COMMUNITY SERVICES PLAN 2012

Comes out every September

 

I. Mission Statement

Catskill Regional Medical Center’s Mission Statement is to “Improve the health of our community by providing exceptional healthcare.” 

Catskill Regional Medical Center’s vision is “We are caring professionals driven by standards of excellence who go above and beyond to provide an exceptional patient care experience.” 

CRMC’s values reflect our Mission and Vision by focusing on:  Putting patients and families first; honesty, integrity and transparency in action; operational excellence; teamwork, collaboration and communication; accountability and an impeccable, healing environment.

 

II. Service Area

A. Hospital Service Area:

Catskill Regional Medical Center’s (CRMC) primary service area utilized for community health services planning has not changed since our Community Services Plan submittal in 2009.  CRMC’s service area for community and local health planning includes all fifteen townships within rural Sullivan County, New York.  CRMC is currently designated by both the New York State Department of Health and federal CMS as a sole community provider and a rural referral center.  CRMC, with Campuses in both Harris and Callicoon, is the sole acute care hospital servicing the 1,000 square mile County.  The Medical Center continues to actively partner with Sullivan County Public Health Service in evaluating and enhancing community health status.

Within Sullivan County the Hospital’s service area is divided into primary and secondary service areas.  The primary service areas are those Sullivan County townships and zip codes which are either closer to CRMC than any other facility or where CRMC has a predominant market share.  Specifically, the Sullivan County townships in the primary service area are Bethel, Callicoon, Cochecton, Delaware, Fallsburg, Forestburgh, Fremont, Liberty, Neversink, Rockland, Thompson and Tusten.  The primary service area zip codes are:  12701, 12720, 12723-12727, 12733-12736, 12738, 12740-12742, 12745, 12747-12754, 12758-12766, 12768, 12775-12779, 12782-12784, 12786-12789, 12791.

CRMC’s secondary service contains the townships of Highland, Lumberland and Mamakating within southeastern Sullivan County.  According to 2010 Census Data, these townships represent approximately 22% of Sullivan County’s overall population of 77,457.  The secondary service area zip codes include:  12719, 12721, 12722, 12732, 12737, 12743, 12769, 12770, 12781, 12785, 12790 and 12792.

B. Description of Service Area:

Sullivan County’s rural service area is characterized by: 1. An extensive and growing geriatric population;  2. Higher proportions of black and Hispanic populations when compared to most upstate New York rural communities;  3. Villages of Monticello, Fallsburg and Liberty surrounded by geographically dispersed rural populations;  4. An economic base predominantly comprised of agriculture as well as services focusing on healthcare, tourism, government, and education; and 5. An extensive medically indigent population with a high proportion of Medicaid recipients and individuals lacking health insurance coverage.

 

III. Participant and Catskill Regional Medical Center’s Role
 

CRMC recognizes that broad-based public participation is an integral component in the development and implementation of an updated Community Services Plan that is responsive to the health needs of the Sullivan County community.  The hospital has participated collaboratively in the Sullivan County Public Health Service (the local health department) 2010 – 2013 community needs assessment. Public participation was obtained through a series of four community health forums conducted in conjunction with Sullivan County Public Health Service.  These forums were held at various locations and times throughout Sullivan County to increase the likelihood of attendance by a broad cross-section of the community.  The forums included an evening program in Harris, NY to attract the working population, a meeting in Callicoon, N.Y., accessible to western Sullivan County consumers, as well as separate meetings in the more populous villages of Monticello and Liberty.  The four Sullivan County health forums were publicized by informational flyers in local post offices, newspaper stories in three local newspapers, radio announcements on several Sullivan County radio stations, as well as news coverage on Cable Television Channel 6.

The Sullivan County Health Department joined the six remaining Hudson Valley regional counties to conduct a consumer health survey funded through a HEAL 9 project grant. There were 280 respondents to the community surveys with a low percentage of both males and the elderly responding.  Survey findings identified additional community health needs including:  1.  High Sullivan County prevalence rates for obesity; 2.  Difficulty affording dental care treatment services; 3.  Significant need for diabetes and cardiovascular heart disease services; 4.  Falls prevention programs; 5.  Need for additional preventative health screening and educational program services.

The Sullivan County Public Health Department contracted with New York Medical College to carry out a regional needs assessment survey of healthcare providers in the County.  CRMC department heads and members of senior management completed and returned the provider questionnaire.  Furthermore, CRMC e-mailed the questionnaire to its complement of more than 200 Sullivan County medical staff members.  

CRMC actively participated in the Hudson Valley Regional Health Planning Summit in June 2010.  The Hudson Valley Health Planning Initiative, funded through a NYSDOH HEAL 9 grant, provided updated community health status data on both a local and regional basis.  The Hudson Valley Health Planning Summit focus groups identified several regional health planning priority areas including: 1) Access to quality healthcare; 2) Chronic Disease prevention and control; and 3) Maternal and child health.  The first two regional health planning objectives are fully consistent with CRMC’s updated Sullivan County Community Services Planning priorities.

In addition, CRMC received healthcare provider input and feedback from members of the Sullivan County Rural Health Network.  This Network is comprised of approximately one dozen local health and human service organizations, including administrative representatives from CRMC.  The Sullivan County Rural Health Network adopted three local healthcare priorities including:  1. Access to healthcare services; 2. Maternal and Child health issues; 3. Behavioral and substance abuse issues.  CRMC remains an active partner in the Sullivan County Rural Health Network as reflected in the selection of Anita Parkhurst, CRMC Grants Administrator, as a Rural Health Network Steering Committee member.

CRMC established a multidisciplinary Community Advisory Board during the fall of 2007.  The CRMC Community Advisory Board is comprised of 33 consumer and provider representatives who continue meeting quarterly to provide feedback on hospital performance, as well as to provide input on Sullivan County community health needs, issues and priorities.  The Hospital Advisory Board identified the prevention, care and treatment of chronic diseases including diabetes and cardiovascular disease, as well as behavioral health issues including mental health and substance abuse, as the highest priority of unmet healthcare needs throughout Sullivan County.

Both the Sullivan County Rural Health Network and CRMC Community Advisory Board continue meeting on a regular basis.  The Sullivan County Rural Health Network meetings are generally bimonthly, while the CRMC Community Advisory Board meetings are quarterly.

 

IV.  Identification of Public Health Priorities
 

CRMC utilized the broad-based input received at four community healthcare forums, Sullivan County consumer survey findings, Sullivan County Rural Health Network feedback as well as recommendations from the Hospital Community Advisory Board to select several health prevention priorities.  CRMC’s preliminary priorities were then reviewed by CRMC senior management executives with the Greater Hudson Valley Health System, the Sullivan County Health Department as well as other community partners.  CRMC has not altered its three paramount Sullivan County Public Health priorities since the 2009 Community Services Plan.

In order to measurably improve community health status by 2013, CRMC, working closely with key Sullivan County community health stakeholders, has adopted three prevention agenda items for Sullivan County. 

A.  Chronic Disease

Chronic disease is the first Sullivan County priority.  Selection of chronic diseases was predicated upon several factors including specifically:  1.  Its identification as a major community need within several community forums; 2.  Recommendation by the Hospital Community Advisory Board members that chronic diseases should be selected as a countywide health priority initiative; 3.  Sullivan County’s extensive and growing geriatric population manifesting high prevalence rates for diabetes, coronary heart disease, congestive heart failure, cardiovascular disease and cancer; 4. High hospital inpatient admission rates at both the Harris and Callicoon Campuses for chronic diseases; 5.  Sullivan County Health Indicator Profiles (2003-2007) substantiating high mortality rates for several chronic diseases.

The chronic disease community objectives posed by CRMC will focus upon achieving three objectives by the year 2013 in Sullivan County:  1.  Reducing the prevalence of adult diabetes and hospitalizations for complications of diabetes; 2.  Decreasing the age-adjusted coronary heart disease hospitalization rate and 3.  Reducing the congestive heart failure hospitalization rate among adults.

 
B.  Mental Health and Substance Abuse

The Hospital has selected mental health and substance abuse as the second health prevention focus.  Mental Health and Substance Abuse were selected as a high public community health priority initiative in Sullivan County because of several factors including:  1.  Consistency with Sullivan County Rural Health Network priority; 2.  Excessive mortality rates during timeframe 2003-2007 from both suicide and cirrhosis of the liver; 3.  Identification of the unmet need for additional mental health services within western Sullivan County outlying communities as well as forums; 4.  Strong recommendation by the Hospital Advisory Committee that mental health and substance abuse should be selected as a County Community Public Health Initiative.

CRMC’s Mental Health/Substance Abuse Sullivan County objectives will focus on:  1. Substantially reducing the excessive age adjusted suicide mortality rate; 2. Decreasing significantly the age adjusted alcohol and substance abuse hospital inpatient admission rates by 2013; 3.  Reducing the percentage of adult reporting greater than 14 days with poor mental health status to no more than 7.8%.

C.  Access to Quality Healthcare

The Hospital selected access to quality healthcare as the third project for the multidisciplinary Sullivan County Prevention agenda.  Access to Quality Healthcare was selected based on several considerations including: 1.  Consumer feedback at each community forum; 2.  NYS DOH Prevention Quality Indicator’s data substantiating large number of Sullivan County hospital inpatient admissions for ambulatory care sensitive conditions; 3.  Priority selection by Sullivan County Rural Health Network Members; 4.  Preliminary results and findings from the Consumer community health needs assessment survey questionnaire which indicated a need for additional, accessible primary medical care and dental services; and  5.  Documentation of nine rural western and northern Sullivan County communities as both primary care health professional shortage area, as well as medically underserved populations.

CRMC will work closely with Sullivan County Public Health Services and other community health organizations to enhance accessibility to quality healthcare services.  Together they will address this goal by focusing on these three objectives throughout Sullivan County:   1.  Expanding the percentage of adult residents who have a regular healthcare provider; 2.  Increasing the percentage of cancer cases diagnosed at early disease stage;  3.  Decreasing substantially from current baseline level of 19%, the proportion of adult residents lacking health insurance coverage.

 

V. Catskill Regional Medical Center’s Community Service Action Implementation Plan Update - 2012

CRMC prepared a three-year Community Services Action Implementation Plan for 2010-2012.  The Action Implementation Plan focuses specifically on long-range solutions to improve the community health status of Sullivan County.  The Plan utilizes the limited available resources to collaboratively implement cost-effective proposals for these public health priority areas. Specifically, the Plan focuses on:  1.  Chronic disease; 2.  Mental health and substance abuse ; 3.  Access to quality healthcare.

A. Chronic Disease:

In 2012, CRMC has focused on Diabetes education.  CRMC’s Diabetes education team has conducted numerous primary, secondary and tertiary prevention oriented educational programs at both Hospital Campuses as well as many community sites and events. The diabetes education team has attended over 30 events to date in 2012, and continues their weekly Diabetes Tip program on the widest reaching local radio station. 

The Grover Hermann Community Health Fair, in May 2012, had several hundred attendees who were provided free cholesterol blood screening in addition to community health education on preventing as well as managing chronic disease complications. Furthermore, CRMC staff members have attended several local events in which they provided blood pressure screenings, reaching more than 500 individuals.

CRMC, as an integral member of the Sullivan County healthcare delivery system, partners with a large number of community health and human service organizations to provide chronic care prevention services.  The Hospital provides space without remuneration for a large number of community support groups such as the Osteoporosis Support Group, the Diabetes Support Group, Cancer Support Group, and Cardiac Support Group.

CRMC conducts community health promotion programs focusing on cancer. CRMC receives three grants in support of the Sullivan County Cancer Services Program (CSP).  The CSP provides no-cost breast, cervical and colon cancer screening to eligible low-income, uninsured men and women throughout Sullivan County.  Diagnostic services are also available to individuals who require follow-up testing. In 2011, 160 Sullivan County residents received at least one screening exam through the program, and the team is looking to provide services to 300 Sullivan County residents in 2012. Also in 2012, CRMC in conjunction with the CSP hosted monthly breast cancer screening events at the CRMC Selma Ettenberg Women’s Health Center in Monticello.  The CSP held the first annual “Main Street Go Blue” event on Broadway in Monticello to promote colon cancer awareness during Colon Cancer Awareness Month.

In conjunction with the American Cancer Society Sullivan County cancer patients are provided cancer research awareness and updates on the scope of services.  Eligible patients diagnosed with breast, cervical, colon or prostate cancers are enrolled in the NYSDOH Medicaid Cancer Treatment Program for the duration of their treatment.  During June 2012, CRMC held its annual Celebration of Life Picnic which represents a life-enhancing celebration for cancer survivors; this past year more than 200 participants attended. 

B. Mental Health and Substance Abuse:

CRMC has selected Mental Health and Substance Abuse as the second component of the three year county community public health prevention agenda.  CRMC currently provides both inpatient substance abuse treatment and inpatient mental health services to Sullivan County residents.  To meet the county’s growing need for residential treatment, CRMC has entered into an agreement with Veritas Villa.  Veritas Villa, located in Kerhonkson, New York, offers separate men’s and women’s treatment services as well as a residential senior program for alcoholic and chemically dependent senior citizens.

In addition, CRMC participates in the recently formed Sullivan County Prescription Drug Task Force which was spearheaded by Sullivan County Public Health Services.  In 2012, the Task Force’s first priority is to quantify the extent of the prescription drug abuse crisis within Sullivan County.  The Task Force’s first prevention initiative for 2012 is to host “Prescription Drug Give Back Days” in conjunction with local law enforcement agencies.  The “give back” program provides Sullivan County residents a safe way to turn-in unused prescription medications and helps to keep those drugs out of the hand of teenagers.

 
C. Access to Quality Healthcare:

CRMC has selected access to quality healthcare as the final component for the three-year priority intervention plan.  CRMC has successfully completed or expanded several initiatives during 2012 to enhance accessibility to quality healthcare program services.

Established in late 2010, a primary care practice in rural Livingston Manor situated within the Rockland/Neversink federally designated primary care health professional shortage area has been expanding since it has opened. Through word of mouth, event appearances and marketing efforts, the number of patients has grown while the number of patient visits has remained constant. A primary care practice in Callicoon also has been growing. This practice gained a new nurse practitioner in January of 2011 and the monthly average number of patient visits has grown by 15% since the end of 2011.  Both Callicoon and Livingston Manor were both underserved areas that now have primary healthcare services.

Another major initiative to increase access to quality healthcare is the renovation, reconfiguration and expansion of the Harris Campus Emergency Department.  The Harris Campus of CRMC has experienced a 50% increase in emergency room utilization during the last decade which creates, at times, substantial operational inefficiencies.  CRMC utilized funding from five major funding sources, including both government grants and private donations for the Emergency Department expansion project.  The Emergency Department expansion has increased access to both emergent and urgent care services to Sullivan County residents.  Funding for the project came from several sources including:  a Health and Human Services award through Congressmen Maurice Hinchey; a grant from the Dormitory Authority of New York; a HEAL 15 New York State Department of Health Grant; a NYS Member Item Grant from Senator John Bonacic; and a significant donation from a local philanthropist.  The expanded Emergency Department facilities have substantially improved patient throughput while the additional new medical equipment ensures that CRMC is providing clinical excellence.  The Phase I renovation project was completed in the Fall of 2011 and the Phase II renovation project was completed in early 2012. 

CRMC has undertaken a community initiative to improve access to quality healthcare by improving healthcare literacy.  CRMC has established its Health Science Library as a Community Health Information Resource Center for Sullivan County consumers.  The Community Health Information Resource Center is open three days/week and staffed with a professional librarian. The librarian assists consumers to identify and procure reference health information in a format readily usable by consumers.  This program has been actively promoted to the community through events, press releases, radio appearances and seminars.  In collaboration with Cornell Cooperative Extension Caregivers Support program, CRMC received funding from the National Library of Medicine subcontract to provide health literacy education sessions to area senior groups.  In the first 8 months of 2012 the CRMC Health Sciences Librarian has conducted six “Communicating Effectively with Healthcare Providers” educational programs.

CRMC is very active in the community in promoting access to quality healthcare. Using a new tracking system in 2012, CRMC was able to quantitatively show increases or decreases in the number of outreach or educational events that CRMC participates in annually. Through the first 8 months of 2012 CRMC staff members have attended or showcased the hospital at more than 60 local events.  Participating in outreach events and other community activities allows CRMC representatives to educate attendees regarding the numerous inpatient and outpatient services that CRMC provides.  In 2012 new services included an upgraded MRI service in Harris and the addition of CT scanning in Callicoon.

As a way of encouraging local high school and community college students to choose careers in healthcare, CRMC hosts several health career programs including: New Visions Health Academy for BOCES students interested in careers in Medicine and Nursing, shadow programs for Orange County Community College MLT and Phlebotomy students, Livingston Manor Wellness Program to educate students on community health initiatives, Orange County Community College Radiology Tech students,  Sullivan County Community College RN students and Sullivan County BOCES adult education LPN students.

Additionally, CRMC offers many free support groups and no-cost or low-cost classes at the hospital, including: Childbirth Classes; Parenting Classes; Osteoporosis Support Group; Sexual Assault Trauma Recovery and Empowerment Group; Overeaters Anonymous; Bereavement Support Groups; Alzheimer's Group; Cancer Support Groups; Cardiac Support Group; Fibromyalgia; Chronic Fatigue Syndrome Myofasical Pain Support Group; Diabetes Discussion Group; Better Breathers and a Brain Injury Support Group. New in 2012 was the addition of a Hearing Loss Support Group.
The following are grants and funding that we have received in the past year, or from prior years that have helped us implement our access to quality healthcare priority:

CRMC receives funding from the New York State Department of Health, Office of Rural Health for both the Harris and Callicoon Campuses.  The 2011 and 2012 funding priority for these grants is specifically to enhance access to services for New Yorkers living in rural areas.  In 2011, funding was utilized to partially offset the cost of Krames-On-Demand patient education software as well as the building modifications necessary to install the CT equipment at the Callicoon Campus and the upgraded MRI equipment in Harris.  The building modifications will allow for enhanced diagnostic imaging services at both hospital Campuses.  In 2012 funding will be utilized to partially offset the equipment costs to implement electronic medical records program, renovations to the primary care office in Callicoon and the purchase of sterilization equipment for new scopes in the operating room.

In addition, CRMC received grant funding from three sources for its RISE (Rape Intervention Services and Education) Program.  The RISE program provides crisis intervention, group and individual counseling to victims of sexual assault and abuse.  RISE advocates also provide prevention education at several school districts within the county.  RISE is very active in the education at local High Schools. RISE funding comes to CRMC through two grants from the NYSDOH and a funding subcontract through the Sullivan County Rural Health Network.

The Callicoon Campus received funding through a NYSDOH initiative that supports Critical Access Hospital activities.  The Callicoon Campus received funding to partially offset the cost of PRI and Screen training for the Critical Access staff, case management training, cardiac core measure training and lab interface equipment compatible with the hospital’s new electronic medical record system through the Small Hospital Improvement Program (SHIP).

CRMC receives two grants each year, one for Harris and one for Callicoon, from the New York State Department of Health Bio-Terrorism Preparedness Program. These monies are used to help conduct internal as well as county-wide drills, subsidize training of staff and to purchase emergency preparedness equipment such as DeCon supplies, computer etc.  In 2011, CRMC participated in fifteen disaster drills and training sessions and similar sessions are planned for 2012.  In drills and training sessions, CRMC works closely with: Sullivan County Sheriff’s Office, Sullivan County Department of Homeland Security, Sullivan County Bureau of Fire, Sullivan County Public Health Services, Sullivan County E911 Office, New York State Police, Monticello Fire Department, (Harris), Callicoon Fire Department, (Callicoon) as well as area Ambulance Corps.  The CRMC Disaster Preparedness Team are members of and participate in the: Sullivan County Local Emergency Planning Committee, The Regional Preparedness Council and The Strategic National Stockpile Committee.

Finally, through a subcontract with the Sullivan County Rural Health Network (SCRHN), CRMC receives funding for three access-to-care initiatives.  As noted earlier, funding from the SCRHN is used to partially offset operating expenses for the RISE program.  In addition, the subcontract partially offsets the cost of having a designated cancer screening outreach coordinator in western Sullivan County.  Finally, a small portion of the SCRHN subcontract is used to partially offset the cost of medical language translation services which improves access and quality of care to CRMC’s non-English speaking patients within all CRMC’s departments.

One of the key barriers to implementing the plan is the fact that CRMC is a NYSDOH-designated financially-distressed hospital because of the Hospital’s high proportion of medically indigent patients.  This high proportion of medically indigent patients results in large amounts of bad debt and charity care, and limited discretionary financial working capital for community public health initiatives.  Therefore, the ability to collaboratively resolve these critical Sullivan County community public health initiatives will be conditional and largely predicated upon procuring additional financial resources.  Furthermore, the active participation and ongoing support by Sullivan County Public Health Service as well as other key community health and human service agency stakeholders will be essential for the successful resolution of these issues.

In addition to hospital sponsored programs, projects and activities, the culture attracts or fosters individual community leadership and service in community civic, political, educational and social welfare organizations promoting literacy, reducing child abuse and family violence, promoting participation in ambulance corps, economic development and beautification, and other efforts contributing to building a healthy community.  CRMC’s senior management and department heads participate on numerous community boards and organizations as an integral component of providing service to the greater Sullivan County community.  During 2011/2012, CRMC leadership staff actively participated in the Sullivan County Partnership for Economic Development, Sullivan County Rural Health Network, Sullivan County Community Services Board of Directors, Sullivan County Chamber of Commerce, Sullivan County Lions, Sullivan County Rotary, and Community Action Coalition to Help the Economy (CACHE).  The ongoing extensive leadership involvement is a testimonial to CRMC’s commitment toward achieving Sullivan County’s community health status and furthering critically needed economic development infrastructure.
 

VI. DISSEMINATION OF REPORT TO THE PUBLIC

CRMC recognizes that broad-based dissemination of our updated Community Services Plan is critical for insuring feedback from both Sullivan County consumers and healthcare providers.  We have utilized several different vehicles for making our updated Sullivan County Community Services Plan readily available to consumers as well as key governmental and provider stakeholders.  A press release announcing the availability of CRMC’s Community Services Plan was prepared and sent out by the Director of Public Relations and Marketing.
 

Copies of CRMC’s 2012 updated Community Services Plan were disseminated to:
1.  Local newspapers for distribution; 2. CRMC’s Health Information Library which is widely utilized by both Sullivan County consumers and healthcare providers. 3. Notice will be put into the monthly and quarterly CRMC newsletters.

Furthermore, CRMC has posted an updated copy of the Community Services Plan on the Hospital Web site.  CRMC’s Community Services Plan has an easily identified listing on the Hospital’s home page. The Community Services Plan is widely viewed by the Sullivan County public as reflected on data indicating there was an average of 95 individuals viewing that page per month during 2011 ranking it CRMC’s 15th most popular web page.
 

VII. CHANGES IMPACTING COMMUNITY HEALTH/PROVISION OF CHARITY CARE/ACCESS TO SERVICES
 

CRMC has several additional strategic planning initiatives which supplement the Sullivan County public health priorities.
CRMC is now a member of the Greater Hudson Valley Health System.  Active participation in the system will generate several, substantial healthcare advantages for Sullivan County residents including specifically:

1. Enhanced accessibility to medical and surgical specialty services presently unavailable;
2. Clinical best-practice benchmarking opportunity to further improve hospital quality of services and generate operational economies of scale;
3. Facilitating enhanced coordination of hospitalization services;
4. Access to a broad range of specialized administrative and financial expertise;
5. Capability of developing an integrated regional healthcare delivery system; 
The integrated healthcare delivery system has resulted in the implementation of electronic medical records system at both CRMC Campuses.  CRMC anticipates that the new EMR system will result in improved quality and fewer medical errors.

One initiative underway is the Grover Hermann Rural Critical Access Hospital expansion of its Bridge to Home Rehabilitation Program Initiative during the last two years.  The program is specifically designed to provide short-term intensive rehabilitation services to discharged hospital inpatients.  The Bridge to Home Rehabilitation program was developed to provide a bridge between acute care hospitalization and home.  The Bridge to Home Rehabilitation program has specifically targeted western Sullivan County’s extensive and growing geriatric population.  There are presently no long-term care facilities within 25 miles of western Sullivan County, substantially diminishing accessibility to short-term rehabilitation services for frail elderly individuals.
    
 

VIII. FINANCIAL AID PROGRAM

CRMC offers financial assistance to all patients that do not have medical coverage or non-covered benefits. Financial Counseling is available to the patients, focusing on applications for Medicaid or Medicaid HMO's in the high dollar services such as Inpatient, Ambulatory Surgery and Oncology. If denied or not eligible for any of the Medicaid programs, the patient is directed towards the Hospital Financial Assistance Program. Applications are available to all patients, including the Callicoon Campus and the Emergency Room, that live within primary and secondary service areas defined by zip code. The Financial Assistance Program has grown considerably in the past year, due in part to the program’s advertising and the employment status of the community. Signage has been put up throughout the Hospital system promoting the service in English and Spanish.

This policy was adopted to ensure that charitable care services are provided first to those patients without available health insurance coverage.    All patients lacking health insurance coverage will receive a substantial discount (53.5%) from current Hospital changes. This policy, consistent with both AHA and HANYS recommendations, is designed to ensure that patients without health insurance pay fees approximating Federal Medicare reimbursement rates.  CRMC is anticipating during the next year modifying its financial assistance program to charge Medicare rates for medically indigent individuals lacking health insurance coverage.

Furthermore, patients with limited financial assets and household income (lower than 300% of the current federal poverty level) are eligible for an additional discount based on income in accordance with our sliding fee schedule.

Primary and secondary service area zip codes for eligibility in the CRMC Financial Assistance Program were based on Sullivan County demographics, coupled with updated CRMC demographics.  The primary and secondary service areas encompass all fifteen Sullivan County townships, as well as adjacent communities in Wayne County, Pennsylvania and Ellenville within southwestern Ulster County where CRMC receives a significant number of inpatients for medical and surgical specialty services.

An installment plan has been developed and implemented to enable hospital patients to minimize the short-term financial impact from hospital payments.

CRMC will periodically review and update the Financial Assistance Policy and Guidelines on an ongoing basis. The Hospital anticipates that the declining economy and rising number of uninsured Sullivan County residents will substantially increase CRMC’s bad debt, as well as its charitable care requirements. The Hospital’s commitment to meet the ongoing substantive charity care contributions and additional bad debts substantiates CRMC’s compliance with its Mission and its willingness to serve all clinically appropriate patients including Sullivan County’s medically indigent who are lacking health insurance coverage.

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Copyright © 2013 Catskill Regional Medical Center
A member of the Greater Hudson Valley Health System