2022-11-10T14:53:23-06:00 2021-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2021-01-01 160743192 SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY INC SOLD 3157874030 418 NORTH MAIN STREET PENN YAN NY 14527 TRISHA KOCZENT CFO 3157874030 2022-11-10 1 TRISHA KOCZENT XXX-XX-XXXX AIMEE J JOZIC P01346943 5853811000 2022-11-09 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JOSE ACEVEDO MD MBA 418 NORTH MAIN STREET PENN YAN NY 14527 38461311 0 X WWW.FLHEALTH.ORG X 1924 NY SOLDIERS AND SAILORS MEMORIAL HOSPITAL IS A COMMUNITY BASED, NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF ALL PEOPLE IN THE CENTRAL FINGER LAKES REGION. WE ARE COMMITTED TO SAFE, HIGH QUALITY, COMPASSIONATE SERVICES THAT ARE CONVENIENT, ACCESSIBLE AND AT REASONABLE COST, THROUGH THE EFFORTS OF OUR EMPLOYEES, MEDICAL STAFF AND VOLUNTEERS. WE ARE A CENTER FOR HEALTH EDUCATION THAT LIVES ITS LEADERSHIP COMMITMENTS THROUGH PARTICIPATION IN AND SPONSORSHIP OF PROFESSIONAL, ALLIED HEALTH AND COMMUNITY HEALTH EDUCATION PROGRAMS. 17 15 460 15 0 0 10965945 2708335 24978321 35172564 669254 464316 30292 64890 36643812 38410105 0 0 0 0 19630111 23069427 0 0 0 9663245 15264311 29293356 38333738 7350456 76367 58295882 51512161 20868180 10640311 37427702 40871850 X SOLDIERS AND SAILORS MEMORIAL HOSPITAL IS A COMMUNITY BASED, NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL DEDICATED TO MAINTAINING AND IMPROVING THE HEALTH OF ALL PEOPLE IN THE CENTRAL FINGER LAKES REGION. WE ARE COMMITTED TO SAFE, HIGH QUALITY, COMPASSIONATE SERVICES THAT ARE CONVENIENT, ACCESSIBLE AND AT REASONABLE COST, THROUGH THE EFFORTS OF OUR EMPLOYEES, MEDICAL STAFF AND VOLUNTEERS. WE ARE A CENTER FOR HEALTH EDUCATION THAT LIVES ITS LEADERSHIP COMMITMENTS THROUGH PARTICIPATION IN AND SPONSORSHIP OF PROFESSIONAL, ALLIED HEALTH AND COMMUNITY HEALTH EDUCATION PROGRAMS. 0 0 4485135 4780724 PATIENT SERVICE PROGRAM: INPATIENT, SOLDIERS & SAILORS MEMORIAL HOSPITAL OPERATES A 25-BED GENERAL ACUTE CARE HOSPITAL INCLUDING 3-BED INTENSIVE CARE UNIT, MEDICAL-SURGICAL AND TELEMETRY UNITS AND A 10-BED IN-PATIENT PSYCHIATRIC UNIT. 17144010 20238234 PATIENT SERVICE PROGRAM: OUTPATIENT, A FULL RANGE OF DIAGNOSTIC AND TREATMENT SERVICES ARE AVAILABLE AT SOLDIERS & SAILORS MEMORIAL HOSPITAL. WE ARE DEDICATED TO PROVIDING A COMPREHENSIVE ARRAY OF HEALTHCARE SERVICES TO PEOPLE IN THE FINGER LAKES REGION. 9525814 10153606 PATIENT SERVICE PROGRAM: LONG TERM CARE, SOLDIERS & SAILORS MEMORIAL HOSPITAL OPERATES A 130-BED SKILLED NURSING FACILITY AND A 20-BED LONG-TERM BEHAVIORAL INTERVENTION SERVICE. 31154959 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 460 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 15 1 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X TRISHA KOCZENT 3157874000 196 NORTH STREET GENEVA NY 14456 LANCE WARD DIRECTOR 1.00 4.00 X 0 0 0 KYLENE ABRAHAM DNP DIRECTOR 1.00 4.00 X 0 0 0 MENZO CASE VICE CHAIR 2.00 8.00 X X 0 0 0 CHEVANNE DEVANEY DIRECTOR 1.00 4.00 X 0 0 0 RYAN HALLINGS SECRETARY 1.00 4.00 X 0 0 0 SUSAN STORK DIRECTOR 1.00 4.00 X 0 0 0 JAMES CHENEY DIRECTOR 1.00 4.00 X 0 0 0 JOHN HICKS DIRECTOR 1.00 4.00 X 0 0 0 ANN MCMULLEN DIRECTOR 1.00 4.00 X 0 0 0 RODOLFO QUEIROZ MD DIRECTOR 1.00 4.00 X 0 0 0 CRAIG DENSMORE DIRECTOR 1.00 4.00 X 0 0 0 PHIL BECKLEY CHAIR 2.00 8.00 X X 0 0 0 TOM BURRALL DIRECTOR 1.00 4.00 X 0 0 0 JOSE A ACEVEDO MD PRESIDENT & CEO 6.00 34.00 X X 0 794360 155495 JEFFREY MORGAN TREASURER & CFO THRU MAY 2021 6.00 34.00 X X 0 0 0 ROBERT ANDERSON MD DIRECTOR 1.00 39.00 X 236049 0 16657 SCOTT MOONEY MD DIRECTOR 1.00 4.00 X 0 0 0 TRISHA KOCZENT TREASURER & CFO FROM JUNE 2021 6.00 34.00 X X 0 179165 1564 JAMES NARDOZZI DIRECTOR 1.00 4.00 X 0 0 0 JASON S FEINBERG MD CHIEF MEDICAL OFFICER 8.00 32.00 X 0 435060 38755 FRANK M KORICH CHIEF OPERATING OFFICER 8.00 32.00 X 0 368284 48444 ARDELLE BIGOS VICE PRESIDENT NURSING 16.00 24.00 X 0 297648 17011 WENDY DISBROW VP PHYS. NETWORK 8.00 32.00 X 0 232546 2750 CHAD M HOFFMAN-FRAGALE VP HUMAN RESOURCES 7.60 32.40 X 0 226134 8963 LUKE B CHEN MD PHYSICIAN 40.00 X 311897 0 5192 DOUGLAS M SINCLAIR MD PHYISCIAN ED 40.00 X 357091 0 9429 TAMARA A PRULL MD PHYISCIAN ED 40.00 X 397075 0 3625 JEFFREY D CHRISTENSON MD PHYSICIAN 40.00 X 262161 0 3375 SIXTO R MEDINA MD PHYSICIAN 40.00 X 309770 0 0 1874043 2533197 311260 23 0 1 0 0 242674 2322966 142695 2708335 PATIENT SERVICE REVENUE 621990 33208203 33208203 1964361 1964361 35172564 489919 489919 25603 51206 -25603 -25603 -25603 OTHER REVENUE 900099 64890 64890 64890 38410105 35172564 0 529206 252706 252706 19702959 18582451 1120508 231504 214784 16720 1811477 1688135 123342 1070781 989305 81476 603759 175166 428593 107196 2070 105126 69709 69709 55750 55720 30 110928 41175 69753 296087 233403 62684 602218 190516 411702 823786 740222 83564 31942 30738 1204 45100 45100 2036121 1934315 101806 435690 54271 381419 PURCHASED SERVICES 4539795 3492659 1047136 SHARED SERVICES 2529152 2529152 SUPPLIES 1442247 1366175 76072 NYS ASSESSMENT TAX 622814 622814 912017 741040 170977 38333738 31154959 7178779 0 34838 40507 9282829 6183446 2838311 3637269 1280275 998997 297955 370344 459637 332097 73558462 57411876 15699827 16146586 20816658 20050820 3648779 3545922 3936773 206173 58295882 51512161 2999746 3606881 6815102 6359606 132403 206173 986989 9933940 467651 20868180 10640311 X 37427702 40871850 37427702 40871850 58295882 51512161 76367 1360193 2007588 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7515 7515 0 PART II-B, LINE 1: PORTION OF ASSOCIATION DUES ATTRIBUTED TO LOBBYING EXPENSES. 0 1 X 517764 517764 27648689 20390854 7257835 2373393 2060972 312421 43018616 34960050 8058566 16146586 LONG TERM DUE TO AFFILIATE 746749 BLUE CROSS (BCR) ADVANCE 2005 394000 DUE TO AFFILIATE -1465079 ADVANCE MEDICARE PAYMENTS 791981 467651 PART IV, LINE 2B: SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY HOLDS AGENCY FUNDS FOR THE CONVENIENCE OF ITS RESIDENTS. 1 1 X 1 X 1 X 1 1 0 1 1 388453 388453 0.01010 13582057 12425701 1156356 0.03020 13970510 12425701 1544809 0.04030 32770 32770 0.00090 6527196 2585664 3941532 0.10280 6559966 2585664 3974302 0.10370 20530476 15011365 5519111 0.14400 24611 24611 0.00060 1321 1321 0.00000 2939 2939 0.00010 50006 50006 0.00130 78877 78877 0.00200 1 859797 413317 4163957 4048357 115600 X 1 1 1 1 SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY INC 418 NORTH MAIN STREET PENN YAN NY 14527 6120700H X X X X SOLDIERS AND SAILORS MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X WWW.FLHEALTH.ORG X 1 19 1 WWW.FLHEALTH.ORG 0 1 X 100.000000000000 200.000000000000 X X X X X 1 1 X X X X 1 X WWW.FLHEALTH.ORG X WWW.FLHEALTH.ORG X WWW.FLHEALTH.ORG X X X X X X 1 X X 0 1 X 1 0 PART V, SECTION A: SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY:PART V, SECTION B, LINE 5: THE ONTARIO, SENECA AND YATES COUNTY PUBLIC HEALTH DEPARTMENTS, IN COLLABORATION WITH FINGER LAKES HEALTH, OTHER HOSPITALS, THE S2AY RURAL HEALTH NETWORK (NOW PIVITAL HEALTH), COMMON GROUND HEALTH AND THE COMMUNITY BASED AGENCIES CONDUCTED SURVEYS OF RESIDENTS IN ONTARIO, YATES AND SENECA COUNTIES THROUGH THE COMMUNITY HEALTH NEEDED ASSESSMENT PROCESS. SURVEYS WERE DISSEMINATED THROUGH MANY DIFFERENT METHODS INCLUDING E-MAIL, WEB PAGES, MAILING OF PAPER COPIES, DISSEMINATION OF PAPER COPIES IN LOCAL STORES, HEALTH CARE FACILITIES, PUBLIC HEALTH AND COMMUNITY FACILITIES, AND DIRECT ASSISTANCE WITHIN COUNTY BUILDINGS/AGENCIES. FINGER LAKES HEALTH INVITED PUBLIC PARTICIPATION IN THE NEEDED ASSESSMENT THROUGH THRIVE, OUR COMMUNITY HEALTH MAGAZINE. THRIVE IS MAILED TO MORE THAN 90,000 HOUSEHOLDS IN THE HEALTH SYSTEM'S SERVICE AREA. FURTHER INPUT FROM THE PUBLIC WAS COLLECTED THROUGH A NUMBER OF FOCUS GROUP SESSIONS THAT WERE HELD THROUGHOUT THE COUNTIES. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:SOLDIERS & SAILORS MEMORIAL HOSPITAL'S ("SSMH") COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH:1. PHYSICAL IMPROVEMENTS AND HOUSING:N/A2. ECONOMIC DEVELOPMENT:SSMH SUPPORTS ECONOMIC DEVELOPMENT IN THE COMMUNITY THROUGH:PAYMENT OF DUES TO THE YATES COUNTY CHAMBER OF COMMERCE TO SUPPORT ECONOMIC DEVELOPMENT INITIATIVES.3. COMMUNITY SUPPORT:TO BE EQUIPPED FOR DISASTER SITUATIONS, SSMH PARTICIPATES IN EMERGENCY PREPAREDNESS/DISASTER READINESS ACTIVITIES, INCLUDING DISASTER DRILLS; STOCKPILING ESSENTIAL SUPPLIES FOR USE DURING A DISASTER; TRAINING STAFF FOR DISASTERS; AND CONDUCTING POD EVENTS AS TRAINING IN THE EVENT OF A DISASTER REQUIRING MASS IMMUNIZATIONS.4. ENVIRONMENTAL IMPROVEMENTS:SSMH ACCEPTS SHARPS FROM COMMUNITY HOUSEHOLDS AND PROVIDES PROPER DISPOSAL OF SAME AT NO COST TO THE HOUSEHOLDS.5. COALITION BUILDING:FINGER LAKES HEALTH, WHICH INCLUDES SSMH, ADMINISTRATIVE TEAM MEMBERS PARTICIPATE IN MULTIPLE COMMUNITY ORGANIZATIONS/PARTNERSHIPS FOR THE BETTERMENT OF THE COMMUNITIES IT SERVES.6. WORKFORCE DEVELOPMENT:-SHADOWING OPPORTUNITIES FOR HIGH SCHOOL STUDENTS.7. NEGATIVE MARGINS:SSMH PROVIDES MENTAL HEALTH OUTPATIENT PROGRAMS, AMBULATORY SURGERY, EMERGENCY AND CLINICAL SERVICES AS WELL AS BEHAVIORAL PROGRAMS AT AN OPERATING LOSS TO IMPROVE THE WELLBEING OF THE COMMUNITY.ALSO, SSMH COMMUNITY SERVICES STAFF TIME IS DEVOTED TO PLANNING AND IMPLEMENTING COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLANS AND IMPLEMENT RESPONSES. PART III, LINE 2: PART III, SECTION A, 3COSTING METHODOLOGY:HFMA P&P BOARD STATEMENT 15, IX. VALUATION AND DISCLOSURE OF BAD DEBTS, 9.1 HAS BEEN APPLIED TO THE AMOUNT REPORTED ON LINE 2. THE BAD DEBT AMOUNT IS RECORDED AT THE AMOUNT THAT THE PAYER IS EXPECTED TO PAY. THE AMOUNT REPORTED ON LINE 3 IS VALUED AT PATIENT CARE COSTS, I.E. THE EXPECTED PAYMENT AMOUNT INCLUDED IN LINE 2 HAS BEEN MULTIPLIED BY THE RATIO OF PATIENT CARE COST TO CHARGES (48.1%). BASED UPON AN ANALYSIS OF INCOME LEVELS FOR ACCOUNTS INCLUDED IN BAD DEBTS WERE ESTIMATED THAT 51% WERE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE PROGRAM. PART III, LINE 3: IT IS NOT ALWAYS POSSIBLE TO OBTAIN SUFFICIENT INFORMATION TO MAKE A DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE OR RECLASSIFY BAD DEBTS AS CHARITY CARE. WHEN INCOME LEVELS ARE LEARNED WE IDENTIFY INDIVIDUALS UNABLE TO PAY FOR SERVICES. HAVING PROVIDED SERVICES TO THOSE INDIVIDUALS WE BELIEVE REPRESENTS A COMMUNITY BENEFIT. PART III, LINE 4: ALLOWANCE FOR DOUBTFUL ACCOUNTS:SSMH ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS TO BE RECOGNIZED IN THE FINANCIALSTATEMENTS BY ANALYZING RESIDENT ACCOUNTS FOR COLLECTABILITY AND APPLYING HISTORICALLYESTABLISHED PERCENTAGES FOR SELF-PAY AND VARIOUS THIRD-PARTY PAYORS TO THE AGING CATEGORIES INTHE ACCOUNTS RECEIVABLE AGING. ACCOUNTS FOR WHICH PAYMENTS HAVE NOT BEEN RECEIVED FOR ASIGNIFICANT AMOUNT OF TIME ARE CONSIDERED DELINQUENT AND THE ACCOUNT IS WRITTEN OFF WHENCUSTOMARY COLLECTION EFFORTS ARE EXHAUSTED.THE HOSPITAL HAS EXPERIENCED AN INCREASE IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AS A RESULT OFAN INCREASE IN AGED RECEIVABLES. PART VI, LINE 2: FINGER LAKES HEALTH ("FLH") BELIEVES THAT HEALTHCARE CONSUMERS TAKING ACTIVE RESPONSIBILITY FOR THEIR OWN HEALTH IS THE SINGLE MOST VITAL ASPECT TO IMPROVING THE QUALITY OF HEALTHCARE AND TO HAVING HEALTHIER INDIVIDUALS AND HEALTHIER COMMUNITIES. FLH HAS LONG RECOGNIZED THE IMPORTANCE OF SOCIAL DETERMINANTS OF HEALTH AND THE VALUE OF POPULATION HEALTH. FLH'S GOAL AS A HEALTHCARE PROVIDER, IS TO BE A VITAL PARTNER WITH HEALTHCARE CONSUMERS (OUR PATIENTS) TO ENCOURAGE AWARENESS AND DIALOGUE ABOUT MODIFIABLE RISK FACTORS, OUTLINE THE PATH AND PROVIDE NECESSARY SUPPORT TO ACHIEVE GOOD HEALTH OUTCOMES, AND POSITIVELY IMPACT THE HEALTH OF THE COMMUNITIES WE SERVE.WE ARE DEVELOPING INITIATIVES, AND DESIGNING OUR FACILITIES WITH PATIENT-CENTERED, EVIDENCE-BASED OUTCOME DRIVEN GOALS IN MIND. OUR TEAM HAS BEEN WORKING TO ACHIEVE THE BEST QUALITY CARE OUTCOMES TO KEEP PATIENTS HEALTHY AND TO DEVELOP PREVENTION-ORIENTED PROGRAMS AIMED AT CREATING AND SUSTAINING HEALTHY COMMUNITIES. WE BASE PROGRAMMING ON AREAS OF HEALTH AND WELLNESS THAT MATTER MOST IN OUR COMMUNITIES. THAT IS DETERMINED BY CONDUCTING HEALTH NEEDS ASSESSMENTS IN OUR COMMUNITIES. FLH COLLABORATES WITH PUBLIC HEALTH DEPARTMENTS IN OUR SERVICE AREA, AS WELL AS THE S2AY RURAL HEALTH NETWORK (NOW PIVITAL HEALTH), COMMON GROUND HEALTH, AND OTHER HUMAN SERVICES PROVIDERS IN OUR SERVICE AREA, TO USE THE FRAMEWORK OF THE NYS HEALTH COMMISSIONER'S "PREVENTION AGENDA" AS A BASIS FOR OUR COMMUNITY HEALTH PLANNING. WE WORKED TOGETHER TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2018-2019 AND ESTABLISH HEALTH PRIORITIES FOR 2019-2021. BY DRAWING UPON THE STATE'S PREVENTION AGENDA, STUDYING DATA COLLECTED THROUGH PRIMARY AND SECONDARY RESEARCH, AND PARTNERING WITH LOCAL HEALTH DEPARTMENTS IN ONTARIO, SENECA AND YATES COUNTIES, WE IDENTIFIED HEALTH PRIORITIES AND SUBSEQUENT COMMUNITY OUTREACH INITIATIVES TO ALIGN WITH THOSE PRIORITIES.TOOLS USED TO CONDUCT THE CHNA, INCLUDED:-DISEASE PREVALENCE DATA-SOCIO-ECONOMIC FACTORS IN THE REGION-BRFSS - BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM CENSUS-A SURVEY IN OUR THRIVE COMMUNITY HEALTH MAGAZINE, CIRCULATED TO 90,000 HOUSEHOLDS IN OUR SERVICE AREA, SEEKING COMMENTS ON THE MOST CRITICAL HEALTH CARE NEEDS IN THE COMMUNITY.-FOCUS GROUPS DONE IN COOPERATION WITH OUR COUNTY PARTNERS TARGETING SPECIFIC POPULATIONS.AS A RESULT OF THIS DATA AND COMMENT ANALYSIS, THE MOST HIGHLY RANKED HEALTH PRIORITIES WERE IDENTIFIED FOR EACH COUNTY, AS NOTED BELOW:FOR ONTARIO COUNTY:-HYPERTENSION-SUBSTANCE ABUSE-OBESITYFOR SENECA COUNTY:-HYPERTENSION-OBESITY-SUBSTANCE ABUSEFOR YATES COUNTY:-CEREBROVASCULAR DISEASE (HYPERTENSION)-BEHAVIORAL HEALTH (SUBSTANCE ABUSE AND MENTAL HEALTH)-OBESITYWE THEN DEVELOPED COMMUNITY SERVICE PLANS (CSP) COMMUNITY HEALTH IMPROVEMENT PLANS (CHIPS) FOR EACH COUNTY OUTLINING ACTION STEPS TO ADDRESS AND TARGET THE PRIORITIES.AS PART OF OUR COMMUNITY SERVICE PLAN TO TARGET THE PRIORITIES, FLH:HAS ALL OF ITS PRIMARY CARE PHYSICIAN PRACTICES PARTICIPATING IN THE REGIONAL BLOOD PRESSURE REGISTRY BEING OVERSEEN BY COMMON GROUND HEALTH IN AN EFFORT TO INCREASE THE PERCENTAGE OF PATIENTS WITH HYPERTENSION WHO HAVE CONTROLLED THEIR BLOOD PRESSURE.PROVIDES EDUCATIONAL HEALTH INFORMATION ON TOPICS SUCH AS STROKE SYMPTOMS, DIABETES PREVENTION, HYPERTENSION, AND OTHERS, IN ITS COMMUNITY HEALTH MAGAZINE THRIVE, WHICH IS MAILED TO MORE THAN 90,000 HOMES IN OUR SERVICE AREA TWICE EACH YEAR. OFFERS "FINGER LAKES HEALTH MATTERS", AN EDUCATIONAL RADIO SHOW THAT AIRS MULTIPLE TIMES EACH YEAR ON THE REGIONAL FINGER LAKES RADIO NETWORK FEATURING FINGER LAKES HEALTH PROFESSIONALS SPEAKING TO A WIDE RANGE OF HEALTH TOPICS, INCLUDING STROKE, DIABETES, WEIGHT LOSS, AND OTHERS.GENEVA GENERAL HOSPITAL IS A JOINT COMMISSION ACCREDITED AND NEW YORK STATE-DESIGNATED STROKE CENTER. PROVIDERS CONDUCT STROKE EDUCATION, IN ADDITION TO THE SUPPORT GROUP, ON A REGULAR SCHEDULE FOR EMERGENCY MEDICAL SERVICES PROVIDERS IN OUR SERVICE AREA, AS WELL AS FOR GENERAL COMMUNITY MEMBERS. THE EDUCATION COVERS SIGNS AND SYMPTOMS, AS WELL AS RISK FACTORS AND PREVENTION INFORMATION.BLOOD PRESSURE SCREENINGS ARE OFFERED BY THE ACUTE REHAB UNIT AT GENERAL AND HEALTH SYSTEM STAFF AT THE COMMUNITY LUNCH PROGRAM IN GENEVA, AS WELL AS AT WORK PLACES OR SPECIAL EVENTS, AS REQUESTED BY COMMUNITY ORGANIZATIONS. PART VI, LINE 3: FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S POLICY IS AVAILABLE TO ASSIST UNINSURED OR UNDERINSURED MEMBERS OF OUR COMMUNITY WHO ARE WILLING BUT UNABLE TO PAY IN FULL FOR THEIR CARE. THE PROGRAM ALLOWS A PERSON TO RECEIVE MEDICALLY NECESSARY AND EMERGENCY SERVICES AT NO CHARGE OR REDUCED CHARGES WHEN THEY MEET CERTAIN ELIGIBILITY REQUIREMENTS. INFORMATION ABOUT THE SERVICES IS AVAILABLE THROUGH SIGNAGE AND APPLICATIONS PLACED IN THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, AND THE PATIENT ACCOUNTS OFFICE. WE HAVE ALSO PUBLISHED THIS INFORMATION IN DIRECT MAIL SENT TO AREA HOMES AND ALSO PROMOTED THE PROGRAM ON OUR LOCAL RADIO SHOW. THE HOSPITAL'S WEBSITE CONTAINS INFORMATION ON FINANCIAL ASSISTANCE. PART VI, LINE 4: SSMH PROVIDES A FULL RANGE OF ACUTE CARE SERVICES TO RESIDENTS OF THE FINGER LAKES REGION IN UPSTATE NEW YORK. THE HOSPITAL REVIEWS DEMOGRAPHIC DATA FROM SOURCES SUCH AS THE US CENSUS TO IDENTIFY TRENDS. THE HOSPITAL USES HEALTH INDICATORS AND UTILIZATION DATA FROM NUMEROUS SOURCES AND RECEIVES COMMUNITY INPUT FROM PUBLIC SURVEYS. WE HAVE A COMMUNITY ADVISORY COMMITTEE WHICH SERVES AS A REGULAR FORUM FOR COMMUNITY INPUT AND FOSTERING COLLABORATION. WE GATHER OPINION RELATED DATA FROM FOCUS GROUPS, SATISFACTION SURVEYS, AND EMPLOYEE OPINION SURVEYS. WE PARTICIPATE IN A NEEDS ASSESSMENT PROCESS AND PARTICIPATE AS AN ACTIVE MEMBER OF THE COMMUNITY THROUGH BOARD PARTICIPATION ON NUMEROUS LOCAL AND STATE-WIDE HEALTH RELATED ORGANIZATIONS. PART VI, LINE 5: SSMH'S COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH PARTNERING WITH AREA PUBLIC HEALTH DEPARTMENTS AND OTHER COMMUNITY BASED ORGANIZATIONS.SSMH STAFF DONATING TIME TO COMMUNITY AGENCIES ON BEHALF OF SSMH AND FINGER LAKES HEALTH SUCH AS:- UNITED WAY- YATES SUBSTANCE ABUSE COALITION- YATES HEALTH PLANNING COUNCIL- CHOOSE HEALTH YATES- REGIONAL WORKSITE WELLNESS COALITION- FINGER LAKES REGIONAL ES COUNCIL- WORKFORCE DEVELOPMENT COMMITTEE- COUNCIL OF CHURCHES CHAPLAINCY COMMITTEE- PENN YAN LIONS CLUB- YATES COUNTY LTC COMMITTEE- ARC OF YATES. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X X 0 1 0 0 0 0 0 0 0 JOSE A ACEVEDO MD PRESIDENT & CEO 0 588791 0 200925 0 4644 0 141077 0 14418 0 949855 0 0 JASON S FEINBERG MD CHIEF MEDICAL OFFICER 0 384644 0 46621 0 3795 0 21826 0 16929 0 473815 0 0 FRANK M KORICH CHIEF OPERATING OFFICER 0 305326 0 58317 0 4641 0 35972 0 12472 0 416728 0 0 TAMARA A PRULL MD PHYISCIAN ED 366075 0 5000 0 26000 0 3625 0 0 0 400700 0 0 0 DOUGLAS M SINCLAIR MD PHYISCIAN ED 314310 0 17825 0 24956 0 9429 0 0 0 366520 0 0 0 LUKE B CHEN MD PHYSICIAN 196154 0 106129 0 9614 0 5192 0 0 0 317089 0 0 0 ARDELLE BIGOS VICE PRESIDENT NURSING 0 259279 0 35206 0 3163 0 2593 0 14418 0 314659 0 0 SIXTO R MEDINA MD PHYSICIAN 276455 0 15000 0 18315 0 0 0 0 0 309770 0 0 0 JEFFREY D CHRISTENSON MD PHYSICIAN 206826 0 14311 0 41024 0 3375 0 0 0 265536 0 0 0 ROBERT ANDERSON MD DIRECTOR 215729 0 13150 0 7170 0 969 0 15688 0 252706 0 0 0 WENDY DISBROW VP PHYS. NETWORK 0 204677 0 27095 0 774 0 2047 0 703 0 235296 0 0 CHAD M HOFFMAN-FRAGALE VP HUMAN RESOURCES 0 224999 0 0 0 1135 0 2250 0 6713 0 235097 0 0 TRISHA KOCZENT TREASURER & CFO FROM JUNE 2021 0 178847 0 0 0 318 0 1500 0 64 0 180729 0 0 PART I, LINE 4B CERTAIN OFFICERS AND DIRECTORS OF SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY GENEVA GENERAL HOSPITAL (GGH), A RELATED IRC SECTION 501(C)(3) ORGANIZATION. GGH DEPOSITED $115,689 INTO A 457(F) PLAN IN 2021 FOR JOSE ACEVEDO, MD, MBA, PRESIDENT & CEO. FORM 990, PART VI, SECTION A, LINE 2 PHIL BECKLEY HAS A BUSINESS RELATIONSHIP WITH JAMES CHENEY. FORM 990, PART VI, SECTION A, LINE 7A FINGER LAKES REGIONAL HEALTH SYSTEM, INC. IS THE 'GENERAL MEMBER' OF SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY, INC. IN THAT ROLE, ELECTION OF DIRECTORS IS RESERVED TO THE GENERAL MEMBER. FORM 990, PART VI, SECTION A, LINE 7B ELECTION AND REMOVAL OF DIRECTORS, AMENDMENT OF BYLAWS, CERTIFICATE OF INCORPORATION AMENDMENTS, ARE RESERVED TO THE GENERAL MEMBER (FLRHS) PER BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE ADMINISTRATIVE COMMITTEE OF THE BOARD PRIOR TO BEING FILED. ANY COMMITTEE FINDINGS ARE REVIEWED AND IMPLEMENTED AS APPROPRIATE BY MANAGEMENT. CHANGES IN IRS REQUIREMENTS AND ORGANIZATION PRACTICES FROM THE PRIOR YEAR ARE HIGHLIGHTED FOR THE COMMITTEE BY MANAGEMENT. THE COMMITTEE REPORTS ON THIS DISCUSSION TO THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 12C SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN PRIOR TO TAKING OFFICE. STATEMENTS ARE REVIEWED ANNUALLY BY AN ADMINISTRATIVE COMMITTEE. THE PROCESS FOR HANDLING ANY CONFLICTS OF INTEREST WHICH MAY ARISE ARE DETAILED IN THE CORPORATE BYLAWS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS REVIEWED BY A COMPENSATION COMMITTEE, AND COMPARABILITY DATA IS PART OF THE DECISION. FORM 990, PART VI, SECTION C, LINE 19 SOLDIERS & SAILORS MEMORIAL HOSPITAL OF YATES COUNTY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC WHERE REQUIRED BY LAW AND UPON REQUEST. THE ORGANIZATION'S FORM 990 IS PROVIDED TO ANY INDIVIDUAL WHO PROVIDES A REQUEST IN PERSON OR WHO SUBMITS A WRITTEN REQUEST. THERE IS NO CHARGE OTHER THAN A REASONABLE FEE FOR COPYING AND POSTAGE. COPIES ARE AVAILABLE AT THE FINANCE OFFICE. AN ELECTRONIC VERSION MAY BE FOUND AT WWW.GUIDESTAR.ORG. FORM 990, PART XII, LINE 2C: SSMH HAS A BOARD COMMITTEE WHO ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR FINGER LAKES REGIONAL HEALTH SYSTEM INC 196 NORTH STREET GENEVA NY 14456 223193606 SOLE MEMBER OF SSMH, FLHF, LCS, HLC, LCN, AND GGH NY 501(C)(3) LINE 7 0 FINGER LAKES HEALTH FOUNDATION 196 NORTH STREET GENEVA NY 14456 150549310 COORDINATOR OF FUNDRAISING ACTIVITIES NY 501(C)(3) LINE 12A, I FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 LIVING CENTER AT GENEVA SOUTH 196 NORTH STREET GENEVA NY 14456 160957268 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 HUNTINGTON LIVING CENTER 369 EAST MAIN STREET WATERLOO NY 13165 510169552 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 GENEVA GENERAL HOSPITAL HOUSING DEVELOPMENT CO 196 NORTH STREET GENEVA NY 14456 222816883 OPERATE LOW INCOME HOUSING FOR ELDERLY & HANDICAPPED NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 TAYLOR BROWN MEMORIAL HOUSING DEVELOPMENT CO 371 EAST MAIN STREET WATERLOO NY 13165 222807734 OPERATE LOW INCOME HOUSING FOR ELDERLY & HANDICAPPED NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 LIVING CENTER AT GENEVA NORTH 196 NORTH STREET GENEVA NY 14456 161449543 SKILLED NURSING FACILITY NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 FLH SENIOR COMMUNITIES INC 196 NORTH STREET GENEVA NY 14456 205604917 DEVELOP AND OPERATE SENIOR CITIZEN HOUSING COMPLEX NY 501(C)(3) LINE 10 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 GENEVA GENERAL HOSPITAL 196 NORTH STREET GENEVA NY 14456 160743032 PROVIDER OF HEALTHCARE SERVICES NY 501(C)(3) LINE 3 FINGER LAKES REGIONAL HEALTH SYSTEM INC 0 SOLDIERS VENTURES INC 196 NORTH STREET GENEVA NY 14456 161556419 INVESTING NY SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY INC C 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0