SARATOGA HOSPITAL
211 Church Street, Saratoga Springs, NY 12866 www.saratogahospital.org

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Organizations Filed Purposes: To serve the people of the Saratoga region by providing them access to excellence in healthcare in a supportive and caring environment.

The foremost commitment of the Hospital is to provide superior quality healthcare to the people of our community, regardless of their ability to pay. Saratoga Hospital is the largest healthcare provider and only hospital located in Saratoga County. The services provided by the Hospital to the community are broad and varied. Following is a listing of some of the most significant of those services: * The Hospital operates the only emergency department in Saratoga County 24 hours per day, 365 days per year. During 2017, the hospital emergency department facilitated 38,199 patient visits. * The Hospital represents the only inpatient acute care facility in Saratoga County. During 2017, the Hospital had 9,919 admissions for inpatient adult and pediatric care. These admissions included 760 births, 697 admissions to our inpatient mental health unit and 59 admissions for Hospice care. Total adult and pediatric inpatient days for the Hospital during 2017 were 42,644 which included 5,207 days of inpatient care in the Critical Care Unit. * The hospital maintains a Financial Assistance policy, eligibility for benefit from which is determined by the Hospital's patient financial services department based upon the financial means of the patient and/or patient's family. The amount of Financial Assistance benefit provided to patients is based on the comparison of their documented income versus annual Federal Poverty Level (FPL) standards. The following is a sliding scale of benefits (as a percentage of patient responsibility for reimbursement) available to patients with varying levels of income: o FPL x 250% or below- 100% discount o FPL x 300%- 75% discount o FPL x 350% - 50% discount o FPL x 400%- 25% discount In addition to the means-tested financial assistance program described above, the Hospital provides an automatic discount from charges (81% for 2017) for any uninsured patients receiving care at any of the hospital's locations. The discount percentage is determined annually and is designed to result in uninsured patients being billed no more for services than the Hospital would be reimbursed by Medicare for the same services. This discount applies regardless of a patient's ability to pay. The discount is shown clearly on any bills sent to the patient in order to enhance awareness of the availability of this benefit. The Hospital also provides discounted rates to uninsured patients receiving care at its emergency department or urgent care site. Uninsured patients are asked to pay a flat fee per visit, regardless of the amount of charges to their account. Each patient is classified into one of three tiers based on the level of services provided, with a progressively higher all-inclusive fee for each tier. The first tier is for urgent care visits consisting of only an office visit, the second tier is for visits including and office visit and any laboratory or x-ray procedures and the third tier is for visits including an office visit and CT or MRI scans. During 2017, the benefits provided under these policies, measured on the basis of costs, amounted to approximately $3,590,000. * The Hospital has one site providing urgent care services to the community. Many patients in the community are unable to access primary care on a timely basis if at all. The Hospital has continually expanded access to the urgent care site, including nights and weekends in order to meet community need. As a result, our urgent care site has become a significant portal of access to care for the community. During 2017, our urgent care site accommodated 34,379 patient visits. * During 2017 the hospital incurred bad debt expense of approximately $5,399,000 measured on the basis of charges. The bad debt expense continues to be largely comprised of patients having no or insufficient insurance, and also of patients using our emergency department and urgent care facilities, which uninsured patients will often utilize as an option as opposed to receiving no care at all. * As the largest healthcare provider in the community, the Hospital serves a significant number of Medicare and Medicaid insured patients. Losses incurred from providing services to Medicare and Medicaid patients during 2017 were approximately $5,964,000 and $7,192,000, respectively. * The Hospital is the community leader in assessing community healthcare needs and working to bring the needed services into the community. These efforts include the following: o Subscriptions to databases providing demographics for the communities served. Based on information such as age, gender, etc. anticipated needs by physician specialty and type of inpatient or outpatient care are determined. o Continuous patient satisfaction surveys are conducted in order to gain patient feedback regarding the quality of care received and perceptions of their overall experience as patients. o "Secret shopper" calls are conducted whereby Hospital personnel call physician practices in the community in order to determine accessability to physician care in terms of days wait to be seen for acute and chronic problems. o Community input is obtained through information gathering sessions held with human resources representatives of local business, as well as representatives from other not-for-profit and governmental agencies operating in the community. In addition to discussion occurring at the sessions, those whose attend as well as those who are unable to attend are asked to return written surveys to the Hospital. The surveys include questions regarding the availability and quality of health care services in the community. o Ongoing dialogue with medical staff members regarding their perceptions regarding quality of care and areas of need for the community. o Formalized tracking processes for patient communications and complaints. * As a result of its leadership role in identifying community healthcare needs, the Hospital is also the key resource in its community for recruiting physicians practicing in areas of medicine identified as underserved in the community. A component of this recruitment effort includes the extension of relocation incentives to physicians in the targeted need areas. The incentives exist in the form of income guarantees that are provided in an effort to make practice start-up financially palatable for relocating physicians. After an initial period during which funds are advanced to physicians as they have shortfalls versus a targeted income amount, the accumulated advances are converted to promissory notes. Should the physician remain in practice in the community for a contractually agreed-upon number of years after the initial benefit period, the note will be forgiven in full. During 2017, the Hospital forgave advances plus accrued interest amounting to approximately $110,000 relating to these arrangements. * The Hospital is the lead agency in Saratoga County for administering the State of New York's Cancer Services Program (CSP). In the role of CSP administrator for the County, Hospital personnel actively seek out low-income members of the community who possess certain risk factors, such as age or gender, and facilitate cancer screenings and, if necessary, treatment services for eligible individuals. The services are provided at no cost to the individuals. The State reimburses the Hospital for any screening or treatment services provided to these patients based on Medicaid reimbursement rates. The State reimburses the Hospital for a portion of the administrative costs incurred by the Hospital in identifying eligible individuals and coordinating screening and treatment services. During 2017, unreimbursed costs of administering the program were approximately $20,000. * Hospital personnel take a leading role in development and maintenance of a County-wide emergency preparedness and response plan, including corresponding with law enforcement, fire, emergency medical services and other relevant agencies to develop, test and maintain a plan for managing the public health effects of a large-scale natural disaster or other significant community-wide crisis.

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