE AREA OF COMMUNITY BUILDING ACTIVITIES, WHICH INCLUDED SUPPORT FOR ECONOMIC DEVELOPMENT, ENVIRONMENTAL IMPROVEMENTS, WORKFORCE DEVELOPMENT, ADVOCACY, COALITION BUILDING AND PHYSICAL IMPROVEMENTS AND HOUSING. YALE-NEW HAVEN HOSPITAL HAS INVESTED A SIGNIFICANT AMOUNT OF TIME AND RESOURCES IN THE DEVELOPMENT AND IMPLEMENTATION OF PUBLIC HEALTH PROJECTS TO IMPROVE HEALTH AND INCREASE ACCESS. NORTHEAST MEDICAL GROUP ESTABLISHED IN 2010, NORTHEAST MEDICAL GROUP (NEMG) IS A SYSTEM-WIDE PHYSICIAN GROUP DESIGNED TO CREATE OPPORTUNITIES FOR BETTER COLLABORATION, IMPROVED QUALITY OF CARE AND CLOSER PHYSICIAN ALIGNMENT. A NOT-FOR-PROFIT MULTISPECIALTY MEDICAL FOUNDATION, NEMG HAS ALIGNED PHYSICIANS AND MID-LEVEL PROVIDERS ACROSS THE HEALTH SYSTEM. NEMG'S INCLUDE HOSPITAL-EMPLOYED PHYSICIANS AT GREENWICH HOSPITAL, BRIDGEPORT HOSPITAL, THE HOSPITALISTS OF YALE-NEW HAVEN HOSPITAL AND COMMUNITY PHYSICIANS. HEADQUARTERED IN BRIDGEPORT, CONNECTICUT, NEMG COMMUNITY PRACTICES EXTEND FROM RYE BROOK, NEW YORK, TO GALES FERRY, CONNECTICUT. THROUGH ITS GROWING PHYSICIAN NETWORK, NEMG HELPS THE HEALTH SYSTEM BETTER CARE FOR PATIENTS ACROSS THE CONTINUUM-FROM HOSPITALS TO NURSING HOMES TO HOME. NEMG OFFERS ITS MEMBERS OPPORTUNITIES FOR COLLABORATION AND RESOURCES TO IMPROVE PRACTICE MANAGEMENT AND CLINICAL QUALITY. IN ADDITION, NEMG SUPPORTS PHYSICIAN PRACTICES THROUGH ECONOMIES OF SCALE, ASSISTANCE WITH RECRUITMENT EFFORTS AND SUPPORT FOR THE DELIVERY OF INTEGRATED, HIGH-QUALITY CARE. NEMG BEGAN ITS THIRD YEAR OF OPERATION IN APRIL AND CONTINUED TO EXPERIENCE TREMENDOUS GROWTH DURING THE YEAR. BY SEPTEMBER 30, 2013, NEMG INCLUDED 81 PRACTICE SITES, REPRESENTING ABOUT 170 PHYSICIANS AND MORE THAN 390 STAFF MEMBERS. FISCAL YEAR 2013 ALSO SAW A LARGE JUMP IN PATIENT VOLUME WITH A 74 PERCENT INCREASE OVER THE SAME PERIOD THE PREVIOUS YEAR. CONSISTENT WITH THE DELIVERY NETWORKS, NEMG TRACKS PERFORMANCE ON KEY METRICS RELATED TO PATIENT CARE, SAFETY AND CLINICAL QUALITY, AND PERFORMED STRONGLY. FOR EXAMPLE, STAFF ACHIEVED 95 PERCENT PERFORMANCE ON CHEMOTHERAPY COMPARED WITH A TARGET OF 90 PERCENT AND REACHED 88 PERCENT IN DEPRESSION SCREENING, EXCEEDING THE TARGET OF 60 PERCENT. NEMG ALSO ACHIEVED STRONG PATIENT SATISFACTION SCORES WHILE SIMULTANEOUSLY INCREASING THE SIZE AND SCOPE OF PRACTICES. NEMG RANKED IN THE 98TH PERCENTILE NATIONALLY AND THE 99TH PERCENTILE IN THE NORTHEAST FOR OVERALL PATIENT SATISFACTION THROUGH THE FIRST TWO QUARTERS OF FISCAL YEAR 2013. |
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FORM 990, PART VI |
SECTION A, LINE 1B: NUMBER OF INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY THE ORGANIZATION SOUGHT TO CONFIRM THE INDEPENDENCE OF EACH VOTING MEMBER OF ITS GOVERNING BODY BY REQUESTING THAT EACH SUCH VOTING MEMBER RESPOND TO A QUESTIONNAIRE CONTAINING THE PERTINENT INSTRUCTIONS AND DEFINITIONS AND DESIGNED TO ELICIT THE INFORMATION NECESSARY TO DETERMINE INDEPENDENCE. BASED ON RESPONSES TO THE QUESTIONNAIRES RECEIVED BY THE ORGANIZATION AND ANNUAL CONFLICTS OF INTEREST DISCLOSURES, THE ORGANIZATION WAS ABLE TO CONFIRM THAT 14 VOTING MEMBERS ARE INDEPENDENT. |
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FORM 990, PART VI, SECTION A, LINE 2 |
BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES SOME OF THE ORGANIZATION'S CURRENT OFFICERS SERVE AS OFFICERS AND/OR DIRECTORS OF TAXABLE AFFILIATES WITHIN THE ORGANIZATION'S CORPORATE SYSTEM. THE INDIVIDUAL OFFICERS DO NOT HAVE PERSONAL FINANCIAL INTERESTS IN THOSE TAXABLE AFFILIATES AND SERVE ONLY AS A FUNCTION OF THEIR ROLES WITH THE ORGANIZATION. THE TAXABLE AFFILIATES FOR WHICH SOME OF THE ORGANIZATION'S OFFICERS SERVE ALSO AS OFFICERS AND/OR DIRECTORS INCLUDE: CENTURY FINANCIAL SERVICES, INC.; COMMUNITY HEALTH CARE PHYSICIANS, P.C.; GREENWICH HEALTH SERVICES, INC.; GREENWICH INTEGRATIVE MEDICINE, P.C.; GREENWICH OCCUPATIONAL HEALTH SERVICES OF NEW JERSEY, P.C.; GREENWICH PEDIATRIC SERVICES, P.C.; MEDICAL CENTER REALTY, INC.; MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.; QUINNIPIAC MEDICAL, P.C.; SHORELINE SURGERY CENTER, LLC.; SSC II, LLC; YNH GERIATRICS SERVICES, P.C.; YNH MEDICAL SERVICES, P.C.; YNHH-MSO, INC.; YNHH PHYSICIANS CORP.; YALE-NEW HAVEN AMBULATORY SERVICES CORPORATION; AND YORK ENTERPRISES, INC. |
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FORM 990, PART VI, SECTION B, LINE 11 |
THE FORM 990 TAX RETURN AND ATTACHED SCHEDULES WERE PREPARED BY EMPLOYEES OF THE SYSTEM TAX DEPARTMENT. THE RETURN IS INITIALLY REVIEWED BY THE DIRECTOR AND VP OF CORPORATE FINANCE. SUBSEQUENTLY IT IS SENT TO ERNST & YOUNG US, LLP FOR THEIR INITIAL REVIEW. AFTER ALL COMMENTS FROM THE ABOVE GROUP ARE CLEARED, THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE ENTITY AND A FINAL VERSION OF THE RETURN IS SENT BACK TO ERNST & YOUNG US, LLP FOR FINAL REVIEW. PRIOR TO FILING, THE ORGANIZATION MADE AVAILABLE A COMPLETE COPY OF THE RETURN TO THE BOARD OF TRUSTEES. A SECURE WEB PORTAL IS AVAILABLE TO BOARD MEMBERS TO ACCESS THE RETURN. |
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FORM 990, PART VI, SECTION B, LINE 12C |
THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC:R-7) AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT SHE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. |
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FORM 990, PART VI, SECTION B, LINE 15 |
THE EXECUTIVE COMPENSATION COMMITTEE OF THE YNHHS STRIVES TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEE IS AUTHORIZED UNDER THE YNHHS BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL YNHHS BOARD ON AN ANNUAL BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND PROVIDED TO THE BOARD. PART VI, LINE 15B THE EXECUTIVE COMPENSATION COMMITTEE OF THE YNHHS STRIVES TO TAKE THE STEPS NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL TAX LAW. THE EXECUTIVE COMPENSATION COMMITTEE IS AUTHORIZED UNDER THE YNHHS BYLAWS AND IS RESPONSIBLE FOR (1) DETERMINING THE OVERALL TOTAL COMPENSATION STRATEGY FOR ALL CORPORATE OFFICERS, (2) APPROVING ALL COMPENSATION AND BENEFITS DECISIONS FOR CORPORATE OFFICERS, AND (3) REPORTING SUCH ACTIONS TO THE FULL YNHHS BOARD ON AN ANNUAL BASIS. IN ADDITION, THE EXECUTIVE COMPENSATION COMMITTEE EXPRESSLY DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION AND BENEFITS FOR ALL CORPORATE OFFICERS, AND ASSURES THAT ALL OFFICER COMPENSATION DECISIONS ARE MADE AFTER THOROUGH CONSIDERATION OF AND COMPARISON TO THE MARKET PRACTICES OF OTHER SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE EXECUTIVES IN COMPARABLE ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONSISTS OF BOARD MEMBERS WHO DO NOT HAVE MATERIAL FINANCIAL INTERESTS THAT COULD BE AFFECTED BY THE OFFICER COMPENSATION DECISIONS MADE BY THE COMMITTEE. THE COMPARABILITY DATA USED TO ASSIST THE EXECUTIVE COMPENSATION COMMITTEE IN ITS COMPENSATION DELIBERATIONS ARE COMPILED BY AN INDEPENDENT, NATIONAL COMPENSATION CONSULTING FIRM THAT IS RETAINED BY AND REPORTS DIRECTLY TO THE EXECUTIVE COMPENSATION COMMITTEE. THE DATA COLLECTED BY THE CONSULTANT CONSISTS OF MARKET INFORMATION FOR EXECUTIVES IN FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE DELIBERATIONS AND DECISIONS OF THE EXECUTIVE COMPENSATION COMMITTEE ARE CONTEMPORANEOUSLY DOCUMENTED, REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND PROVIDED TO THE BOARD. |
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FORM 990, PART VI, SECTION C, LINE 18 |
FORM 990, PART VI, SECTION C, LINE 18: COPIES OF FORM 990, FORM 1023 AND AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN THE SYSTEM TAX DEPARTMENT. OTHER CORPORATE GOVERNING DOCUMENTS ARE MAINTAINED BY OFFICE OF LEGAL AND CORPORATE COMPLIANCE. THE CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, AND DOCUMENT RETENTION POLICY ARE AVAILABLE TO ALL EMPLOYEES ON THE CORPORATE INTERNAL WEBSITE. COPIES OF ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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FORM 990, PART VI, SECTION C, LINE 19 |
FORM 990, PART VI, SECTION C, LINE 19: THE YALE NEW HAVEN HEALTH SYSTEM CONFLICT OF INTEREST POLICY (CC:R-7) AND INDIVIDUAL ANNUAL DISCLOSURE FORM APPLIES TO A POOL OF EMPLOYEES, BOARD MEMBERS AND NON-BOARD MEMBERS SERVING ON BOARD COMMITTEES. THESE "COVERED INDIVIDUALS" ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, UPON BEGINNING EMPLOYMENT OR OTHERWISE BECOMING A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER. COVERED INDIVIDUALS ARE ALSO REQUIRED TO IMMEDIATELY REPORT MATERIAL CHANGES TO THEIR MOST RECENTLY COMPLETED DISCLOSURE STATEMENT. THESE DISCLOSURE STATEMENTS AND REPORTS ARE REVIEWED BY THE OFFICE OF PRIVACY AND CORPORATE COMPLIANCE AND/OR THE LEGAL AND RISK SERVICES DEPARTMENT TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A POTENTIAL CONFLICT ARISES, THE PRESIDENT AND CEO WOULD CONSULT WITH THE BOARD CHAIRPERSON AND THE LEGAL AND RISK SERVICES DEPARTMENT AND TAKE ANY ACTIONS THAT SHE DEEMS REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE A POTENTIAL CONFLICT OF INTEREST. FOR EXAMPLE, A VOTING BOARD OR COMMITTEE MEMBER WOULD BE REQUIRED TO RECUSE HIMSELF OR HERSELF FROM VOTING ON MATTERS RELATED TO THE POTENTIAL CONFLICT AND THE POTENTIAL CONFLICT WOULD BE DISCLOSED TO OTHER VOTING MEMBERS. |
| OTHER FEES |
FORM 990, PART IX, LINE 11G |
CONSULTING FEES: PROGRAM SERVICE EXPENSES 34,211,593. MANAGEMENT AND GENERAL EXPENSES 6,037,340. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,248,933. PERSONNEL SUPPORT: PROGRAM SERVICE EXPENSES 778,410. MANAGEMENT AND GENERAL EXPENSES 137,366. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 915,776. TEMPORARY HELP/TRAINING & DEVELOPMENT: PROGRAM SERVICE EXPENSES 17,017,232. MANAGEMENT AND GENERAL EXPENSES 3,003,041. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,020,273. |
| CHANGES IN NET ASSETS OR FUND BALANCES: |
FORM 990, PART XI, LINE 9: |
TRANSFER TO/FROM AFFILIATES- NEMG/NCDP/NETWORK CORP -35,984,771. OTHER CHANGES IN NET ASSETS -86,700. |
Attach to Form 990 or 990-EZ.