2022-08-23T16:01:08-05:00 2021-09-30 346565596 ERNST & YOUNG US LLP 2005 MARKET ST STE 700 PHILADELPHIA PA 19103 990 2020-10-01 146019179 PUTNAM HOSPITAL CENTER PUTN 8454759500 670 STONELEIGH AVENUE CARMEL NY 10512 STEVEN H ROSENBERG CFO AND TREASURER 8454759500 2022-08-22 1 STEVEN ROSENBERG 999009999 LAUREN E BENNETT P01787029 2154485000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PUTNAM HOSPITAL MARK K HIRKO PRESIDENT 670 STONELEIGH AVENUE CARMEL NY 10512 141287881 0 X WWW.NUVANCEHEALTH.ORG X 1962 NY BECOME THE PARTNER-IN-HEALTH FOR THE PEOPLE THROUGHOUT THE CORE REGIONS OF WESTERN CONNECTICUT AND THE HUDSON VALLEY OF NEW YORK THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. 16 15 940 60 0 0 554397 3184335 137617505 132419830 5597605 2557474 4152493 3040954 147922000 141202593 0 0 0 0 71995729 86215329 0 0 0 84312382 63485719 156308111 149701048 -8386111 -8498455 182378405 193353907 92708973 99359984 89669432 93993923 X BECOME THE PARTNER IN HEALTH FOR THE PEOPLE THROUGHOUT THE CORE REGIONS OF WESTERN CONNECTICUT AND THE HUDSON VALLEY OF NEW YORK THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. 0 0 129980657 0 126961459 INPATIENT SERVICES:PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 3,728; NUMBER OF PATIENT DAYS 14,523; THE HOSPITAL PROVIDED APPROXIMATELY $806,319 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION. OUTPATIENT SERVICES: EMERGENCY VISITS 17,023; OTHER OUTPATIENT VISITS/PROCEDURES 184,378; THE HOSPITAL PROVIDED APPROXIMATELY $1,335,500 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER -INSURED POPULATION. 5481610 0 5354282 INPATIENT PSYCHIATRIC SERVICES: PSYCHIATRIC PATIENTS ADMITTED FOR TREATMENT. NUMBER OF PATIENTS 609; NUMBER OF PATIENT DAYS 5,053. 106564 0 104089 RENTAL INCOME FROM RELATED ORGANIZATIONS FOR SPACE OCCUPIED FOR MEDICAL SERVICES. 797529 0 779005 REBATES AND REFUNDS:EXPENSES: 329,765 REVENUE: 322,105QUALITY INCENTIVE - CJR:EXPENSES: 229,567 REVENUE: 224,235STONELEIGH MANAGEMENT CONTRACT:EXPENSES: 210,952 REVENUE: 206,052MED RECORDS, MISC, PURCHASE DISCOUNT:EXPENSES: 27,245 REVENUE: 26,612 797529 0 779005 136366360 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 940 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 1 1 1 NY X KAREN DARCY 2037394593 100 RESERVE ROAD DANBURY CT 06810 X JEFFREY J REDFIELD DIRECTOR 2.00 0.00 X 0 0 0 JERRY J KLEIN DIRECTOR 2.00 0.00 X 0 0 0 JOHN PETER COLLINS DIRECTOR 2.00 0.00 X 0 0 0 JOSEPH DEMARZO FROM 0101 DIRECTOR 2.00 0.00 X 0 0 0 KAREN FLEMING DIRECTOR 2.00 0.00 X 0 0 0 KEIREN M FARQUHAR DIRECTOR 2.00 0.00 X 0 0 0 KENNETH KEARNEY DIRECTOR 2.00 0.00 X 0 0 0 LORETTA MOLINARI DIRECTOR 2.00 0.00 X 0 0 0 MARJORIE L KEITH DIRECTOR 2.00 0.00 X 0 0 0 MARK K HIRKO MD PRESIDENT PHC & SHARON HOSPITALS 20.00 23.00 X X 0 561004 37839 MATTHEW T MARRONE VICE CHAIRMAN 3.00 0.00 X X 0 0 0 PETER BERGER MD FROM 0101 DIRECTOR 2.00 0.00 X 0 0 0 RAYMOND DURKIN DIRECTOR 2.00 0.00 X 0 0 0 ROBERT WAEGELEIN DIRECTOR 2.00 0.00 X 0 0 0 ROMAN DWORECKI MD FROM 0101 DIRECTOR 2.00 0.00 X 0 0 0 WAYNE RYDER CHAIRMAN 3.00 0.00 X X 0 0 0 CAROLYN MCKENNA ASST. SEC. (TO 12/31); SEC./CLO 3.00 40.00 X 0 646887 16365 STEVEN H ROSENBERG TREASURER/CFO 3.00 40.00 X 0 1701396 642496 CATHERINE FRIERSON CHIEF HUMAN RESOURCE OFFICER 3.00 40.00 X 0 531701 18175 GRACE LINHARD CHIEF DEVELOPMENT OFFICER 3.00 40.00 X 0 445735 19595 JEAN AHN FROM 0201 CHIEF STRATEGY OFFICER 3.00 40.00 X 0 498991 17321 KERRY EATON CHIEF OPERATING OFFICER 3.00 40.00 X 0 936200 96246 WAYNE MCNULTY CHIEF COMPLIANCE OFFICER 3.00 40.00 X 0 380122 25736 ELISH C HOURIHAN VP PATIENT CARE SVCS./CNO 33.00 7.00 X 305462 66526 20045 JULIE REGENBAUM DIRECTOR PHARMACY 40.00 0.00 X 215057 0 10687 LAURIE MUSCARI DIRECTOR MENTAL HEALTH SERVICES 40.00 0.00 X 204461 0 40925 LAWRENCE S SCHEK VP MEDICAL AFFAIRS 40.00 0.00 X 206431 0 12706 RONALD E STEPHENS DIRECTOR OF PATIENT CARE SERVICES 40.00 0.00 X 203038 0 49214 CHERYL BOOTH FORMER ASSISTANT SECRETARY 0.00 0.00 X 0 133541 9679 KATHERINE BACHER FORMER ASSISTANT TREASURER 0.00 0.00 X 0 210144 12407 MICHAEL HOLZHUETER FORMER ASSISTANT SECRETARY 0.00 0.00 X 0 1060019 18913 PETER A KELLY FORMER PHC PRES.; VBMC PRES. 0.00 40.00 X 0 630524 18605 ROBERT FRIEDBERG FORMER HQ PRESIDENT & CEO 0.00 0.00 X 0 1696163 11745 1134449 9498953 1078699 203 1 1 0 0 2875732 237552 71051 1850 3184335 NET PATIENT SRVC. REV. 621110 115744567 115744567 COVID-19 STIMULUS 900099 11216891 11216891 IN-PATIENT PSYCH. SVC. 622210 5354283 5354283 AFF. RENTAL INCOME 532000 104089 104089 132419830 687845 687845 1971093 0 1971093 1971093 1971093 1853864 101053 0 85288 1853864 15765 1869629 1869629 REFUNDS & REBATES 900099 322105 322105 CAFETERIA SALES REV. 900099 290856 290856 QLTY. INCENTIVE PROG. 900099 224235 224235 232665 232665 1069861 141202593 133198835 0 4819423 63887817 57464574 6423243 2666355 2398281 268074 16172449 14546481 1625968 3488708 3137955 350753 158806 158806 308772 308772 281623 281623 8667 7796 871 218023 218023 4265921 3837028 428893 244003 219471 24532 711326 639810 71516 3961097 3562851 398246 4020689 3616451 404238 47188 42444 4744 24335 21888 2447 650016 650016 6581798 5920068 661730 1829423 1498062 331361 MEDICAL SUPPLIES 18377326 18377326 PHYSICIAN FEES 8085057 8085057 PURCHASED SERVICES 4271275 3918722 352553 EQUIPMENT RENTAL 3592090 3154065 438025 5848284 5268014 580270 149701048 136366360 13334688 0 966606 9053355 20968769 9490368 9467842 5581904 2654406 2620673 823077 564306 204032948 145562219 61788359 58470729 52257527 58078684 50000 27847389 55048318 182378405 193353907 11147653 10586380 20734621 19549750 17355 1014 60809344 69222840 92708973 99359984 X 81696485 80777361 7972947 13216562 89669432 93993923 182378405 193353907 X -8498455 3437436 -7098639 16484149 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 8667 0 0 8667 0 SCHEDULE C, PART II-B LINE 1G - LOBBYING ACTIVITIES A PORTION OF THE HEALTHCARE EDUCATION PROJECT DUES AND GREATER NEW YORK HOSPITAL ASSOCIATION DUES, PAID BY PUTNAM HOSPITAL, WAS USED FOR LOBBYING EXPENDITURES ON BEHALF OF THE HOSPITAL INDUSTRY. 1193282 1193282 84356102 47763475 36592627 106242497 96640102 9602395 12241067 1158642 11082425 58470729 POOLED INVESTMENTS 58078684 F 58078684 INTEREST IN FOUNDATION 14853774 DUE FROM RELATED PARTIES 20118846 DSRF 2016A BONDS 496578 MISCELLANEOUS RECEIVABLES 1079899 OPERATING LEASE RIGHT OF USE ASSETS 12379829 MALPRACTICE GROSS UP ASSET 5872135 INVESTMENT IN JV 247257 55048318 THIRD PARTY LIABILITIES 19526791 DUE TO RELATED PARTIES 12368618 SECURITY DEPOSIT LIABILITY 50551 ACCRUED INTEREST 189134 MALPRACTICE GROSS UP LIABILITY 5872135 ASSET RETIREMENT OBLIGATION 3321353 UNFUNDED ABO 16782590 OPERATING LEASE LIABILITY 11111668 69222840 X PART X, LINE 2: AS OF SEPTEMBER 30, 2021, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. 1 1 X 1 X 300.000000000000 1 X 1 0 1 1 1884776 85430 1799346 0.01210 19050213 8981821 10068392 0.06770 20934989 9067251 11867738 0.07980 7137 7137 0.00000 1652538 409639 1242899 0.00840 3406476 2612480 793996 0.00540 5066151 3022119 2044032 0.01380 26001140 12089370 13911770 0.09360 1862 1862 0.00000 1862 1862 0.00000 1 1007082 43412012 66226479 -22814467 X 1 1 1 1 PUTNAM HOSPITAL CENTER 670 STONELEIGH AVENUE CARMEL NY 10512 WWW.NUVANCEHEALTH.ORG 3950000H X X X X PUTNAM HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, SECTION C X X 1 19 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 PUTNAM HOSPITAL PART V, SECTION B, LINE 5: HEALTHECONNECTIONS, THE LHDS AND HOSPITALS PARTNERED IN A COLLABORATIVE TO CREATE A REGIONAL SURVEY TO CONTRIBUTE TO THE COMMUNITY HEALTH ASSESSMENT AND INFORM FUTURE HEALTH IMPROVEMENT EFFORTS IN THE REGION. THE COLLABORATIVE DESIGNED THE SURVEY QUESTIONS TO COLLECT INFORMATION AROUND SEVERAL INITIATIVES AND PRIORITIES PUT FORWARD BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THESE INCLUDED THE PREVENTION AGENDA, THE EIGHT DOMAINS OF LIVABILITY, AND INCORPORATING HEALTHY AGING INTO HEALTH ACROSS ALL POLICIES. TO FURTHER SUPPLEMENT THE DATA COLLECTED FROM THE COMMUNITY, COLLABORATIVE MEMBERS HELD 12 FOCUS GROUPS WITH SERVICE PROVIDERS TO FURTHER UNDERSTAND THE NEEDS OF SPECIFIC COMMUNITIES AND POPULATIONS, AND THE BARRIERS THEY FACE TO ACHIEVING OPTIMAL HEALTH. IN NOVEMBER OF 2017, HEALTHECONNECTIONS HOSTED A MEETING WITH THE HOSPITALS, HEALTH SYSTEMS, PERFORMING PROVIDER SYSTEMS, AND LOCAL HEALTH DEPARTMENTS (LHD) TO DISCUSS THE BENEFITS OF COLLABORATING ON A REGIONAL CHA. THE LHDS THEN CONTRACTED WITH SIENA COLLEGE RESEARCH INSTITUTE (SCRI) IN DECEMBER OF 2017 TO CONDUCT A RANDOM SAMPLE COMMUNITY HEALTH SURVEY OF THE MID-HUDSON REGION IN 2018 TO ASSESS THE HEALTH STATUS AND CONCERNS OF ITS RESIDENTS. LHDS AND HOSPITALS CONTINUED TO COLLABORATE AND MEET REGULARLY THROUGHOUT 2018 AND 2019. THEY WORKED COLLABORATIVELY TO COMPLETE THE REGIONAL CHA, WHICH WAS USED IN PREPARATION FOR THEIR COMMUNITY SERVICE PLANS (CSPS). ADDITIONALLY, THESE MEETINGS PROVIDE A FORUM TO DISCUSS REGIONAL INTERVENTIONS TO TARGET PRIORITY AREAS AND IMPROVE POPULATION HEALTH.ALTHOUGH THE MID-HUDSON REGION COMMUNITY HEALTH SURVEY COLLECTED RESPONSES FROM A RANDOMIZED SAMPLE OF OVER 5,000 HUDSON VALLEY RESIDENTS, THERE ARE SOME POPULATIONS THAT MAY NOT BE FULLY ACCOUNTED FOR IN THIS SURVEY. SOME OF THESE UNDERREPRESENTED POPULATIONS INCLUDE THOSE WHO ARE LOW-INCOME, VETERANS, SENIORS, PEOPLE EXPERIENCING HOMELESSNESS, LGBTQ MEMBERS, AND PEOPLE WITH A MENTAL HEALTH DIAGNOSIS. IN ORDER TO ENSURE THAT THE NEEDS OF THESE POPULATIONS WERE MET, FOCUS GROUPS WERE CONDUCTED WITH PROVIDERS THAT SERVE THESE POPULATIONS IN EACH OF THE SEVEN COUNTIES. THE TERM "PROVIDERS" REFERS TO THOSE WHO OFFER SERVICES, SUCH AS MENTAL HEALTH SUPPORT, VOCATIONAL PROGRAMS, AND PROGRAMS FOR UNDERSERVED POPULATIONS. THE REASON FOR DOING FOCUS GROUPS WITH PROVIDERS, RATHER THAN DIRECTLY SURVEYING THE TARGET POPULATIONS THROUGH CONVENIENCE SAMPLING, WAS THAT A CONVENIENCE SAMPLE RISKS ONLY ACCOUNTING FOR THOSE WHO ARE ALREADY ACCESSING SERVICES AND CARE. THE HOPE IN SURVEYING PROVIDERS WAS THAT THEY WOULD HAVE AN IDEA OF WHAT OBSTACLES AND BARRIERS THESE POPULATIONS FACE WHEN ACCESSING SERVICES. BEFORE THE FOCUS GROUPS TOOK PLACE, A SURVEY WAS SENT OUT TO PROVIDERS WITHIN EACH COUNTY IN ORDER TO SUPPLY ADDITIONAL INSIGHT AROUND LOCAL FACTORS INFLUENCING COMMUNITY HEALTH. THIS SURVEY COVERED SEVERAL TOPICS, INCLUDING THE POPULATIONS THE PROVIDERS SERVE; THE ISSUES THAT AFFECT HEALTH IN THE COMMUNITIES THEY SERVE; BARRIERS TO PEOPLE ACHIEVING BETTER HEALTH; AND INTERVENTIONS THAT ARE USED TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. IN THE MID-HUDSON REGION, 12 FOCUS GROUPS WERE CONDUCTED WITH VARIOUS SERVICE PROVIDERS. THE PARTICIPATING PROVIDERS SERVE A VARIETY OF CLIENTS, INCLUDING CHILDREN, ADULTS WITH DISABILITIES, LOW-INCOME INDIVIDUALS, AND PEOPLE WITH SUBSTANCE USE DISORDERS. WHEN LOOKING AT DATA FROM THE MID-HUDSON REGION AS A WHOLE, THE TOP THREE ISSUES THAT PROVIDERS FELT AFFECTED HEALTH IN THEIR COMMUNITIES WERE ACCESS TO AFFORDABLE, DECENT, AND SAFE HOUSING; ACCESS TO MENTAL HEALTH PROVIDERS; AND ACCESS TO AFFORDABLE, RELIABLE TRANSPORTATION. THE TOP THREE BARRIERS PROVIDERS FELT PREVENTED PEOPLE FROM ACHIEVING BETTER HEALTH IN THEIR COMMUNITIES WERE KNOWLEDGE OF EXISTING RESOURCES, HEALTH LITERACY, AND DRUG AND/OR ALCOHOL USE. MENTAL HEALTH AND SUBSTANCE USE ISSUES, CHRONIC DISEASES, AND HEALTH DISPARITIES WERE THOUGHT TO HIGHLY IMPACT THESE SPECIFIC POPULATIONS IN THE MID-HUDSON REGION. THESE DATA POINTS REFLECT THE MAJORITY OF RESPONSES FROM EACH INDIVIDUAL FOCUS GROUP CONDUCTED IN EACH COUNTY. IN PUTNAM COUNTY, TWO FOCUS GROUPS WERE HELD WHERE 13 RESPONSES WERE COLLECTED FROM PROVIDERS THAT SERVE VARIOUS POPULATIONS. THE FIRST FOCUS GROUP WAS HELD WITH NINE AGENCIES OF THE COMMUNITY RESOURCE GROUP. THIS GROUP FOCUSES ON IDENTIFYING GAPS IN ACCESS TO CARE AND RESOURCES ISSUES FOR THE BREWSTER COMMUNITY, AS A WHOLE, WITH MORE ATTENTION ON THE IMMIGRANT POPULATION. THE SECOND FOCUS GROUP WAS HELD WITH 15 AGENCIES OF THE MENTAL HEALTH PROVIDER GROUP. THIS GROUP IS A FORUM FOR BEHAVIORAL HEALTH PARTNERS TO IDENTIFY GAPS IN SERVICES, DISCUSS ISSUES, AND IDENTIFY SOLUTIONS. SEVERAL AGENCIES WERE REPRESENTED IN THIS MEETING, AND THE DISCUSSION WAS CENTERED AROUND THE SURVEY QUESTIONS THAT WERE DISTRIBUTED PRIOR TO THE FOCUS GROUP. THE CHNA, INCLUDING PRIORITY AREAS TO INFORM THE COMMUNITY SERVICE PLAN, WAS APPROVED BY THE PUTNAM HOSPITAL BOARD OF TRUSTEES ON DECEMBER 4, 2019. THE COMMUNITY SERVICE PLAN WAS ALSO APPROVED ON DECEMBER 4, 2019. A COPY OF THE SURVEY ADMINISTERED, AND DETAILED FOCUS GROUP RESPONSES CAN BE FOUND IN THE 2019 CHNA, FOUND HERE:HTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT PUTNAM HOSPITAL PART V, SECTION B, LINE 6A: SEVEN LOCAL HEALTH DEPARTMENTS OF THE MID-HUDSON REGION, INCLUDING DUTCHESS, ORANGE, PUTNAM, ROCKLAND, SULLIVAN, ULSTER, AND WESTCHESTER COUNTIES, AND HEALTHECONNECTIONS CREATED THE LOCAL HEALTH DEPARTMENT PREVENTION AGENDA COLLABORATIVE WITH THE GOAL OF CREATING THE FIRST REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT. SHORTLY AFTER, THE COLLABORATIVE GAINED THE SUPPORT OF 17 LOCAL HOSPITALS. THE HOSPITAL SYSTEMS OR FACILITIES INCLUDED: BON SECOURS CHARITY HEALTH SYSTEM, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; CATSKILL REGIONAL MEDICAL CENTER, A MEMBER OF THE GREATER HUDSON VALLEY HEALTH SYSTEM; HEALTHALLIANCE HOSPITAL, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; MONTEFIORE HUDSON VALLEY COLLABORATIVE; MONTEFIORE NYACK HOSPITAL; MONTEFIORE ST. LUKE'S CORNWALL; ORANGE REGIONAL MEDICAL CENTER, A MEMBER OF THE GREATER HUDSON VALLEY HEALTH SYSTEM; ST. JOSEPH'S MEDICAL CENTER; AND THE HOSPITALS OF NUVANCE HEALTH. PUTNAM HOSPITAL PART V, SECTION B, LINE 6B: SEVEN LOCAL HEALTH DEPARTMENTS OF THE MID-HUDSON REGION AND HEALTHECONNECTIONS CREATED THE LOCAL HEALTH DEPARTMENT PREVENTION AGENDA COLLABORATIVE WITH THE GOAL OF CREATING THE FIRST REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTH DEPARTMENTS INCLUDED: DUTCHESS COUNTY DEPARTMENT OF BEHAVIORAL & COMMUNITY HEALTH; ORANGE COUNTY DEPARTMENT OF HEALTH; PUTNAM COUNTY DEPARTMENT OF HEALTH; ROCKLAND COUNTY DEPARTMENT OF HEALTH; SULLIVAN COUNTY PUBLIC HEALTH SERVICES; ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH; AND WESTCHESTER COUNTY DEPARTMENT OF HEALTH.PUTNAM HOSPITAL CENTER:PART V, SECTION B, LINE 7A, HOSPITAL WEBSITEHTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT PUTNAM HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA WAS ALSO PRINTED AND DISTRIBUTED THROUGHOUT THE HOSPITAL, INCLUDING THE MAIN LOBBY, PATIENT WAITING AREAS AND HOSPITAL ADMINISTRATION OFFICES. IT IS ALSO AVAILABLE BY REQUEST IN THE NUVANCE HEALTH ADMINISTRATIVE OFFICES.PUTNAM HOSPITAL CENTER:PART V, SECTION B, LINE 10A, HOSPITAL IMPLEMENTATION STRATEGY:HTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT PUTNAM HOSPITAL PART V, SECTION B, LINE 11: EACH NUVANCE HEALTH HOSPITAL HAS A COMMUNITY HEALTH NEEDS COMMITTEE (CHNC) WITH REPRESENTATION FROM BOARD MEMBERS, THE EXECUTIVE TEAM, HOSPITAL STAFF, COMMUNITY MEMBERS AND REPRESENTATIVES FROM THE LOCAL HEALTH DEPARTMENTS AND COMMUNITY AGENCIES. THE CHNC'S AT PUTNAM HOSPITAL CONVENED WORKGROUPS TO REVIEW THE FINDINGS OF THE REGIONAL COMMUNITY HEALTH ASSESSMENT AND REVIEW THE LOCAL HEALTH DEPARTMENT PRIORITY AREAS IN ORDER TO DETERMINE THEIR PREVENTION AGENDA PRIORITIES FOR THE 2019-2021 PERIOD.PUTNAM HOSPITAL CONFIRMED THE FOLLOWING TWO PRIORITIES TO ALIGN WITH THE LOCAL HEALTH DEPARTMENT PRIORITIES:1. PREVENT CHRONIC DISEASES2. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSTHE WORKGROUPS DEVELOPED GOALS, OBJECTIVES, STRATEGIES ACTION STEPS AND METRICS TO MEASURE SUCCESS FOR THESE PRIORITY AREAS.PUTNAM HOSPITAL'S IMPLEMENTATION PLAN INCLUDED:PUTNAM HOSPITAL FARMER'S MARKET TO PROVIDE ACCESS TO FRESH FRUITS, VEGETABLES AND LOCAL FOODS TO EMPLOYEES AND COMMUNITY MEMBERS. THE MARKET WAS HALTED DURING 2021 DUE TO COVID.TAI CHI FOR ARTHRITIS TEACHES FLEXIBILITY EXERCISES TO HELP REDUCE PAINAND STIFFNESS AND IMPROVE MOBILITY. IN-PERSON CLASSES WERE HALTED DUE TO COVID.OFFERING MEDICATION ASSISTED TREATMENT (MAT) TRAINING TO PHYSICIANS. THIS TRAINING ALLOWS PROVIDERS TO APPLY TO THE DEA FOR WAIVERS TO PRESCRIBE BUPRENORPHINE, A MEDICATION APPROVED BY THE FDA FOR TREATMENT OF OPIOID DISORDER. ONLY ONE VIRTUAL SESSION WAS OFFERED IN 2020, WITH LOW ATTENDANCE DUE TO PHYSICIANS HAVING COMPETING PANDEMIC PRIORITIES.DEVELOPMENT OF AN OPIOD STEWARDSHIP PROGRAM TO ENCOURAGE REDUCTION IN OPIOID USE AS THE FIRST LINE OF TREATMENT, TRAINING OF PROVIDERS AND ESTABLISHMENT OF A REFERRAL BASE.PARTICIPATE IN THE NATIONAL DRUG TAKE-BAKE DAYS TO REDUCE THE QUANTITY OF OPIOIDS AVAILABLE ON THE STREETS AND PROVIDE SAFE DISPOSAL OPTIONS FOR COMMUNITY MEMBERS. THE HOSPITAL PARTNERED WITH THE SHERRIFF'S OFFICE TO COLLECT 450 POUNDS OF UNUSED DRUGS IN APRIL 2021.NARCAN TRAINING FOR THE COMMUNITY. THIS TRAINING EXPLAINS HOW NALOXONE WORKS TO REVERSE AN OVERDOSE, WHAT TO DO WHEN AN OVERDOSE IS SUSPECTED AND HOW AND WHEN TO ADMINISTER THE MEDICATION. THIS TRAINING WAS PUT ON HOLD AT THE HOSPITALS IN 2021 DUE TO COVID.THROUGH DISCUSSIONS WITH COMMUNITY PARTNERS, ADDITIONAL PREVENTION AGENDA PRIORITIES WERE IDENTIFIED AS PRIORITIES FOR EACH COUNTY. WHILE SOME OF THESE NEEDS ARE BEING MET BY OTHER NUVANCE HEALTH PROGRAMS, OTHERS ARE BEING ADDRESSED BY THE MANY VALUABLE COMMUNITY ORGANIZATIONS AND HEALTH CARE PARTNERS IN THE COMMUNITY.PUTNAM COUNTY FOCUS AREA - NEEDS NOT BEING ADDRESSED:TOBACCO PREVENTION. PUTNAM HOSPITAL CURRENTLY ADDRESSES THIS WITH SMOKING CESSATION CLASSES, SCREENING QUESTIONS IN THE PATIENT ELECTRONIC MEDICAL RECORD, REFERRALS TO THE NYS QUITLINE, A LOW-COST LUNG SCREENING PROGRAM AND EDUCATIONAL PROGRAMS.PROMOTE A HEALTHY AND SAFE ENVIRONMENT PROTECT VULNERABLE WATERBODIES TO REDUCE POTENTIAL PUBLIC HEALTH RISKS ASSOCIATED WITH EXPOSURE TO RECREATIONAL WATER. PUTNAM HOSPITAL CANNOT DIRECTLY IMPACT THIS PRIORITY.ADDITIONALLY, AS THE COVID-19 PANDEMIC CONTINUED IN 2021, PUTNAM HOSPITAL WAS ABLE TO OFFER MANY COMMUNITY PROGRAMS VIA ZOOM, INCLUDING THEIR DIABETES SUPPORT GROUP, BREAST AND OVARIAN CANCER SUPPORT GROUP AND STRESS MANAGEMENT AND MEDITATION PROGRAMMING. PUTNAM HOSPITAL PART V, SECTION B, LINE 13H: FACILITY: PUTNAM HOSPITALTHE FAP INDICATES A 75% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN 301% AND350% OF THE FPG AND A 60.30% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN351% AND 400% OF THE FPG.PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCEPART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCEPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE 3 1 - PHC OUTPATIENT REHABILITATION SERVICES 2985 NAVAJO ROAD YORKTOWN NY 10598 OUTPATIENT REHABILITATION SERVICES 2 - PHC OP REHAB CENTER - PAWLING 551 ROUTE 22 PAWLING NY 12564 OUTPATIENT REHABILITATION SERVICES 3 - PHC OP REHAB SVCS - KATONAH SATELLITE 160 HARRIS ROAD BEDFORD HILLS NY 10507 OUTPATIENT REHABILITATION SERVICES PART I, LINE 7: THE COST TO CHARGE RATIO PERCENTAGE, BASED ON THE MEDICARE COST REPORT, WAS USED AS THE COSTING METHODOLOGY IN DETERMINING THE AMOUNTS REPORTED. PART I, LINE 7G: THE AMOUNTS REPORTED AS SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE PHYSICIAN CLINIC COSTS. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:PUTNAM HOSPITAL (PH) OFFERS THE EXPERTISE OF OUR STAFF AND RESOURCES OF THE HOSPITAL IN A NUMBER OF COMMUNITY-BUILDING ACTIVITIES THAT IMPROVE THE HEALTH AND SAFETY OF THE COMMUNITY. PUTNAM HOSPITAL PARTICIPATES IN THE COMMUNITIES THAT CARE COALITION (CTC). CTC INCLUDES ALL SECTORS OF THE COMMUNITY (HEALTH CARE, FAMILIES, SCHOOLS, LAW ENFORCEMENT, BUSINESSES, ETC.) AND TAKES A PROACTIVE, DATA-DRIVEN APPROACH TO IDENTIFY AND PRIORITIZE AREAS NEEDING INTERVENTIONS. STAFF ALSO SIT ON THE BOARD OF THE PREVENTION COUNCIL OF PUTNAM COUNTY WHICH IS DEDICATED TO PROMOTING EDUCATION AND AWARENESS RELATED TO SUBSTANCE USE DISORDERS AND PROBLEM GAMBLING TO THE RESIDENTS OF PUTNAM COUNTY, BY PROVIDING THE COMMUNITY WITH UP-TO-DATE INFORMATION AND SERVICES RELATED TO PREVENTION, TREATMENT AND RECOVERY. PH WAS ALSO A FOUNDING MEMBER OF A COUNTY-WIDE FALLS PREVENTION TASK FORCE THAT BROUGHT TOGETHER MANY COUNTY RESOURCES TO ADDRESS ISSUES IN THE AGING POPULATION. PART III, SECTION A, LINE 2: PH FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN ITS RECOGNITION OF BAD DEBT EXPENSE. PATIENT ACCOUNT BALANCES WERE ONLY CONSIDERED FOR BAD DEBT AFTER APPLYING ALL CONTRACTUAL DISCOUNTS AND PAYMENTS, AND SCREENING FOR CHARITY ELIGIBILITY. PART III, SECTION A, LINE 3: PH DOES RECOGNIZE THAT THERE WAS SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WERE ELIGIBLE UNDER THE ORGANIZATION'S CHARITY POLICY. WE DID NOT HAVE A REASONABLE BASIS FOR ESTIMATING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PATIENTS WHO WERE ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY WERE ACCOUNTED FOR UNDER CHARITY CARE RATHER THAN BAD DEBT. PART III, SECTION A, LINE 4: FOOTNOTE ON AUDITED FINANCIALS - THE FOOTNOTE TO THE ORGANIZATION'SFINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ONPAGES 21-26 OF NUVANCE HEALTH AND SUBSIDIARIES CONSOLIDATED AUDITEDFINANCIAL STATEMENTS. PART III, SECTION B, LINE 8: THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE IN EXCESS OF THE COMPANY'S COSTS FOR THE PATIENTS IN THE COMMUNITY. THE COSTING METHODOLOGY USED TO CALCULATE THE SHORTFALL WAS THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT. PART III, SECTION C, LINE 9B: IT IS THE POLICY OF PUTNAM HOSPITAL TO PROVIDE "FINANCIAL ASSISTANCE" (EITHER FREE CARE OR REDUCED PATIENT OBLIGATIONS) TO PERSONS OR FAMILIES WHERE: (I) THERE IS LIMITED OR NO HEALTH INSURANCE AVAILABLE; (II) THE PATIENT FAILS TO QUALIFY FOR GOVERNMENTAL ASSISTANCE (FOR EXAMPLE MEDICARE OR MEDICAID); (III) THE PATIENT COOPERATES WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION; (IV) THE PATIENT DEMONSTRATES FINANCIAL NEED; AND (V) PUTNAM HOSPITAL MAKES AN ADMINISTRATIVE DETERMINATION THAT FINANCIAL ASSISTANCE IS APPROPRIATE. AFTER THE HOSPITAL DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE AVAILABLE TO THE PATIENT BY UTILIZING THE CHARITABLE ASSISTANCE GUIDELINES, WHICH ARE BASED UPON THE MOST RECENT FEDERAL POVERTY GUIDELINES. PUTNAM HOSPITAL SHALL REGULARLY REVIEW THIS FINANCIAL ASSISTANCE POLICY TO ENSURE THAT AT ALL TIMES IT: (I) REFLECTS THE PHILOSOPHY AND MISSION OF THE HOSPITAL; (II) EXPLAINS THE DECISION PROCESSES OF WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND IN WHAT AMOUNTS; AND (III) COMPLIES WITH ALL APPLICABLE STATE AND FEDERAL LAWS, RULES, AND REGULATIONS CONCERNING THE PROVISION OF FINANCIAL ASSISTANCE TO INDIGENT PATIENTS.CONSISTENT WITH THIS MISSION, PUTNAM HOSPITAL RECOGNIZES ITS OBLIGATION TO THE COMMUNITY IT SERVES TO PROVIDE FINANCIAL ASSISTANCE TO INDIGENT PERSONS WITHIN THE COMMUNITY.IN FURTHERANCE OF ITS CHARITABLE MISSION, PUTNAM HOSPITAL WILL PROVIDE BOTH (I) EMERGENCY TREATMENT TO ANY PERSON REQUIRING SUCH CARE; AND (II) ESSENTIAL, NON-EMERGENT CARE TO PATIENTS WHO ARE PERMANENT RESIDENTS OF ITS PRIMARY SERVICE AREA WHO MEET THE CONDITIONS AND CRITERIA SET FORTH IN THIS POLICY, WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SUCH CARE. ELECTIVE PROCEDURES GENERALLY WILL NOT BE CONSIDERED ESSENTIAL, NON-EMERGENT CARE AND USUALLY WILL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE.PUTNAM HOSPITAL WILL COLLECT FROM INDIVIDUALS ON FINANCIAL ASSISTANCE IF THEY RECEIVED A PARTIAL CHARITABLE DISCOUNT. ALL PATIENTS CAN APPLY FOR CHARITABLE CARE ON BALANCES THEY FEEL THAT THEY CANNOT AFFORD. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE CHNAS CONDUCTED EVERY THREE YEARS, THE HOSPITAL HAS A COMMUNITY HEALTH NEEDS COMMITTEE THAT MEETS REGULARLY TO ASSESS ANY ADDITIONAL HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMITTEE PROVIDES OVERSIGHT TO THE HOSPITAL'S COMMUNITY HEALTH PRIORITIES, INCLUDING NEEDS ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS AND OTHER POPULATION HEALTH INITIATIVES. THEY HELP GUIDE PRIORITY ISSUES FOR ACTION TO IMPROVE COMMUNITY HEALTH AND HELP INFORM, GUIDE AND SHARE SUCCESSFUL PROGRAMS AND STRATEGIES THAT ADDRESS HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. ALSO, SIGNS ARE POSTED THROUGHOUT THE HOSPITAL AND COUNSELORS ARE AVAILABLE TO PROVIDE FURTHER ASSISTANCE. ALL UNINSURED INPATIENTS ARE INTERVIEWED BY FINANCIAL COUNSELORS AND ASSESSED FOR ELIGIBILITY FOR ASSISTANCE PROGRAMS. THE HOSPITAL PROVIDES INFORMATIONAL HANDOUTS TO ALL UNINSURED PATIENTS AT THE TIME OF REGISTRATION WHICH REFERS THEM TO FINANCIAL COUNSELING IF THEY WOULD LIKE ASSISTANCE WITH THEIR BILLS. FURTHER, THE HOSPITAL MAILS NOTICES TO ALL SELF-PAY ACCOUNTS REFERRING THEM TO FINANCIAL COUNSELING IF THEY NEED ASSISTANCE. THE COLLECTION DEPARTMENT WILL ALSO REFER PATIENTS TO FINANCIAL COUNSELING WHEN A PATIENT INDICATES THAT THEY CANNOT AFFORD THEIR BALANCES; AND FINALLY, SCHEDULERS REFER UNINSURED PATIENTS TO FINANCIAL COUNSELING PRIOR TO THEIR TEST OR PROCEDURE. THE POLICY AND APPLICATIONS FOR ASSISTANCE ARE ALSO AVAILABLE ONLINE, AS WELL AS UPON REQUEST AT THE HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION:PUTNAM HOSPITAL (PH) IS A 164-BED, ACUTE CARE HOSPITAL OFFERING MEDICAL, SURGICAL, PSYCHIATRIC, AND 24-HOUR EMERGENCY SERVICES. AS THE ONLY HOSPITAL IN PUTNAM COUNTY, PUTNAM HOSPITAL HAS BEEN SERVING THE NEEDS OF PUTNAM, NORTHERN WESTCHESTER AND SOUTHERN DUTCHESS COUNTIES SINCE 1964.EIGHTY PERCENT OF PH'S PATIENT POPULATION COMES FROM THE EASTERN HALF OF PUTNAM, WITH THE SERVICE AREA EXTENDING NORTH TO THE SOUTHEAST CORNER OF DUTCHESS COUNTY AND SOUTH TO SELECT BORDERING ZIP CODES IN NORTHERN WESTCHESTER COUNTY.THE OVERALL POPULATION IN THE PH SERVICE AREA IS 104,387 AND PROJECTED TO STAY FLAT THROUGH 2026. THE AVERAGE HOUSEHOLD INCOME IN THE PUTNAM HOSPITAL SERVICE AREA IS $144,537. A HIGH SCHOOL DIPLOMA OR GED IS THE HIGHEST LEVEL OF EDUCATION COMPLETED BY 26% OF THE SERVICE AREA AGE 25 AND OLDER. (SOURCE: THECLARITAS COMPANY, 2021). ACCORDING TO THE U.S. BUREAU OF LABOR STATISTICS, THE DUTCHESS COUNTY/PUTNAM COUNTY REGION HAD AN UNEMPLOYMENT RATE OF 5.7% IN JANUARY 2021. APPROXIMATELY 5.7% OF THE POPULATION IN PUTNAM COUNTY ARE LIVING IN POVERTY (CENSUS.GOV 2020). APPROXIMATELY 3% OF PH'S MARKET ARE UNINSURED, WHILE MEDICAID (16%), MEDICARE (19%) AND PRIVATE DIRECT OR EXCHANGE MAKE UP THE REST OF THE MARKET (62%). (SOURCE: THE CLARITAS COMPANY, 2021). ACCORDING TO THE HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA.GOV), THERE ARE NO MEDICALLY UNDERSERVED AREAS OR POPULATIONS IN PUTNAM COUNTY. PART VI, LINE 5: COMMUNITY HEALTH PROMOTION:PH IS A 164-BED, ACUTE CARE COMMUNITY HOSPITAL OFFERING MEDICAL, SURGICAL, PSYCHIATRIC, AND 24-HOUR EMERGENCY SERVICES. PH PROVIDES A COMPREHENSIVE RANGE OF INPATIENT AND OUTPATIENT SERVICES OFFERED THROUGH VARIOUS SPECIALTY DEPARTMENTS THAT INCLUDE ADVANCED ORTHOPEDIC, ROBOTIC AND BARIATRIC SURGERIES; NEUROSCIENCES INCLUDING MINIMALLY-INVASIVE SPINAL SURGERIES, STROKE CARE AND A SLEEP DISORDERS LAB; A BLOOD MANAGEMENT PROGRAM; PSYCHIATRIC CARE INCLUDING A PARTIAL-HOSPITALIZATION PROGRAM; A COMPREHENSIVE CANCER PROGRAM; MATERNITY; 24/7 EMERGENCY CARE; THE CENTER FOR WOUND HEALING, PH SLEEP DISORDERS CENTER AND FOUR OUTPATIENT PHYSICAL REHABILITATION SATELLITE FACILITIES. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS WHO LIVE AND WORK IN THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF THE FACILITY. IT ALSO OWNS MEDICAL OFFICE SPACE ON ITS PREMISES WITH SPACE FOR DOCTORS. ANY MEMBER OF ITS ACTIVE MEDICAL STAFF HAS THE PRIVILEGE OF LEASING AVAILABLE OFFICE SPACE. RENT IS DERIVED FROM A FAIR MARKET VALUE ANALYSIS PROVIDED BY AN INDEPENDENT PARTY. THE HOSPITAL OPERATES A 24-HOUR EMERGENCY ROOM WHERE NO ONE REQUIRING MEDICAL ATTENTION IS DENIED CARE. ANY INCOME OVER EXPENSES IS REINVESTED INTO THE HOSPITAL, ITS STAFF AND THE COMMUNITY. PH REALIZES THIS IS NECESSARY TO ACHIEVE AND MAINTAIN HIGH QUALITY STANDARDS, KEEP UP WITH THE RAPID ADVANCEMENT IN TECHNOLOGY, PROVIDE START-UP CAPITAL FOR NEW PROGRAMS, AND EXPAND EXISTING FACILITIES AND PROGRAMS IN ORDER TO PROVIDE QUALITY CARE TO THE COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE:NUVANCE HEALTH IS AN INTEGRATED HEALTH SYSTEM OFERING CONVENIENT, ACCESSIBLE AND AFFORDABLE CARE TO OUR COMMUNITY MEMBERS. OUR TALENTED TEAM OF MORE THAN 15,000 COMPASSIONATE CAREGIVERS PROVIDE HIGH-QUALITY CARE THROUGH: COMMUNITY HOSPITALS, PRIMARY CARE AND SPECIALTY PRACTICE LOCATIONS, OUTPATIENT SETTINGS, HOME CARE SERVICES, A SKILLED NURSING HOME AND REHABILITATION FACILITY AND TELEHEALTH VISITS. FOR FYE2021, THE NETWORK PROVIDED APPROXIMATELY $29,353,000 TOTAL CHARITY CARE.DANBURY HOSPITAL, ITS NEW MILFORD HOSPITAL CAMPUS AND NORWALK HOSPITAL PROVIDE MEDICAL SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. SERVICES INCLUDE ROUTINE INPATIENT ANCILLARY AND OUTPATIENT CARE IN SUPPORT OF THE NETWORK'S MISSION STATEMENT, AS NOTED ABOVE, FOR FYE2021, CHARITY CARE WAS PROVIDED IN THE FOLLOWING AMOUNTS: NORWALK HOSPITAL, $9,323,000, DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS, $7,099,000.ALL HOSPITALS NOTED ABOVE HAVE OPEN MEDICAL STAFFS. IF AN INDIVIDUAL MEETS THE EDUCATIONAL, EXPERIENTIAL AND LICENSOR REQUIREMENTS THEY CAN JOIN THE MEDICAL STAFF.NUVANCE HEALTH MEDICAL PRACTICE CT, INC. (NHMPCT): THE MISSION OF NHMPCT IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND SPECIALTY HEALTH CARE IN THE COMMUNITIES THEY SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO THEIR PATIENTS' NEEDS. THEY SUPPORT A COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THEIR COMMUNITY BY DELIVERING QUALITY CARE, PARTICIPATING IN MEDICAL RESEARCH AND MEDICAL RESIDENCY PROGRAMS AND THE PROVISION OF MEDICAL SERVICES TO PATIENTS. FOR FYE2021 THEY PROVIDED APPROXIMATELY $2,290,000 IN CHARITY CARE.DANBURY HOSPITAL & NEW MILFORD HOSPITAL FOUNDATION INC. (DH/NMHF): DH/NMHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS AND OTHER DANBURY NOT-FOR-PROFIT HEALTH CARE AFFILIATES.NORWALK HOSPITAL FOUNDATION (NHF): NHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO NORWALK HOSPITAL AND OTHER NOT-FOR-PROFIT NORWALK HOSPITAL AFFILIATES.WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC. (WCHNA): WCHNA'S PRINCIPAL PURPOSE IS TO PROVIDE OUTPATIENT HEALTH CARE SERVICES IN VARIOUS LOCATIONS AND ALSO PROVIDE AMBULANCE SERVICES TO DANBURY AND SURROUNDING TOWNS, WHILE SERVING THOSE THAT CANNOT AFFORD THE CARE. FOR FYE2021, WCHNA PROVIDED APPROXIMATELY $40,000 IN CHARITY CARE.WESTERN CONNECTICUT HOME CARE, INC. (WCHC): WCHC PROVIDES STATE OF THE ART CLINICAL SERVICES RANGING FROM PEDIATRIC PATIENTS TO THE ELDERLY UTILIZING BEST PRACTICE IN HOME CARE TO MEET THE NEEDS OF THEIR PATIENTS. EASTERN NEW YORK MEDICAL SERVICES, P.C. (ENYMS): THE MISSION AT ENYMS IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND GASTROENTEROLOGY HEALTH CARE IN THE COMMUNITIES WE SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO OUR PATIENTS' NEEDS. VASSAR BROTHERS MEDICAL CENTER (VBMC) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIEND SERVICES FOR RESIDENTS OF MID-HUDSON VALLEY. FOR FYE2021 VBMC PROVIDED APPROXIMATELY $6,820,000 IN CHARITY CARE.THE FOUNDATION OF VBMC'S PRINCIPAL ACTIVITY IS THE SOLICITATION, RECEIPT, HOLDING, INVESTMENT AND ADMINISTRATION OF CONTRIBUTION ON BEHALF OF VBMC.PUTNAM HOSPITAL (PH) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. FOR FYE2021 PH PROVIDED APPROXIMATELY $1,475,000 IN CHARITY CARE.PUTNAM HOSPITAL CENTER FOUNDATION ACTIVELY SOLICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES.NORTHERN DUTCHESS HOSPITAL (NDH) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. FOR FYE2021 NDH PROVIDED APPROXIMATELY $946,000 IN CHARITY CARE.NORTHERN DUTCHESS HOSPITAL FOUNDATION (NDH) FOUNDATION ACTIVELY SOLIICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES.VASSAR HEALTH CT, INC DBA SHARON HOSPITAL (SH) PROVIDES GENERAL ACUTE CARE WITH A RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS IN THE NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 SH PROVIDED APPROXIMATELY $905,000 IN CHARITY CARE.NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY OPERATES AND MAINTAINS A RESIDENTIAL HEALTHCARE FACILITY FOR THE CARE AND TREATMENT OF PERSONS WHO REQUIRE MEDICAL CARE AND RELATED SERVICES. FOR FYE2021 NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY PROVIDED APPROXIMATELY $133,000 IN CHARITY CARE.NUVANCE HEALTH MEDICAL PRACTICE, PC IS THE BENEFICIAL OWNER OF VARIOUS PHYSICIAN PRACTICES THAT PROVIDE A FULL RANGE OF HOSPITAL-BASED AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY AND IN THE NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 NUVANCE HEALTH MEDICAL PRACTICE, PC PROVIDED APPROXIMATELY $155,000 IN CHARITY CARE.HUDSON VALLEY CARDIOVASCULAR PRACTICE (HVCP) PROVIDES INVASIVE AND NONINVASIVE CARDIOVASCULAR, DIAGOSTIC AND THERAPEUTIC SERVICES AND IS LOCATED THROUGHOUT THE MID-HUDSON VALLEY AND NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 HUDSON VALLEY CARDIOVASCULAR PRACTICE PROVIDED APPROXIMATELY $72,000 IN CHARITY CARE.HEALTH QUEST HOME CARE, INC. WAS FORMED TO OPERATE A HOME HEALTH CARE SERVICE BUSINESS SERVING RESIDENTS OF THE MID-HUDSON VALLEY. FOR FYE2021 HEALTH QUEST HOME CARE PROVIDED APPROXIMATELY $97,000 IN CHARITY CARE. WELLS MANOR HOUSING DEVELOP. FUND CORP. IS A PRIVATE FOUNDATION. WELLS MANOR OPERATES AN APARTMENT COMPLEX OF 75 UNITS UNDER SECTION 202 OF THE NATIONAL HOUSING ACT OF 1959 AND SECTION 8 OF THE NATIONAL HOUSING ACT OF 1937, REGULATED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. ALAMO AMBULANCE SERVICES, INC'S ASSETS WERE SOLD IN SEPTEMBER 2009; HOWEVER, IT HAS MAINTAINED ITS LICENSE TO PROVIDE TRANSPORT TO SICK, DISABLED, OR INJURED PERSONS, GENERALLY WITHIN DUTCHESS, ORANGE, ULSTER AND PUTNAM COUNTIES, NEW YORK. PART VI, LINE 7: NEW YORK AND CONNECTICUT X 1 1 1 1 0 0 0 0 0 1 0 STEVEN H ROSENBERG TREASURER/CFO 0 725983 0 0 0 975413 0 601834 0 40662 0 2343892 0 866877 ROBERT FRIEDBERG FORMER HQ PRESIDENT & CEO 0 179463 0 0 0 1516700 0 5538 0 6207 0 1707908 0 0 MICHAEL HOLZHUETER FORMER ASSISTANT SECRETARY 0 92086 0 131172 0 836761 0 7023 0 11890 0 1078932 0 0 KERRY EATON CHIEF OPERATING OFFICER 0 756173 0 60000 0 120027 0 94667 0 1579 0 1032446 0 0 CAROLYN MCKENNA ASST. SEC. (TO 12/31); SEC./CLO 0 584841 0 0 0 62046 0 14250 0 2115 0 663252 0 0 PETER A KELLY FORMER PHC PRES.; VBMC PRES. 0 525953 0 25000 0 79571 0 17100 0 1505 0 649129 0 0 MARK K HIRKO MD PRESIDENT PHC & SHARON HOSPITALS 0 485468 0 11380 0 64156 0 17100 0 20739 0 598843 0 0 CATHERINE FRIERSON CHIEF HUMAN RESOURCE OFFICER 0 481256 0 0 0 50445 0 14250 0 3925 0 549876 0 0 JEAN AHN FROM 0201 CHIEF STRATEGY OFFICER 0 417628 0 0 0 81363 0 14250 0 3071 0 516312 0 0 GRACE LINHARD CHIEF DEVELOPMENT OFFICER 0 384162 0 0 0 61573 0 17100 0 2495 0 465330 0 0 WAYNE MCNULTY CHIEF COMPLIANCE OFFICER 0 346401 0 0 0 33721 0 14250 0 11486 0 405858 0 0 ELISH C HOURIHAN VP PATIENT CARE SVCS./CNO 276972 40757 22755 25000 5735 769 15637 3406 828 174 321927 70106 0 0 RONALD E STEPHENS DIRECTOR OF PATIENT CARE SERVICES 183873 0 16734 0 2431 0 12588 0 36626 0 252252 0 0 0 LAURIE MUSCARI DIRECTOR MENTAL HEALTH SERVICES 182854 0 16099 0 5508 0 6038 0 34887 0 245386 0 0 0 JULIE REGENBAUM DIRECTOR PHARMACY 197427 0 16977 0 653 0 0 0 10687 0 225744 0 0 0 KATHERINE BACHER FORMER ASSISTANT TREASURER 0 191893 0 0 0 18251 0 12144 0 263 0 222551 0 0 LAWRENCE S SCHEK VP MEDICAL AFFAIRS 183781 0 20587 0 2063 0 12265 0 441 0 219137 0 0 0 CHERYL BOOTH FORMER ASSISTANT SECRETARY 0 126698 0 1500 0 5343 0 7876 0 1803 0 143220 0 0 SCHEDULE J, PART I, LINE 1A FOR THE FOLLOWING, TAXABLE COMPENSATION REPORTED IN PART VII INCLUDES GROSS-UP PAYMENTS FOR TRAVEL STIPENDS: ONE HIGHEST COMPENSATED EMPLOYEE. SCHEDULE J, PART I, LINE 3 PUTNAM HOSPITAL CENTER RELIED ON NUVANCE HEALTH, A RELATED TAX EXEMPT ORGANIZATION, TO APPROVE AND DETERMINE COMPENSATION FOR THE CEO AND TOP MANAGEMENT, WHICH USED A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO GATHER COMPARABLE DATA ON OTHER KEY EMPLOYEES. SCHEDULE J, PART I, LINE 4A DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, MICHAEL HOLZHUETER RECEIVED $694,731 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF DECEMBER 11, 2019. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, ROBERT FRIEDBERG RECEIVED $1,246,154 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF DECEMBER 11, 2019. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. SCHEDULE J, PART I, LINE 4B WESTERN CONNECTICUT HEALTH NETWORK (WCHN), A RELATED ORGANIZATION, PREVIOUSLY ESTABLISHED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO KEY MEMBERS OF THE EXECUTIVE GROUP. UNDER THE AGREEMENTS FOR THE SERP, AMOUNTS PROMISED TO ELIGIBLE EXECUTIVES ARE BASED ON TARGETED RETIREMENT BENEFITS AND THE PAYMENT OF BENEFITS IS SUBJECT TO VESTING. THE BENEFITS AT THE VESTED AGE ARE PROVIDED IN THE FORM OF AN ACTUARIAL EQUIVALENT LUMP SUM PLUS A TAX GROSS-UP AMOUNT TO THE PARTICIPANTS. WCHN MAINTAINS AN ACCRUAL ON ITS BOOKS FOR THE PARTICIPANTS OF THE SERP. THE ACCRUALS ARE MAINTAINED SOLELY FOR ACCOUNTING PURPOSES AND ARE UNFUNDED. STEVEN H. ROSENBERG PARTICIPATED IN THE SERP AND ACCRUED BENEFITS AS OF SEPTEMBER 30, 2021. FOR CALENDAR YEAR 2020, STEVEN H. ROSENBERG RECEIVED A PAYOUT OF $866,877, WHICH IS REFLECTED AS COMPENSATION ON SCHEDULE J, PART II ON THE FORM 990, FOR THE CURRENT YEAR. ROBERT FRIEDBERG, KERRY EATON, MICHAEL HOLZHEUTER AND KATHERINE BACHER PARTICIPATED IN A SERP PLAN WITH HEALTH QUEST SYSTEMS, INC. (HEALTH QUEST), A RELATED ORGANIZATION. HEALTH QUEST MADE THE FOLLOWING CONTRIBUTIONS TO THE PARTICIPANTS, WHICH ARE REPORTED ON SCHEDULE J, PART II. AS OF JANUARY 15, 2021, THE HEALTH QUEST SERP PLAN WAS TERMINATED. KERRY EATON - $77,567 EFFECTIVE OCTOBER 1, 2020, NUVANCE HEALTH ESTABLISHED AN EXECUTIVE RETIREMENT PLAN IN ORDER TO PROVIDE NONQUALIFIED DEFINED CONTRIBUTION RETIREMENT BENEFITS TO DESIGNATED KEY MEMBERS OF ITS EXECUTIVE MANAGEMENT TEAM, SELECTED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. ONLY EXECUTIVES OCCUPYING DESIGNATED TIER 1 OR TIER 2 EXECUTIVE POSITIONS ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN CALENDAR YEAR 2020, CONTRIBUTIONS RELATED TO THIS PLAN ARE INCLUDED IN EACH PARTICIPANT'S WAGES AND ARE REFLECTED IN THE AMOUNTS REPORTED ON SCHEDULE J, PART II, COLUMN (B)(III) - OTHER REPORTABLE COMPENSATION. SCHEDULE J, PART I, LINE 7: NUVANCE HEALTH ANNUAL LEADERSHIP INCENTIVE PLAN (EXCERPTS FROM): THE PURPOSE OF THE NUVANCE HEALTH ANNUAL LEADERSHIP INCENTIVE PLAN ("PLAN") IS TO ENGAGE AND MOTIVATE THE ORGANIZATION'S LEADERS TO FURTHER THE CHARITABLE MISSION OF NUVANCE HEALTH AND ITS AFFILIATES AND SUBSIDIARIES, BY PROMOTING EFFECTIVE MANAGEMENT OF OPERATIONS, DELIVERY OF HIGH-QUALITY CARE AND SERVICE, AND RESPONSIBLE USE OF RESOURCES TO MEET COMMUNITY NEEDS. THIS PLAN IS INTENDED TO ASSIST NUVANCE HEALTH, AND ITS AFFILIATES AND SUBSIDIARIES TO ATTRACT AND RETAIN LEADERSHIP WITH THE TALENT AND EXPERIENCE NEEDED TO BE SUCCESSFUL BY PROVIDING MEANINGFUL INCENTIVES AND REWARDS FOR OUTSTANDING PERFORMANCE. INDIVIDUALS MUST BE AN ELIGIBLE EMPLOYEE TO BE CONSIDERED AS A PARTICIPANT IN THIS PLAN. AN ELIGIBLE EMPLOYEE IS AN INDIVIDUAL EMPLOYED BY NUVANCE HEALTH AND HOLDS A POSITION ASSIGNED TO ONE OF THE FOLLOWING TIERS, AS OF APRIL 30TH OF THE PLAN YEAR: -TIER I, PRESIDENT, CEO, SENIOR EXECUTIVE -TIER II, EXECUTIVE -TIER III, SENIOR LEADER (A) -TIER III, SENIOR LEADER (B) -TIER IV, LEADER (A) ORGANIZATIONAL GOALS ARE GENERALLY BASED ON THE FOLLOWING CATEGORIES AND ARE WEIGHTED THROUGH A SPLIT BETWEEN ORGANIZATIONAL AND INDIVIDUAL: -QUALITY AND SERVICE -PEOPLE AND CULTURE -PATIENT EXPERIENCE -FINANCIAL STRENGTH EACH PLAN YEAR, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD ("THE COMMITTEE"), IN ITS SOLE DISCRETION AND UNLESS OTHERWISE APPROPRIATELY DELEGATED, SELECTS PARTICIPANTS FROM A LIST OF ELIGIBLE EMPLOYEES NOMINATED BY THE CEO. THE CEO, EX OFFICIO, IS AN ELIGIBLE EMPLOYEE FOR PURPOSES OF SELECTION TO PARTICIPATE IN THE PLAN. EACH PLAN YEAR, THE COMMITTEE, BASED ON INPUT FROM THE CEO, MAY ESTABLISH A THRESHOLD AWARD, A TARGET AWARD AND/OR A MAXIMUM AWARD FOR EACH PARTICIPANT. AWARD OPPORTUNITIES ARE ESTABLISHED BASED ON COMPETITIVE MARKET PRACTICES AND ON NUVANCE HEALTH'S COMPENSATION PHILOSOPHY. AWARD OPPORTUNITIES MAY BE BASED ON ADDITIONAL FACTORS, INCLUDING NUVANCE HEALTH'S FINANCIAL AND OPERATIONAL PERFORMANCE, REFLECTING MARKET PAY PRACTICES AND BENCHMARKING FOR COMPARABLE POSITIONS, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE. EACH PLAN YEAR, THE COMMITTEE, AND UNLESS OTHERWISE APPROPRIATELY DELEGATED FOR ANY PLAN YEAR, SHALL ESTABLISH PERFORMANCE GOALS TO EVALUATE THE PERFORMANCE OF EACH PARTICIPANT. AFTER COMPLETION OF EACH PLAN YEAR, THE COMMITTEE MAY EVALUATE WHETHER THE PERFORMANCE OF NUVANCE HEALTH AND PARTICIPANT MEETS OR EXCEEDS THE PERFORMANCE GOALS ESTABLISHED FOR THE PLAN YEAR. IF PERFORMANCE WARRANTS, THE COMMITTEE MAY APPROVE A FINAL AWARD AMOUNT FOR EACH PARTICIPANT AND APPROVE ANY ADDITIONAL CONDITION ON PAYMENT OF THE AWARD. NUVANCE HEALTH EXECUTIVE LONG TERM INCENTIVE PLAN (EXCERPTS FROM): ONLY EXECUTIVES OCCUPYING DESIGNATED TIER 1 EXECUTIVE POSITIONS SHALL BE ELIGIBLE EMPLOYEES TO PARTICIPATE IN THE PLAN. UNDER THE PLAN, PARTICIPANTS WILL BE ELIGIBLE TO RECEIVE INCENTIVE AWARD PAYMENTS BASED UPON THE ACHIEVEMENT OF SELECTED AND STRATEGICALLY IMPORTANT PERFORMANCE GOALS IDENTIFIED FOR EACH PERFORMANCE PERIOD. THE AWARD OPPORTUNITIES FOR AN ELIGIBLE EMPLOYEE WITH RESPECT TO A PERFORMANCE PERIOD SHALL BE EXPRESSED AS A PERCENTAGE OF HIS OR HER AVERAGE BASE SALARY IN EFFECT DURING THE APPLICABLE PERFORMANCE PERIOD. PRIOR TO THE BEGINNING OF EACH PERFORMANCE PERIOD, THE COMMITTEE MAY ESTABLISH A MINIMUM PERFORMANCE REQUIREMENT FOR NUVANCE HEALTH. NO FINAL AWARDS MAY BE GRANTED TO ANY PARTICIPANT FOR A PERFORMANCE PERIOD IN WHICH MINIMUM PERFORMANCE REQUIREMENTS, IN ANY, WERE NOT MET. THE FINAL AWARD PAYABLE TO EACH PARTICIPANT WILL BE DETERMINED WITHIN 60 DAYS FOLLOWING THE END OF THE PERFORMANCE PERIOD. AWARDS FOR A GIVEN PERFORMANCE PERIOD WILL BE PAID IN A SINGLE LUMP-SUM ON THE PAYMENT DATE PROVIDED HOWEVER, THAT NO PAYMENT WILL BE MADE UNTIL THE RESULTS ARE VERIFIED AND AUDITED. A DUTCHESS COUNTY LOCAL DEV CORP 273106797 267045GD8 2016-07-07 24377573 CONSTRUCT & EQUIP FACILITY 0 0 0 A 3398520 24519590 334598 7760 54554 24122678 2016 0 1 1 1 A 0 1 1 1 0 0.00090 0.00090 0 0 1 A 0 0 0 1 0 0 0 0 1 A 0 PART I, LINE A, COLUMN E TOTAL ISSUE PRICE PER IRS FORM 8038: $438,672,525.55, ALLOCATED BETWEEN 3 ORGANIZATIONS: VASSAR BROTHERS MEDICAL CENTER (FEIN: 14-1338586) PUTNAM HOSPITAL (FEIN: 14-6019179) NORTHERN DUTCHESS HOSPITAL (FEIN: 14-1338467) PART II, LINE 3 THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: DUTCHESS COUNTY LOCAL DEV CORP DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2021 NOTE REGARDING THE REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF PUTNAM HOSPITAL ("PH") IS HEALTH QUEST SYSTEMS, INC. NUVANCE HEALTH IS THE SOLE MEMBER OF HEALTH QUEST SYSTEMS, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER (HEALTH QUEST SYSTEMS, INC.) SHALL ELECT PUTNAM HOSPITAL'S (PH'S) OFFICERS. SUBJECT TO THE APPROVAL OF THE MEMBER, ANY VACANCY OR VACANCIES OCCURRING IN ANY OFFICE MAY BE FILLED UNTIL THE NEXT MEETING AT WHICH OFFICERS ARE ELECTED BY THE AFFIRMATIVE VOTE OF THE REMAINING DIRECTORS IN OFFICE AT ANY MEETING OF THE BOARD, THOUGH SUCH REMAINING DIRECTORS MAY CONSTITUTE LESS THAN A QUORUM. ANY OFFICER MAY BE REMOVED AT ANY TIME WITH OR WITHOUT CAUSE BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN FUNDAMENTAL DECISIONS TO BE UNDERTAKEN BY THE CORPORATION REQUIRE THE APPROVAL OF THE MEMBER, INCLUDING BUT NOT LIMITED TO THE FOLLOWING: (I) ELECTION OR REMOVAL OF A DIRECTOR OR AN OFFICER WHO IS NOT AN EMPLOYEE OR CONTRACTOR; (II) AMENDMENT OF THE CORPORATION'S ORGANIZATIONAL DOCUMENTS; (III) ADOPTION OF OR REVISIONS TO POLICIES RELATING TO THE CONTROL AND SUPERVISION OF THE INVESTMENT OF THE CORPORATION'S FUNDS; (IV) ADOPTION OF OR AMENDMENT TO ANY OF THE CORPORATION'S QUALIFIED OR NON-QUALIFIED BENEFIT PLANS; (V) ADOPTION OF OR REVISIONS TO ANY SYSTEM-WIDE QUALITY, PERFORMANCE AND CREDENTIALING STANDARDS AND PROCEDURES; (VI) APPROVAL OF ALL AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES REVIEW OF THE SYSTEMWIDE ACCOUNTING POLICIES AND CONTROLS AND THE SELECTION OF THE INDEPENDENT AUDITORS; (VII) ADOPTION OF OR ANY MATERIAL REVISIONS TO THE CAPITAL BUDGET AND OPERATING BUDGET; (VIII) ADOPTION OF, REVISIONS TO AND OVERSIGHT OF ANY SYSTEM-WIDE POLICIES AND PRACTICES RELATING TO REGULATORY COMPLIANCE; (IX) ANY CESSATION OF ANY SERVICE LINE OWNED OR CONTROLLED DIRECTLY OR INDIRECTLY; (X) ANY CLOSURE, SALE OR TRANSFER OF A HOSPITAL; (XI) ANY ASSIGNMENT FOR THE BENEFIT OF CREDITORS, THE FILING OF ANY PETITION IN VOLUNTARY BANKRUPTCY, THE FILING OF ANY PETITION OR ANSWER SEEKING REORGANIZATION, OR AN ARRANGEMENT WITH CREDITORS UNDER THE FEDERAL BANKRUPTCY LAW; (XII) ANY CHANGE IN THE TAX STATUS OF OR REVISION OF, THE CHARITY CARE POLICIES; (XIII) ANY MERGER, CONSOLIDATION OR SIMILAR TRANSACTION; (XIV) ANY INCURRENCE, ASSUMPTION, OR GUARANTEE OF ANY DEBT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE ORGANIZATION AND A DRAFT FORM 990 IS REVIEWED BY INTERNAL MANAGEMENT. A COMPLETE DRAFT IS THEN POSTED TO AN INTRANET SITE FOR NUVANCE BOARD MEMBERS, THE ULTIMATE PARENT OF THE ORGANIZATION, TO REVIEW PRIOR TO FILING. THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, TRUSTEES/DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE, AUDIT & PRIVACY OFFICER. ALSO THEY ARE REQUIRED TO DISCLOSE ANY CONFLICT TO THE BOARD OR DIRECTLY TO THE CHAIRMAN PRIOR TO ANY MEETING. AFTER A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED ALONG WITH ALL RELATED MATERIAL FACTS, THE BOARD PROCEEDS TO DISCUSS AND DETERMINE THROUGH A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER AN ACTUAL CONFLICT OR DUALITY OF INTEREST EXISTS. IF THE INTERESTED PERSON IS PRESENT AT THE START OF THE DISCUSSION, HE OR SHE MAY ANSWER QUESTIONS RELATED TO THE MATTER AND PROVIDE ADDITIONAL, RELEVANT FACTS BUT IS REQUIRED TO LEAVE THE MEETING DURING DELIBERATIONS REGARDING WHETHER AN ACTUAL CONFLICT OR DUALITY OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 14: THE ORGANIZATION FOLLOWS A RECORD RETENTION POLICY THAT HAS BEEN APPROVED ONLY BY THE AUDIT COMMITTEE, NOT THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 15B NUVANCE HEALTH'S EXECUTIVE TOTAL REWARDS PHILOSOPHY IS DESIGNED TO ALIGN WITH THE COMPANY'S STRATEGIC DIRECTION, AND TO REINFORCE ITS CORE MISSION, VISION AND VALUES. IN ORDER TO ACHIEVE ITS OVERALL PERFORMANCE OBJECTIVES, NUVANCE HEALTH PROVIDES TOTAL REWARDS PROGRAMS THAT RECOGNIZE EXECUTIVES FOR PERFORMING WORK WELL TO ENSURE THE ACHIEVEMENT OF COMPANY GOALS. THESE PROGRAMS SERVE TO PROMOTE THE ATTRACTION, ENGAGEMENT, AND RETENTION OF TALENTED EXECUTIVES THROUGHOUT THEIR CAREERS WITH NUVANCE HEALTH. THE TOTAL REWARDS PROGRAMS ARE DESIGNED TO BE MARKET COMPETITIVE, COMPLIANT WITH REGULATORY GUIDELINES REFLECTIVE OF BEST PRACTICES, AND DIFFERENTIATED TO CREATE STRONG COMPETITIVE ADVANTAGE. TOTAL REWARDS PROGRAMS ARE REVIEWED ON AN ONGOING BASIS TO ENSURE CONTINUED MARKET COMPETITIVENESS, RELEVANT VALUE TO EXECUTIVES, AND FISCAL RESPONSIBILITY. TOTAL REWARDS FOR NUVANCE HEALTH EXECUTIVES CONSISTS OF KEY COMPONENTS OF COMPENSATION AND BENEFITS. OVERALL EXECUTIVE REWARDS PROGRAM WILL EMPHASIZE PERFORMANCE-BASED ELEMENTS, WHEREBY TARGETED LEVELS OF COMPENSATION WILL ONLY BE ACHIEVED IF THE ORGANIZATION AND INDIVIDUAL ACHIEVE STRETCH GOALS AND OBJECTIVES. BASED ON THE LABOR MARKETS FOR TALENT FOR EXECUTIVE ROLES, NUVANCE HEALTH WILL UTILIZE A WEIGHTED BLEND OF BOTH NATIONAL COMPARABLY SIZED HEALTH CARE PROVIDER MARKET DATA WITH A +30% GEOGRAPHIC DIFFERENTIAL APPLIED (DIFFERENTIAL TO BE VALIDATED ON A PERIODIC BASIS) AT TWO-THIRDS WEIGHT AND NATIONAL COMPARABLY SIZED GENERAL INDUSTRY DATA, FOR IDENTIFIED ROLES WHERE SKILL SETS OVERLAP AT ONE-THIRD WEIGHT. GEOGRAPHIC DIFFERENTIAL REFLECTS THE OBSERVED AND REPORTED COMPENSATION DIFFERENTIAL BETWEEN NUVANCE HEALTH'S OPERATING REGION AND THE BROADER NATIONAL HEALTH CARE PROVIDER MARKET. NUVANCE HEALTH'S TOTAL REWARDS PHILOSOPHY AND PRACTICES ARE TARGETED AT THE 50TH PERCENTILE OF THE RELEVANT MARKET FOR BASE SALARY, AND 75TH PERCENTILE FOR TOTAL CASH AND TOTAL DIRECT (WHERE AVAILABLE) COMPENSATION ELEMENTS IF TARGET PERFORMANCE IS ACHIEVED UNDER VARIABLE COMPENSATION PROGRAMS. NUVANCE HEALTH'S COMMITTEE HAS DISCRETION TO POSITION INDIVIDUAL LEVELS ABOVE OR BELOW THIS TARGETED COMPETITIVE POSITIONING, BASED ON SUCH FACTORS AS POSITIONING TO MARKET, HIGH DEMAND SKILLSETS AND DIFFICULT TO FILL OR CRITICAL TO THE ORGANIZATION'S STRATEGY AND SUCCESS. OUR GOVERNANCE PROMOTES CONSISTENCY AND EQUITY; PROVIDES CLARITY AND GUIDANCE TO DECISION-MAKERS; ENSURES STANDARD PROCESSES AND PROCEDURES FOR ASSESSING, CALIBRATING, ADMINISTERING, AND DELIVERING EFFECTIVE TOTAL REWARDS THROUGHOUT THE NUVANCE HEALTH SYSTEM. OVERSIGHT AND GOVERNANCE OF THE EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAMS FOR ELIGIBLE EXECUTIVES/DISQUALIFIED INDIVIDUALS (CURRENTLY CEO, PRESIDENT AND TIERS 1 AND 2) WILL BE AT THE COMPENSATION COMMITTEE OF THE BOARD LEVEL AND WILL FOLLOW A STRUCTURED AND RIGOROUS PROCESS TO ENSURE COMPLIANCE WITH INTERMEDIATE SANCTIONS UNDER IRS GUIDELINES. FORM 990, PART VI, SECTION C, LINE 19 POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILING SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS. FORM 990, PART VII (ADDT'L INFORMATION) FOR THOSE OFFICERS AND TOP 5 EMPLOYEES, FOR WHICH ONLY 40 HOURS IS NOTED TO REFLECT PAID HOURS, ACTUAL HOURS WORKED EXCEEDED THIS AMOUNT. NOTE: ALL AMOUNTS IN COLUMN F, OF PART VII, "ESTIMATED AMOUNT OF OTHER COMPENSATION", REPRESENTS BENEFITS, AND DO NOT REFLECT ANY COMPENSATION FOR WHICH THE AVERAGE AMOUNT OF TIME WORKED CAN BE REFLECTED. FORM 990, PART XI, LINE 9: ADDITIONAL PENSION LIABILITY 10,503,587. CUMULATIVE EFFECT ADJUSTMENT UPON THE ADOPTION OF ASC 842, LEASES -124,434. CHANGE IN EQUITY INTEREST IN THE FOUNDATIONS 6,404,876. RECLASSIFICATION OF NET ASSET GL ACCOUNTS UPON GL SYSTEM CONVERSION -299,880. FORM 990, PART XI, LINE 8: ($7,098,639) IS REPORTED ON FORM 990, PART XI, LINE 8 AS A PRIOR PERIOD ADJUSTMENT. DURING THE TAX YEAR, NUVANCE HEALTH (THE ULTIMATE PARENT COMPANY, RECENTLY FORMED BY THE MERGER OF TWO HEALTH SYSTEMS) WAS FINALIZING THE ALIGNMENT OF ACCOUNTING POLICIES AND PROCEDURES ACROSS THE ENTITIES WITHIN THE HEALTH SYSTEM. AS A RESULT, IT WAS DETERMINED THE HISTORICAL ACCOUNTING USED TO REPRESENT THE INTEREST PHC HELD IN THE SUPPORTING FOUNDATION (PUTNAM HOSPITAL CENTER FOUNDATION) NEEDED TO BE ADJUSTED. THIS HAD NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS OF NUVANCE HEALTH AS A WHOLE, AS PUTNAM HOSPITAL CENTER'S INTEREST IN THE FOUNDATION IS ELIMINATED IN CONSOLIDATION. AS A RESULT, A ONE-TIME CORRECTING ENTRY WAS RECORDED TO TRUE UP THE INTEREST IN THE FOUNDATION RECORDED ON PUTNAM HOSPITAL CENTER'S BALANCE SHEET. ALAMO AMBULANCE SERVICES INC 45 READE PLACE POUGHKEEPSIE NY 12601 141745417 TRANSPORTATION NY 501(C)(3) 12, TYPE III-FI HQ 1 DANBURY HOSP & NEW MILFORD HOSP FDN INC 24 HOSPITAL AVENUE DANBURY CT 06810 237425557 FUNDRAISING CT 501(C)(3) 7 WCHN 1 DANBURY HOSPITAL 24 HOSPITAL AVENUE DANBURY CT 06810 060646597 ACUTE CARE CT 501(C)(3) 3 WCHN 1 EASTERN NEW YORK MEDICAL SERVICES PC 100 RESERVE ROAD DANBURY CT 06810 455431389 PHYSICIAN SERVICES NY 501(C)(3) 10 WCHN 1 HEALTH QUEST HOME CARE (CERTIFIED) 45 READE PLACE POUGHKEEPSIE NY 12601 141788412 HOME HEALTH NY 501(C)(3) 10 HQ 1 HEALTH QUEST HOME CARE (LICENSED) 45 READE PLACE POUGHKEEPSIE NY 12601 141788410 HOME HEALTH NY 501(C)(3) 10 HQ 1 NUVANCE HEALTH MEDICAL PRACTICE PC 45 READE PLACE POUGHKEEPSIE NY 12601 562669185 MEDICAL CARE NY 501(C)(3) 10 HQ 1 HEALTH QUEST SYSTEMS INC 45 READE PLACE POUGHKEEPSIE NY 12601 141678068 MANAGEMENT NY 501(C)(3) 10 NUVANCE 1 HEALTH QUEST URGENT MEDICAL PRACTICE PC 45 READE PLACE POUGHKEEPSIE NY 12601 800152047 MEDICAL CARE NY 501(C)(3) 10 HQ 1 HUDSON VALLEY CARDIOVASCULAR PRACTICE PC 45 READE PLACE POUGHKEEPSIE NY 12601 463756713 MEDICAL CARE NY 501(C)(3) 10 HQ 1 NDH FOUNDATION 6531 SPRINGBROOK AVENUE RHINEBECK NY 12572 141776208 FUNDRAISING NY 501(C)(3) 7 HQ 1 NORTHERN DUTCHESS HOSPITAL 6511 SPRINGBROOK AVENUE RHINEBECK NY 12572 141338467 HOSPITAL NY 501(C)(3) 3 HQ 1 NORTHERN DUTCHESS RES HEALTHCARE FACILITY 6526 SPRINGBROOK AVENUE RHINEBECK NY 12572 223129608 NURSING HOME NY 501(C)(3) 10 HQ 1 NORWALK HOSPITAL FOUNDATION 34 MAPLE STREET NORWALK CT 06856 222577707 FUNDRAISING CT 501(C)(3) 7 WCHN 1 NUVANCE HEALTH 45 READE PLACE POUGHKEEPSIE NY 12601 834214573 SUPPORT NY 501(C)(3) 12, TYPE III-FI N/A 0 NUVANCE HEALTH MEDICAL PRACTICE CT INC 100 RESERVE ROAD DANBURY CT 06810 061137531 PHYSICIAN SERVICES CT 501(C)(3) 10 WCHN 1 PUTNAM HOSPITAL CENTER FOUNDATION 670 STONELEIGH AVENUE CARMEL NY 10512 061399319 FUNDRAISING NY 501(C)(3) 12, TYPE I HQ 1 THE NORWALK HOSPITAL ASSOCIATION 24 STEVENS STREET NORWALK CT 06850 066068853 HEALTH SERVICES CT 501(C)(3) 3 WCHN 1 VASSAR BROTHERS HOSPITAL FOUNDATION 45 READE PLACE POUGHKEEPSIE NY 12601 141736429 FUNDRAISING NY 501(C)(3) 7 HQ 1 VASSAR BROTHERS MEDICAL CENTER 45 READE PLACE POUGHKEEPSIE NY 12601 141338586 HOSPITAL NY 501(C)(3) 3 HQ 1 VASSAR HEALTH CONNECTICUT INC 50 HOSPITAL HILL ROAD SHARON CT 06069 815056290 HOSPITAL CT 501(C)(3) 3 HQ 1 WELLS MANOR HOUSING DEVELOPMENT FUND CORP 56 ASTOR DRIVE RHINEBECK NY 12572 112611902 LOW INCOME NY 501(C)(3) PRIVATE FOUNDATION HQ 1 WESTERN CONNECTICUT HOME CARE INC 100 SAW MILL ROAD DANBURY CT 06810 060655138 HOME HEALTHCARE CT 501(C)(3) 10 WCHN 1 WESTERN CT HEALTH NETWORK AFFILIATES INC 95 LOCUST AVENUE DANBURY CT 06810 222594968 OUTPATIENT HEALTHCARE SERVICES CT 501(C)(3) 10 WCHN 1 WESTERN CT HEALTH NETWORK INC 24 HOSPITAL AVENUE DANBURY CT 06810 222594977 PROGRAM DEVELOPMENT CT 501(C)(3) 12 TYPE II NUVANCE 1 NEW MILFORD MRI LLC 21 ELM STREET NEW MILFORD CT 06776 271877801 INACTIVE CT N/A N/A 0 0 NORWALK SURGERY CENTER LLC 40 CROSS STREET STE 120 NORWALK CT 06851 272394942 SURGERY CENTER CT N/A N/A 0 0 WCHN INVESTMENTS LLC 24 HOSPITAL AVE DANBURY CT 06810 475523212 INVESTMENTS CT N/A N/A 0 0 NUVANCE HEALTH INSURANCE COMPANY LTD 23 LIME TREE BAY PO BOX 105 GRAND CAYMAN CJ 980438151 MALPRACTICE CJ N/A C 0 SWC CORPORATION 24 STEVENS STREET NORWALK CT 06850 222577718 PHARMACY CT N/A C 0 TACONIC IPA INC 1351 ROUTE 55 LAGRANGEVILLE NY 12540 223007320 MEDICAL CARE NY N/A C 0 VASSAR HQ MED PRACTICE OF CT INC 100 RESERVE ROAD DANBURY CT 06810 821466583 MEDICAL CARE CT N/A C 0 ADVANCED CTR FOR REHAB MED 24 STEVENS STREET NORWALK CT 06850 061304799 INACTIVE CT N/A C 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 HEALTH QUEST MEDICAL PRACTICE PC Q 80614 COST METHOD HEALTH QUEST MEDICAL PRACTICE PC M 11273655 COST METHOD HEALTH QUEST MEDICAL PRACTICE PC L 7453193 COST METHOD VASSAR HEALTH CONNECTICUT INC L 147805 COST METHOD VASSAR HEALTH CONNECTICUT INC M 298248 COST METHOD NORTHERN DUTCHESS HOSPITAL P 465370 COST METHOD NORTHERN DUTCHESS HOSPITAL M 303642 COST METHOD VASSAR BROTHERS MEDICAL CENTER P 1211782 COST METHOD VASSAR BROTHERS MEDICAL CENTER M 1656741 COST METHOD NUVANCE HEALTH P 12931870 COST METHOD NUVANCE HEALTH M 18017104 COST METHOD NUVANCE HEALTH Q 100858 COST METHOD NUVANCE HEALTH L 17548997 COST METHOD WESTERN CONNECTICUT HEALTH NETWORK INC P 41119086 COST METHOD WESTERN CONNECTICUT HEALTH NETWORK INC M 41136910 COST METHOD HUDSON VALLEY CARDIOVASCULAR PRACTICE PC L 396474 COST METHOD HEALTH QUEST SYSTEMS INC P 16917367 COST METHOD HEALTH QUEST SYSTEMS INC R 168918 COST METHOD HEALTH QUEST SYSTEMS INC L 16164858 COST METHOD HEALTH QUEST SYSTEMS INC Q 233261 COST METHOD HEALTH QUEST SYSTEMS INC J 229872 COST METHOD HEALTH QUEST SYSTEMS INC M 30140770 COST METHOD DANBURY HOSPITAL P 2411391 COST METHOD DANBURY HOSPITAL M 13427595 COST METHOD DANBURY HOSPITAL Q 177356 COST METHOD PUTNAM HOSPITAL FOUNDATION L 753775 COST METHOD PUTNAM HOSPITAL FOUNDATION C 2873384 COST METHOD