2026-05-07T12:30:28-05:00 2025-06-30 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2024-07-01 222807681 MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC MEMO 5855931100 191 NORTH MAIN STREET WELLSVILLE NY 14895 BOYD CHAPPELL CHIEF FINANCIAL OFFICER 5855931100 2026-04-23 1 1 AIMEE JOZIC P01329472 5853811000 2026-04-23 2024 2025-03-06 01:10:19Z BOYD CHAPPELL 191 NORTH MAIN STREET WELLSVILLE NY 14895 107027980 0 X WWW.URMC.ROCHESTER.EDU/JONES-MEMORIAL-HOSPITAL X 1921 NY JONES MEMORIAL HOSPITAL IS COMMITTED TO ENSURING ACCESS TO THE HIGHEST QUALITY HEALTHCARE FOR OUR COMMUNITY IN A CARING MANNER. 16 11 600 60 0 0 7493556 953750 68677425 93533006 87780 109495 6435016 12403704 82693777 106999955 0 0 0 0 33862776 40088352 0 0 0 41849458 56500500 75712234 96588852 6981543 10411103 96754018 105845618 46598623 45282326 50155395 60563292 JONES MEMORIAL HOSPITAL PROVIDES THE HIGHEST QUALITY HEALTHCARE IN A CARING MANNER TO IMPROVE THE QUALITY OF LIFE FOR OUR COMMUNITIES. 0 0 82316431 105495181 QUALITY OF HEALTH CARE: THE MEMORIAL HOSPITAL OF WILLIAM F. & GERTRUDE F. JONES, INC. A/K/A JONES MEMORIAL HOSPITAL IS A SOLE COMMUNITY PROVIDER WITH 49 ACUTE CARE BEDS, NOT FOR PROFIT, LOCATED IN RURAL WELLSVILLE NY IN A PROFESSIONALLY UNDERSERVED AREA. WE PROVIDE PRIMARY CARE, AMBULATORY CARE, EMERGENCY CARE AND ACUTE (MEDICAL, SURGICAL, PEDIATRIC, OB AND GYN) AND INTENSIVE CARE PLUS COMMUNITY OUTREACH PROGRAMS. WE ADMITTED 1,670 PATIENTS PLUS 362 BIRTHS. THE HOSPITAL HAS PROVIDED CHARITY CARE TO INDIGENT PATIENTS TOTALING $548,746. 82316431 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 116 0 1 600 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X BOYD CHAPPELL 5855964002 191 N MAIN ST WELLSVILLE NY 14895 KAROL MARCIANO CHAIRPERSON 1.00 55.00 X X 0 166119 45723 DANIEL JOHNSON VICE CHAIRMAN 1.00 X X 0 0 0 JENNY BILOTTA TREASURER 1.00 X X 0 0 0 STEVEN GOLDSTEIN BOARD MEMBER 1.00 71.00 X 0 1408233 183208 MARK TAUBMAN BOARD MEMBER 1.00 75.00 X 0 742745 44194 MICHAEL APOSTOLAKOS BOARD MEMBER 1.00 64.00 X 0 733026 115508 SAMANTHA GILKEY BOARD MEMBER 2.00 X 0 0 0 RICHARD EWELL BOARD MEMBER 1.00 X 0 0 0 IAN JONES BOARD MEMBER 1.00 X 0 0 0 JAMES KNAPP SECRETARY 1.00 X X 0 0 0 RHIANNON SISSON BOARD MEMBER 1.00 X 0 0 0 STEVEN MAURO BOARD MEMBER 1.00 X 0 0 0 ANDRES RUBERT MD CHIEF OF MEDICAL STAFF 40.00 X 386600 0 31651 JUDITH HOPKINS BOARD MEMBER 1.00 X 0 0 0 AMY BENNETT BOARD MEMBER 1.00 X 0 0 0 JENNIFER JOYCE BOARD MEMBER 1.00 X 0 0 0 JAMES HELMS CHIEF EXECUTIVE OFFICER 40.00 X 271154 0 18974 BOYD CHAPPELL CHIEF FINANCIAL OFFICER 40.00 X 228617 0 10350 PAUL AXTELL MD ORTHOPAEDIC SURGEON 40.00 X 718000 0 45618 HEATHER LANPHERE MD OB/GYN 40.00 X 474010 0 37188 NISHANT CHAUDHARY MD HOSPITALIST 40.00 X 444891 0 34312 SADDAM YASIN MD PEDIATRICIAN 40.00 X 455650 0 20655 LU-ANNE KAYE OB/GYN 40.00 X 365530 0 31112 3344452 3050123 618493 60 0 1 0 DELPHI HOSPITALIST SERVICES 2701 CULVER ROAD ROCHESTER NY 14622 STAFFING 1736603 DELPHI HEALTHCARE 2701 CULVER ROAD ROCHESTER NY 14622 STAFFING 1303615 PICCO PULMONARY & INTERNAL MEDICINE 11 MAIN STREET HORNELL NY 14843 MEDICAL PHYSICIAN 975715 KINLEY CONTRACTORS 2383 W FIVE MILE RD ALLEGANY NY 14706 CONSTRUCTION 462767 STONEBRIDGE ANESTHESIA SERVICES 910 GENESEE ST STE 200 ROCHESTER NY 14611 CRNA 349575 10 334118 277713 341919 953750 PATIENT SERVICE REVENUE 621990 93533006 93533006 93533006 109495 109495 113168 28025 85143 85143 85143 340B CONTRACT PHARMACY 900099 9998416 9998416 OTHER INCOME 900099 1963759 1963759 CAFETERIA 722514 386495 386495 -30109 -30109 12318561 106999955 105495181 0 551024 X 578991 578991 33097857 29071630 4026227 149092 138897 10195 6262412 5427083 835329 153588 153588 143180 143180 19496619 18685180 811439 118419 675 117744 74028 5650 68378 91768 12520 79248 1491030 1390342 100688 117189 82623 34566 399823 399823 4334017 2364426 1969591 498174 233792 264382 SUPPLIES 20113978 20048905 65073 PURCHASED SERVICES 6156351 3378533 2777818 OTHER EXPENSES 1732813 86727 1646086 REPAIRS AND MAINTENANCE 1132754 1048555 84199 446769 340893 105876 96588852 82316431 14272421 0 8692187 5451203 5537433 16503689 351408 263175 10238432 9903160 1474961 1288417 203065 381204 74836301 33932905 43502099 40903396 143845 226970 26610588 30924404 96754018 105845618 10215274 7708510 36383349 37573816 46598623 45282326 X 45750449 57155379 4404946 3407913 50155395 60563292 96754018 105845618 X 10411103 360901 -364107 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 8027 8027 0 PART II-B, LINE 1: AS A MEMBER OF AMERICAN HOSPITAL ASSOCIATION, INC. AND HEALTHCARE ASSOCIATION OF NEW YORK STATE, INC., A PORTION OF MEMBERSHIP DUES REPRESENTS AMOUNTS DESIGNATED FOR LOBBYING ACTIVITIES. THESE ASSOCIATION ORGANIZATIONS, OF WHICH THE HOSPITAL IS A MEMBER, PERFORMS DIRECT LOBBYING AND ADVOCACY ACTIVITIES ON BEHALF OF ITS MEMBERS. 286460 26687 313147 252845 33615 286460 229814 23031 252845 267607 -37793 229814 212182 55425 267607 1.00000 0 1 1 393177 393177 39303516 14399554 24903962 968631 851416 117215 31367030 18161910 13205120 2803947 520025 2283922 40903396 ESTIMATED THIRD-PARTY PAYOR RECEIVABLES 1488850 BENEFICIAL INTEREST IN PERPETUAL TRUST 2152518 BENEFICIAL INTEREST IN FOUNDATION 1296013 GOODWILL 2230000 OTHER RECEIVABLES 2874040 INSURANCE CLAIMS RECEIVABLE 2622224 OPERATING RIGHT OF USE ASSET 5192202 DUE FROM AFFILIATES 11812965 FINANCE RIGHT OF USE ASSET 1255592 30924404 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS, NET 1344277 ASSET RETIREMENT OBLIGATION 625887 OPERATING LEASE LIABILITY 6669298 PENSION LIABILITY 1493584 INSURANCE LIABILITY 2515393 DUE TO AFFILIATES 24925377 37573816 PART V, LINE 4: TO SUPPORT JONES MEMORIAL HOSPITAL 1 1 1 X 1 X 1 1 1 0 1 1 505749 0 505749 0.00520 19823609 11769178 8054431 0.08340 0 0 20329358 11769178 8560180 0.08860 6 4899 6785 6785 0.00010 1 60000 20000 20000 0.00020 7 64899 26785 26785 0.00030 7 64899 20356143 11769178 8586965 0.08890 4 4936 2777 2777 0.00000 4 4936 2777 2777 0.00000 1 3440568 17999174 21573523 -3574349 X 1 1 1 1 JONES MEMORIAL HOSPITAL 191 NORTH MAIN STREET WELLSVILLE NY 14895 HTTPS://WWW.URMC.ROCHESTER.EDU/JONES-M X X X X JONES MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 25 1 1 1 1 X HTTPS://WWW.URMC.ROCHESTER.EDU/JONES-MEMORIAL-HOSPITAL/ABOUT-US/COMMUNITY-S X CHROME-EXTENSION://EFAIDNBMNNNIBPCAJPCGLCLEFINDMKAJ/HTTPS://WWW.ALLEGANYCO. 1 25 1 URMC.ROCHESTER.EDU/JONES-MEMORIAL-HOSPITAL/ABOUT-US/COMMUNITY-SERVICE-PLAN 0 1 X 200.000000000000 400.000000000000 1 1 X X X 1 X URMC.ROCHESTER.EDU/PAY-A-BILL/FINANCIAL-ASSISTANCE/JONES-MEMORIAL-HOSPITAL X RMC.ROCHESTER.EDU/PAY-A-BILL/FINANCIAL-ASSISTANCE/JONES-MEMORIAL-HOSPITAL X URMC.ROCHESTER.EDU/PAY-A-BILL/FINANCIAL-ASSISTANCE/JONES-MEMORIAL-HOSPITAL X X X X X 1 X 0 X X X X 1 X 0 0 JONES MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: PLEASE SEE SCHEDULE H, PART VI, LINE 2 SUPPLEMENTAL INFORMATION. JONES MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: CUBA MEMORIAL HOSPITAL. JONES MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: ALLEGANY COUNTY DEPARTMENT OF HEALTH, ALLEGANY COUNTY COMMUNITY WELLNESS COMMITTEE AND CUBA MEMORIAL HOSPITAL. JONES MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: DOMAIN AREA: ECONOMIC STABILITY PRIORITY AREA: NUTRITION SECURITY: INTERVENTIONS/STRATEGIES/ACTIVITIES WILL WORK TOWARD INCREASING FOOD SECURITY IN HOUSEHOLDS WITH AN ANNUAL TOTAL INCOME OF LESS THAN $25,000 FROM 46% TO 61.4% BY EXPANDING AND CREATING ACCESS POINTS AT LOCATIONS SUCH AS COLLEGES, SCHOOLS, EMERGENCY FOOD PROGRAMS, FOOD PANTRIES, COMMUNITY GARDENS, FARMERS MARKETS AND MORE - TO GET AFFORDABLE, HIGH QUALITY, AND NUTRITIOUS FOOD TO FAMILIES. JMH- FINANCIALLY SUPPORTS AREA FOOD PANTRIES THROUGH MONETARY DONATIONS (WELLNESS FUNDS) ESTIMATES OF NUMBER OF MEALS/FAMILIES SERVED. CARE TEAM MAKE REFERRALS SHARE FOOD PANTRY INFORMATION DOMAIN AREA: SOCIAL AND COMMUNITY CONTEXT PRIORITY AREA: DEPRESSION INTERVENTIONS/STRATEGIES/ACTIVITIES WILL WORK TOWARD REDUCING THE PERCENTAGE OF ADULTS WITH A MAJOR DEPRESSIVE EPISODE DURING THE PAST YEAR IN ALLEGANY COUNTY BY DECEMBER 2030 THROUGH THE DEVELOPMENT OF A COLLABORATIVE CARE MODEL TO ENSURE THAT INDIVIDUALS WITH DEPRESSION RECEIVE TREATMENT. ER, URGENT CARE AND MEDICAL PRACTICES SCREEN FOR MENTAL HEALTH AND BASED ON SCORE, PROVIDER MAKES APPROPRIATE REFERRALS FOR TREATMENT. - SOCIAL WORKERS AND BEHAVIORAL HEALTH OFFICER ASSIST WITH CONNECTING PATIENTS WITH SERVICES. JMH PRACTICES: IN THE PRACTICES WE ARE SCREENING INDIVIDUALS, AT MINIMUM, ANNUALLY FOR ANXIETY (GAD7) AND DEPRESSION USING THE PHQ2 AND PHQ9 (IF PHQ2 IS POSITIVE) SCREENINGS IN EPIC. THE NURSES COMPLETE THE SCREENING, AND THE PROVIDER FOLLOWS UP WITH ASSESSMENT AND RECOMMENDATION. THIS IS EASILY IDENTIFIABLE IN THE HEALTH MAINTENANCE SECTION WHEN THE SCREENING WAS LAST COMPLETED. DOMAIN AREA: HEALTHCARE ACCESS & QUALITYPRIORITY AREA: PREVENTATIVE SERVICES FOR CHRONIC DISEASE PREVENTION AND CONTROL INTERVENTIONS/STRATEGIES/ACTIVITIES WILL FOCUS ON INCREASING THE PERCENTAGE OF ADULT MEDICAID MEMBERS AGED 18 YEARS AND OLDER WITH HYPERTENSION WHO ARE CURRENTLY TAKING MEDICATION TO MANAGE THEIR HIGH BLOOD PRESSURE FROM 79.5% TO 80.7% BY IMPLEMENTING COMMUNITY SCREENINGS TO DETECT AND ADDRESS HYPERTENSION IN ADULTS WHO MAY NOT HAVE REGULAR ACCESS TO CARE. ALLEGANY COUNTY: 2016-2021 RATE IMPROVED FROM 71.6% TO 79.5% NYS WAS AT 80.2%. JMH: - PROVIDE COMMUNITY HEALTH FAIRS TO SCREEN FOR HBP 3-4 ANNUALLY- BLOOD PRESSURE PROGRAM IN COLLABORATION WITH JMH PROVIDERS - BLOOD PRESSURE MACHINES IN JMH LAB AND YMCA. PRIORITY AREA: PREVENTATIVE SERVICES LEAD SCREENINGS: INTERVENTIONS/STRATEGIES/ACTIVITIES WILL FOCUS ON INCREASING THE PERCENTAGE OF CHILDREN IN A SINGLE BIRTH COHORT TESTED AT LEAST TWICE FOR LEAD BEFORE 36 MONTHS OF AGE FROM 52.57% TO 60% IN ALLEGANY COUNTY BY DECEMBER 2030. - THE ALLEGANY COUNTY DEPARTMENT OF HEALTH ACTIVELY WORKS TO PROVIDE EDUCATION AND OUTREACH ABOUT THE DANGERS OF LEAD POISONING FOR CHILDREN, AND OUR PARTNERS WILL CONDUCT OUTREACH IN COMMUNITIES THAT HAVE OLDER, POORLY MAINTAINED HOUSING WITH HIGH-RISK FOR LEAD EXPOSURE, AND PROVIDE EDUCATION REGARDING LEAD EXPOSURE PREVENTION TO FAMILIES. - JMH- SCREENS AND EDUCATES PARENTS OF ONE AND TWO YEAR OLD CHILDREN FOR LEAD AT MEDICAL VILLAGE PEDIATRICS, DR KAYE, BRADLEY, HORNELL SUITE 109, HORNELL PEDIATRICS, NORTH MAIN STREET OFFICE. 10 1 - JONES MEMORIAL HEALTH CARE CLINIC 127 N MAIN STREET WELLSVILLE NY 14895 EXTENSION CLINIC 2 - JONES MEMORIAL HEALTH CARE CLINIC 15 LODER STREET WELLSVILLE NY 14895 EXTENSION CLINIC 3 - JONES MEMORIAL HEALTH CARE CLINIC 13 LODER STREET WELLSVILLE NY 14895 EXTENSION CLINIC 4 - JONES MEMORIAL HEALTH CARE CLINIC 5877 OLD STATE ROUTE 19 BELMONT NY 14813 EXTENSION CLINIC 5 - JONES MEMORIAL HEALTH CARE CLINIC 120 1ST STREET BOLIVAR NY 14715 EXTENSION CLINIC 6 - ONCOLOGY AND INFUSION CENTER 1504 WEST STATE STREET OLEAN NY 14760 EXTENSION CLINIC 7 - JONES MEMORIAL HEALTH CARE CLINIC 7309 SENECA ROAD N SUITE 114 HORNELL NY 14843 EXTENSION CLINIC 9 - JONES MEMORIAL HEALTH CARE CLINIC 20 MAIN STREET ANDOVER NY 14806 EXTENSION CLINIC 10 - JONES MEMORIAL HEALTH CARE CLINIC 7309 SENECA ROAD N SUITE 101 HORNELL NY 14843 EXTENSION CLINIC 11 - JONES MEMORIAL HEALTH CARE CLINIC 7309 SENECA ROAD N SUITE 109 HORNELL NY 14843 EXTENSION CLINIC PART I, LINE 7: WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES CALCULATION WAS USED. IN ACCORDANCE WITH ACCOUNTING STANDARD CODIFICATION 606, PRICE CONCESSIONS ARE TREATED AS A CONTRAREVENUE ITEM ON THE STATEMENT OF REVENUE. PART III, LINE 2: PATIENT ACCOUNTS RECEIVABLE ARE DUE 30 DAYS AFTER THE DATE OF DISCHARGE. RECEIVABLES PAST DUE MORE THAN 120 DAYS ARE CONSIDERED DELINQUENT. DELINQUENT RECEIVABLES ARE GENERALLY WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD PARTY PAYERS. BAD DEBT EXPENSE IS CALCULATED BY DEDUCTING BAD DEBT ADJUSTMENTS AND RECEIPTS FROM TRANSFERS TO THE COLLECTION AGENCY. IN ADDITION, AN ANALYSIS IS DONE MONTHLY BASED ON SELF PAY AGING AND ASSESSED RESERVE PERCENTAGES IN ORDER TO DETERMINE REASONABLENESS. FURTHER INFORMATION IS ON PAGE 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE DUE 30 DAYS AFTER THE DATE OF DISCHARGE. RECEIVABLES PAST DUE MORE THAN 120 DAYS ARE CONSIDERED DELINQUENT. DELINQUENT RECEIVABLES ARE GENERALLY WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD PARTY PAYERS. BAD DEBT EXPENSE IS CALCULATED BY DEDUCTING BAD DEBT ADJUSTMENTS AND RECEIPTS FROM TRANSFERS TO THE COLLECTION AGENCY. IN ADDITION, AN ANALYSIS IS DONE MONTHLY BASED ON SELF PAY AGING AND ASSESSED RESERVE PERCENTAGES IN ORDER TO DETERMINE REASONABLENESS. FURTHER INFORMATION IS ON PAGE 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE AMOUNT ON LINE 6 IS CALCULATED FROM WORKSHEET E PARTS A AND B ON THE COST REPORT. THE FULL LOSS SHOULD BE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE RECEIVE A DISCOUNT FROM A SLIDING FEE SCHEDULE BASED ON THE FEDERAL POVERTY GUIDELINES. FLEXIBLE PAYMENT PLANS ARE INCORPORATED AS APPROPRIATE. PART VI, LINE 2: OUR COMMUNITY NEEDS ASSESSMENT WAS COMPLETED IN ALLEGANY COUNTY IN 2025. THERE WERE A TOTAL OF 2,226 RESPONSES COMPARED TO 570 IN 2022. THESE WERE A COMBINATION OF ELECTRONIC AND PAPER SURVEYS THROUGHOUT THE COUNTY. THERE ALSO WERE SEVERAL FOCUS GROUPS HELD THROUGHOUT THE COUNTY . THAT DATA WAS TABULATED AND FROM THAT THE DOMAINS AND PRIORITIES WERE CHOSEN BY A TASK FORCE OF COMMUNITY PARTNERS, HOSPITALS AND COUNTY AGENCIES. - DATA REVIEWED:- ALLEGANY COUNTY 2025 COMMUNITY SURVEY AND FOCUS GROUPS- LEADING CAUSES OF DEATH - NYS DOH COMMUNITY HEALTH INDICATORS- NYS PREVENTION AGENDA DASHBOARD- COUNTY HEALTH RANKINGS- NYSIIS DATA- CENSUS.GOV DATA - PRESENTED TO KEY STAKEHOLDERS 9-9-25 PART VI, LINE 3: OUR PATIENT STATEMENTS PROVIDE A NOTICE INFORMING PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM. WE HAVE FINANCIAL COUNSELORS THAT CONTACT OUR SELF PAY POPULATION AND INFORM THEM OF OUR PROGRAM. THEY SEND LETTERS FOR THOSE THEY ARE UNABLE TO REACH BY TELEPHONE. WE HAVE SIGNAGE THROUGHOUT OUR CAMPUS INDICATING WE HAVE A FINANCIAL ASSISTANCE PROGRAM WITH THE CONTACT INFORMATION. EACH SELF PAY INPATIENT IS SEEN AND EDUCATED ABOUT OUR PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: THE HOSPITAL SERVICE AREA IS PRIMARILY ALLEGANY AND STEUBEN COUNTIES, WHILE 80 PERCENT OF THE INPATIENT AND OUTPATIENT VISITS ORIGINATE FROM WELLSVILLE, BOLIVAR, ANDOVER, BELMONT, SCIO, FRIENDSHIP, BELFAST, ANGELICA AND WHITESVILLE FOR THE PURPOSES OF COMMUNITY HEALTH NEED AND COLLABORATION EFFORTS. JONES MEMORIAL HOSPITAL VIEWS THE GREATER ALLEGANY COUNTY REGION AS THE SERVICE AREA. JONES MEMORIAL HOSPITAL IS THE ONLY ACUTE CARE HOSPITAL IN ALLEGANY COUNTY WITH HPSA DESIGNATION. PART VI, LINE 5: JONES MEMORIAL HOSPITAL PROMOTES COMMUNITY WELLNESS IN MANY WAYS. THE FOLLOWING ACTIVITIES WERE COMPLETED IN 2025: CHRONIC DISEASE AND CARDIOVASCULAR ISSUES ARE A SERIOUS HEALTH INDICATOR FOR OUR COUNTY. ACTIVITIES SURROUNDING HIGH BLOOD PRESSURE AND OBESITY ARE SUPPORTED BY THE HOSPITAL. 1. HYPERTENSION- THE HOSPITAL PURCHASED 125 BLOOD PRESSURE CUFFS FOR 8 JMH OFFICES IN THE COUNTY. THEY DISTRIBUTED TO PATIENTS WITH HIGH BLOOD PRESSURES TO SELF-MONITOR. 2. AUTOMATIC BLOOD PRESSURE MACHINES ARE LOCATED IN THE LAB LOBBY AT JMH AND THE YMCA.3. WELLNESS FAIRS- COMPLETED FOR THE COMMUNITY AT NORTHERN LIGHTS AND RUNNINGS WITH OVER 30 PEOPLE. RESULTS SHOWED: 17% HAD BORDERLINE TO HIGH CHOLESTEROL; 36% WERE PRE-DIABETIC; 89% HAD PRE-HYPERTENSIVE OR HYPERTENSIVE BLOOD PRESSURE; 42% HAD FAIR TO POOR FLEXIBILITY; 70% WERE OVERWEIGHT TO OBESE. JMH AND COMMUNITY RURAL HEALTH DAY WELLNESS FAIR WITH OVER 95 COMMUNITY MEMBERS AND EMPLOYEES. BLOOD PRESSURE, BMI, BONE DENSITY, GLUCOSE AND CHOLESTEROL, PULMONARY FUNCTION TESTS COMPLETED. OUTCOMES SHOWED CHOLESTEROL WAS BORDERLINE OR HIGH IN 38%; 42% WERE EITHER PRE-DIABETIC OR DIABETIC; 75% WERE PRE-HYPERTENSIVE OR HYPERTENSIVE; FLEXIBILITY WAS 80% FAIR TO VERY POOR; 57% HAD LOW LUNG FUNCTION; 70% WERE OVERWEIGHT TO OBESE. PARTNERED WITH OFFICE OF THE AGING, ARDENT HEALTH CARE AND OTHER GROUPS TO OFFER THE OFFICE OF THE AGING SENIOR FORUM. THIS HAD OVER 36 PARTICIPANTS AND OUTCOMES SHOWED OVER 50% OF PATIENTS WERE PRE-HYPERTENSIVE AND 70% WERE OVERWEIGHT OR OBESE. 31% WERE HIGH IN CHOLESTEROL . 4. PROMOTION OF ACTIVITY TO IMPROVE WELLNESS: GLOW RUN AND RIDGE WALK AND RUN COMPLETED WITH OVER 1,000 COMMUNITY MEMBERS PARTICIPATED. 5. MAPLE FESTIVAL BLOOD PRESSURE SCREENINGS IN ANDOVER. 6. COUNTYWIDE WELLNESS MEETING TO SUPPORT THE COMMUNITY SERVICE PLAN OF CHRONIC DISEASE, LOWERING OBESITY AND SUPPORTING LOCAL FARMERS MARKETS ALONG WITH MENTAL HEALTH PROGRAMING. PART VI, LINE 6: THE HOSPITAL IS AFFLIATED WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER (URMC). TOGETHER WITH THE HOSPITAL, URMC AND ITS OTHER HEALTH CARE AFFLIATES PROVIDE COMPREHENSIVE HEALTHCARE SERVICES IN NEW YORK STATE. THIS AFFLIATION PROVIDES ENHANCED CARE TO RESIDENTS OF THE HOSPITAL'S SERVICE AREA THROUGH ACCESS TO SPECIALISTS AND SPECIALTY SERVICES. THE UNIVERSITY OF ROCHESTER MEDICAL CENTER IS AN INTEGRATED ACADEMIC HEALTH CENTER THAT COMPRISES THE SCHOOL OF MEDICINE AND DENTISTRY, INCLUDING ITS FACULTY PRACTICE (UNIVERSITY OF ROCHESTER MEDICAL FACULTY GROUP), STRONG MEMORIAL HOSPITAL, HIGHLAND HOSPITAL, GOLISANO CHILDREN'S HOSPITAL, JAMES P. WILMOT CANCER CENTER, STRONG WEST, SCHOOL OF NURSING, EASTMAN INSTITUTE FOR ORAL HEALTH, VISITING NURSE SERVICE, HIGHLANDS AT PITTSFORD, THE HIGHLANDS LIVING CENTER, INC., HIGHLANDS AT BRIGHTON, FF THOMPSON HEALTH SYSTEM, INC., JONES MEMORIAL HOSPITAL, NOYES HEALTH, GENEVA GENERAL HOSPITAL, SOLDIERS & SAILORS MEMORIAL HOSPITAL, ST. JAMES HOSPITAL AND ACCOUNTABLE HEALTH PARTNERS, LLC. UR MEDICAL CENTER AND THE AFFLIATED HEALTH CARE ENTITIES HAVE EMBRACED A COMPREHENSIVE APPROACH TO COMMUNITY HEALTH, WHICH EMPLOYS THE MULTIDISCIPLINARY SKILLS FOUND IN AN ACADEMIC MEDICAL CENTER TO BOTH PROVIDE IMPORTANT COMMUNITY SERVICES AND CONDUCT COMMUNITYBASED RESEARCH. THESE ACTIVITIES HELP INFORM POLICYMAKERS AND THE COMMUNITY ABOUT LOCAL HEALTH CHALLENGES, EVALUATE THE EFFECTIVENESS OF INTERVENTIONS, AND SERVE AS A FOUNDATION FOR EVIDENCEBASED PRACTICES TO IMPROVE HEALTH AND OVERALL QUALITY OF LIFE. X X X 0 1 0 0 0 0 0 0 0 STEVEN GOLDSTEIN BOARD MEMBER 0 1297334 0 0 0 110899 0 158430 0 24778 0 1591441 0 0 MICHAEL APOSTOLAKOS BOARD MEMBER 0 702547 0 0 0 30479 0 83430 0 32078 0 848534 0 0 MARK TAUBMAN BOARD MEMBER 0 697274 0 0 0 45471 0 22719 0 21475 0 786939 0 0 PAUL AXTELL MD ORTHOPAEDIC SURGEON 718000 0 0 0 0 0 26019 0 19599 0 763618 0 0 0 HEATHER LANPHERE MD OB/GYN 474010 0 0 0 0 0 18788 0 18400 0 511198 0 0 0 NISHANT CHAUDHARY MD HOSPITALIST 444891 0 0 0 0 0 15909 0 18403 0 479203 0 0 0 SADDAM YASIN MD PEDIATRICIAN 455650 0 0 0 0 0 2444 0 18211 0 476305 0 0 0 ANDRES RUBERT MD CHIEF OF MEDICAL STAFF 386600 0 0 0 0 0 13779 0 17872 0 418251 0 0 0 LU-ANNE KAYE OB/GYN 365530 0 0 0 0 0 13246 0 17866 0 396642 0 0 0 JAMES HELMS CHIEF EXECUTIVE OFFICER 271154 0 0 0 0 0 10827 0 8147 0 290128 0 0 0 BOYD CHAPPELL CHIEF FINANCIAL OFFICER 228617 0 0 0 0 0 9145 0 1205 0 238967 0 0 0 KAROL MARCIANO CHAIRPERSON 0 162119 0 0 0 4000 0 15361 0 30362 0 211842 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED EMPLOYER PAID AMOUNTS THAT ARE INCLUDED IN DEFERRED COMPENSATION: STEVEN GOLDSTEIN - SERP PLAN - $125,000 MICHAEL APOSTOLAKOS, MD - SERP PLAN - $50,000 DAVID LINEHAN - -SERP PLAN - $150,000 FORM 990, PART VI, SECTION A, LINE 2 SOME OF THE TRUSTEES OF THE ORGANIZATION HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER THROUGH THEIR EMPLOYMENT AND/OR THEY SERVE AS AN OFFICER OF A RELATED ORGANIZATION, THE UNIVERSITY OF ROCHESTER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE HOSPITAL IS THE UNIVERSITY OF ROCHESTER. FORM 990, PART VI, SECTION A, LINE 7A THE UNIVERSITY OR ROCHESTER HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUCH AS AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS AND APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION ARE SUBJECT TO THE APPROVAL OF THE UNIVERSITY OF ROCHESTER. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WAS PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. THE 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE HOSPITAL REQUIRES ALL BOARD MEMBERS, EXECUTIVE LEADERSHIP, AND DEPARTMENT MANAGERS TO COMPLETE THE CONFLICT OF INTEREST STATEMENT TO IDENTIFY ACTUAL AND POTENTIAL CONFLICTS. THE STATEMENTS ARE REVIEWED BY THE HOSPITAL'S COMPLIANCE OFFICER FOR ANY POTENTIAL CONFLICTS. IF A CONFLICT IS IDENTIFIED, THE INDIVIDUAL WITH THE CONFLICT WILL NOT BE ALLOWED TO PARTICIPATE IN ANY DISCUSSION OR DECISION IN ANY AREA OF CONFLICT IDENTIFIED. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S SALARY IS SET FOR A SPECIFIC CONTRACT PERIOD BY THE BOARD OF DIRECTORS AND INCLUDES AN ESCALATION CLAUSE FOR INCREASES DURING THE CONTRACT PERIOD. THE PROCESS INCLUDES A REVIEW OF COMPARABLE DATA FOR THE MARKET AREA AND THE COMPLETE CONTRACT IS APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION OF OTHER TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES IS DONE THROUGH A WAGE ANALYSIS PERFORMED BY THE HUMAN RESOURCES DIRECTOR. THE ANALYSIS COMPARES CURRENT WAGE TO MARKET DATA. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL'S FORM 990 IS AVAILABLE UPON REQUEST. THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC. THE HOSPITAL PUBLISHES AN ANNUAL FINANCIAL AND STATISTICAL REPORT IN THE LOCAL NEWSPAPER EACH SPRING. IT ALSO HAS THESE DOCUMENTS AVAILABLE FOR IN PERSON REVIEW OR WITHIN 30 DAYS OF A WRITTEN REQUEST FROM THE GENERAL PUBLIC. COPIES OF THESE DOCUMENTS ARE STORED IN THE ADMINISTRATIVE OFFICE OF THE HOSPITAL FOR THIS PURPOSE. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 18,685,180. MANAGEMENT AND GENERAL EXPENSES 783,822. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,469,002. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 27,617. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,617. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF PENSION PLAN -6,490. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST -251,824. CHANGE IN VALUE OF BENEFICIAL INTEREST IN FOUNDATION -105,793. FORM 990. PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR UNIVERSITY OF ROCHESTER 910 GENESEE STREET STE 200 ROCHESTER NY 14611 160743209 SCHOOL NY 501(C)(3) LINE 2 0 HIGHLAND HOSPITAL OF ROCHESTER 1000 SOUTH AVENUE ROCHESTER NY 14620 160743037 HOSPITAL NY 501(C)(3) LINE 3 SPHS 0 THE HIGHLAND FOUNDATION INC 1000 SOUTH AVENUE ROCHESTER NY 14620 237310662 FUNDRAISING NY 501(C)(3) LINE 12A, I HIGHLD HOSP 0 HIGHLAND FACILITIES DEVELOPMENT CORP 1000 SOUTH AVENUE ROCHESTER NY 14620 223039077 MEDICAL BLDG NY 501(C)(3) LINE 10 HIGHLD HOSP 0 HIGHLAND COMMUNITY DEVELOPMENT CORP 100 HAHNEMANN TRAIL PITTSFORD NY 14534 223154715 ELDER CARE NY 501(C)(3) LINE 10 SPHS 0 THE HIGHLANDS LIVING CENTER INC 500 HAHNEMANN TRAIL PITTSFORD NY 14534 223240227 HEALTHCARE NY 501(C)(3) LINE 10 SPHS 0 THE MEADOWS AT WESTFALL INC 5901 LAC DE VILLE BLVD ROCHESTER NY 14618 161502303 HEALTHCARE NY 501(C)(3) LINE 10 SPHS 0 STRONG PARTNERS HEALTH SYSTEM INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER NY 14642 161499099 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