2020-11-14T09:21:40-06:00 2019-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2019-01-01 150532220 OSWEGO HOSPITAL OSWE 3153495531 110 WEST SIXTH STREET OSWEGO NY 13126 ERIC T CAMPBELL CHIEF FINANCIAL OFFICER 3153495531 2020-11-12 1 THOMAS J GIUFRE P00841958 3154463600 2020-11-12 67.242.7.99 2020-11-12 18:10:38 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D2E8F385EE88BD29EFAB248CF612B9DA1F974714 2019 2021-01-29 14:40:06Z MICHAEL HARLOVIC 110 WEST SIXTH STREET OSWEGO NY 13126 144920338 0 X WWW.OSWEGOHEALTH.ORG X 1881 NY OSWEGO HOSPITAL'S MISSION IS TO PROVIDE ACCESSIBLE, QUALITY CARE AND IMPROVE THE HEALTH OF THE RESIDENTS IN OSWEGO COUNTY. OSWEGO HOSPITAL IS A SOLE COMMUNITY PROVIDER. OSWEGO HOSPITAL SERVES A PRIMARY SERVICE AREA OF APPROXIMATELY 117,124 RESIDENTS WHICH IS COMPRISED OF OSWEGO, FULTON, MEXICO, CENTRAL SQUARE, HANNIBAL, PULASKI AND STERLING. IN ADDITION, OSWEGO HOSPITAL PROVIDES SERVICES IN PARISH AND PHOENIX. 21 17 1363 104 0 0 257103 13580506 104297162 109144030 812183 1597640 18605619 19137350 123972067 143459526 0 0 0 0 69933368 75669387 0 0 223864 55467257 60740345 125400625 136409732 -1428558 7049794 119660326 128382782 53338475 53453236 66321851 74929546 THE MISSION OF OSWEGO HEALTH IS TO PROVIDE ACCESSIBLE, QUALITY CARE AND IMPROVE THE HEALTH OF RESIDENTS IN OUR COMMUNITY.YOUR HEALTH AND WELLNESS LEADER DEDICATED TO EXCELLENT CARE. 0 0 51014221 40688926 INPATIENT SERVICES PROVIDED BY OSWEGO HOSPITAL TO RESIDENTS OF OSWEGO COUNTY AND THE SURROUNDING AREAS: MEDICAL/SURGICAL/WOMEN SERVICES(MATERNITY,NEWBORN AND NURSERY)/INTENSIVE CARE/INPATIENT BEHAVIORAL HEALTH. 68497608 68455104 OUTPATIENT SERVICES PROVIDED BY OSWEGO HOSPITAL TO RESIDENTS OF OSWEGO COUNTY AND SURROUNDING AREAS: EMERGENCY/REHABILIATION SERVICES/OCCUPATIONAL HEALTH/ REFERRED AMBULATORY AND AMBULATORY SURGICAL/REFERRED DIAGNOSTIC AND THERAPEUTIC TESTING CONSISTING OF: LABORATORY/ACR ACCREDITED RADIOLOGY/COMPUTER TOMOGRAPHY(CT),MAGNETIC RESONANCE IMAGING(MRI),NUCLEAR MEDICINE AND ULTRASOUND IMAGING SERVICES/ADULT, CHILD AND FAMILY OUTPATIENT BEHAVIORAL HEALTH SERVICES. 19198792 19198792 119511829 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 152 0 1 1363 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 17 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X ERIC T CAMPBELL-OSWEGO HOSPITAL 3153495531 110 WEST SIXTH STREET OSWEGO NY 13126 ED ALBERTS DIRECTOR 1.00 1.00 X 0 0 0 PETER CULLINAN DIRECTOR 1.00 1.00 X 0 0 0 MARK SLAYTON TREASURER 1.00 1.00 X X 0 0 0 LYNNE EGGERT DIRECTOR 1.00 1.00 X 0 0 0 BARBARA BATEMAN DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL ALCASID MD MEDICAL STAFF PRESIDENT 1.00 1.00 X X 0 0 0 RONALD TASCARELLA DIRECTOR 1.00 1.00 X 0 0 0 WILLIAM CLARK DIRECTOR 1.00 1.00 X 0 0 0 TIMOTHY BARNHART DIRECTOR 1.00 1.00 X 0 0 0 RENATO MANDANAS MD CMO 36.40 3.60 X X 360714 0 33645 ADAM GAGAS PAST CHAIR 1.00 1.00 X 0 0 0 FLOYD BACKES DIRECTOR 1.00 1.00 X 0 0 0 DANIEL DORSEY DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL BACKUS DIRECTOR 1.00 1.00 X 0 0 0 ELLEN HOLST CHAIR 1.00 1.00 X X 0 0 0 GARY BOZEMAN MD DIRECTOR 1.00 1.00 X 0 0 0 ATOM AVERY VICE CHAIR 1.00 1.00 X X 0 0 0 SCOTT VANGORDER DO DIRECTOR 1.00 1.00 X 0 0 0 ZACH MENTER DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL HARLOVIC PRESIDENT AND CEO 40.00 0.00 X X 558933 0 67004 VICTORIA FURLONG SECRETARY 1.00 1.00 X X 0 0 0 ERIC CAMPBELL CFO 40.00 0.00 X 300060 0 8443 JEFFREY COAKLEY EXEC VP, COO 31.10 8.90 X 338151 0 9242 GREG KELLER ORTHOPEDIC 40.00 0.00 X 495915 0 20634 MICHAEL DIAZ ORTHOPEDIC 40.00 0.00 X 643000 0 25466 MELANIE GROCH OTOLARYNGOLOGISTS 40.00 0.00 X 637350 0 9198 NICHOLAS GROCH OTOLARYNGOLOGISTS 40.00 0.00 X 637625 0 32943 SANJEEV VERMA ANESTESIOLOGIST 40.00 0.00 X 479821 0 32995 4451569 0 239570 78 0 1 0 REHAB RESOURCES PC 159 WEST FIRST STREET OSWEGO NY 13126 PHYSICAL THERAPY 1211308 MICROSOFT LICENSING GP 6100 NEIL RD STE 210 RENO NV 89511 IT SVCS 401183 BOND SCHOENICK & KING PLLC ONE LINCOLN CENTER SYRACUSE NY 13202 LEGAL SERVICES 385425 PORT CITY EMERGENCY PHYSICIANS PO BOX 677979 DALLAS TX 75267 EMERGENCY ROOM PHYSICIANS 271692 PIPELINE HEALTH HOLDINGS LLC 600 CALIFORNIA ST SAN FRANCISCO CA 94108 TELEPHARMACY 271544 12 307569 13048850 224087 13580506 MEDICAID AND MEDICARE 900099 63156840 63156840 INSURANCE AND OTHER 900099 45987190 45987190 109144030 1181781 1181781 1003212 1064654 -61442 -61442 -61442 785805 26212 365516 30642 420289 -4430 415859 415859 HOSPITAL CONTRACT SVCS 900099 14474275 14474275 PHARMACY SALES 900099 683693 683693 DSRIP PAYMENTS 900099 355852 355852 3684972 3684972 19198792 143459526 128342822 0 1536198 1676192 394359 1281833 60681083 54225951 6272610 182522 923740 808704 112352 2684 8278463 7247568 1006844 24051 4109909 3598093 499876 11940 867702 49185 818517 396898 396898 129522 129522 17665 17665 558398 6107 552291 828254 531565 295737 952 2521462 2201251 320211 1786894 1548286 238608 188952 136243 52568 141 995350 868946 126404 7691532 6714753 976779 1333323 403351 929972 PURCHASE SERVICES 10247982 8399653 1848329 BAD DEBT NON PATIENT 8884609 8884609 SUPPLIES - MEDICAL 8352561 8340618 11943 PROFESSIONAL FEES 4349529 4325829 23700 11589712 10826758 761380 1574 136409732 119511829 16674039 223864 4308 4308 24573298 19359171 13510757 13378688 1945787 2162539 1485526 1606992 3174451 3371825 159256328 100238513 56047756 59017815 10514666 11375740 899856 905077 7503921 17200627 119660326 128382782 13430641 18699640 24902379 22084529 15005455 12669067 53338475 53453236 X 56057277 53917794 10264574 21011752 66321851 74929546 119660326 128382782 X 7049794 1015308 542593 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 32773 0 1 20182 0 52955 0 PART II-B, LINE 1: LINE 1F, ACTIVITIES PAID FOR LOBBYING EFFORTS FOR HOSPITAL ISSUES IN NYS. LINE 1H, OSWEGO HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, HANYS AND IROQUOIS HEALTHCARE ASSOCIATION. ANNUALLY,A PORTION OF OUR DUES IN THESE ASSOCIATIONS REPRESENTS SOME LOBBYING ACTIVITIES. THE TOTAL OF DUES PAID THAT REPRESENT LOBBYING IS APPROXIMATELY 23.38% OF $86,311. THE REMAINDER IS ATTRIBUTED TO PROVIDING NECESSARY INFORMATION AND ANALYTICS REGARDING HEALTH CARE LEGISLATION AND GOVERNMENT REGULATIONS. THE LOBBYING EFFORTS ARE AIMED SPECIFICALLY AT HEALTH CARE ISSUES ACROSS THE HEALTH CARE INDUSTRY. 0 10264575 232280 971171 10007532 100911 362894 21011752 10662830 232676 -25674 469085 136172 10264575 8650651 191934 2162665 243945 98475 10662830 8473140 98878 157392 78759 8650651 8373320 84492 230457 215129 8473140 0.32000 0.68000 0 0 505045 505045 78219911 39979444 38240467 4064 4064 0 73675174 60255005 13420169 6852134 6852134 59017815 GRANTS RECEIVABLE 11678472 ASSETS WHOSE USE IS LIMITED 5126812 INTEREST IN NET ASSETS OF OHF 395343 17200627 ADVANCE FROM 3RD PARTY 899000 DUE TO 3RD PARTY PAYOR 3859451 LTD PENSION OBLIGATION 6375344 OTHER LIABILITIES 1535272 12669067 X PART V, LINE 4: TEMPORARILY RESTRICTED FUNDS ARE USED PRIMARLY FOR NEW CONSTRUCTION AND EQUIPMENT. THE INTEREST EARNED ON THE PERMANENTLY RESTRICTED FUNDS ARE FOR OPERATIONS. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2019 AND 2018, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2016 THROUGH 2019. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. 1 1 X 1 X 1 X 1 1 1 0 1 1 274981 274981 0.00210 29471660 24701387 4770273 0.03610 29746641 24701387 5045254 0.03820 39 25874 25874 0.00020 6323198 3313895 3009303 0.02280 39 6349072 3313895 3035177 0.02300 39 36095713 28015282 8080431 0.06120 0 2036701 40759218 41737070 -977852 X 1 0 2 1 OSWEGO HOSPITAL 110 WEST SIXTH STREET OSWEGO NY 13126 X X X 2 OSWEGO HOSP-ALVIN L KRAKAU MTL HLTH CTR 74 BUNNER ST OSWEGO NY 13126 X MENTAL HEALTH SERVICES O/P,REHAB O/P, AND PSYCH OSWEGO HOSPITAL 2 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTP://WWW.OSWEGOHEALTH.ORG/ X 1 18 1 HTTPS://WWW.OSWEGOHEALTH.ORG/MEDIA/3171/CHNA-2018-FINAL.PDF 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.OSWEGOHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-SERVICES/ X HTTPS://WWW.OSWEGOHEALTH.ORG/MEDIA/3255/PATIENT-FINANCIAL-2019-WEB.PDF X HTTPS://WWW.OSWEGOHEALTH.ORG/MEDIA/3281/FINANCIAL-ASSISTANCE-2019-RE X X X X X X 1 X 0 X X X 1 X 0 0 OSWEGO HOSPITAL PART V, SECTION B, LINE 5: THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OSWEGO HEALTH UTILIZED DATA FROM HEALTHECONNECTIONS (AND HEALTHECNY), WHICH COMPARES THE DATA BETWEEN SIX CENTRAL NEW YORK COUNTIES, INCLUDING CAYUGA, CORTLAND, MADISON, ONEIDA, ONONDAGA AND OSWEGO COUNTIES. HEALTHECONNECTIONS USE OF COMMUNITY HEALTH DATA AND BEST PRACTICES, TO ENABLE CENTRAL NEW YORK STAKEHOLDERS TO TRANSFORM AND IMPROVE PATIENT CARE, IMPROVE THE HEALTH OF POPULATIONS AND LOWER HEALTH CARE COSTS. ASSISTING OSWEGO HEALTH IN ITS SURVEY OF THE COMMUNITY AND TO CONDUCT IN-DEPTH INTERVIEWS (IDI) WITH KEY COMMUNITY MEMBERS WAS RESEARCH & MARKETING STRATEGIES (RMS). RMS CONDUCTS CONSULTING, MARKET RESEARCH, AND STRATEGIC PLANNING ACTIVITIES ACROSS WIDE SPECTRUM OF INDUSTRY SEGMENTS. IN ADDITION, OSWEGO HEALTH USED DATA FROM THE CENTRAL NEW YORK CARE COLLABORATIVE (CNYCC). THIS ORGANIZATION IS A PARTNERSHIP THAT CONNECTS MORE THAN 2,000 HEALTHCARE AND COMMUNITY BASED SERVICE PROVIDERS IN SIX COUNTIES ACROSS CENTRAL NEW YORK - CAYUGA, LEWIS, MADISON, ONEIDA, ONONDAGA AND OSWEGO. THE PRIMARY GOAL OF THE COLLABORATIVE IS TO SERVE THE POPULATION BY IMPROVING THE COORDINATION OF HEALTHCARE SERVICES, ENHANCING THE QUALITY OF PERFORMANCE OUTCOMES, AND CREATING AN OVERALL BETTER SYSTEM OF CARE FOR PATIENTS.MANY OF THESE STATISTICS FOR THIS CHNA WERE PROVIDED BY HEALTHECONNECTIONS, WHICH USES A VARIETY OF SOURCES FOR ITS DATA, INCLUDING STATE AND NATIONAL SOURCES. MOST OF THE DATA ARE REPORTED ON AN ANNUAL BASIS. MOST THE DATA LISTED IN THIS REPORT WAS FOUND ON THE HEALTHECONNECTIONS WEBSITE IN APRIL 2018, WITH UPDATES DONE IN NOVEMBER. OSWEGO HOSPITAL PART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED IN THE CHNA WHICH ARE BEING SPECIFICALLY ADDRESSED BY OSWEGO HEALTH IN THIS IMPLEMENTATION PLAN ARE: OSWEGO HEALTH WILL WORK WITH THE OSWEGO COUNTY HEALTH DEPT. AND THE NINE OSWEGO COUNTY SCHOOL DISTRICTS TO IMPLEMENT A HEALTH HIGHWAY PROGRAM IN ALL 24 ELEMENTARY SCHOOLS IN OSWEGO COUNTY. AS A MEANS OF REDUCING THE HIGH RATE OF OBESITY IN THE COUNTY. THE PROGRAM RAISES AWARENESS OF THE IMPORTANT ROLE HEALTHY EATING/EXERCISE HAVE ON MAINTAINING HEALTHY LIFESTYLE. INCREASE ACCESS AND PARTICIPATION IN DIABETES SELF MANAGEMENT EDUCATION AND PROGRAMS BY INCREASING THE NUMBER OF INDIVIDUALS RECEIVING OUTPATIENT DIABETIC EDUCATION AND ATTENDING DIABETIC SUPPORT GROUPS BY AT LEAST 5%.REDUCE THE OCCURRENCE OF SUICIDE IN OSWEGO COUNTY AMONG BOTH ADULTS AND YOUTH.INCREASE SUICIDE PREVENTION ACTIVITIES AND MENTAL HEALTH SERVICES AMONG YOUTH IN OSWEGO COUNTY. 10 1 - FULTON MEDICAL HEALTH CENTER 510 S FOURTH ST FULTON NY 13069 OUTPATIENT CLINIC 2 - CENTRAL SQUARE MEDICAL CENTER 3045 EAST AVE CENTRAL SQUARE NY 13036 OUTPATIENT CLINIC 3 - RADIOLOGY EXT CLINIC PULASKI 61 DELANO ST PULASKI NY 13142 OUTPATIENT CLINIC 4 - OSWEGO HOSPMEXICO FAMILY HEALTH CENTER 5856 SCENIC AVE MEXICO NY 13114 OUTPATIENT CLINIC 5 - AMS OF OSWEGO HEALTH 98 N SECOND ST FULTON NY 13069 OUTPATIENT CLINIC 6 - PARISH HEALTH SERVICES CENTER ROUTE 69 PARISH NY 13131 OUTPATIENT CLINIC 7 - OSWEGO HOSP RADIOLOGY & LAB SVCS 10 GEORGE ST OSWEGO NY 13126 OUTPATIENT CLINIC 8 - PHOENIX HEALTH SERVICES CENTER 7 BRIDGE ST PHOENIX NY 13135 OUTPATIENT CLINIC 9 - OH FULTON HEALTH SERVICES CENTER 501 1/2 SOUTH SECOND ST FULTON NY 13069 OUTPATIENT CLINIC 10 - LAKESIDE HEART CLINIC 177 W FOURTH ST OSWEGO NY 13126 OUTPATIENT CLINIC PART I, LINE 7: THE RCC USED TO CALCULATE COLUMN (C) DOES NOT INCLUDE BAD DEBTS. WE APPLIED THE RATIO OF COST TO CHARGES AGAINST THE BAD DEBT AMOUNT TO OBTAIN THE COST RELATED TO BAD DEBT CHARGE WRITE-OFFS. THIS RATIO WAS CALCULATED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE AND THEREFORE ARE NOT REPORTED AS REVENUE. THE HOSPITAL DOES NOT APPLY DISCOUNTS AND/OR PAYMENTS TO BAD DEBT EXPENSE. A RECOVERY OF A BAD DEBT WOULD BE OFFSET AGAINST THE BAD DEBT EXPENSE. PART I, LINE 7G: OSWEGO HOSPITAL OPERATES THE FOLLOWING SERVICES AT A LOSS TO THE ORGANIZATION: INPATIENT HOSPITALIST PROGRAM, ANESTHESIA PROGRAM, AND OUTPATIENT BEHAVIORAL HEALTH SERVICES. IN EACH CASE THE COMMUNITY'S CAPACITY TO PROVIDE THE SERVICE WOULD BE BELOW THE COMMUNITY'S NEED FOR THE SERVICE. 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 $ 4,217,646. PART III, LINE 4: INFORMATION RELATING TO BAD DEBT EXPENSE IS INCLUDED IN FOOTNOTE 2(K) NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE ON PAGE 12-18 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: USED MEDICARE ONLY TOTAL CHARGES FROM REVENUE REPORT AND APPLIED THE RATIO OF COST TO CHARGES CALCULATED ON WORKSHEET 2 OF SCHEDULE H. APPROXIMATELY 37% OF OUR REVENUE IS DERIVED FROM MEDICARE PATIENTS. WE FEEL THE SHORTFALL FROM THIS PROGRAM IS DIRECTLY A COMMUNITY BENEFIT IN THAT WE ARE THE SOLE PROVIDER OF SERVICES IN OSWEGO COUNTY. THE ELDERLY POPULATION IN THIS AREA IS SIGNIFICANT AND WITHOUT OUR SERVICES, OUR ELDERLY POPULATION WOULD HAVE TO TRAVEL 40 - 50 MILES FOR CARE. THIS COULD BE CRITICAL IN EMERGENCY SITUATIONS. SOME OF THESE PEOPLE ARE ALONE AND HAVE NO READILY AVAILABLE MEANS OF TRANSPORTATION. WE ALSO HAVE EXTREME WEATHER DURING 3 TO 4 MONTHS OF THE YEAR WHICH ADDS BURDEN TO THE TRANSPORTATION ISSUE OF THESE PEOPLE. PART VI, LINE 2: IN ADDITION TO REGULAR COMMUNICATION WITH OUR VOLUNTEER BOARD AND COMMITTEE MEMBERS, OSWEGO HOSPITAL UNDERTAKES MANY PLANNING ACTIVITES TO DETERMINE THE HEALTH NEEDS OF RESIDENTS. STRATEGIC PLANNING IDENTIFIES CRITICAL ISSUES AND ESTABLISHES 3-5 YEAR GOALS BASED ON OUR IN-DEPTH INTERNAL AND EXTERNAL EXAMINATION OF THE ORGANIZATION. PRESS GANEY HAS BEEN CONTRACTED TO SURVEY PATIENT SATISFACTION AND A RESEARCH FIRM IS ENGAGED TO PROVIDE A COMMUNITY PERCEPTION STUDY.IN 2018, OSWEGO HEALTH PARTNERED WITH THE HEALTHCARE DIVISION OF RESEARCH & MARKETING STRATEGIES (RMS HEALTHCARE) TO ASSIST THE ORGANIZATION WITH THE DEVELOPMENT OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA.) THIS CHNA WAS COMMISSIONED TO INVENTORY, ASSESS, AND PRIORITIZE HEALTHCARE NEEDS AND SERVICES WITHIN THE COMMUNITY. IT ALSO COMPLIES WITH THE RECENT FEDERAL REGULATORY STATUTE. THE CHNA IS DESIGNED TO ENHANCE OSWEGO HEALTH'S OVERALL STRATEGIC PLAN AND AID THEM IN IDENTIFYING WHAT SERVICES ARE MOST NEEDED AND DESIRED BY THE COMMUNITY IT SERVES. THE ULTIMATE GOAL IS TO OPTIMIZE HEALTHCARE DELIVERY AND TO PROVIDE HIGH QUALITY CARE. THIS CHNA FULFILLS THE REQUIREMENTS OF NEW STATUTES PUT IN PLACE BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA) THAT REQUIRES NON-PROFIT HOSPITALS TO CONDUCT CHNAS EVERY THREE YEARS TO REMAIN IN COMPLIANCE. THE CHNA UTILIZES INPUT FROM MEMBERS OF THE COMMUNITY IN THE FORM OF STAKEHOLDERS AND RESIDENTS AND REPRESENT AN INTEREST IN THE OSWEGO HEALTH SERVICE AREA. RMS WORKED CLOSELY WITH MEMBERS OF THE COMMUNITY AND THE MANAGEMENT TEAM OF OSWEGO HEALTH TO COMPLETE THE ASSESSMENT. PART VI, LINE 3: OSWEGO HOSPITAL HAS COLLABORATED WITH ORGANIZATIONS THAT MAINTAIN FACILITATED ENROLLERS IN OSWEGO COUNTY, SUCH AS OSWEGO COUNTY OPPORTUNITIES, NORTHERN OSWEGO COUNTY HEALTH SERVICES, THE RURAL MIGRANT MINISTRY AND OTHERS TO ENSURE THAT INDIVIDUALS THAT NEED ASSISTANCE IN PAYING THEIR MEDICAL BILLS ARE PROVIDED INFORMATION ON AVAILABLE PROGRAMS AND THE ELIGIBILITY REQUIREMENTS OF THESE PROGRAMS. THE HOSPITAL ALSO PROVIDES A PLACE FOR INDIVIDUALS TO MEET ONE ON ONE WITH FACILITATED ENROLLMENT PROVIDERS AT SEVERAL LOCATIONS ACROSS OSWEGO COUNTY. ALL PATIENTS ADMITTED TO OSWEGO HOSPITAL ARE PROVIDED WITH A BROCHURE TITLED "MEDICAL BILLS EXPLAINED" WHICH OUTLINES PAYMENT OPTIONS AND SOURCES OF APPLICATIONS FOR FINANCIAL ASSISTANCE. OUR FINANCIAL ASSISTANCE POLICY AND APPLICATION IS ALSO AVAILABLE ON THE WEBSITE AT WWW.OSWEGOHEALTH.ORG. OSWEGO HOSPITAL HAS TWO FINANCIAL COUNSELORS ON STAFF THAT ARE CERTIFIED APPLICATION COUNSELORS WITH TRAINING IN THE NYS HEALTH INSURANCE EXCHANGE. PART VI, LINE 4: THE OSWEGO HOSPITAL SERVICE AREA ENCOMPASSES MUCH OF OSWEGO COUNTY, A RURAL AND ECONOMICALLY-CHALLENGED REGION. OSWEGO HOSPITAL IS PART OF THE OSWEGO HEALTH SYSTEM PROVIDING CARE TO APPROXIMATELY 85,900 RESIDENTS IN THE COUNTY, WHICH HAS A TOTAL POPULATION OF APPROXIMATELY 120,000. WITHIN THE BOUNDARIES OF OSWEGO COUNTY ARE THE CITIES OF FULTON AND OSWEGO, AS WELL AS SEVERAL TOWNS AND VILLAGES, INCLUDING CENTRAL SQUARE, MEXICO, PARISH, PHOENIX AND PULASKI. PART VI, LINE 5: AS OSWEGO COUNTY'S HEALTHCARE LEADER, OSWEGO HEALTH TAKES SERIOUSLY ITS COMMITMENT TO PROVIDE EDUCATIONAL HEALTH SERVICES AND PROGRAMS TO COMMUNITY RESIDENTS. AS A PART OF THAT OBLIGATION, STAFF MEMBERS TAKE PART IN COMMUNITY EVENTS THROUGHOUT THE YEAR THAT OFFER EDUCATIONAL MATERIALS AND FREE SCREENINGS. IN THE LAST YEAR ALONE, OSWEGO HEALTH PARTICIPATED IN THE OSWEGO COUNTY SENIOR HEALTH AND INFORMATION FAIR SPONSORED BY STATE SENATOR PATTY RITCHIE, THE CENTRAL SQUARE APPLE FESTIVAL, OSWEGO FARMERS MARKET, FULTON FARMERS MARKET, FULTON MEMORIAL DAY PARADE, FULTON BIKE RODEO, OSWEGO INDEPENDENCE DAY PARADE, OSWEGO HARBORFEST. IN ADDITION, OUR ORGANIZATION PARTICIPATED IN NUMEROUS HEALTH FAIRS HELD THROUGHOUT OSWEGO COUNTY. WE ALSO HOSTED OUR HEALTHY YOU EVENT THAT FEATURED SEVERAL SPEAKERS ON BREAST CARE AND CANCER IN OCTOBER. HEALTHY HIGHWAY IS A NEW INITIATIVE IMPLEMENTED IN ALL 24 ELEMENTARY SCHOOLS IN OSWEGO COUNTY THAT IS FOCUSED ON REDUCING THE CHILDHOOD OBESITY RATE. THE PROGRAM IS A COLLABORATION BETWEEN OSWEGO HEALTH, THE OSWEGO COUNTY LEGISLATURE, THE SHINEMAN FOUNDATION AND THE NINE COUNTY SCHOOL DISTRICTS. THS HEALTHY HIGHWAY PROGRAM USES TRAFFIC THEMES AND METAPHORS TO PROMOTE HEALTHY FOODD CHOICES AND THE IMPORTANCE OF BEING ACTIVE AND FIT. THROUGH THE PROGRAM, CHILDREN LEARN THAT IT IS IMPORTANT TO "FUEL" THEIR BODIES WITH "GREEN LIGHT" FOODS AND TO LIMIT THEIR "RED LIGHT" FOOD CHOICES. IT'S ALL INCORPORATED INTO A VARIETY OF ACTIVITIES TO REINFORCE HEALTHY CHOICES, WHICH IS BEING APPLIED THROUGHOUT THE SCHOOL. THE PROGRAM ALSO OFFERS MANY ACTIVITIES TO PROMOTE PHYSICAL EXERCISE. AT SOME OF THESE FUNCTIONS, WE ACTIVATED OUR SUN PATROL, WHERE STAFF DISTRIBUTED FREE PACKETS OF SUNSCREEN TO YOUNG FAMILIES. OUR SUN PATROL HAS BEEN A MAJOR OSWEGO HEALTH INITIATIVE FOR NEARLY 35 YEARS.IN ADDITION, WE OFFERED FOUR BLOOD ANALYSIS SCREENINGS AT A LOW-COST TO COMMUNITY MEMBERS. MORE THAN 1,200 INDIVIDUALS TOOK ADVANTAGE OF MULTI BLOOD ANALYSIS SCREENINGS HELD IN CENTRAL SQUARE, PULASKI, FULTON AND OSWEGO.OSWEGO HEALTH ALSO RECOGNIZES THE IMPORTANCE OF COLLABORATING WITH OTHER HEALTHCARE PROVIDERS TO DEVELOP PROGRAMS AND EVENTS THAT BENEFITED THE COMMUNITY. AMONG THOSE PARTNERS WERE THE OSWEGO COUNTY HEALTH DEPARTMENT, OSWEGO COUNTY OPPORTUNITIES,CONNECTCARE,THE FULTON AND OSWEGO YMCAS,THE OSWEGO COUNTY TRAFFIC SAFETY COUNCIL,THE GREATER OSWEGO FULTON CHAMBER OF COMMERCE AND THE FULTON POLICE DEPARTMENT. OUR ORGANIZATION ALSO INVITES THE COMMUNITY INTO ITS FACILITIES WHERE STAFF MEMBERS PROVIDE AN ARRAY OF FREE SUPPORT GROUPS. THESE SUPPORT GROUPS ASSIST THOSE WITH FACING HEALTH CONCERNS SUCH AS DIABETES, BREAST CANCER AND BARIATRICS, AS WELL AS ALZHEIMER'S CAREGIVERS. TO ASSIST THOSE COMMUNITY MEMBERS THAT WISH TO QUIT SMOKING, WE OFFER A FREE ONLINE SMOKING CESSATION PROGRAM, SMOKEFREE.GOV THROUGH OUR WEBSITE. THIS PROGRAM ALLOWS RESIDENTS TO QUIT IN THE PRIVACY OF THEIR HOMES. AS A PART OF THE PROGRAM, WE HAVE CERTIFIED SMOKING CESSATION COUNSELORS AVAILABLE TO OFFER SUPPORT AND GUIDANCE. THESE COUNSELORS ARE ALSO AVAILABLE FOR 1:1 SESSIONS.IN ADDITION, OSWEGO HEALTH ALSO OFFERS AN ASK THE DOCTOR PROGRAM, WHERE PHYSICIANS PROVIDE A PRESENTATION TO THE PUBLIC ON THEIR AREA OF EXPERTISE. DURING 2019, OUR PHYSICIANS PRESENTED PROGRAMS ON CHRONIC COUGH, HEALTHY HEART, ORTHOPEDIC CARE, WOMEN'S NIGHT OUT, BREAST CANCER.IN AN EFFORT TO GIVE YOUTHS AN EARLY, FIRST-HAND LOOK AT HEALTHCARE CAREERS, OSWEGO HOSPITAL HOSTED A MASH CAMP FOR SEVENTH AND EIGHTH GRADERS LAST SUMMER THAT ATTRACTED MORE THAN 20 YOUTHS.FINALLY, OSWEGO HOSPITAL HOSTED FOUR BLOOD DRIVES FOR THE AMERICAN RED CROSS DURING 2019. PART VI, LINE 6: THE OSWEGO HEALTH SYSTEM PROVIDES MANY SERVICES AND PROGRAMS THAT TOGETHER PROVIDE THE REGION WITH HEALTHCARE SERVICES FROM BIRTH TO MATURITY. OSWEGO HEALTH, INC., SOLE MEMBER OF SYSTEM CORPORATIONS, IS A NOT-FOR-PROFIT HOLDING CORPORATION, ESTABLISHED IN 1997, THAT CONSTITUTES AN INTEGRATED, COMPREHENSIVE HEALTHCARE SYSTEM. THIS INCLUDES OSWEGO HOSPITAL, A 164-BED COMMUNITY HOSPITAL PROVIDING ACUTE, MEDICAL, EMERGENCY, SURGICAL, MATERNITY AND BEHAVIORAL SERVICES; THE MANOR AT SENECA HILL, A 120-BED SKILLED NURSING FACILITY THAT ALSO OFFERS REHABILITATION SERVICES AND AN ADULT DAY HEALTH SERVICES PROGRAM; AND SPRINGSIDE AT SENECA HILL, WHICH PROVIDES RETIREMENT LIVING; AS WELL AS THE FULTON MEDICAL CENTER (FMC) IN FULTON. THE FMC PROVIDES AN URGENT CARE, MEDICAL IMAGING, LABORATORY, PHYSICAL THERAPY AND OCCUPATIONAL HEALTH SERVICES. OSWEGO HEALTH ALSO OPERATES THE CENTRAL SQUARE MEDICAL CENTER IN THE VILLAGE OF CENTRAL SQUARE, WHICH OFFERS URGENT CARE, LABORATORY, MEDICAL IMAGING AND PHYSICAL THERAPY SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 X X X X 1 1 0 0 0 0 0 0 0 RENATO MANDANAS MD CMO 327214 0 33500 0 0 0 8400 0 25245 0 394359 0 0 0 MICHAEL HARLOVIC PRESIDENT AND CEO 468933 0 90000 0 0 0 54044 0 12960 0 625937 0 0 0 ERIC CAMPBELL CFO 270060 0 30000 0 0 0 7645 0 798 0 308503 0 0 0 JEFFREY COAKLEY EXEC VP, COO 303951 0 34200 0 0 0 8400 0 842 0 347393 0 0 0 GREG KELLER ORTHOPEDIC 445915 0 50000 0 0 0 0 0 20634 0 516549 0 0 0 MICHAEL DIAZ ORTHOPEDIC 618000 0 25000 0 0 0 963 0 24503 0 668466 0 0 0 MELANIE GROCH OTOLARYNGOLOGISTS 612350 0 25000 0 0 0 8400 0 798 0 646548 0 0 0 NICHOLAS GROCH OTOLARYNGOLOGISTS 612625 0 25000 0 0 0 8400 0 24543 0 670568 0 0 0 SANJEEV VERMA ANESTESIOLOGIST 455601 0 24220 0 0 0 8400 0 24595 0 512816 0 0 0 PART I, LINES 4A-B THE PRESIDENT/CEO HAS A SERP PLAN AGREEMENT IN WHICH A PORTION OF THE ANNUAL BASE SALARY FOR THE PRESIDENT/CEO IS CREDITED TO THE SERP PLAN ACCOUNT EACH YEAR UPON MEETING CERTAIN EMPLOYMENT CRITERIA. THE SERP PLAN WAS APPROVED BY THE COMPENSATION COMMITTEE WHICH IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. CYNTHIA TASCARELLA EMPLOYEE 77141 EMPLOYMENT OF CYNTHIA TASCARELLA BY OSWEGO HOSPITAL. SHE IS THE SPOUSE OF BOARD MEMBER, RONALD TASCARELLA. 0 FORM 990, PART VI, SECTION A, LINE 2 CYNTHIA TASCARELLA IS THE SPOUSE OF BOARD MEMBER, RONALD TASCARELLA, AND RECEIVED COMPENSATION IN THE AMOUNT OF $77,141. FORM 990, PART VI, SECTION A, LINE 6 OSWEGO HEALTH INC IS THE SOLE MEMBER OF THE OSWEGO HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A OSWEGO HEALTH INC, THE SOLE MEMBER MAY APPOINT, AND REMOVE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE APPROVED BY OSWEGO HEALTH INC., THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 AND ITS SUPPORTING AND SUPPLEMENTAL INFORMATION WAS PREPARED AND VERIFIED FOR ACCURACY BY THE SENIOR ACCOUNTANT. ALL TOTALS ARE TIED TO THE FINANCIAL STATEMENTS WHICH HAVE BEEN AUDITED BY AN OUTSIDE ACCOUNTING FIRM. THE RETURN IS REVIEWED INTERNALLY BY THE CHIEF FINANCIAL OFFICER. IN ADDITION, THE RETURN IS REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. THE 990 IS THEN PRESENTED TO THE OSWEGO HEALTH AUDIT COMMITTEE AND MADE AVAILABLE TO MEMBERS OF THE HOSPITAL BOARD. FORM 990, PART VI, SECTION B, LINE 12C OUR OFFICERS AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST OF THEMSELVES AND THEIR FAMILY MEMBERS ON A QUESTIONNAIRE DISTRIBUTED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND PERFORMANCE OF THE ORGANIZATION'S PRESIDENT & CEO IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE OSWEGO HEALTH BOARD AND COMPENSATION IS APPROVED BY THE BOARD. THE COMMITTEE USES THE SERVICES OF AN INDEPENDENT CONSULTANT TO ASSIST IN THE EVALUATION PROCESS AND THE DETERMINATION OF APPROPRIATE COMPENSATION BASED ON PERFORMANCE, EXPERIENCE, TENURE AND MARKET VALUE OF SALARY RANGES AS COMPARED TO NATIONAL, REGIONAL AND LOCAL SURVEYS FOR SIMILAR POSITIONS. COMPENSATION AND PERFORMANCE OF OTHER OFFICERS IS REVIEWED ANNUALLY BY THE PRESIDENT & CEO WITH THE ASSISTANCE OF THE HR DIRECTOR AND IS ALSO REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE. COMPENSATION IS BASED ON SALARY BENCHMARK DATA OBTAINED FROM AN INDEPENDENT CONSULTANT AND GATHERED FROM VARIOUS INDEPENDENT SOURCES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE MADE AVALABLE BY REQUEST AND/OR SUBJECT TO COVENANT REQUIREMENTS IN DEBT INSTRUMENTS. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY 778,265. OTHER COMP OF NPPS -141,550. CHANGE IN INTEREST NET ASSET -94,122. FORM 990, PART XII, LINE 2C THERE HAS BEEN NO CHANGE TO THE PROCESS OSWEGO HEALTH INC 110 WEST SIXTH STREET OSWEGO NY 13126 161555936 PARENT HEALTH COMPANY NY 501 C 3 LINE 11B SCHEDULE A N/A 0 SENECA HILL MANOR INC 20 MANOR DRIVE OSWEGO NY 13126 223163818 LONG TERM CARE NY 501 C 3 LINE 11 TYPE III OSWEGO HEALTH INC 0 SPRINGSIDE AT SENECA HILL 10 COUNTY RT 45A OSWEGO NY 13126 161555935 ADULT LIVING FACILITY NY 501 C 3 LINE 9 SCHEDULE A OSWEGO HEALTH INC 0 OH PROPERTIES INC 110 WEST SIXTH STREET OSWEGO NY 13126 161365960 REAL ESTATE COMPANY NY 501 C 3 LINE 11 2 SCHEDULE A OSWEGO HEALTH INC 0 PHYSICIAN CARE PC 110 WEST SIXTH STREET OSWEGO NY 13126 900864974 NONPROFIT CORPORATION NY 501 C 3 LINE 11 TYPE III OSWEGO HOSPITAL 1 OSWEGO HEALTH FOUNDATION INC 110 WEST SIXTH STREET OSWEGO NY 13126 800822020 SUPPORTING ORGANIZATION NY 501 C 3 LINE 11A SCHEDULE A OSWEGO HEALTH INC 0 OSWEGO HEALTH HOME CARE LLC 113 SCHUYLER ST FULTON NY 13069 472463736 HOME HEALTH AGENCY NY OSWEGO HEALTH INC RELATED 106964 45321 0 0 0.60000 OH SERVICES INC 110 WEST SIXTH STREET OSWEGO NY 13126 161390603 HEARING DIAGNOSTICS AND SOLUTIONS NY OSWEGO HEALTH INC 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 PHYSICIAN CARE PC D 7330000 DEMAND NOTE AGREEMENT (FMV) PHYSICIAN CARE PC J 13581840 LEASE,ADMIN & PROF SERVICE AGREEM PHYSICIAN CARE PC Q 12949588 PAYMENT FROM CONTROLLED ENTITY(FM PHYSICIAN CARE PC A 957983 LEASE AGREEMENTS (FMV)