2022-08-11T12:20:10-05:00 2021-09-30 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2020-10-01 150346515 ALICE HYDE MEDICAL CENTER ALIC 5184833000 133 PARK STREET MALONE NY 12953 CHRISTOPHER HICKEY SVP/CFO 5184833000 2022-08-10 1 CHRISTOPHER HICKEY 999009999 THOMAS J GIUFRE P00841958 3154463600 2022-08-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHRISTOPHER HICKEY 133 PARK STREET MALONE NY 12953 102169059 0 X WWW.ALICEHYDE.COM X 1905 NY TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE. 11 9 934 3 0 0 11454304 3584173 78564107 88387739 128961 28594 9235109 10158497 99382481 102159003 0 0 0 0 61392080 61678177 0 0 0 37270166 40846844 98662246 102525021 720235 -366018 86331725 84353502 59567017 57326608 26764708 27026894 ALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE. 0 0 82708678 98143545 ALICE HYDE MEDICAL CENTER PROVIDES PATIENT CARE AS A GENERAL MEDICAL/SURGICAL HOSPITAL AND SKILLED NURSING FACILITY. ALICE HYDE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 1,054 PATIENTS ADMITTED. PROVIDED 490,579 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 93,443 PHYSICIAN OFFICE VISITS, AND PROVIDED 43,962 DAYS OF SKILLED NURSING FACILITY CARE. 9,972 DAYS OF ASSISTED LIVING FACILITY CARE WAS ALSO PROVIDED DURING THE PERIOD. 82708678 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 83 0 1 934 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X CHRISTOPHER HICKEY SVPCFO 5184833000 133 PARK STREET MALONE NY 12953 BRIAN MONETTE CHAIRMAN 10.00 X X 0 0 0 KEVIN HART SECRETARY 10.00 X X 0 0 0 ROBERT G MAIN JR VICE CHAIR 10.00 X X 0 0 0 EMILE BENARDOT MD BOARD MEMBER 10.00 X 0 0 0 NICHOLAS EELLS CPA BOARD MEMBER 10.00 X 0 0 0 PAUL KOEHLER BOARD MEMBER 10.00 X 0 0 0 CAROL MCKEE BOARD MEMBER 10.00 X 0 0 0 MARINA MEDVED DO BOARD MEMBER 10.00 X 0 0 0 THOMAS FITZPATRICK TREASURER 10.00 X X 0 0 0 DONNA KISSANE BOARD MEMBER 10.00 X 0 0 0 JASON ELLIS BOARD MEMBER 10.00 X 0 0 0 MATT JONES COO 50.00 X 223595 0 27288 MICHELLE LEBEAU CEO 2.00 48.00 X 0 558456 33449 CHRISTOPHER HICKEY SVP/CFO 8.00 42.00 X 0 405322 17462 DR LISA MARK CHIEF MEDICAL OFFICER 8.00 40.00 X 0 320611 26253 RITA NGUYEN DDS DENTIST 40.00 X 185764 0 13961 THOMAS SCMANIA CRNA 40.00 X 200001 0 15966 JULIE MARSHALL AVP 40.00 X 180646 0 15819 DEBRA PIERCEY CRNA 10.00 X 210001 0 8547 JOSEPH ROBINSON PHYSICIAN 40.00 X 181098 0 0 1181105 1284389 158745 78 0 1 0 NORTH COUNTRY HEALTHCARE 183 PARK STREET MALONE NY 12953 PHYSICIAN FEES 219625 MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS MN 554850737 PHYSICIAN FEES 158888 GERALD CAHILL 81 CONSTABLE STREET MALONE NY 12953 PHYSICIAN FEES 140800 EMILE BENARDOT 58 ELM STREET MALONE NY 12953 PHYSICIAN FEES 125500 4 39750 3378274 166149 3584173 PATIENT CARE 622000 88387739 88387739 88387739 28594 28594 363452 1319 362133 362133 362133 49295 39750 8737 40558 40558 340B REVENUE 900099 5501924 5501924 DSRIP REVENUE 900099 1845429 1845429 2408453 2408453 9755806 102159003 98143545 0 431285 250883 250883 50723830 43618280 7105550 1671321 1402415 268906 5607118 4713939 893179 3425025 2867431 557594 124548 124548 95077 95077 2688678 2164117 524561 112517 112517 293641 187901 105740 1290357 825699 464658 138067 88349 49718 532168 508668 23500 3877245 3186274 690971 MEDICAL SUPPLIES AND PH 11542602 7386111 4156491 PHYSICIANS 6858044 5520040 1338004 PURCHASED SERVICES 6283453 6025931 257522 BAD DEBT EXPENSE 2505180 2505180 4505267 1708343 2796924 102525021 82708678 19816343 0 7733540 5567628 23812025 22803463 6489078 9020323 116693 108695 873454 1044798 2125014 1735101 62435111 23887819 39992037 38547292 3441278 4069482 15029 16283 1733577 1440437 86331725 84353502 12099607 11011978 31643884 30802906 15823526 15511724 59567017 57326608 X 25814960 25904127 949748 1122767 26764708 27026894 86331725 84353502 X -366018 628204 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 949748 173019 1122767 872503 77245 949748 829056 43447 872503 183946 611091 34019 829056 183946 183946 1.00000 0 0 2051000 2051000 42839591 14250961 28588630 14492295 8759748 5732547 3052225 877110 2175115 38547292 DUE TO RELATED PARTIES 4182011 OTHER LIABILITIES 1507942 THIRD PARTY PAYABLES 1874552 OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS 549012 CONTRACT LIABILITY - MEDICARE ACCELERATED PAYMENTS 7269315 FINANCE LEASE 128892 15511724 X 99662560 8737 8737 99653823 2505180 2505180 102159003 100028578 8737 8737 100019841 2505180 2505180 102525021 PART X, LINE 2: THE MEDICAL CENTER IS INCORPORATED AND RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). ACCORDINGLY, THE IRS HAS DETERMINED THAT THE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER ACCOUNTS FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH ADDRESSES HOW TO ACCOUNT FOR AND REPORT THE EFFECTS OF TAXES BASED ON INCOME. NO PROVISION FOR UNCERTAIN TAX POSITIONS HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2018 THROUGH 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 8,737. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS 2,505,180. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 8,737. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS 2,505,180. DECEMBER ONLINE AUCTION 24325 11750 12575 1216 SPRING ONLINE AUCTION 28220 12500 15720 710 1 36500 15500 21000 6811 89045 39750 49295 8737 8737 40558 1 1 1 X 1 X 1 1 1 0 0 1491893 379698 1112195 0.01110 24095281 8660262 15435019 0.15430 25587174 9039960 16547214 0.16540 145188 145188 0.00150 145188 145188 0.00150 25732362 9039960 16692402 0.16690 1 2505180 16012 18076823 23669108 -5592285 X 1 1 1 1 ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 WWW.ALICEHYDE.COM 1624000H X X X ALICE HYDE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN X HTTPS://AHIHEALTH.ORG/ARHN/ HTTPS://COUNTYFRANKLIN.DIGITALTOWPATH.ORG:1007 X 1 19 1 HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.ALICEHYDE.COM X WWW.ALICEHYDE.COM X WWW.ALICEHYDE.COM X X X X X 1 X 0 X X X 1 X 0 0 ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 5: TO HELP INFORM A COLLABORATIVE APPROACH TO IMPROVING COMMUNITY HEALTH, THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) SOUGHT TO IDENTIFY PRIORITIES, FACTORS AND RESOURCES THAT INFLUENCE THE HEALTH OF RESIDENTS OF THE ADIRONDACK REGION (CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN AND WASHINGTON COUNTIES). ARHN SURVEYED STAKEHOLDERS IN THE SEVEN-COUNTY SERVICE AREA, TO PROVIDE THE CHA COMMITTEE WITH INPUT ON REGIONAL HEALTH CARE NEEDS AND PRIORITIES. STAKEHOLDERS INCLUDED PROFESSIONALS FROM HEALTH CARE, SOCIAL SERVICES, EDUCATIONAL, AND GOVERNMENTAL INSTITUTIONS AS WELL AS COMMUNITY MEMBERS. ALICE HYDE MEDICAL CENTER ENGAGED ESSENTIAL CLINICAL STAFF AS PART OF AN INTERNAL PRIORITIZATION COMMITTEE TO ASSESS AND IDENTIFY THE KEY CRITICAL AREAS FOR TARGETED FOCUS AS DETERMINED BY THE 2019 COMMUNITY STAKEHOLDER SURVEY, AND IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION TO THE VARIETY OF COMMUNITY AND REGIONAL RESOURCES AVAILABLE, ALICE HYDE MEDICAL CENTER ASSESSED DATA AND PROGRAMS FROM ITS OUTPATIENT PRIMARY CARE PRACTICES, THE EMERGENCY DEPARTMENT AND OTHER KEY HOSPITAL DEPARTMENTS TO FURTHER IDENTIFY AREAS OF FOCUS AND AVAILABLE ASSETS. LEAD STAFF FROM FRANKLIN COUNTY PUBLIC HEALTH, THE UNIVERSITY OF VERMONT HEALTH NETWORK ALICE HYDE MEDICAL CENTER AND ADIRONDACK HEALTH WORKED WITH PARTNERS TO COLLECT ACTIVITIES AND INTERVENTIONS IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. DETERMINATION OF SPECIFIC INTERVENTIONS RELATED TO EACH PRIORITY AREA WAS BASED ON ALIGNMENT WITH THE SPECIFIC GOALS AND OBJECTIVES EACH AGENCY IS COMMITTED TO; OTHER POPULATION HEALTH BASED INITIATIVES OCCURRING WITHIN THE ORGANIZATION; AND ORGANIZATIONAL ABILITY TO MAKE A SUSTAINED IMPACT WITH THE INTERVENTION. ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 6A: ADIRONDACK HEALTH - ADIRONDACK MEDICAL CENTER ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 6B: FRANKLIN COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH UNIT ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2019-2021 COMMUNITY SERVICE PLAN CYCLE: (1) PREVENT CHRONIC DISEASE AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PREVENT CHRONIC DISEASE HEALTHY EATING AND FOOD SECURITYACTION PLAN ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSPREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR EMPLOYEE WALKING TRAILS - PROMOTE AND PROVIDE MAPS (INSIDE HOSPITAL AND AROUND CAMPUS) MALONE COMMUNITY FUN RUN PROGRAM SPONSORSHIP (SIX WEEKLY EVENTS DURING SUMMER MONTHS).PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN CERTIFIED TOBACCO CESSATION SPECIALIST (CTCS) EMBEDDED IN AHMC PRIMARY CARE PRACTICES IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE. UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN UTILIZE PRIMARY CARE EMR REMINDER SYSTEM TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. IMPLEMENT FIT-DNA TESTING PROGRAM FOR IMPROVED PATIENT ADHERENCE AND CONVENIENCE WITH COLORECTAL CANCER SCREENINGS. EXPANSION OF CLINIC HOURS BEING PILOTED AT RURAL HEALTH CLINIC IN MOIRA (DWYER HC) TO ENSURE ADDITIONAL ACCESS FOR PATIENTS NEEDING CARE, SCREENINGS, OR TESTING. MEDICAID/MEDICARE INSURANCE ENROLLMENT AGENTS ONSITE FOR PATIENT REFERRALS M-F FROM ED, PRIMARY CARE, AND WALK-IN CLINIC. UTILIZE HIXNY DATA ON PRE-DIABETIC NON-DIAGNOSED INDICATORS BY LAB RESULTS TO IDENTIFY AT-RISK PATIENTS. COLLABORATE WITH CVPH TO ACCESS AND IMPLEMENT DIABETES PREVENTION PROGRAM WITH ACCESS TO CERTIFIED DPP AND HEALTH COACH. PARTICIPATE IN THE ADIRONDACKS ACO POPULATION HEALTH COMMITTEE TO ENSURE A TEAM-BASED APPROACH TO CHRONIC DISEASE CARE MANAGEMENT FOR PATIENTS AT AHMC PRIMARY CARE PRACTICES. AHMC PRIMARY CARE EMR SYSTEM ESTABLISHED WITH EVIDENCE-BASED CLINICAL DECISION SUPPORT REFERENCE AND GUIDELINES FOR PATIENT TREATMENT. UTILIZE AHMC PRACTICE EMR TO EFFECTIVELY MANAGE PATIENT ALERTS, MEASUREMENT AND REPORTING TO IMPROVE CARE DELIVERY. IMPLEMENTATION OF INTEGRATED NETWORK-WIDE EHR (EPIC) AT AHMC IN 2021 TO ENHANCE CARE COORDINATION ACROSS THE ENTIRE CONTINUUM. INSTALLATION OF MEDICAL HOME COMMUNITY RESOURCE SPECIALIST WITHIN AHMC PRIMARY CARE TO TRACK AND REPORT FOLLOW- THROUGH WITH MEDICATION ADHERENCE (BY TARGET YEAR 2) AND PROVIDE PATIENT EDUCATION AND INTERVENTION AS NECESSARY. PARTICIPATE ON NORTH COUNTRY CHRONIC DISEASE PREVENTION COALITION TO IMPLEMENT THE NORTH COUNTRY HEALTHY HEART NETWORK'S (NC HHN) PRE-DIABETES PREVENTION PROGRAM THROUGH THE AHMC PRIMARY CARE SETTING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PROMOTE WELL BEING ACTION PLAN INVESTIGATE THE OPPORTUNITY FOR INTEGRATION OF BEHAVIORAL HEALTH SERVICES INTO THE AHMC PRIMARY CARE RURAL HEALTH CLINIC PRACTICES. DEVELOP A PLAN TO CONSTRUCT A NEW AHMC PRIMARY CARE BUILDING ON CAMPUS, TO DEVELOP A COORDINATED, MULTI-DISCIPLINARY APPROACH TO CARE DELIVERY THAT INCLUDES BEHAVIORAL HEALTH. ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN CREATE EDUCATION SESSIONS FOR PRIMARY CARE PROVIDERS ON OPIOID PRESCRIBING ESTABLISHMENT OF PAIN MANAGEMENT PROGRAM WITH AHMC PAIN MANAGEMENT PROVIDER TO CREATE ACCESS TO SPECIALIZED AND APPROPRIATE CARE OF PATIENTS DEALING WITH CHRONIC PAIN. CONTINUED COORDINATION BETWEEN CRISIS INTERVENTION CENTER AND AHMC ED TO ENSURE PATIENTS RECEIVE THE APPROPRIATE LEVEL OF CARE. INVESTIGATE INCREASED OPPORTUNITIES TO COLLABORATE WITH ST. JOSEPH'S REHABILITATION CENTER. IMPLEMENTATION OF THE NYS PSYCKES SYSTEM IN THE AHMC EMERGENCY DEPARTMENT, PROVIDING ACCESS TO BEHAVIORAL AND MENTAL HEALTH INFORMATION AS WELL AS SUBSTANCE USE INFORMATION FOR MEDICAID PATIENTS WHO ARE TREATING IN THE ED, IN ORDER TO INFORM TREATMENT PLANS AND IMPROVE COORDINATION OF CARE. INVESTIGATE IMPLEMENTATION OF ADDITIONAL SAFE DISPOSAL BOXES ON AHMC CAMPUS OR IN OUTLYING HEALTH CENTER (S). CREATE MEDIA AND PROMOTION AROUND ORGANIZED TAKE BACK DAYS TO ENSURE PUBLIC IS EDUCATED.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. PART V, SECTION B, LINE 20B: ON MARCH 23, 2020 THE ORGANIZATION SUSPENDED COLLECTION ACTIVITIES IN RESPONSE TO THE COVID-19 PANDEMIC, IN RECOGNITION OF THE FACT THAT MANY PATIENTS, STAFF AND MEMBERS OF THE WIDER COMMUNITY WOULD FACE FINANCIAL CHALLENGES IN ADDITION TO HEALTH CHALLENGES DURING THE PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020. PART V, SECTION B, LINE 20A: ALICE HYDE MEDICAL CENTER DOES NOT PURSUE LEGAL ACTION IN ORDER TO COLLECT A DEBT, INCLUDING NOT SELLING DEBT INFORMATION TO ANOTHER PARTY FOR COLLECTIONS, REPORTING TO INDIVIDUAL CREDIT AGENCIES REGARDING PAYMENT STATUS, NOR DOES ALICE HYDE MEDICAL CENTER REFUSE TREATMENT FOR PAST DEBT OBLIGATIONS. 1 1 - ALICE HYDE NURSING HOME 45 SIXTH STREET MALONE NY 12953 SKILLED NURSING FACILITY PART I, LINE 7: UTILIZED IS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,505,180. PART III, LINE 2: OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.5% OF NET REVENUE. PART III, LINE 3: WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. PART III, LINE 4: ON OCTOBER 1, 2018, THE MEDICAL CENTER ADOPTED, USING THE FULL RETROSPECTIVE APPROACH, ASU 2014-09 AND ASU 2016-08, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) AND REVENUE FROM CONTRACTS WITH CUSTOMERS: PRINCIPAL VERSUS AGENT CONSIDERATIONS (REPORTING REVENUE GROSS VERSUS NET), RESPECTIVELY, WHICH PROVIDES GUIDANCE FOR REVENUE RECOGNITION. THE STANDARD'S CORE PRINCIPLE IS THAT A COMPANY WILL RECOGNIZE REVENUE WHEN IT TRANSFERS PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE COMPANY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE MOST SIGNIFICANT CHANGE FROM THE ADOPTION OF THE NEW STANDARD RELATES TO THE ESTIMATION OF IMPLICIT PRICE CONCESSIONS. UNDER THE PREVIOUS STANDARDS, THE ESTIMATE FOR AMOUNTS NOT EXPECTED TO BE COLLECTED BASED UPON HISTORICAL EXPERIENCE, WERE REFLECTED AS PROVISION FOR DOUBTFUL ACCOUNTS, AND PRESENTED SEPARATELY AS AN OFFSET TO NET PATIENT SERVICE REVENUE. UNDER THE NEW STANDARD, THE ESTIMATE FOR AMOUNTS NOT EXPECTED TO BE COLLECTED BASED ON HISTORICAL EXPERIENCE WILL CONTINUE TO BE RECOGNIZED AS A REDUCTION TO NET PATIENT SERVICE REVENUE, HOWEVER, NOT REFLECTED SEPARATELY AS PROVISION FOR DOUBTFUL ACCOUNTS.UNDER THE NEW STANDARD, SUBSEQUENT CHANGES IN ESTIMATE OF COLLECTABILITY DUE TO A CHANGE IN THE FINANCIAL STATUS OF A PAYER, FOR EXAMPLE A BANKRUPTCY, WILL BE RECOGNIZED AS BAD DEBT EXPENSE AND PRESENTED AS AN OPERATING EXPENSE. THE ADOPTION OF THIS GUIDANCE IN 2019, AND AMOUNTS RECOGNIZED AS BAD DEBT EXPENSE AND INCLUDED IN SUPPLIES AND OTHER EXPENSES, DID NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2020 MEDICARE COST REPORT. THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK. PART III, LINE 9B: THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. AS AN ACCOMMODATION TO PATIENTS AND FAMILIES, COLLECTION ACTIVITY WAS SUSPENDED IN MARCH 2020 IN RECOGNITION OF THE FINANCIAL CHALLENGES ASSOCIATED WITH THE COVID-19 PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020. PART VI, LINE 3: THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED. THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE. PART VI, LINE 4: ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES. PART VI, LINE 5: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2019-2021 COMMUNITY SERVICE PLAN CYCLE: (1) PREVENT CHRONIC DISEASE AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PREVENT CHRONIC DISEASE HEALTHY EATING AND FOOD SECURITYACTION PLAN ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSPREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR EMPLOYEE WALKING TRAILS - PROMOTE AND PROVIDE MAPS (INSIDE HOSPITAL AND AROUND CAMPUS) MALONE COMMUNITY FUN RUN PROGRAM SPONSORSHIP (SIX WEEKLY EVENTS DURING SUMMER MONTHS).PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN CERTIFIED TOBACCO CESSATION SPECIALIST (CTCS) EMBEDDED IN AHMC PRIMARY CARE PRACTICES IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE. UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN UTILIZE PRIMARY CARE EMR REMINDER SYSTEM TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. IMPLEMENT FIT-DNA TESTING PROGRAM FOR IMPROVED PATIENT ADHERENCE AND CONVENIENCE WITH COLORECTAL CANCER SCREENINGS. EXPANSION OF CLINIC HOURS BEING PILOTED AT RURAL HEALTH CLINIC IN MOIRA (DWYER HC) TO ENSURE ADDITIONAL ACCESS FOR PATIENTS NEEDING CARE, SCREENINGS, OR TESTING. MEDICAID/MEDICARE INSURANCE ENROLLMENT AGENTS ONSITE FOR PATIENT REFERRALS M-F FROM ED, PRIMARY CARE, AND WALK-IN CLINIC. UTILIZE HIXNY DATA ON PRE-DIABETIC NON-DIAGNOSED INDICATORS BY LAB RESULTS TO IDENTIFY AT-RISK PATIENTS. COLLABORATE WITH CVPH TO ACCESS AND IMPLEMENT DIABETES PREVENTION PROGRAM WITH ACCESS TO CERTIFIED DPP AND HEALTH COACH. PARTICIPATE IN THE ADIRONDACKS ACO POPULATION HEALTH COMMITTEE TO ENSURE A TEAM-BASED APPROACH TO CHRONIC DISEASE CARE MANAGEMENT FOR PATIENTS AT AHMC PRIMARY CARE PRACTICES. AHMC PRIMARY CARE EMR SYSTEM ESTABLISHED WITH EVIDENCE-BASED CLINICAL DECISION SUPPORT REFERENCE AND GUIDELINES FOR PATIENT TREATMENT. UTILIZE AHMC PRACTICE EMR TO EFFECTIVELY MANAGE PATIENT ALERTS, MEASUREMENT AND REPORTING TO IMPROVE CARE DELIVERY. IMPLEMENTATION OF INTEGRATED NETWORK-WIDE EHR (EPIC) AT AHMC IN 2021 TO ENHANCE CARE COORDINATION ACROSS THE ENTIRE CONTINUUM. INSTALLATION OF MEDICAL HOME COMMUNITY RESOURCE SPECIALIST WITHIN AHMC PRIMARY CARE TO TRACK AND REPORT FOLLOW- THROUGH WITH MEDICATION ADHERENCE (BY TARGET YEAR 2) AND PROVIDE PATIENT EDUCATION AND INTERVENTION AS NECESSARY. PARTICIPATE ON NORTH COUNTRY CHRONIC DISEASE PREVENTION COALITION TO IMPLEMENT THE NORTH COUNTRY HEALTHY HEART NETWORK'S (NC HHN) PRE-DIABETES PREVENTION PROGRAM THROUGH THE AHMC PRIMARY CARE SETTING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PROMOTE WELL BEING ACTION PLAN INVESTIGATE THE OPPORTUNITY FOR INTEGRATION OF BEHAVIORAL HEALTH SERVICES INTO THE AHMC PRIMARY CARE RURAL HEALTH CLINIC PRACTICES. DEVELOP A PLAN TO CONSTRUCT A NEW AHMC PRIMARY CARE BUILDING ON CAMPUS, TO DEVELOP A COORDINATED, MULTI-DISCIPLINARY APPROACH TO CARE DELIVERY THAT INCLUDES BEHAVIORAL HEALTH. ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN CREATE EDUCATION SESSIONS FOR PRIMARY CARE PROVIDERS ON OPIOID PRESCRIBING ESTABLISHMENT OF PAIN MANAGEMENT PROGRAM WITH AHMC PAIN MANAGEMENT PROVIDER TO CREATE ACCESS TO SPECIALIZED AND APPROPRIATE CARE OF PATIENTS DEALING WITH CHRONIC PAIN. CONTINUED COORDINATION BETWEEN CRISIS INTERVENTION CENTER AND AHMC ED TO ENSURE PATIENTS RECEIVE THE APPROPRIATE LEVEL OF CARE. INVESTIGATE INCREASED OPPORTUNITIES TO COLLABORATE WITH ST. JOSEPH'S REHABILITATION CENTER. IMPLEMENTATION OF THE NYS PSYCKES SYSTEM IN THE AHMC EMERGENCY DEPARTMENT, PROVIDING ACCESS TO BEHAVIORAL AND MENTAL HEALTH INFORMATION AS WELL AS SUBSTANCE USE INFORMATION FOR MEDICAID PATIENTS WHO ARE TREATING IN THE ED, IN ORDER TO INFORM TREATMENT PLANS AND IMPROVE COORDINATION OF CARE. INVESTIGATE IMPLEMENTATION OF ADDITIONAL SAFE DISPOSAL BOXES ON AHMC CAMPUS OR IN OUTLYING HEALTH CENTER (S). CREATE MEDIA AND PROMOTION AROUND ORGANIZED TAKE BACK DAYS TO ENSURE PUBLIC IS EDUCATED.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X X 0 1 0 0 0 0 0 0 0 MICHELLE LEBEAU CEO 0 470774 0 87682 0 0 0 0 0 33449 0 591905 0 0 CHRISTOPHER HICKEY SVP/CFO 0 379788 0 25534 0 0 0 0 0 17462 0 422784 0 0 DR LISA MARK CHIEF MEDICAL OFFICER 0 320611 0 0 0 0 0 0 0 26253 0 346864 0 0 MATT JONES COO 223595 0 0 0 0 0 3805 0 23483 0 250883 0 0 0 DEBRA PIERCEY CRNA 200001 0 10000 0 0 0 0 0 8547 0 218548 0 0 0 THOMAS SCMANIA CRNA 200001 0 0 0 0 0 0 0 15966 0 215967 0 0 0 RITA NGUYEN DDS DENTIST 185764 0 0 0 0 0 5116 0 8845 0 199725 0 0 0 JULIE MARSHALL AVP 168215 0 12431 0 0 0 5746 0 10073 0 196465 0 0 0 JOSEPH ROBINSON PHYSICIAN 181098 0 0 0 0 0 0 0 0 0 181098 0 0 0 PART I, LINE 3 IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A FRANKLIN COUNTY CIVIC DEVELOPMENT CORP 800627350 35313PAA0 2013-10-31 27375000 CONSTRUCTION OF 135 BED SKILLED NURSING FACILITY AND 30 BED ASSISTED LIVING 0 0 0 A 5830000 1975000 27375000 1675004 6213316 2015 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 SEAN CURTIN FORMER CEO PART V X 150865 108695 0 1 1 108695 MARINA MEDVED BOARD MEMBER 219625 COMPANY CONTRACTED FOR PHYSICIAN SERVICES 0 KIM JONES SPOUSE OF OFFICER 88788 CY 2020 SALARY 0 PART II, LOANS TO AND FROM INTERESTED PERSONS: (C) PURPOSE OF LOAN:THE ORGANIZATION HAS AN AGREEMENT WITH AND HAS PROVIDED THE EXECUTIVE WITH A LOAN FOR EDUCATIONAL EXPENSES UP TO A MAXIMUM OF $185,000, FOR A 5 YEAR PERIOD WITH INTEREST ACCRUED AT A COMPETITIVE MARKET RATE. THE ANNUAL PAYMENT, INCLUDING INTEREST, WILL BE FORGIVEN IF THE EXECUTIVE REMAINS EMPLOYED WITH THE ORGANIZATION FOR FIVE YEARS. DURING FY2019, THE EXECUTIVE LEFT EMPLOYMENT. THE LOAN TERMS WERE RENEGOTIATED FOR A 15 YEAR REPAYMENT PERIOD AT A COMPETITIVE FAIR MARKET RATE OF INTEREST. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER BRIAN MONETTE HAS A FAMILY RELATIONSHIP. BOARD MEMBERS BRIAN MONETTE AND MARINA MEDVED HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATIONS DID HAVE MEMBERS, AND UVMHN, INC., IS ALICE HYDE MEDICAL CENTER'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A UVMHN, INC., AS ALICE HYDE MEDICAL CENTER'S SOLE MEMBER HAS RESERVE POWERS THAT ALLOW THE UNIVERSITY OF VERMONT HEALTH NETWORK AND UVMHN, INC, TO REFUSE THE ACCEPTANCE OF NEW BOARD MEMBERS APPOINTED BY THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS IF UVMHN, INC., DOES NOT AGREE WITH THE CHOICE OF APPOINTMENTS. THE PROCESS OF APPOINTING MEMBERS TO THE GOVERNING BODY IS A COLLABORATION OF THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS AND UVMHN, INC., AS A RESULT. FORM 990, PART VI, SECTION A, LINE 7B THE UNIVERSITY OF VERMONT HEALTH NETWORK THROUGH UVMHN, INC., HAS CERTAIN RESERVE POWERS THAT REQUIRE UVMHN, INC., TO APPROVE CERTAIN DECISIONS MADE BY THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE. FORM 990, PART VI, SECTION B, LINE 15 ALICE HYDE MEDICAL CENTER (AHMC) HAS A FORMAL PROCESS THAT IS USED TO DETERMINE THE COMPENSATION OF THE CEO ON AN ANNUAL BASIS. THIS PROCESS INCLUDES A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, ENGAGING AN INDEPENDENT CONSULTANT, PERFORMANCE OF A COMPENSATION SURVEY OR STUDY, REVIEW OF OTHER ORGANIZATION'S 990 FORMS, AND APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE. A WRITTEN EMPLOYMENT AGREEMENT IS ESTABLISHED SETTING FORTH THE COMPENSATION AND BENEFITS OF THE CEO. AHMC PAYS NON-FIXED EARNINGS BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE CEO. COMPENSATION FOR SENIOR LEADERS IS REVIEWED ANNUALLY, IN ACCORDANCE WITH NATIONAL BENCH MARKETING AND INTERNAL EQUITY WITHIN THE UVM HEALTH NETWORK. REVIEW IS CONDUCTED BY HUMAN RESOURCES, LOCALLY AND NETWORK-WIDE. NON-FIXED EARNINGS OF OTHER OFFICERS ARE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA AND COMPARATIVE MARKET DATA. IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN SCHEDULE J, PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION C, LINE 18 THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN INVESTMENT POOL 628,204. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. 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