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E L L I O T H E A L T H S Y S T E M C O M M U N I T Y B E N E F I T R E P O R T 2 0 1 5 New Hampshire is living better.

What is Community Benefit? Community Benefits are programs and services that address community healthcare needs and include but are not limited to: Financial Assistance Also known as Charity Care, these are free or discounted health services provided to persons who cannot afford to pay and who meet Elliot s financial assistance policy criteria. Community Health Improvement Services These are community outreach, education, and wellness programs we engage in for which we are not reimbursed. Subsidized Health Services These are clinical services provided despite a financial loss so significant that a negative margin remains after removing the effects of financial assistance, Medicaid shortfalls and bad debt. Health Professions Education This includes contributing to the education of future and current health care professionals in training that is required by state law, accrediting body or health profession specialty. Research This includes studies or investigations designed to generate knowledge that will be made available to the public. Financial Contributions These are in-kind services donated to community organizations that support community benefit activities provided by others. Community Building Activities These are programs that address underlying causes of health problems and thus improve health status and quality of life such as poverty, homelessness and environmental hazards. Information provided by: CHA A Guide for Planning & Reporting Community Benefit 2012 edition

Inpatient Behavioral Heath As a statewide leader in providing inpatient behavioral healthcare, Elliot has been offering comprehensive services to the community for all ages and stages of illness. Elliot is one of the few remaining Designated Receiving Facilities in the state, accepting both adult and geriatric patients, who are unable to maintain their safety. With two inpatient units, employing highly trained and skilled providers and staff, Elliot is positioned to help patients and families address serious behavioral and psychiatric issues. Elliot s 29-bed geriatric psychiatric unit (GPU) serves patients age 65 and older, suffering from various psychiatric illness such as dementia, psychotic and mood disorders, anxiety, and depression. Last year this unit admitted close to 300 patients and provided Electroconvulsive Therapy (ECT) treatments to 200 inpatients. Pathways is Elliot s 12-bed adult psychiatric unit, caring for patients from 18-64 years old suffering from acute episodes of psychiatric illness including psychotic and mood disorders, anxiety, and depression. Close to 500 patients were admitted to this unit last year, with the psychiatrists on the service also providing numerous consults to patients on the medical floors with psychiatric needs.

Outpatient Behavioral Health Complementary to our inpatient services, are Elliot s Behavioral Health Outpatient Services, treating patients ages 2-65 for a variety of diagnosis that impact patients day to day lives. With eight therapists, three psychiatric nurse practitioners and three outpatient psychiatrists, our outpatient services continue to meet a rising critical need for the community. Utilizing a co-location model, most of our clinics are located within our primary care physician offices. We have sites in Hooksett, Bedford, Londonderry, Windham, Raymond and Manchester as well as the Pain Center at River s Edge. Last year alone we completed 21,858 visits in the outpatient clinics. In 2015, we took co-location one step further and started an integrated care program at three of our sites. This integration creates access to a therapist while patients visit with their primary care provider. This allows for complete, whole-body treatment and care planning. In this model, we offer short term treatment of 6 8 sessions of therapy to get the patient back on their feet as soon as possible. This program assists patients in managing the issue at hand without having to commit to years of therapy. The primary care physicians enjoy the support of a therapist in their office knowing that they can offer comprehensive care to their patients.

Value to the Community: Elliot provides over 120 million in unfunded care. FY 2015 Medicare 36,133,674 Bad Debt, 11,872,870 Charity Care, 8,809,814 Community Benefit Activities, 18,760,873 Community Health Health Professions Education Subsidized Health Services Medical Research Financial Contributions Community Building Community Benefit Operations Activites Total FY 2015 Financial Benefit 143,850 995,446 16,565,882 5,456 641,513 219,181 189,545 18,760,873 Medicaid 45,262,135 FY 2015 Financial Benefit Charity Care 8,809,814 Community Benefit Activities 18,760,873 Medicaid 45,262,135 Medicare 36,133,674 Bad Debt 11,872,870 Total Unfunded Care 120,839,366 Financials Last year, Elliot provided over 120 Million dollars in unfunded care to the community. This included Charity Care for those who do not have the means to pay, and Community Benefit Activities whereby Elliot provided such things as education, research, and subsidized health services for the community. Also included in the unfunded care was the Medicare and Medicaid shortfall and bad debt. Almost 75% of the uncompensated care to the community comes from the medical care provided to the elderly and indigent without reimbursement from the state and federal government for the cost of that care.

M I S S I O N Elliot Health System strives to: INSPIRE wellness HEAL our patients SERVE with compassion in every interaction. THE COMMUNITY WE SERVE Elliot offers Greater Manchester Communities the best possible and most appropriate patient care. The patient shall not be denied appropriate care on the basis of race, religion, color, national origin, sex, age, disability, marital status, sexual orientation or source of payment. The Greater Manchester Community Health Needs Assessment June 2013 is the most recent community needs assessment which as identified areas of need that healthcare organization should address in the coming year(s). Elliot would like to ask you to help us rate the areas of need that you feel are most important among the list. Please select the top three areas of need in your opinion. Aging Issues: stroke, Alzheimer s, pneumonia, transportation, medication coordination, caregiver support, inadequate out of home care Ambulatory Care Sensitive Conditions marker for lack of adequate preventive care: need care coordination Barriers to access of health care services related to poverty: lack of insurance, cost, transportation, lack of information on how to access care and what services are available if uninsured, language, lack of a medical home Behavioral Health Issues: mental health services and access, substance abuse specifically illicit drug use and tobacco use and Violence & Crime: neglect and abuse, safe neighborhoods, suicide, youth crime Chronic disease: heart disease, cancer, COPD, and Asthma Dental services/access: specifically for adults Obesity: diabetes, poor eating habits, lack of physical activity Teen Pregnancy STD s: specifically chlamydia Are there areas of need that do not appear on the list that you feel are more important? If so, please specify: If access to care is an barrier to receiving care, please specify what the issue is that you face: Language and/or cultural barriers Timeliness of a scheduling appointments Availability of the service in our area Other: Please tear off this page or cut out this questionnaire and send us your feedback: Elliot Community Benefit, c/o Jennifer Driscoll, 445 Cypress Street, #8, Manchester, NH 03103 Concern over a medical bill should never prevent a patient from receiving quality health care. Patients with financial concerns are encouraged to call a Financial Advocate at 603-663-7235 or visit our website at http://elliothospital.org/website/paymy-bill-financial-assistance.php Community Benefit Staff Jennifer Driscoll VP, Planning and Business Development Michelle Drewniak Community Benefit Coordinator 603.663.2822 This report is produced by the Elliot Public Affairs and Marketing Department E L L I O T H E A L T H S Y S T E M C O M M U N I T Y B E N E F I T R E P O R T 2 0 1 5