Mary Hitchcock Memorial Hospital

Programs: Mary hitchcock memorial hospital (the hospital), is an acute and tertiary care teaching hospital located in lebanon, new hampshire. The hospital is a not-for-profit organization, as described in section 501(c)(3) of the internal revenue code (the code) and is exempt from federal income taxes on related income pursuant to section 501(a) of the code. The hospital provides a broad range of patient services and health related community services, consistent with its role as a major teaching hospital, a tertiary care referral hospital, and as a prospective payment system hospital (as defined by cms). These include a full range of services in both acute and critical medicine, surgery, psychiatry and rehabilitation for infants, children and adults. During fy 2017 the hospital provided 126,886 acute patient days of inpatient service and had 27,786 total acute care discharges, while the hospital's emergency room was open to the public 24 hours per day, 7 days per week and had 31,387 discharges. Dartmouth-hitchcock clinic provides the physician staff to the hospital and the sophistication essential for the development of the hospital as the largest and only teaching hospital in new hampshire and the designation by the federal government as a rural referral center for northern new england. The shared mission of the hospital and clinic is to advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time. Consistent with this mission and in partnership with the dartmouth-hitchcock clinic, the hospital provides high quality, cost effective, comprehensive, and integrated health care to individuals, families, and the communities it serves regardless of a patient's ability to pay. The hospital actively supports community-based health care and promotes the coordination of services among health care providers and social services organizations. Through formal affiliations and other clinical collaborations, the hospital also seeks to partner with other area health care providers to improve the health status of the region. The jack byrne center for palliative & hospice care, on which construction began in 2016 and which will admit its first patients in december, 2017, will coordinate the clinical, educational, and research efforts of the hospital and visiting nurse alliances around the region, to offer much-needed care for patients at the end of life, in a clinical setting that meets the needs of patients and their families. The hospital also continues to build its telemedicince program to provide care across its rural region and in particular to make specialist consultation and care available to community hospitals. This allows caregivers at remote locations to access specialists at dartmouth-hitchcock and bring them "virtually" to the patient's bedside. D-h's connected care center in lebanon offers a 24/7 team of physicians, pharmacists, and nurses supporting care in 40+ specialties to 11 facilities in new hampshire and vermont. Acute care telehealth service lines, which include teleemergency, telepharmacy, teleneurology, and teleicu, bring together pools of doctors and nurses from all over the country and the world. During fy17, telepsychiatry and teleurgentcare were added as services within the d-h connected care center. In an effort to integrate behavioral health and primary care, the hospital is the lead convener for the state of new hampshire delivery system reform incentive program ("dsrip") for the region 1 integrated delivery network. This program is funded through a section 1115 waiver research and demonstration transformation waiver that the state of new hampshire received from cms. The waiver enables health care providers and community partners within a region to form relationships focused on transforming care, to combat the opioid crisis, and strengthen the states strained mental health system. This work began in july 2016 and will continue through december 31, 2020. In addition to the hospital, dartmouth-hitchcock clinic and cheshire medical center are playing leadership roles in this initiative. The hospital files an annual community benefits report with the state of new hampshire which outlines the community and charitable benefits they provide. The most recent community benefits reports are available upon request or can be found on dartmouth-hitchcock's web site (www. Dartmouth-hitchcock. Org). Financial assistance, formerly called charity care, represents services provided to patients who cannot afford health care services due to inadequate financial resources which result from being uninsured or underinsured. For the year ended june 30, 2017 the hospital provided financial assistance to 5,417 patients in the amount of $15,421,451, as measured by gross charges. The estimated cost of providing this care for the year ended june 30, 2017 was $6,453,877. The hospital also routinely provides services to medicaid patients at reimbursement levels that are below the cost of the care provided. The community health activities includes the cost or value of several different types of programs including the cost of community based education, health fairs, health screenings, support groups, and programs and materials that promote wellness and prevent illness. Examples of these types of efforts include partnering with the healthy eating active living nh initiative, the women's health resource center, and smoking prevention and cessation. This category also includes financial contributions and the contribution of time and services to community programs, hospitals and agencies. The hospital also provides a significant amount of uncompensated care to its patients reported as provision for bad debt, which is not included in the amounts reported above. During the year ended june 30, 2017, the hospital reported a provision for bad debt of approximately $23,850,195.

as a component of new hampshires only integrated academic medical center, the hospital provides the geisel school of medicine at dartmouth (gsm) support for physicians' unpaid teaching time as part of its community benefit initiatives, consisting of the time physicians spend providing clinical supervision and education for residents and medical students. In addition, the hospital provides in-kind support for research and other grants representing costs in excess of awards for numerous grant-funded health research and service initiatives awarded to the clinic and gsm. Other community benefit initiatives include subsidizing the costs of providing medical and clinical education to professionals across new hampshire, vermont and beyond as well as uncompensated costs of academic and medical research activities. Beginning in fy17, dartmouth-hitchcock began a transition of research activities and management from the geisel school to d-h. This transition saw the recruitment of a new vice president for research operations to develop the research enterprise.