PART I, LINE 7:
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THE PATIENTS COST-TO-CHARGE RATIO WAS COMPUTED USING ALL CHARGES AND EXPENSES LESS NON-ALLOWABLE. THE COST TO CHARGE RATIO WAS USED TO COMPUTE COST. COST-TO-CHARGE WAS DERIVED BY DIVIDING TOTAL CHARGES FROM THE FINANCIAL STATEMENTS INTO TOTAL COST FROM THE FINANCIAL STATEMENTS, LESS NON-PATIENT COSTS.
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PART I, LN 7 COL(F):
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THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,268,979.
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PART III, LINE 4:
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990 PART III LINE 3:THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE MEDICAL CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE, THESE AMOUNTS ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. DURING 2016 AND 2015, COSTS INCURRED BY THE MEDICAL CENTER IN THE PROVISION OF CHARITY CARE WERE BASED ON THE RATIO OF THE MEDICAL CENTER'S COSTS TO GROSS CHARGES AND APPROXIMATED $340,000 AND $225,000 FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015, RESPECTIVELY. THE MEDICAL CENTER GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY AGREEMENTS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR DOUBTFUL ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. SERVICES RENDERED TO INDIVIDUALS WHEN PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
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PART III, LINE 8:
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THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS COST TO CHARGE RATIO. THE SHORTFALL REPORTED IS COMMUNITY BENEFIT EXPENSE BECAUSE THIS AMOUNT REPRESENTS THE UNREIMBURSED COSTS TO THE MEDICAL CENTER FOR PROVIDING CARE FOR THE COMMUNITY'S ELDERLY AND DISABLED.
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PART III, LINE 9B:
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COLLECTION POLICY PROVISIONS PATIENTS THAT QUALIFY FOR THE MEDICAL CENTER'S CHARITY CARE PROGRAM HAVE THE CHARGES ON THEIR ACCOUNTS FORGIVEN AS THEY ARE PLACED IN CHARITY CARE AND THE BALANCES ARE WRITTEN OFF. THE MEDICAL CENTER'S CHARITY CARE PROGRAM USED THE FEDERAL POVERTY GUIDELINES (FPG) AS A GUIDE WITH HIGH-END LIMITS AT 300% OF THE FPG. IN THOSE SITUATIONS WHERE THE PATIENT'S INCOME IS BETWEEN 200% - 300% OF THE FPG, A SMALL COST SHARE WOULD BE THE ONLY AMOUNT NOT INCLUDED IN CHARITY CARE. ADDITIONALLY THIS SMALL COST SHARE WOULD BE THE ONLY AMOUNT TURNED OVER TO COLLECTION WITH THE OPPORTUNITY OF EVENTUALLY BEING WRITTEN OF TO BAD DEBT IF NOT PAID.
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PART VI, LINE 2:
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A CHA/CHIP PLANNING TEAM COMPROSED OF OCHD, FSL, SEMC AND RMH STAFF MET REGULARLY STARTING IN EARLY 2016. THE PLANNING TEAM CAME TO CONSENSUS ON THE APPROACH TO UPDATE THE CHA AND REASSESS PRIORITIES ESTABLISHED IN THE CHIP. DATA FROM THE ONEIDA COUNTY PREVENTION AGENDA DASHBOARD, NEW YORK STATE QUITLINE PARTNERS REPORTS, ONEIDA COUNTY TEEN ASSESSMENT PROJECT (TAP), PEDIATRIC NUTRITION SURVEILLANCE SYSTEM (PEDNSS) REPORTS, COUNTY HEALTH RANKINGS, BRIDGES COMMUNITY SURVEY, AND THE CNY CARE COLLABORATIVE (CNYCC) COMMUNITY HEALTH ASSESSMENT WERE REVIEWED TO ASSESS AREAS FOR IMPROVEMENT AND STATUS IN ACHIEVING THE GOALS AND OBJECTIVES OUTLINED IN THE PREVIOUS CHIP. THE CNYCC COMMUNITY HEALTH ASSESSMENT AND WORK TO SUPPORT THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP), AN INITIATIVE TO TRANSFORM THE HEALTH SYSTEM OF NEW YORK STATE, WERE ALSO FACTORED INTO THE ASSESSMENT PROCESS. THE PLANNING TEAM, IN ORDER TO SECURE STAKEHOLDER FEEDBACK, ESTABLISHED A PLAN FOR SEEKING STAKEHOLDER AND COMMUNITY FEEDBACK AS OUTLINED BELOW:IN MARCH 2016, THE PLANNING TEAM PRESENTED TO THE ONEIDA COUNTY HEALTH COALITION GENERAL MEMBERSHIP (APPROXIMATELY 60 PEOPLE IN ATTENDANCE) INFORMATION ON THE CHA AND CHIP ACTIVITIES. THE OCHC IS COMPRISED OF BOARD REPRESENTATION OF SECTORS AND ORGANIZATIONS THAT CONVENE UNDER THE DIRECTION OF THE OCHD TO DISCUSS AND ALAYZE DATA ON VARIOUS HEALTH ISSUES AND TRENDS. PARTNERS WERE PROVIDED WITH A SUMMARY OF THE PREVENTATION AGENDA DATA AND THE SELECTED CHIP FOCUS AREAS AND WORK GROUP ACTIVITIES. MEMBERS WERE APPRISED OF, AND INVITED TO PARTICIPATE IN THE WORK GROUPS AND COMMUNITY HEALTH ASSESSMENT ACTIVITIES. AS A FOLLOW UP TO COLLECT MORE IN-DEPTH PARTNER FEEDBACK, IN MAY 2016, THE PLANNING TEAM CONVENED MEMBERS OF THE ONEIDA COUNTY HEALTH COALITION STEERING COMMITTEE, A GROUP OF APPROXIMATELY 20 COMMUNITY AGENCIES AND ORGANIZATIONS THAT OVERSEE AND GUIDE THE LARGER COMMUNITY HEALTH PARTNERSHIP. PARTNERS WERE PRESENTED WITH AN OVERVIEW OF THE COMMUNITY HEALTH ASSESSMENT UPDATE AND COMMUNITY AND STATUS IN ACHIEVING THE DEFINED GOALS AND OBJECTIVES. THE PREVENTION AGENDA INDICATOR DATA AND GOALS WERE REVIEWED ALONG WITH AN OVERVIEW OF HOW EACH OF THE FOCUS AREAS ALIGN WITH HOSPITAL DSRIP INITIATIVES, SPECIFICALLY: THE INITIATIVES OF THE TOBACCO CESSATION WORK GROUP ALIGNED WITH DSRIP FOCUS AREAS TO DSRIP 4.D.I. - REDUCE PRETERM BIRTHS AND DSRIP 3.B.I. - CARDIOVASCULAR DISEASE MANAGEMENT AND THE INITIATIVES OF THE BREASTFEEDING WORK GROUP INDIRECTLY ALIGN WITH DSRIP GOALS (E.G., HEALTHY START FOR BABIES AND HEALTH BENEFITS TO MOTHER) TO REDUCE UNNECESSARY UTILIZATION THROUGH PRIMARY PREVENTION. THE PLANNING TEAM OUTLINED ITS SUCCESSES AND CHALLENGES AND OBTAINED INPUT FROM THE STEERING COMMITTEE ON AREAS FOR IMPROVEMENT AND IDENTIFIES OTHER POTENTIAL PARTNERS OR RESOURCES THAT COULD SUPPORT CHIP WORK GROUP ACTIVITIES. AS A RESULT OF THE DIALOGUE, THE OCHC STEERING COMMITTEE REAFFIRMED THAT THE PLANNING TEAM AND WORK GROUPS SHOULD CONTINUE THEIR EFFORTS TO ADDRESS THE CHIP FOCUS AREAS AND GOALS OUTLINED IN THE 2013 - 2017 CHIP. THE PLANNING TEAM ALSO ESTABLISHED MECHANISMS TO COLLECT COMMUNITY PERSPECTIVE ON THE CHIP FOCUS AREAS. HEALTH DEPARTMENT STAFF PRESENTED A SHORT COMMENT CARD TO COMMUNITY MEMBERS AT ALL SEVEN (7) PUBLIC HEALTH EVENTS ON NEEDS AND PERCEPTIONS RELATED TO TOBACCO CESSATION AND BREASTFEEDING. ADDITIONALLY, THE PLANNING TEAM REVIEWED THE FINDINGS FROM THE CNYCC NEEDS ASSESSMENT WHICH INCLUDED A PRIMARY CARE ASSESSMENT, CNY CONSUMER ACCESS SURVEY, CNY SAFETY NET ASSESSMENT (MEDICAID AND SELF-PAY POPULATIONS) AND KEY INFORMANT INTERVIEWS. OCHC SUMMARY OF COMMUNITY INPUT: QUESTION RESPONSES (FROM 7 COMMUNITY EVENTS, NOT LISTED IN ANY PARTICULAR ORDER) WHAT CAN WE DO, AS A COMMUNITY TO HELP MORE MOTHERS' BREASTFEED THEIR BABIES? EDUCATION - INFORMATIONAL CLASSES FOR BREAST FEEDING, EDUCATION & SUPPORT, EDUCATE THE PUBLIC AT WORK PLACES ABOUT BREAST FEEDING, MORE EDUCATION IN SCHOOLS, MORE EDUCATION IN HOSPITALS, ESPECIALLY YOUNGER MOMS. SUPPORT - MORE SUPPORT AFTER DELIVERY, DON'T GIVE FORMULA IN HOSPITAL IF NURSING, BE ALLOWED TO PUMP AT WORK. COMMUNITY AWARENESS - RAISE AWARENESS ON RIGHT TO PUMP AT WORK, HELP PUBLIC ACCEPT BREASTFEEDING AS NATURAL, HELP PUBLIC ACCEPT BREASTFEEDING SHOULD BE ABLE TO BE DONE IN ANY LOCATION. WHAT CAN WE DO AS A COMMUNITY TO HELP MORE PEOPLE STOP SMOKING? EDUCATION - EDUCATION IN SCHOOLS TO HIGHLIGHT DANGERS, MORE FACE TO FACE EDUCATION IN SCHOOLS AND WITH EMPLOYERS (WITH PEOPLE WHO HAVE SUFFERED EFFECTS OF SMOKING), REMIND PEOPLE OF REASONS TO QUIT. CESSATION SERVICES AND SUPPORT - HYPNOSIS, ACUPUNCTURE, ACCESS TO NRT (NICOTINE REPLACEMENT THARAPY), SUPPORT TO STAY ON TOP OF QUIT ATTEMPT LONG-TERM, DOCTORS NEED TO ADDRESS MORE, SUPPORTS TO JUST DO IT OTHER - NOTHING MORE CAN BE DONE, HAS TO COME FROM THE PERSON WHEN THEY ARE READY, TRIED EVERYTHING, NOTHING LEFT TO TRY OF I'D DO IT MYSELF, STOP SELLING CIGARETTES. WHAT ARE THE TOP HEALTH ISSUES FOR YOU AND YOUR FAMILY? ACCESS - INSURANCE COST AND CONFUSION, INSURANCE HAVING IT AND KEEPING IT, FINDING FAMILY PHYSICIANS, THERAPY SERVICES (PT, OT), DENTAL. HEALTH ISSUES - OVERWEIGHT OBESITY, WEIGHT GAIN, EXERCISE, BREASTFEEDING, ALLERGIES, HEART DISEASE/CARDIAC ISSUES, HIGH BLOOD PRESSURE, EATING, NUTRITION, SUGAR, FOOD PREPARATION, TIME, MEAL PLANNING, AFFORDABILITY, FAST FOOD, KIDS (FRUITS & VEGETABLES), EXERCISE, TIME TO WORKOUT, ALZHEIMERS, LYME DISEASE/TICKS, MENTAL & PHYSICAL HEALTH, CHRONIC PAIN, WEAK BONES, CONTAGIOUS DISEASES, STDS, SMOKING, CIGARETTES, DRUGS, DRUGS IN THE STREET, DRINKING, LEAD, LEAD TESTING, HOUSING, POLLUTION, ANEMIA, HYGIENE.
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PART VI, LINE 3:
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PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHIS IS COMMUNICATED THROUGH ST ELIZABETH MEDICAL CENTER'S FACILITATED ENROLLMENT PROGRAM AND THE FINANCIAL ASSISTANCE PROGRAM. INFORMATION IS INCLUDED IN THE PATIENT INFORMATION GUIDES PRESENTED TO INPATIENTS AND OUTPATIENTS AND IS AVAILABLE ON THE HOSPITAL'S WEBSITE.ST ELIZABETH MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAMTO SUPPORT OUR MISSION, THE ST ELIZABETH MEDICAL CENTER HAS DEVELOPED THE FINANCIAL ASSISTANCE PROGRAM. THE MEDICAL CENTER WILL MAKE AVAILABLE A RESONABLE AMOUNT OF UNCOMPENSATED SERVICES TO ELIGIBLE PERSONS.ST. ELIZABETH MEDICAL CENTER'S FACILITATED ENROLLMENT PROGRAMIN 2000, ST ELIZABETH MEDICAL CENTER DEVELOPED AND IMPLEMENTED THE FACILITATED ENROLLMENT PROGRAM AS A RESULT OF THE UNIQUE COLLABORATION THAT WAS FORGED BETWEEN ST ELIZABETH MEDICAL CENTER AND ONEIDA COUNTY SOCIAL SERVICES DEPARTMENT. THIS PROGAM ALLOWS ST ELIZABETH MEDICAL CENTER STAFF, PATIENT ACCOUNT REPRESENTATIVES, TO ACT AS AN AUTHORIZED REPRESENTATIVE OF THE PATIENT AT THE ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES AND SUBMIT THE APPLICATION FOR BENEFITS. THIS SUCCESSFUL PROGRAM HAS EXPANDED THROUGHOUT THE PAST SEVERAL YEARS TO INCLUDE OUTPATIENTS AND EMERGENCY DEPARTMENT PATIENTS.
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PART VI, LINE 4:
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SERVICE AREA:THE ONEIDA COUNTY HEALTH DEPARTMENT AND THE HOSPITALS SERVE THE ENTIRE COUNTY. HOSPITAL PATIENT CENSUS INCLUDES RESIDENTS FROM HERKIMER AND MADISON AS WELL, WITH APPROXIMATELY 80% OF PATIENTS RESIDING IN ONEIDA COUNTY ZIP CODES. THE THREE HOSPITALS IN THE COUNTY INCLUDE: MOHAWK VALLEY HEALTH SYSTEM WHICH INCLUDES FAXTON-ST. LUKE'S HEALTHCARE (FSLH) AND ST ELIZABETH MEDICAL CENTER (SEMC), LOCATED IN THE CITY OF UTICA; AND ROME MEMORIAL HOSPITAL (RMH) LOCATED IN THE CITY OF ROME. GEOGRAPHY:ONEIDA COUNTY IS LOCATED IN CENTRAL NEW YORK WITH A POPULATION OF APPROXIMATELY 233,944. THERE ARE THREE CITIES IN THE COUNTY: UTICA POPULATION OF 62,000; ROME POPULATION OF 33,000; AND THE SMALL CITY OF SHERRILL. THERE ARE 45 TOWNS AND VILLAGES THAT COVER A TOTAL OF 1,257.11 SQUARE MILES. SIXTY-SEVEN PERCENT (67%) OF THE COUNTY'S POPULATION RESIDES IN URBAN AREAS AND 33% IN RURAL AREAS.AGE:LIKE MANY OTHER COMMUNITIES, ONEIDA COUNTY HAS A SIGNIFICANT AND GROWING AGING POPULATION WITH A MEDIAN AGE OF 41.2 AND 16.8% OF THE POPULATION 65 YEARS AND OLDER. RACE & ETHNICITY:THE RACIAL AND THNIC CHARACTERISTICS OF ONEIDA COUNTY ARE: WHITE (84.9%); BLACK (5.5%); ASIAN (4.0%); OTHER (2.0%), TWO OR MORE RACES (3.1%); AND HISPANIC OR LATINO (5.5%). ONEIDA COUNTY IS THE HOME OF ONE OF THE LARGEST REFUGEE RESETTLEMENT AGENCIES IN THE COUNTRY, THE MOHAWK VALLEY RESOURCE CENTER FOR REFUGEES (MVRCR). SINCE 1981, THE MVRCR HAS RESETTLED OVER 15,000 INDIVIDUALS IN THE CITY OF UTICA OF VARYING ETHNICITIES AND NATIONALITIES INCLUDING VIETNAMESE, RUSSION, BOSNIAN, SOMALI BANTU, BURMESE AND NEPALI TO NAME A FEW (MVRCR): 17.6% FOREIGN-BORN RESIDENTS CONSTITUTE THE POPULATION OF THE CITY OF UTICA. 26.6% HOUSEHOLDS IN UTICA SPEAK A LANGUAGE OTHER THAN ENGLISH.WITHIN THE COUNTY BORDER IS A PORTION OF THE MEMBERS (549) AND TERRITORY OF THE ONEIDA INDIAN NATION (NYS OFFICE OF CHILDREN AND FAMILY SERVICES, "A PROUD HERITAGE - NATIVE AMERICAN SERVICES IN NYS", 2001 EDITION) IN THE COUNTY, THERE ARE POCKETS OF AMISH AND MENNONITE POPULATIONS IN RURAL AREAS (DATA UNAVAILABLE). ECONOMIC:-PERCENTAGE OF FAMILIES AND PEOPLE WHOSE INCOME IN THE PAST 12 MONTHS IS BELOW THE POVERTY LEVEL IS 11.7% AND THE PERCENTAGE WITH RELATED CHILDREN UNDER 18 YEARS IS 20.8%; THE PERCENTAGE OF PEOPLE 65 YEARS AND OLDER BELOW THE POVERTY LEVEL IS 9.1%. THE PERCENTAGE OF THE POPULATION 16 YEARS AND OLDER THAT IS UNEMPLOYED IS 4.8%.-PERCENT WITH HIGH SCHOOL GRADUATE DEGREE OR HIGHER IS 87.5%.-PERCENT OF CIVILIAN NON-INSTITUTIONALIZED POPULATION WITH HEALTH INSURANCE COVERAGE IS 93.1%; 67.5% OF THESE HAVE PRIVATE HEALTH INSURANCE AND 40.6% WITH PUBLIC COVERAGE. 6.9% HAVE NO HEALTH INSURANCE COVERAGE. -THE EIGHT COUNTIES OF CNY HAVE A TOTAL OF 277,458 MEDICAID ENROLLEES; ONONDAGA AND ONEIDA COUNTY ACCOUNT FOR 171,713 OR 62% OF ALL OF THE MEDICAID ENROLLEES. (CENTRAL NY CARE COLLABORATIVE COMMUNITY HEALTH ASSESSMENT)
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PART VI, LINE 5:
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PROMOTION OF COMMUNITY HEALTHTHESE ACTIONS REPRESENT THE MEDICAL CENTER'S EMPLOYEE OUTREACH BEYOND THE HOSPITAL AND MEDICAL GROUP OFFICES INTO AREA COMMUNITIES, AND THEY SPAN A WIDE REACH OF EVENTS AND SITES. ALONG WITH HOSPITALS ACROSS THE STATE AND NATION, ST ELIZABETH NOW MONITORS HOW OUR FAITHFULNESS TO THE REGIONAL POPULATION MEETS OUR LOCAL COMMUNITIES' UNIQUE HEALTH NEEDS.THEREFORE, COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. OUR CATHOLIC TRADITION AND MEDICAL CENTER MISSION TEACH US TO PUT THE NEEDS OF THE POOR AND VULNERABLE FIRST. AMONG OUR COMMUNITY BENEFIT ACTIVITIES ARE:-CHARITY CARE FOR PEOPLE UNABLE TO AFFORD SERVICE-HEALTH EDUCATION AND ILLNESS PREVENTION-HEALTHCARE INITIATIVES FOR AT-RISK YOUTHS-FREE OR LOW-COST CLINICS AND-INITIATIVES TO RAISE AWARENESS AND RECEIVE PUBLIC INPUTMANY OF THESE ACTIVITIES ARE ADVANCED IN COLLABORATION WITH COMMUNITY MEMBERS AND OTHER ORGANIZATIONS TO IMPROVE HEALTH AND QUALITY OF LIFE. THE MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH AN OPEN MEDICAL STAFF AND A COMMUNITY BOARD. SEMC FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY USING ITS SURPLUS FOR TRAINING AND EDUCATION OF ITS EMPLOYEES AND BY INVESTING IN HEALTHCARE TECHNOLOGY.
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PART VI, LINE 6:
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ST ELIZABETH MEDICAL CENTER (SEMC) AND FAXTON ST LUKE'S HEALTHCARE (FSLH) AFFILIATED UNDER THE MOHAWK VALLEY HEALTH SYSTEM (MVHS) ON MARCH 6, 2014. THE TWO ORGANIZATIONS ARE NOW GOVERNED BY A SINGLE, 18-MEMBER MVHS BOARD OF DIRECTORS AND A SINGLE MANAGEMENT TEAM. AS THE ORGANIZATIONS MOVE FORWARD, THEY WILL CONTINUE TO WORK COLLABORATIVELY TO MEET THEIR RESPECTIVE 2016 COMMUNITY SERVICE PLAN GOALS.
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PART VI, LINE 7, REPORTS FILED WITH STATES
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NY
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