2023-11-06T10:17:29-07:00 2022-12-31 990 2022-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 Dates Drive Ithaca NY 14850 Martin Stallone President/CEO 6072744441 2023-11-06 1 1 11 1 AAL2 X 2022 2023-04-26 12:10:37Z Martin Stallone MD 101 Dates Drive Ithaca NY 14850 351480052 0 X www.cayugamed.org X 1981 NY To deliver the highest quality healthcare in partnership with our community, one person at a time. 18 16 2222 185 539481 351606 10012082 9054156 307293148 329842861 6632717 2971976 2021456 771141 325959403 342640134 463365 404592 0 0 138256083 156530368 0 0 0 190476270 185067767 329195718 342002727 -3236315 637407 328652418 306334753 160562946 118390244 168089472 187944509 Cayuga Medical Center will remain the region's leading hospital, healthcare provider, and most trusted driver of integrated health services, together with valued partners. We empower our people and employ our capabilities to equitably improve the well-being of the communities we serve. 0 0 263594734 404592 329105900 Patient Service - General inpatient and outpatient hospital care. Services are provided to those in need regardless of the patients' ability to pay, race, creed, national origin, life circumstances, or disease. Cayuga Medical Center works closely with the community to determine health needs and support the development of programs and services that improve the health status of the community. 0 0 0 Health Career scholarships are awarded to students pursuing a healthcare degrees and emergency funds are provide temporary funds to employees adversely affected by emergent situations. In 2022 scholarships were paid out of the Foundation due to increase in Foundation restricted funds available for scholarships. 0 0 0 263594734 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 348 0 0 2222 1 1 1 0 0 0 0 0 1 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Rebecca Gould 6072744441 101 Dates Drive Ithaca NY 14850 Deidre Blake CMC Med Staff President 0 40 X 0 1675476 1675476 Martin Stallone President & CEO 39 1 X X 999371 0 54196 John-Paul Mead Director 3 40 X 61343 326334 326334 John Collett CFO/VP of Finance 39 1 X 522400 0 37400 Srisatish Devapatla Neonatologist 40 0 X 468576 0 42754 Andreia De Lima Serra Vice President 40 0 X 442726 0 57598 Tracy Gates COO 39 1 X 438142 0 58769 Justin Runke Vice President 39 1 X 416548 0 56154 Michael Berlin Assistant Vice President 39 1 X 417926 0 14452 Ramesh Vidavalur Neonatologist 40 0 X 392626 0 32454 Tom LiVigne Chair 4.00 0 X X 24000 0 0 Paula Younger Vice Chair 4 0 X X 19750 0 0 John Lambert Director 3 0 X 16750 0 0 Brooke Hollis Director 3 0 X 16000 0 0 Kenneth Clarke Director 3 0 X 15500 0 0 Fred Wickham Director 3 0 X 15500 0 0 Joel Malina Director 3 0 X 8750 0 0 Carl Sgrecci Director 3 0 X 3750 0 0 Cris Donovan Director 3 0 X 2250 0 0 James Brown Director 3.00 0 X 2000 0 0 La Jerne Terry Cornish Director 3.00 0 X 1750 0 0 Jennifer Whitaker Director 3 0 X 1500 0 0 Eunice Nayo Director 3.00 0 X 1000 0 0 Greg Hartz Treasurer 4.00 0 X 0 0 0 Suzanne Blowers Secretary 4 0 X 0 0 0 Laurie Mante Director 3 0 X 0 0 0 4288158 2001810 2355587 222 1 1 0 Mayo Collaborative Services PO BOX 4100 ROCHESTER MN 55903 LAB TESTING 3467521 CORNELL UNIVERSITY 146 LANGMUIR LAB 95 BROWN ROAD ITHACA NY 14850 LAB TESTING 3064236 MEDUIT HEALTH SERVICES 8085 KNUE RD INDIANAPOLIS IN 46250 OUTSOURCED REVENUE CYCLE SERVICES 2671821 MEDICAL SOLUTIONS LLC 666 WALNUT ST SUITE 700 DES MOINES IA 50309 TEMP STAFFING 2518503 HEALTH CAROUSEL PO BOX 714216 CINCINNATI OH 45271 TEMPORARY STAFFING 1591969 73 0 0 0 363000 8659176 31980 0 9054156 Patient Revenue 622000 302440002 302440002 0 0 27402859 27402859 0 0 329842861 3613168 0 325774 3287394 0 0 0 0 0 0 0 0 0 0 8152979 45747 8794171 45747 -641192 0 -641192 0 0 -641192 0 Cafeteria Meals 722212 1294395 0 0 1294395 -523254 -736961 213707 0 771141 342640134 329105900 539481 3940597 X 404592 404592 0 0 0 0 0 0 2128074 2128074 0 0 112553348 81829504 30723844 11687242 8496959 3190283 22204894 16180597 6024297 7956810 5784829 2171981 1685455 363550 1321905 524438 194042 330396 130220 130220 18522 18522 0 0 52500 52500 69610894 56986426 12624468 2126842 2126842 67802037 61922448 5879589 5028408 4218984 809424 0 0 7056770 3856232 3200538 263837 69668 194169 0 0 0 0 489788 0 489788 0 0 12532306 6808374 5723932 1774568 1508383 266185 Licenses/Certifications/Permit Fees 134635 76177 58458 Purchased Services 15836547 14893969 942578 342002727 263594734 78407993 0 4360 4360 31533747 6195866 0 0 32628993 33575285 0 0 0 0 0 0 11845524 12086785 18699155 15957691 318808863 213701672 97631177 105107191 100852477 86530046 0 0 0 0 1529995 1529995 33926990 45347534 328652418 306334753 43550999 43121968 0 0 0 0 17615493 19472532 0 0 0 0 0 0 0 0 99396454 55795744 160562946 118390244 X 160595305 180636486 7494167 7308023 168089472 187944509 328652418 306334753 X 637407 -17039119 0 0 0 36256749 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 20173 0 20173 0 Schedule C, Part II-B, Line 1 Cayuga Medical Center belongs to organizations that lobby on the behalf of their members. This includes HANYS and Iroquois Healthcare Association. 1770578 982867 -285865 0 0 0 2467580 1764186 6391 1 0 0 0 1770578 1750507 16066 129 0 2516 0 1764186 1728201 29316 216 0 7226 0 1750507 1703145 35761 199 0 10904 0 1728201 0 0.362 0.638 0 1 1 2829462 0 2829462 176822078 0 104511056 72311022 2641403 0 2361091 280312 121441668 0 102209069 19232599 15074252 0 4620456 10453796 105107191 Beneficial interest in assets of foundation 9051814 Right of use asset 14266257 Life insurance 2270162 Equity in related parties 19759301 45347534 0 Lease liability 14441334 Accrued pension cost 8049750 Accrued postretirement 9495225 Due 3rd party payors 18252213 Due to Affiliate 4972321 Medicare Advance 584901 55795744 361857517 -17039119 0 0 36256502 19217383 342640134 0 0 0 342640134 342002727 0 0 0 0 0 342002727 0 0 0 342002727 Schedule D, Part V, Line 4 The intended use of the endowment funds is to support Cayuga Medical Center's ongoing mission to deliver the highest quality healthcare in partnership with our community, one person at a time. Schedule D, Part XI, Line 2d Unrealized Gain on Interest Rate Swap = $14,183 Other Changes in Pension & Post-Retirement Benefit (Gain in CY) = $36,242,319 1 1 X 1 X 1 X 1 0 0 0 0 189612 0 189612 0.0006 0 0 47887103 34052851 13834252 0.0405 0 0 0 0 0 0 0 0 48076715 34052851 14023864 0.0411 0 0 46975032 293763 46681269 0.1365 0 0 3421942 0 3421942 0.01 0 0 25166641 20351997 4814644 0.0141 0 0 0 0 0 0 0 0 13958 0 13958 0.00 0 0 75577573 20645760 54931813 0.1606 0 0 123654288 54698611 68955677 0.2017 1 0 189612 25649939 22880738 2769201 X 1 0 1 1 Cayuga Medical Center at Ithaca 101 Dates Drive Ithaca NY 14850 www.cayugamed.org 5401001H X X X X Cayuga Medical Center at Ithaca 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X http://www.cayugamed.org/wp-content/uploads/2020/08/2019-2024_CHA-CHIP-Tompkins-1.pdf 1 22 1 http://www.cayugamed.org/wp-content/uploads/2020/08/2019-2024_CHA-CHIP-Tompkins-1.pdf 0 0 1 X 100 300 X 1 1 X X X 1 X https://www.cayugamed.org/visiting-us/paying-for-your-care/ X https://www.cayugamed.org/visiting-us/paying-for-your-care/ X https://www.cayugamed.org/visiting-us/paying-for-your-care/ X X X X X 1 X 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Cayuga Medical Center at Ithaca As in years past, the qualitative process provided crucial community input into this assessment. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center, and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers and through panels and presentation by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part V, Section B, Line 6b-Cayuga Medical Center at Ithaca Tompkins County Health Department, Tompkins County Mental Health, Office for the Aging, Cayuga Health System, Health Planning Council, Horn Research Consulting, Ithaca College, Cornell University, Human Services Coalition, and Cornell Cooperative Extension of Tompkins County. Schedule H, Part V, Section B, Line 11-Cayuga Medical Center at Ithaca Cayuga Medical Center (CMC) is actively working to address the needs of individuals suffering from mental health and/or substance abuse conditions by improving the care available to this population within the hospital setting and actively collaborating with community-based providers for the outpatient setting. Cayuga Medical Center is directly participating in the Tompkins County CHNA/CHIP Steering Committee and has representation from our Cayuga Center for Health Living, a service within CMC that focuses on chronic disease prevention and treatment. The health needs not addressed by the document include: percent of population (all ages) living in poverty, percent of population (under age 18) living in poverty, percent of single parent households with children under the age of 18 living in the home, percent of individuals uninsured and the housing affordability rate. CMC is not directly addressing these health conditions. CMC is however, aligned with and supports the United Way in Tompkins County which helps address housing and poverty needs. CMC additionally is aligned with the Health Planning Council which assists in enrolling individuals into Medicaid and other affordable insurance programs and CMC provides space at the hospital for enrollment of individuals into these programs. 16 Cayuga Medical Center - CHOA 10 Arrowwood drive ithaca NY 14850 diagnostic imaging, hematology/oncology services Cayuga Medical Center - Urgent Care Cortland 1129 Commons ave Cortland NY 13045 urgent care, diagnostic imaging, lab services, outpatient physical therapy. Cayuga Medical Center - Cayuga Wellness Center 310 Taughannock Blvd Ithaca NY 14850 cardiac rehab, outpatient physical therapy, bariatric clinic & nutritional services Cayuga Medical Center - CHOA 201 Dates Drive ithaca NY 14850 Hematology & Oncology Services Cayuga Medical Center - Surgicare 10 Arrowwood drive ithaca NY 14850 outpatient surgical services Cayuga Medical Center - Brentwood PT 10 Brentwood Drive ithaca NY 14850 outpatient rehabilitation services Cayuga Medical Center - Brentwood Imaging 10 Brentwood drive ithaca NY 14850 Diagnostic Imaging services Cayuga Medical Center - Cayuga Endoscopy Center 2435 N Triphammer rd ithaca NY 14850 Endoscopy services Cayuga Medical Center - Dryden Draw Station 5 Evergreen st Dryden NY 13053 lab draw station Cayuga Medical Center - craft road lab draw 1020 craft rd suite b ithaca NY 14850 lab draw station Cayuga Medical Center - cayuga heights lab draw 905 hanshaw road ithaca NY 14850 lab draw station Cayuga Medical Center - it offices 767 warren road ithaca NY 14850 information & technology systems. Cayuga Medical Center - mass sampling site 40 catherwood drive ithaca NY 14850 COVID collection site and inventory warehousing. Cayuga Medical Center - lab processing 53 Brown Rd ithaca NY 14850 lab processing Cayuga Medical Center - Cortland MOB 1123 Commons Ave Cortland NY 13045 Medical Offices Cayuga Medical Center - Cortland CHOA 1081 Commons ave cortland NY 13045 hematology & cancer services Schedule H, Part I, Line 7 Cayuga Medical Center utilized its cost accounting system to obtain the cost of services related to financial assistance and subsidized health services, lines 7a and 7g. All other costs were derived from actual expenses incurred in the period that were directly related to the provision of the service or program. Schedule H, Part I, Line 7, Column f No bad debt expense that was incurred in Form 990, Part IX, line 25, column (A), was subtracted for the purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f). Schedule H, Part III, Section A, Line 4 "The Medical Center recognizes patient service revenue at amounts that reflect the consideration to which they expect to be entitled in exchange for providing patient care. These amounts are due from patients, third-party payors (including commercial payors and government programs) and others, and they include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews and investigations. The Medical Center recognizes patient service revenue in the period in which they satisfy performance obligations under contracts by providing healthcare services to patients. The Medical Center determines its performance obligations based on the nature of the services provided. Revenues for performance obligations satisfied over time are recognized based on actual charges incurred in relation to total expected charges as this method provides a reasonable estimate of the transfer of services over the term of performance obligations based on the inputs needed to satisfy the obligations. Generally, performance obligations satisfied over time relate to patients receiving inpatient acute care services. The Medical Center measures performance obligations from admission to the point when there are no further services required for the patient, which is generally the time of discharge. The Medical Center recognizes revenues for performance obligations satisfied at a point in time, which generally relate to patients receiving outpatient services, when services are provided and the patient does not require additional services. Because all of the Medical Center's patient service performance obligations generally relate to contracts with a duration of less than one year and as a result, they have elected to apply the optional exemption provided in FASB Accounting Standards Codification (ASC) 606-10-50-14(a) and, therefore, do not disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations referred to above are primarily related to inpatient acute care services at the end of the reporting period. The performance obligations for these contracts are generally completed when the patients are discharged, which generally occur within days or weeks of the end of the reporting period. The Medical Center determines the transaction price based on standard charges for services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with its financial aid policies, and implicit price concessions. Estimates of contractual adjustments and discounts are determined based on contractual agreements, discount policies and historical experience. For uninsured patients that do not qualify for charity care, the Medical Center recognizes revenue on the basis of its standard rates for services provided. Based on its historical experience, a significant portion of the Medical Center's uninsured patients will likely be unable or unwilling to pay for the services provided. Thus, the Medical Center records an implicit price concession to reduce accounts to their net realizable value at the time management believes it is probable a receivable will not be recovered. There are various factors that can impact collection trends, such as changes in the economy, unemployment rates, the number of uninsured and underinsured patients, the volume of patients through the emergency department, the increased burden of co-pays, co-insurance amounts and deductibles to be made by patients with insurance, and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Estimates of implicit price concessions are determined based on historical collection experience with these classes of patients using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than as individual contracts. The financial statement effect of using this practical expedient are not materially different from an individual contract approach. Hospitals are typically paid for services at amounts that are negotiated with insurance companies or are set by the government. The Medical Center has contractual rate agreements with third-party payors that provide for payments at amounts different from established charges. These contractual rates agreements include prospectively determined rates per discharge or visit, cost-based reimbursement, discounted charges, per diem payments and fee-for-service payments. The Medical Center recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of these contractual rates for the services rendered. Settlements with third-party payors for retroactive revenue adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the contractual agreement with the payor, correspondence from the payor and historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, as new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Agreements with third-party payors typically provide for payments at amounts less than established chargesThe Medical Center grants unsecured credit to its patients, most of whom are local residents and are insured under third-party payor agreements. The Medical Center does not believe significant audit risks exists for government payors, commercial and other third-party payors. When the Medical Center has unconditional right to payment, subject only to the passage of time, the right is treated as a receivable. Patient accounts receivable, including billed and unbilled accounts for which the Medical Center has the unconditional right to payment, and estimated amounts due from third-party payors for retroactive adjustments, are receivables if the right to consideration is unconditional and only the passage of time is required before payment of the consideration is due. For patient accounts receivable, the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction of patient accounts receivable rather than an allowance for doubtful accounts. The amount on line 2 is total implicit contract concessions multiplied by the percentage of cost vs charges for Charity Care per our audited financial statement footnote. The Amount on line 3 is the amount from line two multiplied by the percent of financial assistance gross patient charges divided by total gross patient charges. This eligible portion is immaterial and only the cost of the charity care is included in our reported community benefit." Schedule H, Part III, Section B, Line 8 The cost to charge ratio of 47.99% was calculated from our facilities cost accounting system based on the total cost to total charges on Medicare account only was applied to the Medicare gross patient revenue of $166,227,348. The result was then reduced by the worksheet 6 Medicare cost of $35,445,999 for the FY 2022 allowable cost of care. The revenue was reduced by Final Deductions of $105,131,410 and then reduced by the worksheet 6 Medicare revenue of $56,891,766 for the FY 2022. Schedule H, Part III, Section C, Line 9b CMC's standard operating practice is to stop all collection efforts and hold accounts back from bad debt until the patient is given sufficient time to complete a financial assistance application. Review of the application will be made by the hospital and patients are notified of determination within 30 days of receipt of a completed application. If a patient does not qualify for either partial or full assistance, then a monthly payment plan is offered to the patient for any remaining balances due. If the patient qualifies for any financial assistance, an adjustment is immediately posted to the patients account upon determination of qualification. The accounts for patient's qualifying for financial assistance are earmarked as "charity." Such accounts do not qualify for collection. Schedule H, Part VI, Line 2 To determine the health needs of our community, a comprehensive analysis was conducted through quantitative and qualitative methods. In the quantitative analysis, multiple sources provided the reportable statistics including the New York State Community Health Indicators, the County Health Rankings Report, as well as internal data from Cayuga Medical Center. The data collected for the quantitative assessment was then sorted into the following health categories: Demographics and socioeconomic status, Access to healthcare, Health status of overall population and priority populations, Risk factor behaviors and conditions related to top 5 causes of death, child health, Infectious diseases, Natural environment, Social and mental health environment, and Resources/Assets. For every indicator, comparisons were made utilizing the mean value for each individual county, the aggregate value for the total community, the New York State without New York City state value and the U.S. value where applicable to generate context for interpretation. Information for this assessment was collected in a different manner this year, as the CHNA and Community Health Improvement Plan (CHIP) was a combined effort with the Local Health Department of Tompkins County. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center, and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers and through panels and presentation by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. For example, data on hospitalizations related to mental health and substance abuse showed steep increases over the last 2-10 years, indicating that mental health and substance abuse continues to be a priority for Tompkins County. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part VI, Line 3 There is signage in all patient registration areas at Cayuga Medical Center (CMC), as well as in other patient waiting areas, advising patients that financial assistance is available. Financial assistance brochures are also available at all registration areas. Patients who request financial assistance are provided with the CMC policy and an application. Financial counselors are available to assist patients in completion of the application and to answer any questions. Self-pay billing statements provide information on financial assistance policies, as well as the contact information to call for assistance. CMC's call center contacts patients regarding unpaid bills and advises patients of the availability of financial assistance. The Financial Assistance Policy and application are posted and available on the CMC website at www.cayugamed.org. CMC has facilitated enrollers from Medicaid Managed Care Plans on-site. Patients are referred to the facilitated enrollers for determination of Medicaid eligibility. Information regarding the on-site facilitated enrollers is also available on CMC's website. Schedule H, Part VI, Line 4 Located in the Finger Lakes region, Cayuga Medical Center serves populations from six counties: Cayuga, Cortland, Schuyler, Seneca, Tioga, and Tompkins Counties. Many of these areas are designated rural counties and Tompkins County is New York State's smallest Metropolitan Statistical Area. The total service area spans approximately 1,000 square miles in the middle of the state with an average population density of fewer than 125 persons per square mile. There are several distinct health and health-related factors affecting residents of this area: A) The region is home to an older community. Since the 2000 Census, growth in the 65+ age cohort has ranged from 15% to 32% across the region and is projected to increase by 18% between 2016 and 2021. Issues with chronic disease and psychological distress are well documented for this demographic. Overall, 22.9% of adults aged 55 and over are likely to be in fair or poor health, ranging from 19.6% of those aged 55-64 to 32.1% or those azged 85 and over (National Health Statistics Reports, Health Characteristics of Adults Aged 55 Years and Over: United States, 2004-2007, CDC, 2009). B) Access to health care professionals within the region is problematic. Many of the counties have zip codes within that county with Health Professional Shortage Areas (HPSA's) designations for physician, dental, and mental health care for Medicaid beneficiaries. Even when a provider is available, the rural environment, defined by hilly terrains and lakes as geographic barriers, creates transportation challenges that can limit access. C) In aggregate, residents of the services are fiscally challenged. The median household within the region in 2019 was $58,743, which was $6,580 below the state average (QuickFacts, Census Bureau). Schedule H, Part VI, Line 5 Cayuga Medical Center (CMC) has a mirror board at the Cayuga Health System (CHS) level, CMC's active parent holding company. The majority of the CHS board of directors are all residents of Tompkins County, CMC's primary service area. Additionally, any qualified healthcare professional that meets the high quality standards of our credentialing process may apply and secure medical staff privileges within an identified department or specialty. As a 501(c)(3) organization, CMC reinvests any surplus in annual operating margin to improve the medical care for the community, including patient-side and technology improvements, facility structure and infrastructure, and improvements in care delivery. As an example, CMC is investing over $20 million to renovate a portion of the local mall to provide consolidated services to patients in the community with access to public transportation. CMC has also investing heavily in a new state of the art downtown campus with a medical office building, affordable housing, and market rate housing/business locations. The medical office building will include a Medicaid friendly primary care, a women's health center, and expansive oncology services. CMC operates several programs at a loss every year to ensure such services are available in the community including Neonatology, Cardiac Rehab, and Behavioral Services. Schedule H, Part VI, Line 6 As of September 2014, Cayuga Medical Center is a subsidiary member of Cayuga Health System. Schuyler Hospital is also a subsidiary member of Cayuga Health System. Each subsidiary organization has their own separately identified primary and secondary service areas and is responsible for improving the health of those communities. In 2019, Schuyler Hospital collaborated with its local health department to complete its CHNA/CHIP. As of 2017, Cayuga Health System has a mirror board with representatives from each of the former subsidiary boards as members. The organizations are exploring a more unified approach to the CHNA/CHIP process in future years. The strategic plan is now aligned at the System level, and the needs of each community have been incorporated across the plan. Schedule H, Part VI, Line 7 New York State 1 Reach Medical PLLC 1001 W Seneca Street ITHACA NY 14850 823284560 501(c)(3) 343938 0 CASH BASIS N/A TO COLLABORATE IN CONNECTION WITH THE TRAINING OF MEDICAL RESIDENTS AND NURSING STUDENTS ON THE CARE OF PATIENTS WITH SUBSTANCE ABUSE DISORDERS. CAYUGA MEDICAL ASSOCIATES 101 TRUMANSBURG ROAD ITHACA NY 14850 204356115 501(c)(3) 7642 0 CASH BASIS N/A TO COLLABORATE IN CONNECTION WITH THE TRAINING OF MEDICAL RESIDENTSA ND NURSING STUDENTS ON THE CARE OF PATIENTS WITH SUBSTANCE ABUSE DISORDERS. TOMPKINS CORTLAND COMMUNITY COLLEGE 170 NORTH STREET PO BOX 139 DRYDEN NY 13053 160928736 501(c)(3) 53012 0 CASH BASIS N/A TO COLLABORATE IN CONNECTION WITH THE TRAINING OF MEDICAL RESIDENTSA ND NURSING STUDENTS ON THE CARE OF PATIENTS WITH SUBSTANCE ABUSE DISORDERS. 3 0 Schedule I, Part I, Line 2 The Medical Center provides funds to organization to collaborate for nursing programs. The grants operate under individual agreements with defined terms and conditions on which an organization is granted funds. The grantees are required to report the expenditures and outcomes. The Medical Center maintains the books and records consistent with its record retention policy. X X 1 1 X X X X 0 1 0 0 0 1 0 1 0 Martin Stallone President & CEO 772870 0 205613 0 20888 0 44700 0 9496 0 1053567 0 0 0 John Collett CFO/VP of Finance 432706 0 81350 0 8344 0 37400 0 0 0 559800 0 0 0 Tracy Gates COO 362150 0 68531 0 7461 0 56400 0 2369 0 496911 0 0 0 Srisatish Devapatla Neonatologist 447008 0 1200 0 20367 0 30800 0 11954 0 511329 0 0 0 Andreia De Lima Serra Vice President 383730 0 58997 0 0 0 49200 0 8398 0 500325 0 0 0 Justin Runke Vice President 349104 0 67444 0 0 0 46700 0 9454 0 472702 0 0 0 Michael Berlin Assistant Vice President 371388 0 43538 0 3000 0 13725 0 727 0 432378 0 0 0 Ramesh Vidavalur Neonatologist 375625 0 1000 0 16000 0 23000 0 9454 0 425079 0 0 0 John-Paul Mead Director 0 318704 0 7630 0 0 0 9150 0 15286 0 350770 0 0 Deidre Blake CMC Med Staff President 0 867238 0 808238 0 0 0 9150 0 26951 0 1711577 0 0 Schedule J, Part I, Line 1a All employees are eligible for a health club membership subsidy for which the medical center will reimburse employees 50% of the monthly single membership fee. The CEO was given a tax gross up payment in 2022 to cover life insurance premiums recognized as income by the CEO. Schedule J, Part I, Line 4 CEO Dr. Martin Stallone participates in an economic regime collateral assignment split-dollar life insurance plan with CMC. The medical center makes annual fixed premium payments on the policy for the next 3 years. Schedule J, Part I, Line 6 Incentive compensation paid to executives are based on goals and metrics communicated prior to the start of the fiscal year. The Board regularly reviews performance against the goals and metrics and determines if they have been attained and an incentive compensation payment is earned. Schedule J, Part I, Line 7 All employees, including officers, were permitted to exchange a portion of the PTO for a cash payout. A TOMPKINS COUNTY DEVELOPMENT CORP 272290745 890096AA8 2010-08-31 14275000 FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES 0 0 0 B TOMPKINS COUNTY DEVELOPMENT CORPORATION 272290745 890096AA8 2013-04-09 25000000 FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES 0 0 0 A 14275000 0 14275000 0 0 0 285500 0 142750 13846750 0 0 2010 0 0 1 1 B 9961570 0 25000000 0 0 0 613238 0 0 24386762 0 0 2013 0 0 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 A 1 1 1 DEUTSHE BANK 12 0 0 0 0 0 B 1 0 0 0 0 0 A 1 B 1 Form 990, Part VI, Section B, Line 11b The 990 is prepared by the accountant and assistant controller of Cayuga Medical Center. The 990 is then reviewed by the Controller, external accountants, CFO, and then all members of the board, in that order. Form 990, Part VI, Section B, Line 12c Cayuga Medical Center maintains a conflict of interest policy which board members are required to sign annually. CMC regularly and consistently monitors and enforces compliance with the policy by reviewing statement for conflicts, identifying disqualified persons, and recording all proceeds related to conflict of interest transactions. Form 990, Part VI, Section B, Line 15 Cayuga Medical Center determines compensation of the CEO and other officers by utilizing independent compensation consultants and/or compensation surveys. A formal written contract for the CEO is reviewed and approved by the executive committee of the Board of Directors. Form 990, Part VI, Section C, Line 19 Form 990, conflict of interest statement, financial statements, and other governing documents are available upon request to any community members Form 990, Part IX, Line 11g Primarily maintenance contracts, COVID reference lab costs, and other misc purchased services/contracted services expenses, CMA subsidy, and primary recruitment expenses Form 990, Part XI, Line 9 Pension Gains - $36,242,319 Gain on Interest Rate Swaps - $14,183 Rounding $247 CAYUGA HEALTH SYSTEM INC 101 DATES DRIVE ITHACA NY 14850 471899601 SUPPORT COMMUNITY HEALTHCARE NY 501(c)(3) 12 N/A 0 SCHUYLER HOSPITAL 220 STEUBEN STREET MONTOUR FALLS NY 14865 150533564 HOSPITAL NY 501(c)(3) 3 N/A 0 CAYUGA MEDICAL ASSOCIATES 1301 TRUMANSBURG ROAD ITHACA NY 14850 204356115 MEDICAL PRACTICES NY 501(c)(3) 9 CAYUGA MEDICAL CENTER AT ITHACA 0 Cayuga Medical Center Foundation 101 Dates Drive Ithaca NY 14850 161072414 Charitable Support NY 501(c)(3) 11 Cayuga Medical Center at Ithaca 0 CAYUGA MEDICAL OFFICE BUILDING ASSOCIATION 201 DATES DRIVE ITHACA NY 14850 161261492 BUILDING MANAGEMENT NY N/A Related 0 1 0.73 TOMPKINS OFFICE MANAGEMENT SYSTEM 101 DATES DRIVE ITHACA NY 14850 161437217 OFFICE MANAGEMENT NY CAYUGA MEDICAL CENTER AT ITHACA C 1 1 ISLAND HEALTH & FITNESS 310 TAUGHANNOCK BLVD ITHACA NY 14850 203036206 FITNESS NY TOMPKINS OFFICE MANAGEMENT SYSTEM C 0.7 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 0 CAYUGA MEDICAL ASSOCIATES b 43331573 2022 SUBSIDY FOR MEDICAL PRACTICES OPERATING AT A LOSS CAYUGA MEDICAL ASSOCIATES j 188617 XRAY EQUIPMENT LEASE AND BUILDING LEASES CAYUGA MEDICAL ASSOCIATES k 65128 RADIOLOGICAL, LAB AND COVID-RELATED SPACES CAYUGA MEDICAL ASSOCIATES m 2978592 HOSPITALIST AND INTENSIVIST SERVICES CAYUGA MEDICAL ASSOCIATES l 3498074 SALE OF SERVICES, OVERSIGHT, STAFFING, AND OTHER CONTRACTUAL AGREEMENTS CAYUGA MEDICAL OFFICE BUILDING ASSOCIATION k 495738 LEASE OF MEDICAL OFFICE SPACE CAYUGA MEDICAL OFFICE BUILDING ASSOCIATION l 182788 LAND, LEASE AND MAINTENANCE FEES Cayuga Medical Center Foundation q 52800 CONTRACTED SERVICES Cayuga Medical Center Foundation m 427630 FUNDRAISING SERVICES TOMPKINS OFFICE MANAGEMENT SYSTEM k 52690 LEASE OF MEDICAL OFFICE SPACE SCHUYLER HOSPITAL p 2060562 SCHUYLER HOSPITAL REIMBURSES CAYUGA MEDICAL CENTER FOR THE FOLLOWING SERVICES:ANESTHESIA, LAB TESTING, INSIGHTS, KRONOS AND RELAY HEALTH SOFTWARE COSTS, AP MAILINGS, SPLIT ADVERTISING, RL SOLUTIONS AND ICONTRACTS, SUPPLIES, AS WELL AS SHARED INSURANCE AND LEGAL FEES SCHUYLER HOSPITAL m 605954 SCHUYLER HOSPITAL UTILIZES CAYUGA MEDICAL CENTER TO PERFORM THE FOLLOWING SERVICES: SLEEP, EKG STAFF, PAYROLL, AP, WOUND CLINIC STAFF, REMOTE PHARMACY, 340B SERVICES, RADIOLOGY TECHS, CASE MANAGEMENT, OVERSIGHT, AND BIO-ENGINEERING SCHUYLER HOSPITAL l 124423 SCHUYLER HOSPITAL PROVIDES STAFFING FOR NURSING, PHARMACY, LAB AND NURSE AIDE TRAINING POSITIONS AS NEEDED TO CMC Submission of the 990 was postponed until post-single audit which is completed in the late summer.