Community Health Needs Assessment

Methodology

The purpose of the Community Health Needs Assessment (CHNA) for Mount Sinai Medical Center of Florida, Inc. is to comply with 501(r) of the Internal Revenue Code. This CHNA was adopted on November 1, 2015.

The methodology of this report follows the recommendations of the Association of American Medical Colleges (AAMC) and the National Committee on Vital and Health Statistics.

The report includes statistical data and scholarly opinions from a variety of federal, state and local government health agencies and from private organizations and community stakeholders.

Additional input was sought from people representing the broad interests of the community as well as local health experts via public meetings, interviews and an online assessment survey.

For more details, please contact skilroy@msmc.com.

Mission

To provide high quality health care to our diverse community enhanced through teaching, research, charity care and financial responsibility.

Mount Sinai Medical Center is South Florida’s largest independent, not-for-profit teaching hospital. Mount Sinai provides acute and emergency care, cardiovascular, rehabilitation, neonatal, maternity and psychiatric services while remaining dedicated to graduate medical education as one of Florida’s largest six statutory teaching hospitals.

Each year, Mount Sinai invests more than $20 million in its teaching programs to train approximately 166 residents and fellows to be doctors in 17 medical specialties. Mount Sinai’s undergraduate medical education program serves more than 300 students annually.  The allied health program trains more than 500 students for health care professions.

Defining the Primary Service Area
Mount Sinai is located on and is the only hospital and emergency service provider on the northeastern barrier islands of Miami-Dade County.  These are 32 manmade islands which form a geographic enclave totaling 10.5 square land miles.  The city of Miami Beach is the largest Census Designated Place (CDP) on the barrier islands.

Northeastern Barrier Island Municipalities

Miami Beach
North Bay Village
Surfside
Bay Harbor Islands
Sunny Isles Beach
Indian Creek
Golden Beach
Bal Harbor
Miami (island)

According to inpatient use statistics, 31.3% of Mount Sinai inpatient discharges were residents from the city of Miami Beach.  An additional 18.5% were residents from other barrier island communities and four other neighboring “mainland” zip codes.

The remaining 34.3% of inpatient discharges were evenly distributed among 80+ Miami-Dade County zip codes.  This reinforces Mount Sinai’s historical role as serving greater Miami-Dade Dade with its core specialties.  Additionally, 13.3% of inpatient discharges were associated with out-of-county, out-of-state and international zip codes.

Demographic Summary

Population
The Barrier islands are estimated to have 130,638 year round residents.  Of this total, 87,779 are within the immediate service area of Miami Beach.  Miami-Dade County’s population is 2,500,625.

Gender
The primary service area has a larger percentage of males (51%) than females (49%).  This is similar to the Miami-Dade County composition of males (48%) and females (52%).

Age
The primary service area is an older population. The median age is 40.3 years old.  This is slightly older than the County and national median age. The significance of this is that disease related death increases with age.

Race & Ethnicity
The primary service area’s residents are 87.4% White, 4% Black and 8.4% all others. The county by contrast is 74% white, 19% Black with 5.7% all others.  In the primary service area, 51% report their ethnicity as Hispanic.  Countywide, 65% report their ethnicity as Hispanic.

Income
The median household income for the primary service area is $42,265. This is lower than the county, state and national median.  However, Miami Beach has pockets of extreme wealth with 7.2% of the population earning more than $200,000 and extreme poverty with 15.3% living below the federal poverty line.

Educational Attainment
The primary service area has a high rate of adults over 25 with four-year college degrees – 42.3%.  In contrast, the county’s rate is 25.2%.

Health Disparity Assessment
Wide differences in income and education, new US residency and lesser English skills are factors that point to a niche of residents for which there may be a healthcare disparity and a need of safety net healthcare services.

Community Health Needs

The community health priorities presented are based on an analysis of demographic, environmental, statistical and behavioral public health data.

Leading Causes of Disease Related Death Population Healthcare Service Priorities
Heart Disease Addressing the Physician Shortage
Cancer Safety Net Services – Uninsured
Stroke Geriatric Medicine
Chronic Obstructive Pulmonary Disease Maternity & Prenatal Medicine
Mental & Behavioral Disorders Emergency Medical Services
Environmental Health Priorities Behavioral Health & Other Priorities
Sun Protection/ UV Radiation Nutrition & Physical Activity
Prevent Drowning Injury/Death Reducing Tobacco & Alcohol Use
AIDS/HIV Prevention & Treatment

Implementation Strategy

Adoption Date
The outlined implementation strategy was adopted by Mount Sinai Medical Center as required in 501 (r) 3 of the Internal Revenue Code on April 4, 2016.

Tier One – Provide a wide range of Safety Net services
First, Mount Sinai will continue to provide a wide variety of community health services in its role as a teaching and community hospital, and sole emergency services provider on the northeastern barrier islands of Miami Dade County.

  • Training to address Florida’s physician and healthcare worker shortage
  • Charity care for the uninsured and underinsured;
  • Disaster first response health services and regional leadership
  • Emergency medical services;
  • Adult psychiatric and behavioral care;
  • Intensive geriatric / senior care;
  • Maternity services and neonatal emergent care;
  • Health and disease prevention education;
  • Interventional and community health screenings.

Tier Two – Focus Centers of Excellence on Mission Drive Community Health Priorities
Mount Sinai will focus resources on the leading disease related conditions that cause fatalities and other identified local  health care needs for its teaching mission and fiscal responsibility.

  • Address Heart Disease;
  • Address Cancer;
  • Address Stroke;
  • Address Alzheimer’s Disease;
  • Address Chronic Obstructive Pulmonary Disease.

Community Healthcare Resources within Three Mile Radius
Within three miles of Mount Sinai, there are no other acute care hospitals. There are four public health centers, including three Federally Qualified Health Centers: the Miami Beach Community Health Center (two locations) and the Borinquen Health Care Center.  For substance and mental health issues, there are two residential treatment centers.  For geriatric residential services, there are five nursing homes and five assisted living facilities.

Community Health Needs Not within the Implementation Strategy
Specialized AIDS/HIV services are not within the implementation strategy.  These health services for the uninsured or underinsured are already provided by the Miami Beach Community Health Centers, the Borinquen Health Care Center and Jackson Memorial Health Center and the Miami-Dade County Health Department/Office of HIV/AIDS.

Ongoing General and Expert Community Input
Mount Sinai is committed to receiving input to better assess community health needs.

Community Health Needs Survey
As part of a three-year strategy, an online health needs assessment survey modeled on questions used by the National Center for Chronic Disease Prevention and Health Promotion Risk Factor Surveillance System will collect input from those in the service area.  The survey instrument will be promoted through advertising and marketing efforts.

City of Miami Beach Health Advisory Committee
Mount Sinai maintains a seat and lead role on the Health Advisory Committee of the City of Miami Beach, along with the Miami Beach Community Health Center and the Health Council of South Florida.  This is a body of local representatives that meet to address the demographic and health issues illustrated in this report in a publicly advertised meeting forum.

Public Access and Community Comment on this Health Needs Assessment
This report will be widely available on www.msmc.com.  Public comment can be addressed to the Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, Florida 33140.

Conroy, Joanne M, M.D, Chief Health Care Officer.  A letter from the Association of American Medical Colleges (AAMC) to the Internal Revenue Service Regarding: Notice 2010-39, Requests for Comments Regarding Additional Requirements for Tax-Exempt Hospitals. July 19, 2010.

National Committee On Vital and Health Statistics. (2010) Recommendations on Community Health Assessment and the Roles of State Health Agencies and the Federal Government. Retrieved from http://www.ncvhs.hhs.gov/commrec1.htm.