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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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        <PersonNm>J CHAD TEETERS MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>GEOFFREY WITTIG MD</PersonNm>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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        <PersonNm>MICHAEL A JOHNSEN</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MARK PRUNOSKE</PersonNm>
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        <ReportableCompFromRltdOrgAmt>416451</ReportableCompFromRltdOrgAmt>
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        <PersonNm>DOUGLAS MAYHLE MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT CAPECCI MD</PersonNm>
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      <Form990PartVIISectionAGrp>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KEVIN O'KEEFE MD</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>SVETLANA YUDINA MD</PersonNm>
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        <PersonNm>ALBERTO VELASCO MD</PersonNm>
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        <ContractorAddress>
          <USAddress>
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          <USAddress>
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        <FormAndLineReferenceDesc>NICHOLAS H. NOYES MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: COMMON GROUND HEALTH REGIONAL CHA/CHIP: DEVELOPMENT OF THE 2022-2024 COMMUNITY HEALTH ASSESSMENT, COMMUNITY SERVICE PLANS, AND COMMUNITY HEALTH IMPROVEMENT PLANS WAS A JOINT PROCESS, WHICH BEGAN IN THE SUMMER OF 2021. WHILE SUBMISSION OF THE REGIONAL COMMUNITY HEALTH ASSESSMENT WAS ON BEHALF OF THE EIGHT COUNTIES, EACH HEALTH DEPARTMENT MANAGED ITS OWN COUNTY'S PRIORITIZATION AND PLANNING MEETINGS WITH ASSISTANCE FROM THE S2AY RURAL HEALTH NETWORK, COMMON GROUND HEALTH, AND THE GENESEE VALLEY HEALTH PARTNERSHIP. REGIONAL CHECK-INS OCCURRED ON A MONTHLY BASIS.LIVINGSTON COUNTY CHA/CSP/CHIP: SELECTION OF THE 2022-2024 COMMUNITY HEALTH ASSESSMENT (CHA), COMMUNITY SERVICE PLAN (CSP), AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITY AND DISPARITY AREAS WAS A JOINT PROCESS WHICH BEGAN IN THE SUMMER OF 2021 WITH ASSISTANCE FROM PIVOTAL PUBLIC HEALTH PARTNERSHIP AND COMMON GROUND HEALTH. A VARIETY OF PARTNERS WERE ENGAGED THROUGHOUT THE PROCESS INCLUDING THE PUBLIC HEALTH DEPARTMENT AND UR MEDICINE|NOYES HEALTH STAFF, COMMUNITY-BASED ORGANIZATIONS (CBOS), OFFICE FOR AGING, SKILLED NURSING FACILITY, CASA, COUNTY GOVERNMENT EMPLOYEES, THE GENESEE VALLEY HEALTH PARTNERSHIP, COMMON GROUND HEALTH, COMMUNITY MEMBERS, AND MORE. THE CHA LEADERSHIP COMMITTEE PARTNERS' ROLE IN THE ASSESSMENT WAS TO HELP INFORM AND SELECT THE 2022-2024 PRIORITY AREAS BY SHARING ANY PERTINENT DATA OR CONCERNS AND ACTIVELY PARTICIPATING IN PLANNING MEETINGS. ON JUNE 21, 2021, THE LIVINGSTON COUNTY HEALTH DEPARTMENT AND UR MEDICINE|NOYES HEALTH ENGAGED KEY STAKEHOLDERS ON THE CHA LEADERSHIP TEAM IN A PRIORITIZATION MEETING FACILITATED BY COMMON GROUND HEALTH. KEY PARTNERS AND COMMUNITY MEMBERS WERE INVITED TO ATTEND THE PRIORITIZATION MEETINGS, INCLUDING ALL THOSE WHO ATTENDED PRIOR FOCUS GROUPS. SOCIAL MEDIA PLATFORMS, E-MAIL, NEWS MEDIA AND NEWSLETTERS WERE UTILIZED TO HELP STIMULATE PARTICIPATION. COMMON GROUND HEALTH PROVIDED GROUP MEMBERS COPIES OF COUNTY SPECIFIC PRE-READ DOCUMENTS IN ADVANCE OF THE MEETINGS. THE DOCUMENTS INCLUDED INFORMATION ON CURRENT PRIORITY AREAS AND PROGRESS MADE TO DATE, AS WELL AS A MIX OF UPDATED QUANTITATIVE, QUALITATIVE, PRIMARY AND SECONDARY DATA ON EACH OF THE FIVE PRIORITY AREAS OUTLINED IN THE NEW YORK STATE PREVENTION AGENDA. DATA WAS COLLECTED FROM A VARIETY OF DIFFERENT SOURCES INCLUDING, BUT NOT LIMITED TO THE AMERICAN COMMUNITY SURVEY, THE ENHANCED BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, COUNTY RANKINGS AND ROADMAPS, VITAL STATISTICS, COMMUNICABLE DISEASE AND DENTAL REPORTS, PRIMARY DATA COLLECTED FROM THE MY HEALTH STORY 2018 SURVEY AND LOCAL DATA SOURCES SUCH AS LIVINGSTON COUNTY'S PREVENTION NEEDS ASSESSMENT.USING THE ABOVE REFERENCED DATA AND GROUP DISCUSSIONS, PARTICIPANTS UTILIZED CLEAR IMPACT TO RANK A LIST OF GROUP-IDENTIFIED PRIORITIES. TO ADDRESS THE PREVIOUSLY MENTIONED PRIORITIES AND DISPARITIES, THE HEALTH DEPARTMENT FACILITATED A CHIP PLANNING MEETING WHERE PARTNERS DISCUSSED OPPORTUNITIES TO LEVERAGE EXISTING WORK. EXISTING WORK EFFORTS WERE THEN COMPARED TO INTERVENTION OPTIONS (PRIMARILY SELECTED FROM THE NEW YORK STATE PREVENTION AGENDA REFRESH CHART) AND WERE INFORMALLY VOTED ON AND SELECTED.IN ADDITION, THE ONGOING COLLABORATIVE PROCESS FOR UPDATING AND REVISING THE ASSESSMENT, INCLUDING NEW INFORMATION ON DATA, WILL OCCUR DURING THE ANNUAL STATE OF THE COUNTY HEALTH REPORT 2019 UPDATE PRESENTATION AND DURING GENESEE VALLEY HEALTH PARTNERSHIP MEMBERSHIP MEETINGS AND SUBCOMMITTEE MEETINGS, SUCH AS THE SUICIDE PREVENTION TASK FORCE AND BE WELL MEETINGS. THESE COMMITTEES ARE COMPRISED OF DIVERSE COMMUNITY SECTORS INCLUDING COMMUNITY MEMBERS. RECRUITMENT OF NEW MEMBERS OCCURS ON PARTNERS' WEBSITES AND SOCIAL MEDIA. THE GENESEE VALLEY HEALTH PARTNERSHIP BOARD OF DIRECTORS REVIEWS ANNUAL MEMBERSHIP TO IDENTIFY GAPS IN MEMBERSHIP BASED ON CURRENT HEALTH PRIORITIES.THE LIVINGSTON COUNTY HEALTH DEPARTMENT, IN PARTNERSHIP WITH UR MEDICINE|NOYES HEALTH, HAS SELECTED THE FOLLOWING PRIORITY AREAS AND DISPARITY FOR THE 2022-2024 ASSESSMENT AND PLANNING PERIOD:PREVENT CHRONIC DISEASE 1. HEALTHY EATING AND FOOD SECURITY PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS 1. PREVENT MENTAL AND SUBSTANCE USE DISORDERS DISPARITY3. LOW SOCIOECONOMIC STATUS</ExplanationTxt>
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        <FormAndLineReferenceDesc>NICHOLAS H. NOYES MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: LEAD CHA/CHIP AGENCIES:1. LIVINGSTON COUNTY DEPARTMENT OF HEALTH 2. UR MEDICINE|NOYES HEALTH3. PIVOTAL PUBLIC HEALTH PARTNERSHIP - EIGHT COUNTY PARTNERSHIP FOR CHEMUNG, LIVINGSTON, ONTARIO, SCHUYLER, SENECA, STEUBEN, WAYNE, AND YATES COUNTIES4. COMMON GROUND HEALTH - EIGHT-COUNTY REGIONAL REPORT FOR CHEMUNG, LIVINGSTON, ONTARIO, SCHUYLER, SENECA, STEUBEN, WAYNE AND YATES COUNTIESLIST OF LIVINGSTON COUNTY PRIORITIZATION AGENCIES:-LIVINGSTON COUNTY PUBLIC HEALTH-UR MEDICINE|NOYES HEALTH-COMMON GROUND HEALTH-SUNY GENESEO-GLOW ARC-LIVINGSTON COUNTY CENTER FOR NURSING AND REHAB-HEALTH AND WELLNESS-TRI-COUNTY FAMILY MEDICINE-OFFICE FOR AGING-LIVINGSTON COUNTY VETERANS' SERVICES-GENESEE VALLEY HEALTH PARTNERSHIP-NOYES MENTAL HEALTH AND WELLNESS-LIVINGSTON COUNTY MENTAL HEALTH-CASA/TRINITY-LIVINGSTON COUNTY PLANNING DEPARTMENT-CANCER SERVICES-UR CENTER FOR COMMUNITY HEALTH AND PREVENTION-LIVINGSTON COUNTY SHERRIFF'S DEPARTMENT-COMMUNITY MEMBERS-PIVOTAL PUBLIC HEALTH PARTNERSHIP-CORNELL COOPERATIVE EXTENSION-LIVINGSTON COUNTY DEPARTMENT OF SOCIAL SERVICES</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>NICHOLAS H. NOYES MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 7D: BESIDES CHA/CSP/CHIP'S PREVIOUSLY LISTED WEBSITE POSTINGS, THE 2022-2024 CHA/CHIP UPDATE WAS ALSO SHARED WITH THE FOLLOWING COMMUNITY ORGANIZATIONS, BOARDS, AND COALITIONS: -ALL APPROPRIATE LOCAL PUBLIC RELATIONS OUTLETS IN THE FORM OF A PRESS/MEDIA RELEASE-CHA/CSP/CHIP UPDATE PRESENTATIONS WERE PROVIDED TO: CONTINUUM OF CARE COALITION, GENESEE VALLEY HEALTH PARTNERSHIP MEMBERSHIP, UR MEDICINE|NOYES HEALTH BOARD OF DIRECTORS, UR MEDICINE|NOYES HEALTH MANAGEMENT TEAM, AND LIVINGSTON COUNTY CHA/CHIP LEADERSHIP COMMITTEE. A 2022-2024 CHA/CHIP UPDATE WAS ALSO SCHEDULED FOR APRIL'S ANNUAL LIVINGSTON COUNTY - STATE OF THE COUNTY HEALTH REPORT PRESENTATION.-UR MEDICINE|NOYES HEALTH'S 2022 ANNUAL REPORT WILL INCLUDE CHA/CHIP UPDATE INFORMATION.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>NICHOLAS H. NOYES MEMORIAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: THE FOLLOWING INITIATIVES ARE PROVIDED BY NOYES HEALTH AS PART OF CURRENT CHA/CHIP PRIORITIES: -PREVENT CHRONIC DISEASE: OBESITY PREVENTION-PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSEPREVENT CHRONIC DISEASE-LIVING HEALTHY NY CLASSES: NOYES HEALTH PROVIDES UP TO FOUR 6-WEEK CERTIFIED CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS THROUGHOUT THE SERVICE AREA FREE OF CHARGE TO EDUCATE PARTICIPANTS TO SUCCESSFULLY MANAGE THEIR CHRONIC DISEASE AND/OR CHRONIC PAIN. FOUR SESSIONS WERE HELD VIA ZOOM AND IN PERSON, WITH A TOTAL OF 32 PARTICIPANTS COMPLETING THE SERIES.-NOYES DIABETES EDUCATION PROGRAM: NOYES HEALTH MAINTAINS A CERTIFIED AADE DIABETES EDUCATION PROGRAM IN OUR RURAL REGION TO PROVIDE INDIVIDUAL DIABETES EDUCATION SERVICES. SERVICES INCLUDE: INDIVIDUAL COUNSELING, INSULIN PUMP STARTS AND UPGRADES, CONTINUOUS GLUCOSE MONITOR SCREENINGS, ANNUAL DIABETES HEALTH FAIR, AND NOYES CDCES OVERSEES A COUNTYWIDE DIABETES COALITION. -BE WELL IN LIVINGSTON: UR MEDICINE|NOYES HEALTH AND THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH, WITH GRANT SUPPORT FROM THE GENESEE VALLEY HEALTH PARTNERSHIP, HAVE CO-LED THIS COMMUNITY HEALTH IMPROVEMENT COMMITTEE SINCE INCEPTION IN 2017.GOAL: TO REDUCE OBESITY IN CHILDREN AND ADULTS BY IMPLEMENTING POLICY, SYSTEM AND ENVIRONMENTAL CHANGES.OUR MISSION: SUPPORT SUSTAINABLE HEALTHY LIFESTYLE CHOICES WITHIN COMMUNITIES THROUGH POLICY, SYSTEM AND ENVIRONMENTAL CHANGES UTILIZING LOCAL RESOURCES.OUR VISION: BE WELL IN LIVINGSTON WILL SUPPORT LOCAL COMMUNITIES WITH OPPORTUNITIES TO PROMOTE HEALTHY LIVING.THE COMMITTEE OVERSEES AND SUPPORTS COMMUNITY EFFORTS TO EAT BETTER, MOVE MORE AND STRESS LESS, UTILIZING LOCAL RESOURCES. ASSESSMENTS ARE COMPLETED AT SCHOOLS, WORKSITES, LOCAL GOVERNMENT FACILITIES, SERVICE GROUPS, CHURCHES, ETC; DATA IS ANALYZED; AND PRIORITIES IDENTIFIED BY THE LOCAL BE WELL COMMITTEE. THE COUNTY-WIDE BE WELL COMMITTEE ASSISTS WITH MEETING MANAGEMENT, RESOURCES, COMMUNICATIONS, AND EVENT SUPPORT. THE MODEL WAS DEVELOPED WITH THE FIRST RURAL TOWN, NUNDA, BASED ON HEALTH DATA AND NEEDS IN 2018, AND THEN WAS EXPANDED TO THE SECOND RURAL TOWN, MOUNT MORRIS, IN Q4 2019.2022 WAS YEAR FIVE FOR BE WELL IN NUNDA, WHICH HAS CONTINUED WITH SUPPORT OF THE STEERING COMMITTEE. FITNESS ACTIVITIES ARE PROMOTED MONTHLY, DALTON SCHOOL FITNESS TRAIL WAS RESTORED AND IS BEING UTILIZED BY THE PE TEACHERS AND PUBLIC AND TWO LOCATIONS WERE ADDED TO PROMOTE GEOCACHING AS AN ACTIVITY TO GET RESIDENTS MOVING. THE IMPLEMENTATION OF A FARM DROP BOX MADE FRESH FRUITS AND VEGETABLES EASIER TO ACCESS FOR NUNDA RESIDENTS. THE CONTINUED PARTNERSHIP WITH FOODLINK OF ROCHESTER PROVIDES THE NUNDA COMMUNITY A POP-UP PANTRY TWICE A MONTH TO ADD ANOTHER FREE FOOD SOURCE FOR THOSE IN NEED. THE COFFEE CLUB "CALICO COUNTRY LEARNERS", WHICH OFFERS SOCIALIZATION TO THE OLDER POPULATION, CONTINUED TO BE ON HOLD DUE TO THE PANDEMIC. BE WELL CHANGED ITS WAY OF THINKING WHEN COVID-19 CREATED CHALLENGES. EDUCATIONAL SOCIAL MEDIA POSTS CONTINUED. A COMMUNITY EUCHRE NIGHT BEGAN IN WINTER OF 2022 AND HAS GROWN TO BE WELL ATTENDED. DISCUSSION OF A FIRST EVER 5K FUNDRAISER FOR THE NUNDA COMMUNITY IS BEGINNING. THE PANDEMIC CREATED CHALLENGES FOR BE WELL IN MOUNT MORRIS. A VIRTUAL SURVEY WAS CONDUCTED TO FIND THE GREATEST AREAS OF NEED IN THE COMMUNITY. THE TOP THREE PRIORITIES WERE NUTRITION, PHYSICAL ACTIVITY AND OBESITY PREVENTION. SWOT ANALYSIS FOUND THAT THE MOUNT MORRIS COMMUNITY DOES NOT HAVE A GROCERY STORE WITHIN ITS TOWN, AND HAS NO ACCESS TO A COMMUNITY CENTER OR GYM, OTHER THAN THE ONE IN THE SCHOOL. PLANNING HAS BEGUN TO FORM PARTNERSHIPS WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS PARTNERS FOR PROGRESS AND THE PLANNING BOARD. THE MAYOR OF MOUNT MORRIS APPOINTED A LIAISON TO ATTEND MONTHLY BE WELL MEETINGS IN HIS ABSENCE. WORK BEGAN TO FORM A STEERING COMMITTEE THAT INCLUDES KEY MOUNT MORRIS RESIDENTS THAT ARE MOTIVATED TO WORK TOWARDS A HEALTHIER COMMUNITY. FIRST EVENT SCHEDULED FOR JANUARY 2022 WAS A NEW YEARS DAY WALK, 4 RESIDENTS PARTICIPATED. CONTINUING TO ENHANCE THE PUBLIC MEMBERSHIP TO ENGAGE THE COMMUNITY.-NOYES HEALTH DESIGNATED STROKE CENTERTHE STAFF AT NOYES HEALTH ARE COMMITTED TO PROVIDING QUALITY STROKE CARE TO EVERY PATIENT. OUR PROVIDERS AND NURSING STAFF ARE TRAINED IN EARLY STROKE CARE AND WORK HARD EVERY DAY TO PROVIDE THE BEST POSSIBLE OUTCOME FOR OUR PATIENTS. TIME IS THE MOST IMPORTANT FACTOR WHEN SOMEONE IS POSSIBLY SUFFERING A STROKE AND OUR TEAM IS READY TO BEAT THAT CLOCK. BEING A DESIGNATED STROKE CENTER MEANS THAT OUR TEAM HAS WORKED HARD TO MEET THE STRINGENT STANDARDS SET BY NEW YORK STATE FOR STROKE CARE AND WILL CONTINUE EFFORTS TO ONLY IMPROVE OUR PROGRAM. OUR TEAM CONTINUES WITH ITS PRIMARY STROKE CENTER DESIGNATION THROUGH COLLABORATIVE WORK WITH NYS DEPARTMENT OF HEALTH, UNIVERSITY OF ROCHESTER MEDICAL CENTER AND REGIONAL CARE PARTNERS. THIS ALLOWS OUR EMERGENCY PROVIDERS TO CONNECT WITH A TEAM OF INTERVENTIONAL STROKE NEUROLOGISTS 24/7. THIS BRINGS THE SPECIALIZED RESOURCES OF UR MEDICINE, A COMPREHENSIVE STROKE CENTER, TO THE RESIDENTS OF THIS RURAL COMMUNITY AND SURROUNDING COMMUNITIES. PART OF OUR STROKE CENTER DESIGNATION IS EDUCATION. EDUCATION IS STILL PROVIDED IN CONJUNCTION WITH COMMUNITY OUTREACH SERVICES DEPARTMENT TO PROVIDE EDUCATION TO PATRONS OF OUR DIABETES EDUCATION, CAREGIVER RESOURCE CENTER AND MEDICAL ALERT PROGRAMS.-DANSVILLE POP UP PANTRYNOYES HEALTH, IN PARTNERSHIP WITH THE LOCAL DANSVILLE YMCA BRANCH AND FOODLINK OF ROCHESTER, BROUGHT A NEW FOOD SERCURITY OPTION TO THE DANSVILLE COMMUNITY. THIS DRIVE UP FOOD PANTRY DOES NOT REQUIRE PROOF OF INCOME TO RECEIVE FOOD. THE ONLY DATA COLLECTED AT REGISTRATION IS RELEVANT TO THE AGE GROUP IN EACH HOUSEHOLD. THE FIRST POP UP PANTRY WAS HELD MARCH 2022 AT THE FIREMAN'S PAVILION IN BABCOCK PARK AND SERVED 308 FAMILIES AND 790 TOTAL INDIVIDUALS. A TOTAL OF 4 POP UP PANTRIES WERE CONDUCTED THROUGH JUNE 2022 AND A TOTAL OF 1,216 FAMILIES AND 3,201 INDIVIDUALS SERVED.PROMOTE MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS-ACCESS TO CARE: THE NOYES MENTAL HEALTH AND WELLNESS CLINIC CONTINUED TO EXPAND TO MEET INCREASING NEEDS FOR COUNSELING AND THERAPEUTIC INTERVENTIONS IN THE REGION. THE MENTAL HEALTH AND WELLNESS STAFF COLLABORATE WITH PATIENTS, THEIR FAMILIES, AND COUNTY AGENCIES TO SUPPORT WELLNESS AND RECOVERY, AND TO MAKE A PROFOUND DIFFERENCE IN THE LIVES OF AREA RESIDENTS - THOSE STRUGGLING WITH LIFE'S EVERYDAY CHALLENGES, AS WELL AS THOSE WITH SEVERE AND PERSISTENT MENTAL ILLNESS. THE COVID-19 PANDEMIC OPENED A BRAND NEW OPPORTUNITY OF TELEMEDICINE APPOINTMENTS AS THE FACILITY WENT COMPLETELY REMOTE FOR A PORTION OF 2021. CRISIS AND IN-PERSON VISITS REMAIN AVAILABLE. THERE ARE 5 FULL-TIME PSYCHIATRIC PROVIDERS AND 25 FULL-TIME THERAPISTS. CONSTRUCTION WAS COMPLETED ON THE NEW MENTAL HEALTH BUILDING IN AVON AND OPERATIONS STARTED IN 2022. THIS HELPS ADDRESS THE EVER-INCREASING NEED FOR MENTAL HEALTH SERVICES.-MONITOR/SECURE/DISPOSE PROGRAM: LIVINGSTON COUNTY CONTINUES TO SEE AN ISSUE WITH OPIATE ABUSE AND ADDICTION. MANY DRUG ADDICTIONS BEGIN WITH PRESCRIPTIONS. IN RESPONSE TO THIS NEED, ONE OF THE COUNTY'S PRIORITIES WAS TO RESTRICT AVAILABILITY AND TO MONITOR, SECURE, AND SAFELY DISPOSE OF PRESCRIPTION DRUGS. SEVEN MEDICATION DROP BOXES WERE INSTALLED IN SEPARATE LOCATIONS THROUGHOUT THE COUNTY IN WHICH THOUSANDS OF POUNDS OF UNWANTED MEDICATIONS WERE DISPOSED. THE PROGRAM IS PROVIDED IN PARTNERSHIP WITH CASA/TRINITY TO ORDER/INSTALL BOXES PER REGULATIONS, AND LIVINGSTON COUNTY SHERIFF'S DEPARTMENT PICKS UP/DISPOSES OF UNWANTED MEDICATIONS VIA INCINERATION. MED DROP BOX LOCATION INFORMATION IS AVAILABLE AT ALL NOYES HEALTH SITES TO SHARE WITH PATIENTS/FAMILIES/CAREGIVERS. -SUICIDE PREVENTION TASK FORCE: NOYES MENTAL HEALTH STAFF CONTINUE TO BE ACTIVE PARTICIPANTS ON LIVINGSTON COUNTY'S SUICIDE PREVENTION TASK FORCE. THE GOAL IS TO CULTIVATE A SAFETY-ORIENTED CULTURE COMMITTED TO REDUCING SUICIDES IN LIVINGSTON COUNTY. THE TASK FORCE MEETS MONTHLY AT THE LIVINGSTON COUNTY GOVERNMENT CENTER. THE TASK FORCE INTRODUCED THE LOCK &amp; TALK PROGRAM IN DECEMBER 2021. THIS PROGRAM INCORPORATES MEDICATION SAFETY, GUN SAFETY, AND MENTAL HEALTH RESOURCES TO PREVENT SUICIDES. THREE PROGRAMS WERE CONDUCTED FROM DECEMBER 2021 THOUGH JUNE 2022, A TOTAL OF 60 PARTICIPANTS ATTENDED.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>5</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - LIVINGSTON HEALTH SERVICES</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>50 EAST SOUTH STREET</AddressLine1Txt>
            <CityNm>GENESEO</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14454</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT SURGERY, DIAGNOSTIC, AND URGENT CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - NOYES MENTAL HEALTH CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>9221 ROBERT HART DRIVE</AddressLine1Txt>
            <CityNm>DANSVILLE</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14437</ZIPCd>
          </USAddress>
          <FacilityTxt>MENTAL HEALTH CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - NOYES CNTR FOR KIDNEY DISEASE &amp; DIALYSIS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4616 MELLENIUM DRIVE</AddressLine1Txt>
            <CityNm>GENESEO</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14454</ZIPCd>
          </USAddress>
          <FacilityTxt>CHRONIC DIALYSIS CENTER AND NEPHROLOGIST</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - AVON MENTAL HEALTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>5712 TEC DRIVE</AddressLine1Txt>
            <CityNm>AVON</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14414</ZIPCd>
          </USAddress>
          <FacilityTxt>MENTAL HEALTH CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - NOYES PHYSICAL OCCUPATIONAL SPEECH THERA</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>60 RED JACKET STREET</AddressLine1Txt>
            <CityNm>DANSVILLE</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14437</ZIPCd>
          </USAddress>
          <FacilityTxt>PHYSICAL, OCCUPATIONAL, SPEECH THERAPY</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHA COMMUNITY HEALTH SURVEYIN THE FALL OF 2021, UR MEDICINE | NOYES HEALTH WORKED WITH THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH, PIVOTAL PUBLIC HEALTH PARTNERSHIP AND COMMON GROUND HEALTH TO BEGIN THE 2022 LIVINGSTON COUNTY COMMUNITY HEALTH ASSESSMENT PROCESS. THE DECISION WAS MADE TO UTILIZE A NEW COMMUNITY HEALTH ASSESSMENT TOOL: CLEAR IMPACT. THE FIRST STEP IN THE 9 STEP PROCESS BEGAN WITH CREATING A LEADERSHIP TEAM OF MULTIPLE SECTORS ACROSS LIVINGSTON COUNTY. ADDITIONALLY, THE CREATION OF "MY HEALTH STORY 2.0" IS SLATED TO BE COMPLETED BY SUMMER 2022 WITH A GOAL OF COMPLETING 500 SURVEYS BY LIVINGSTON COUNTY RESIDENTS.COALITION BUILDING ACTIVITIESNOYES CONTINUUM OF CARE COALITION: THIS 40 AGENCY COALITION MEETS SIX TIMES PER CALENDAR YEAR AT NOYES HOSPITAL FOR EDUCATION, AGENCY UPDATES, AND NETWORKING. SOME EXAMPLES OF EDUCATION INCLUDED CANCER SERVICES PROGRAM OF THE FINGER LAKES, TOGETHER IN CARING, AND PERSON-CENTERED SERVICES.MEMBERS USE THE GROUP EMAIL ADDRESS OF TARA_COFFEY@URMC.ROCHESTER.EDU TO SHARE AGENCY AND PROGRAM INFORMATION IN BETWEEN MEETINGS. HEALTH AND HUMAN SERVICE AGENCY PARTNERSHIPS AND COLLABORATIONS HAVE STRENGTHENED VIA THIS COALITION.CANCER SUPPORT SERVICES COALTIONUR MEDICINE|NOYES HEALTH CONTINUES TO RECOGNIZE OPPORTUNITIES TO EXPAND SUPPORT SERVICES FOR PATIENTS AND CAREGIVERS ACROSS THE TRI-COUNTY REGION AND CONTINUES TO REACH OUT TO REGIONAL CANCER SERVICE SUPPORT PROGRAMS, HEALTH CARE AGENCIES, CANCER SURVIVORS, INDIVIDUALS, AND COMMUNITY GROUPS. CANCER SUPPORT SERVICE PROVIDERS AND PARTNERS MEET MONTHLY FOR EDUCATION, INFO SHARING AND PARTNERSHIPS TO GROW OUR RURAL AREA CANCER SUPPORT SERVICES. MEETINGS ARE HELD SIX TIMES PER YEAR FOR INFORMATION SHARING AND HOSTING PROGRAM SPEAKERS.PARTNERSHIP PROGRAMSNOYES CAREGIVER RESOURCE CENTER: THE CAREGIVER RESOURCE CENTER AT UR MEDICINE|NOYES HEALTH PROVIDES CAREGIVER SUPPORT SERVICES IN PARTNERSHIP WITH LIVINGSTON COUNTY OFFICE FOR THE AGING. THE PROGRAM ASSISTS INFORMAL CAREGIVERSSPOUSES, ADULT CHILDREN, OTHER FAMILY MEMBERS, FRIENDS, AND NEIGHBORSIN THEIR EFFORTS TO CARE FOR PERSONS WHO NEED HELP WITH EVERYDAY TASKS. THIS CRUCIAL ASSISTANCE ALLOWS THESE PERSONS WITH CHRONIC ILLNESSES OR DISABILITIES TO REMAIN LIVING IN THEIR OWN HOMES THROUGHOUT OUR COMMUNITY.SERVICES INCLUDE INFORMATION &amp; ASSISTANCE, RESPITE CARE (BOTH IN-HOME AND DAY CARE), SUPPORT GROUPS, EDUCATION, MONTHLY CAREGIVER NEWSLETTER, AND COORDINATION OF THE ANNUAL CAREGIVER SYMPOSIUM EVENT. THE CAREGIVER RESOURCE CENTER PROVIDED ASSISTANCE TO 116 NEW FAMILIES FROM JULY 2021 THROUGH JUNE 30, 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>IMPLICIT PRICE CONCESSIONS ARE ESTIMATED BASED ON HISTORICAL COLLECTION RATES, WHICH ARE UPDATED ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>PAGES 9-12 IN THE ATTACHED FINANCIAL STATEMENTS CONTAIN THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE IS NO MEDICARE SHORTFALL; THEREFORE, NONE IS TREATED AS COMMUNITY BENEFIT AND NO COSTING METHODOLOGY IS USED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL ASSISTANCE ELIGIBLE PATIENT BALANCES ARE DISCOUNTED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND FEDERAL POVERTY GUIDELINES. PATIENTS WHO DO NOT APPLY FOR FINANCIAL ASSISTANCE AND HAVE NOT PAID BALANCES OWED ON ACCOUNTS HAVE A DETERMINATION OF PRESUMPTIVE ELIGIBILITY SCORE BY AN OUTSIDE VENDOR USING ANALYTICAL SOFTWARE. PATIENTS DEEMED ELIGIBLE BY THIS VENDOR ARE NOT SENT TO AN OUTSIDE COLLECTION AGENCY AND RECEIVE 100% DISCOUNT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>NEEDS ASSESSMENTSELECTION OF THE 2022-2024 COMMUNITY HEALTH ASSESSMENT (CHA), COMMUNITY SERVICE PLAN (CSP) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITY AND DISPARITY AREAS WAS A JOINT PROCESS WHICH BEGAN IN THE SUMMER OF 2021 WITH ASSISTANCE FROM PIVOTAL PUBLIC HEALTH PARTNERSHIP AND COMMON GROUND HEALTH. A VARIETY OF PARTNERS WERE ENGAGED THROUGHOUT THE PROCESS INCLUDING THE PUBLIC HEALTH DEPARTMENT AND NOYES HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS (CBOS), OFFICE FOR AGING, SKILLED NURSING FACILITY, CASA, COUNTY GOVERNMENT EMPLOYEES, THE GENESEE VALLEY HEALTH PARTNERSHIP, COMMON GROUND HEALTH, COMMUNITY MEMBERS AND MORE. THE CHA LEADERSHIP COMMITTEE PARTNERS' ROLE IN THE ASSESSMENT WAS TO HELP INFORM AND SELECT THE 2022-2024 PRIORITY AREAS BY SHARING ANY PERTINENT DATA OR CONCERNS AND ACTIVELY PARTICIPANTING IN PLANNING MEETINGS.ON JUNE 21, 2021, THE LIVINGSTON COUNTY HEALTH DEPARTMENT AND UR MEDICINE|NOYES HEALTH ENGAGED KEY STAKEHOLDERS ON THE CHA LEADERSHIP TEAM IN A PRIORITIZATION MEETING FACILITATED BY COMMON GROUND HEALTH. KEY PARTNERS AND COMMUNITY MEMBERS WERE INVITED TO ATTEND THE PRIORITIZATION MEETINGS, INCLUDING ALL THOSE WHO ATTENDED PRIOR FOCUS GROUPS. SOCIAL MEDIA PLATFORMS, E-MAIL, NEWS MEDIA, AND NEWSLETTERS WERE UTILIZED TO HELP STIMULATE PARTICIPATION. COMMON GROUND HEALTH PROVIDED GROUP MEMBERS WITH COUNTY-SPECIFIC PRE-READ DOCUMENTS IN ADVANCE OF THE MEETINGS. THE DOCUMENTS NCLUDED INFORMATION ON CURRENT PRIORITY AREAS AND PROGRESS MADE TO DATE, AS WELL AS A MIX OF UPDATED QUANTITATIVE, QUALITATIVE, PRIMARY AND SECONDARY DATA ON EACH OF THE FIVE PRIORITY AREAS OUTLINED IN THE NEW YORK STATE PREVENTION AGENDA. DATA WAS COLLECTED FROM A VARIETY OF DIFFERENT SOURCES INCLUDING, BUT NOT LIMITED TO THE AMERICAN COMMUNITY SURVEY, THE ENHANCED BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, COUNTY RANKINGS AND ROADMAPS, VITAL STATISTICS, COMMUNICABLE DISEASE AND DENTAL REPORTS, PRIMARY DATA COLLECTED FROM THE MY HEALTH STORY 2018 SURVEY AND LOCAL DATA SOURCES SUCH AS LIVINGSTON COUNTY'S PREVENTION NEEDS ASSESSMENT. A COPY OF THE PRE-READ DOCUMENT, PRIORITIZATION MEETING MATERIALS AND MEETING ATTENDEES ARE AVAILABLE UPON REQUEST.USING THE ABOVE REFERENCED DATA AND GROUP DISCUSSIONS, PARTICIPANTS UTILIZED CLEAR IMPACT TO RANK A LIST OF GROUP-IDENTIFIED PRIORITIES. TO ADDRESS THE PREVIOUSLY MENTIONED PRIORITIES AND DISPARITIES, THE HEALTH DEPARTMENT FACILITATED A CHIP PLANNING MEETING WHERE PARTNERS DISCUSSED OPPORTUNITIES TO LEVERAGE EXISTING WORK. EXISTING WORK EFFORTS WERE THEN COMPARED TO INTERVENTION OPTIONS (PRIMARILY SELECTED FROM THE NEW YORK STATE PREVENTION AGENDA REFRESH CHART) AND WERE INFORMALLY VOTED ON AND SELECTED.IN ADDITION, THE ONGOING COLLABORATIVE PROCESS FOR UPDATING AND REVISING THE ASSESSMENT, INCLUDING NEW INFORMATION ON DATA, WILL OCCUR DURING THE ANNUAL STATE OF THE COUNTY HEALTH REPORT IN AN UPDATE PRESENTATION AND DURING GVHP MEMBERSHIP MEETINGS AND SUBCOMMITTEE MEETINGS SUCH AS: THE SUICIDE PREVENTION TASK FORCE AND BE WELL MEETINGS. THESE COMMITTEES ARE COMPRISED OF DIVERSE COMMUNITY SECTORS INCLUDING COMMUNITY MEMBERS. RECRUITMENT OF NEW MEMBERS OCCURS ON PARTNERS' WEBSITES AND SOCIAL MEDIA. THE GVHP BOARD REVIEWS ANNUAL MEMBERSHIP TO IDENTIFY GAPS IN MEMBERSHIP BASED ON CURRENT HEALTH PRIORITIES.THE LIVINGSTON COUNTY HEALTH DEPARTMENT, IN PARTNERSHIP WITH UR MEDICINE|NOYES HEALTH, HAS SELECTED THE FOLLOWING PRIORITY AREAS AND DISPARITY FOR THE 2022-2024 ASSESSMENT AND PLANNING PERIOD:PRIORITY AREAS &amp; DISPARITYPREVENT CHRONIC DISEASE 1. HEALTHY EATING AND FOOD SECURITY PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS2. MENTAL AND SUBSTANCE USE DISORDERS PREVENTION DISPARITY: LOW SOCIOECONOMIC STATUS AND OLDER ADULTSTHE COMPLETE DETAILED 8-REGION 2021-2024 CHA/CHIP REPORT CAN BE FOUND:HTTPS://WWW.URMC.ROCHESTER.EDU/NOYES/COMMUNITY-OUTREACH.ASPX</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR 2021, UR MEDICINE|NOYES HEALTH CONTINUED EFFORTS TO COMMUNICATE THE FINANCIAL AID POLICY. WE HAVE A DEDICATED FINANCIAL AID COUNSELOR WHO CONTACTS ALL FINANCIAL AID ELIGIBLE PATIENTS AND IS A CERTIFIED MEDICAID ENROLLER. EVERY UNINSURED AND UNDERINSURED PATIENT RECEIVED A FINANCIAL AID PACKET CONSISTING OF UR MEDICINE|NOYES HEALTH'S POLICY FOR FINANCIAL ASSISTANCE, OUR FINANCIAL ASSISTANCE SUMMARY WHICH GIVES A BRIEF EXPLANATION OF HOW WE CAN HELP OUR PATIENTS WITH LIMITED INCOMES, OUR FREQUENTLY ASKED QUESTIONS SHEET, AND OUR FINANCIAL ASSISTANCE APPLICATION. A PRESUMPTIVE ENROLLER FOR PREGNANT WOMEN ATTENDING THE NOYES FIRST STEPS PROGRAM, SOCIAL WORKERS, AND A DEDICATED FINANCIAL ASSISTANCE BILLING REPRESENTATIVE WHO WORKS SPECIFICALLY WITH ALL UNINSURED PATIENTS BEFORE, DURING AND FOLLOWING ADMISSION/SERVICE/CARE AVAILABLE AS NEEDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>DEMOGRAPHIC AND SOCIOECONOMIC HEALTH INDICATORS (BASED ON THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2019 1 YEAR ESTIMATES):LIVINGSTON COUNTY IS HOME TO CONESUS AND HEMLOCK LAKES AND LETCHWORTH STATE PARK. IT IS LOCATED SOUTH OF MONROE COUNTY AND NORTH OF STEUBEN AND ALLEGANY COUNTIES. THE NORTHERN PORTION OF THE COUNTY'S PROXIMITY TO THE CITY OF ROCHESTER MAKES IT EASILY ACCESSIBLE FOR JOBS FOR THOSE ABLE TO COMMUTE. AN ESTIMATED 65,000 PERSONS RESIDE IN THE COUNTY, THE MAJORITY OF WHICH (94%) ARE WHITE NON-HISPANIC. WOMEN OF CHILDBEARING AGE MAKE UP 18% OF THE POPULATION, AND 25.3% OF THE 18+ POPULATION ARE LIVING WITH A DISABILITY. 2017 ESTIMATES REVEAL 31% OF THE 65+ POPULATION IS LIVING ALONE. THIS RATE IS UP 19% FROM 2012 WHEN 26% OF THE 65+ POPULATION WAS LIVING ALONE.A SIGNIFICANT NUMBER - 14.6% - OF LIVINGSTON COUNTY RESIDENTS ARE LIVING BELOW THE FEDERAL POVERTY LEVEL, AND ANOTHER 16% LIVE NEAR IT. THE RATES ARE HIGHER IN COMMUNITIES SUCH AS GENESEO, MOUNT MORRIS, AND DANSVILLE. HIGHER LEVEL EDUCATION HAS BEEN ON THE RISE WITH AN INCREASE NOTICED IN BACHELOR'S DEGREES OBTAINED.27% OF LIVINGSTON COUNTY RESIDENTS RENT THEIR HOME. IN ADDITION, 8% OF OCCUPIED HOUSING UNITS HAVE NO VEHICLES AVAILABLE. ANOTHER 32% HAVE ACCESS TO ONE VEHICLE. OF NOTE, THE AVERAGE HOUSEHOLD SIZE FOR OCCUPIED HOUSING IS GREATER THAN TWO PEOPLE. APPROXIMATELY 50% OF RESIDENTS ARE PAYING 35% OR MORE OF THEIR HOUSEHOLD INCOME IN RENT COSTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>PROMOTION OF COMMUNITY HEALTH:UR MEDICINE|NOYES HEALTH MEDICAL STAFF IS AN OPEN MEDICAL STAFF AND IS STAFFED WITH DOCTORS WHO STRIVE TO MEET OUR GOAL FOR EXCEPTIONALLY PERSONALIZED PATIENT CARE - LIKE EVERYONE AT UR MEDICINE|NOYES HEALTH, THE PATIENT IS THE FOCUS. REPRESENTING A WIDE RANGE OF SPECIALTIES AND SUBSPECIALTIES, OUR PHYSICIANS HAVE EXPERTISE AND EXPERIENCE TO PROVIDE YOU WITH THE HIGHEST STANDARD OF CARE, INCLUDING: GENERAL SURGERY, INTERNAL MEDICINE, FAMILY PRACTICE, ORTHOPEDICS, ONCOLOGY, PODIATRY, AND OBSTETRICS. UR MEDICINE|NOYES HEALTH BOARD OF DIRECTORS: OUR ORGANIZATION IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITIES OF LIVINGSTON AND SURROUNDING COUNTIES. THE 17 MEMBERS BRING DIVERSE BACKGROUNDS AND TALENTS TO THE ORGANIZATION. THEY SET THE STRATEGIC DIRECTION OF UR MEDICINE|NOYES HEALTH AND ARE CONSTANTLY ADVOCATING FOR THE HOSPITAL, PATIENTS, AND FAMILIES.NOYES COMMUNITY OUTREACH SERVICES: PROVIDES MANY PREVENTION, EDUCATION AND SCREENING SERVICES THROUGHOUT THE COMMUNITIES IN OUR SERVICES AREA, VIA ONE-TO-ONE VISITS, CLASSES, EVENTS, AND/OR CLINICS:-NOYES HEALTH MEDICAL ALERT PROGRAM AND MEDICATION DISPENSING SERVICES: TO SUPPORT SAFETY/ACCESS TO HELP AND MEDICATION MANAGEMENT FOR AGING AND DISABLED POPULATIONS LIVING AT HOME. PRIMARILY ALL HOME VISITS. PROGRAM WORK ALSO INCLUDES COUNTYWIDE FALL PREVENTION INITIATIVES: HOME SAFE HOME, FALL PREVENTION EDUCATION PROMOTION, ANNUAL FALL PREVENTION WORKSHOP (LEAD AGENCY).-NOYES FIRST STEPS: PRENATAL EDUCATION AND SUPPORT SERVICES FOR LOW INCOME AND/OR HIGH NEED CLIENTS TO SUPPORT HEALTHY BIRTH OUTCOMES, OFFICE AND HOME VISITS. CHILD BIRTH EDUCATION AND INFANT FEEDING CLASSES ALSO PROVIDED TO COMMUNITY. CASE MANAGER FACILITATES THE QUARTERLY REGIONAL MATERNAL CHILD HEALTH COALITION.-CAREGIVER RESOURCE CENTER: EDUCATION, INFORMATION AND ASSISTANCE, SUPPORT GROUPS, RESPITE, MONTHLY NEWSLETTER PROVIDED TO CAREGIVERS CARING FOR LOVED ONES WITH ALZHEIMER'S OR DEMENTIA VIA HOME VISITS, PHONE CALLS, CLASSES, AND EVENTS. PROVIDED IN PARTNERSHIP WITH THE LOCAL OFFICE FOR THE AGING. -CHRONIC DISEASE SELF-MANAGEMENT CLASSES: YEAR-ROUND LIVING HEALTHY, LIVING HEALTHY WITH CHRONIC PAIN, AND LIVING HEALTHY WITH DIABETES CLASSES. PROGRAM FREE TO COMMUNITY AND FUNDING SOURCES ARE BASED ON GRANTS AND OTHER AGENCY RESOURCES. -COMMUNITY EDUCATION: HEALTH AND WELLNESS TOPICS AS REQUESTED AND HEALTH EDUCATION ARTICLES IN LOCAL NEWSPAPERS AS PROVIDED BY SPECIALTIES.-SCREENING CLINICS: FREE BLOOD PRESSURE SCREENINGS AT LOCAL GROCERY STORES AND FAIR AND FESTIVAL EVENTS, WITH PHYSICIAN REFERRAL AND FOLLOW UP, AS NEEDED. CURRENTLY ON HOLD DUE TO THE COVID-19 PANDEMIC.-WORKSITE WELLNESS PROGRAM: FITNESS, NUTRITION, AND STRESS MANAGEMENT OPPORTUNITIES THROUGHOUT THE YEAR COORDINATED BY OUR WELLNESS COMMITTEE FOR APPROXIMATELY 550 UR MEDICINE|NOYES HEALTH EMPLOYEES AND THEIR FAMILY MEMBERS.-CANCER SUPPORT SERVICES: UR MEDICINE|NOYES HEALTH LEADS THE CANCER SUPPORT COALITION WORKING WITH CANCER SUPPORT PROGRAMS AND SERVICES IN A FIVE COUNTY REGION TO SUPPORT PATIENTS OF THE MYERS CANCER CENTER AT UR MEDICINE|NOYES HEALTH.-DIABETES EDUCATION PROGRAM: AADE RECOGNIZED DIABETES ED PROGRAM FOR OUR REGION AND PROVIDES INDIVIDUAL COUNSELING AT A VARIETY OF LOCATIONS IN SERVICE AREA. INSULIN PUMP STARTS AND SUPPORT ARE ALSO PROVIDED ALONG WITH CGMS SCREENING. THE CDCES LEADS THE COUNTY-WIDE DIABETES COALITION.-HOME SAFE HOME: IN-HOME FALL PREVENTION ASSESSMENTS AND HOME MODIFICATIONS. UR MEDICINE|NOYES HEALTH PROVIDES THE PROGRAM MANAGER WHO DOES OUTREACH AND SCREENS ALL REFERRALS FOR HOME FALL RISK ASSESSMENT OF OLDER ADULTS LIVING AT HOME. LIFESPAN OF ROCHESTER IS THE PROGRAM PARTNER WHO PROVIDES THE STAFF AND EQUIPMENT TO DO THE ASSESSMENTS AND LIGHT HOME MODIFICATIONS, I.E. INSTALLATION OF GRAB BARS/RAILINGS, SHOWER CHAIRS, ETC. THE PROGRAM IS CURRENTLY GRANT FUNDED AND FREE TO INDIVIDUALS 60+ WHO MEET INCOME GUIDELINES. PARTNERSHIPS: -UR MEDICINE|NOYES HEALTH ACTIVELY COLLABORATES WITH ALL HEALTH AND HUMAN SERVICE AGENCIES IN LIVINGSTON COUNTY, I.E. OFFICE FOR AGING, DEPARTMENT OF HEALTH, DEPARTMENT OF SOCIAL SERVICES, ARC OF LIVINGSTON-WYOMING, CATHOLIC CHARITIES OF LIVINGSTON COUNTY, AND TRIAD, ETC.-UR MEDICINE|NOYES HEALTH MANAGERS SIT AS BOARD MEMBERS AND/OR GENERAL MEMBERS OF THE COUNTY-WIDE RURAL HEALTH NETWORK, GENESEE VALLEY HEALTH PARTNERSHIP.-UR MEDICINE|NOYES HEALTH STAFF LEAD THE CONTINUUM OF CARE COALITION STARTED IN 2013, WHICH HAS OVER 40 AGENCY MEMBERS AND MEETS SIX TIMES PER CALENDAR YEAR.-UR MEDICINE|NOYES HEALTH STAFF ALSO LEAD THE DIABETES EDUCATION COALITION AND MATERNAL CHILD HEALTH COALITION FOR LIVINGSTON COUNTY.-UR MEDICINE|NOYES HEALTH HAS HOSPITAL STAFF ON MULTIPLE COUNTY COMMITTEES AND BOARDS, I.E. OFFICE FOR AGING ADVISORY BOARD, TRIAD, COMMUNITY RESOURCE NETWORK, FALL PREVENTION COALITION, AND TWO COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) COMMITTEES: TRAUMA INFORMED COMMUNITIES AND BE WELL IN LIVINGSTON.-HOSPITAL ADMINISTRATORS SIT ON SEVERAL COMMUNITY AND REGIONAL HOSPITAL BOARDS, I.E. LIVINGSTON COUNTY HOSPICE BOARD OF DIRECTORS, LIVINGSTON COUNTY PROFESSIONAL ADVISORY BOARD, HEALTHCARE ASSOCIATION OF NEW YORK STATE BOARD OF DIRECTORS, ALFRED STATE COLLEGE NURSING ADVISORY BOARD, GENESEE COMMUNITY COLLEGE NURSING ADVISORY BOARD, UNIVERSITY OF ROCHESTER SCHOOL OF NURSING ADVISORY COMMITTEE, PANDION SOURCING NATIONAL LLC BOARD OF DIRECTORS, AND THE REGIONAL EMERGENCY MEDICINE ADVISORY BOARD. -NOYES COMMUNITY OUTREACH SERVICES PROVIDE MANY PREVENTION, EDUCATION AND SCREENING SERVICES THROUGHOUT THE COMMUNITY AND INCLUDES HOME VISITS FOR SOME SERVICES:--NOYES HEALTH MEDICAL ALERT PROGRAM AND MEDICATION DISPENSING SERVICES: ALL HOME VISITS--NOYES FIRST STEPS: PRENATAL EDUCATION AND SUPPORT SERVICES FOR LOW INCOME AND/OR HIGH NEED CLIENTS, INCLUDES OFFICE AND HOME VISITS.--CAREGIVER RESOURCE CENTER: HOME VISITS, PHONE CALLS, CLASSES, SUPPORT GROUPS, AND EVENTS.--LIVING HEALTHY AND LIVING HEALTHY WITH DIABETES: CHRONIC DISEASE SELF-MANAGEMENT CLASSES PROVIDED THROUGHOUT THE COUNTY FOUR TIMES PER YEAR.--CLINICS: FREE BLOOD PRESSURE SCREENINGS AT LOCAL GROCERY STORES AND FAIR AND FESTIVAL EVENTS CURRENTLY ON HOLD DUE TO THE COVID-19 PANDEMIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>NICHOLAS H. NOYES MEMORIAL HOSPITAL IS AFFILIATED WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER (URMC). TOGETHER WITH NICHOLAS H. NOYES MEMORIAL HOSPITAL, URMC AND ITS OTHER HEALTH CARE AFFILIATES PROVIDE COMPREHENSIVE HEALTHCARE SERVICES IN NEW YORK STATE. THIS AFFILIATION 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, ST. JAMES HOSPITAL AND ACCOUNTABLE HEALTH PARTNERS, LLC. UR MEDICAL CENTER AND THE AFFILIATED 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 COMMUNITY-BASED RESEARCH. THESE ACTIVITIES HELP INFORM POLICYMAKERS AND THE COMMUNITY ABOUT LOCAL HEALTH CHALLENGES, EVALUATE THE EFFECTIVENESS OF INTERVENTIONS, AND SERVE AS A FOUNDATION FOR EVIDENCE-BASED PRACTICES TO IMPROVE HEALTH AND OVERALL QUALITY OF LIFE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>NY</ExplanationTxt>
      </SupplementalInformationDetail>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>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 - $159,400 ROBERT MCCANN, M.D. - SERP PLAN - $12,800 MARK TAUBMAN, M.D. - SERP PLAN - $150,000 MARK PRUNOSKE - 457(F) PLAN - $27,887 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED EMPLOYER PAID AMOUNTS THAT ARE INCLUDED IN OTHER REPORTABLE COMPENSATION: STEVEN GOLDSTEIN - 457(F) PLAN - $1,749,057 MARK PRUNOSKE - 457(F) PLAN - $32,572 THESE AMOUNTS REPRESENT EMPLOYEE DEFERRALS OF COMPENSATION, PLUS INVESTMENT EARNINGS, OVER SEVERAL YEARS THAT VESTED AND WERE PAID PURSUANT TO THE REQUIREMENTS OF THE PLAN. THE EMPLOYEE DEFERRALS WERE REPORTED AS DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C IN PRIOR YEARS AND ARE ALSO REFLECTED IN SCHEDULE J, PART II, COLUMN F.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>LIVINGSTON COUNTY INDUSTRIAL DEVELOPMENT AGENCY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>161136853</BondIssuerEIN>
        <CUSIPNum>538655AD3</CUSIPNum>
        <BondIssuedDt>2005-06-29</BondIssuedDt>
        <IssuePriceAmt>9471914</IssuePriceAmt>
        <PurposeDesc>ACQUISITION, RENOVATION, CONSTRUCTION, AND EQUIPPING OF HOSPITAL</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>5205000</RetiredAmt>
        <TotalProceedsAmt>9763548</TotalProceedsAmt>
        <InReserveFundAmt>805638</InReserveFundAmt>
        <CapitalizedInterestAmt>625676</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>189438</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>6449941</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>1692856</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2006</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>1</MgmtContractBondFincdPropInd>
        <EngageBondCounselContractsInd>1</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusConcerningUBIPct>0.01200</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.01200</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>MEDICOR INTERNAL MEDICINE PLLC</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>ENTITY MORE THAN 35% OWNED BY AHSEN SHEIKH, DIRECTOR</RelationshipDescriptionTxt>
        <TransactionAmt>392443</TransactionAmt>
        <TransactionDesc>CONTRACTED SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>SEVERAL OF THE DIRECTORS OF NICHOLAS H. NOYES MEMORIAL HOSPITAL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER THROUGH THEIR EMPLOYMENT. MARK TAUBMAN IS AN OFFICER OF THE UNIVERSITY OF ROCHESTER. STEVEN GOLDSTEIN, ROBERT MCCANN, AND J. CHAD TEETERS ARE EMPLOYEES OF THE UNIVERSITY OF ROCHESTER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE CORPORATE MEMBER OF NICHOLAS H. NOYES MEMORIAL HOSPITAL IS LIVINGSTON HEALTH CARE SYSTEM, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>UP TO 18 "COMMUNITY DIRECTORS" ARE APPOINTED BY LIVINGSTON HEALTH CARE SYSTEM, INC. TO THE BOARD OF DIRECTORS. UP TO 3 "UR DIRECTORS" ARE APPOINTED BY THE UNIVERSITY OF ROCHESTER TO THE BOARD OF DIRECTORS. THE UNIVERSITY OF ROCHESTER RESERVES THE POWER TO ELECT AND REMOVE THE DIRECTORS OF THE HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN DECISIONS REQUIRE THE APPROVAL OF LIVINGSTON HEALTH CARE SYSTEM, INC. AS THE SOLE CORPORATE MEMBER OF NICHOLAS H. NOYES MEMORIAL HOSPITAL, INCLUDING BUT NOT LIMITED TO: SIGNIFICANT PURCHASES OR SALES OF REAL PROPERTY, AMENDMENTS TO THE CERTIFICATE OF INCORPORATION, MERGERS, AND DISSOLUTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND BOARD OF DIRECTORS PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>DIRECTORS, COMMITTEE MEMBERS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST (A) PRIOR TO VOTING ON OR OTHERWISE DISCHARGING THEIR DUTIES WITH RESPECT TO ANY MATTER INVOLVING THE CONFLICT THAT COMES BEFORE THE BOARD OR COMMITTEE, (B) PRIOR TO ENTERING INTO ANY CONTRACT OR TRANSACTION INVOLVING THE CONFLICT, (C) AS SOON AS POSSIBLE AFTER THEY LEARN OF THE CONFLICT, AND (D) ON AN ANNUALLY COMPLETED AND SUBMITTED CONFLICT OF INTEREST DISCLOSURE FORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS REVIEWS THE GOALS AND OBJECTIVES OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER ALONG WITH COMPARABILITY DATA TO DETERMINE COMPENSATION. THE DELIBERATION AND DECISION IS RECORDED IN THE MINUTES OF THE BOARD OF DIRECTORS. THE PRESIDENT/CHIEF EXECUTIVE OFFICER DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES BASED ON COMPARABILITY DATA AND PERFORMANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>NICHOLAS H. NOYES MEMORIAL HOSPITAL'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 13,142,094. MANAGEMENT AND GENERAL EXPENSES 3,287,800. FUNDRAISING EXPENSES 170. TOTAL EXPENSES 16,430,064.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN FUNDED STATUS OF PENSION PLAN 475,174. CHANGE IN INTEREST OF FOUNDATION -789,916.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FFT SENIOR COMMUNITIES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1 FERRIS HILLS</AddressLine1Txt>
          <CityNm>CANANDAIGUA</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14424</ZIPCd>
        </USAddress>
        <EIN>161557494</EIN>
        <PrimaryActivitiesTxt>ELDER CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>FF THOMPSON HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HIGHLAND COMMUNITY DEVELOPMENT CORP -</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>100 HAHNEMANN TRAIL</AddressLine1Txt>
          <CityNm>PITTSFORD</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14534</ZIPCd>
        </USAddress>
        <EIN>223154715</EIN>
        <PrimaryActivitiesTxt>ELDER CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>STRONG PARTNERS HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HIGHLAND HOSPITAL OF ROCHESTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 SOUTH AVENUE</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14620</ZIPCd>
        </USAddress>
        <EIN>160743037</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>STRONG PARTNERS HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE HIGHLAND FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 SOUTH AVENUE</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14620</ZIPCd>
        </USAddress>
        <EIN>237310662</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HIGHLAND HOSPITAL OF ROCHESTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HIGHLAND FACILITIES DEVELOPMENT CORPORATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1000 SOUTH AVENUE</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14620</ZIPCd>
        </USAddress>
        <EIN>223039077</EIN>
        <PrimaryActivitiesTxt>MEDICAL BLDG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HIGHLAND HOSPITAL OF ROCHESTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>LIVINGSTON HEALTH CARE SYSTEM INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161455240</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIVERSITY OF ROCHESTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>RED JACKET CENTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161037658</EIN>
        <PrimaryActivitiesTxt>MEDICAL BLDG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LIVINGSTON HEALTH CARE SYSTEM INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 CLARA BARTON STREET</AddressLine1Txt>
          <CityNm>DANSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14427</ZIPCd>
        </USAddress>
        <EIN>161584778</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LIVINGSTON HEALTH CARE SYSTEM INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JONES MEDICAL SERVICES PC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>191 NORTH MAIN STREET</AddressLine1Txt>
          <CityNm>WELLSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14895</ZIPCd>
        </USAddress>
        <EIN>465210222</EIN>
        <PrimaryActivitiesTxt>MEDICAL CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>JONES MEMORIAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>191 NORTH MAIN STREET</AddressLine1Txt>
          <CityNm>WELLSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14895</ZIPCd>
        </USAddress>
        <EIN>473763374</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>191 NORTHMAIN STREET</AddressLine1Txt>
          <CityNm>WELLSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14895</ZIPCd>
        </USAddress>
        <EIN>222807681</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIVERSITY OF ROCHESTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UNIVERSITY OF ROCHESTER BROADCASTING CORPORATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>201 WILSON COMMONS</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14627</ZIPCd>
        </USAddress>
        <EIN>160743209</EIN>
        <PrimaryActivitiesTxt>BROADCAST LIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(4)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UNIVERSITY OF ROCHESTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE COMMUNITY SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2180 EMPIRE BOULEVARD</AddressLine1Txt>
          <CityNm>WEBSTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14580</ZIPCd>
        </USAddress>
        <EIN>825091873</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE LICENSED SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2180 EMPIRE BOULEVARD</AddressLine1Txt>
          <CityNm>WEBSTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14580</ZIPCd>
        </USAddress>
        <EIN>161561691</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UR MEDICINE HOME CARE CERTIFIED SERVICES INC</BusinessNameLine1Txt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>EXCELL TECHNOLOGY VENTURES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>343 STATE STREET KODAK TOWER 2ND FL</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14650</ZIPCd>
        </USAddress>
        <EIN>800909149</EIN>
        <PrimaryActivitiesTxt>BIOTECH INCUBATOR</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ACCOUNTABLE HEALTH PARTNERS LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>135 CORPORATE WOODS STE 320</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14623</ZIPCd>
        </USAddress>
        <EIN>300787967</EIN>
        <PrimaryActivitiesTxt>ACCT CARE NETWORK</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>LUMINATE VENTURE CHALLENGE CORP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>260 EAST MAIN STREET SUITE 6000</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14604</ZIPCd>
        </USAddress>
        <EIN>823954131</EIN>
        <PrimaryActivitiesTxt>BUSINESS INCUB</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ACCOUNTABLE HEALTH PARTNERS IPA LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>135 CORPORATE WOODS STE 320</AddressLine1Txt>
          <CityNm>ROCHESTER</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14623</ZIPCd>
        </USAddress>
        <EIN>371746016</EIN>
        <PrimaryActivitiesTxt>INDEP PRACTICE ASSOC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AHP INSURANCE COMPANY</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>76 ST PAUL STREET SUITE 500</AddressLine1Txt>
          <CityNm>BURLINGTON</CityNm>
          <StateAbbreviationCd>VT</StateAbbreviationCd>
          <ZIPCd>05401</ZIPCd>
        </USAddress>
        <EIN>814644839</EIN>
        <PrimaryActivitiesTxt>CAPTIVE INSURANCE CO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>VT</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HORNELL MEDICAL VILLAGE LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>7100 ROUTE 70A</AddressLine1Txt>
          <CityNm>HORNELL</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14843</ZIPCd>
        </USAddress>
        <EIN>611886863</EIN>
        <PrimaryActivitiesTxt>HOLD REAL ESTATE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
