2019-11-12T09:18:29-07:00 2018-12-31 990 2018-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 Dates Drive Ithaca NY 14850 Martin Stallone CEO of Cayuga Medical Center 6072744441 2019-11-11 66.152.124.189 2018 2020-03-31 21:24:44Z Martin Stallone 101 Dates Drive Ithaca NY 14850 258590638 0 X www.cayugamed.org X 1981 NY To deliver the highest quality healthcare in partnership with our community, one person at a time. 16 14 1780 175 439967 282055 404188 1235160 209179911 237954712 4075885 2377810 2773561 5743987 216433545 247311669 1000 6750 0 0 100859776 110319583 0 0 0 99920889 112450918 200781665 222777251 15651880 24534418 264911114 263637669 109258088 113560752 155653026 150076917 To deliver the highest quality healthcare in partnership with our community, one person at a time. 0 0 167645869 0 242121061 Patient service - General inpatient and outpatient hospital care. Services are provided to those in need regardless of the patients' ability to pay, race, creed, national origin, life circumstances, or disease. Cayuga Medical Center works closely with the community to determine health needs and to support the development of programs and services that improve the health status of the community. 6750 6750 0 A health career scholarship awarded to students pursuing a healthcare degree. Two participants in 2018. 0 0 0 167652619 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 352 0 1780 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X John Collett 6072744441 101 Dates Drive Ithaca NY 14850 Tom LiVigne Chairman 1 1 X X 0 0 0 Larry Baum Vice Chair 1 1 X X 0 0 0 Greg Hartz Treasurer 1 1 X X 0 0 0 Suzanne Blowers Secretary 1 1 X X 0 0 0 Joel Malina Director 1 1 X 0 0 0 James Brown Director 1 1 X 0 0 0 Gary Ferguson Director 1 1 X 0 0 0 Rev Dr Ken Clarke Director 1 1 X 0 0 0 Paula Younger Director 1 1 X 0 0 0 John Lambert MD Director 1 1 X 0 0 0 Jerry Mickelson Director 1 1 X 0 0 0 Carl Sgrecci Director 1 1 X 0 0 0 Fred Wickham Director 1 1 X 0 0 0 Eunice Nayo Director 1 1 X 0 0 0 Jim Watson Schuyler Hospital President & CEO 1 40 X 0 323282 0 John Rudd President/CEO 40 1 X X 4961584 0 23400 John Collett CFO/VP 40 0 X 340667 0 53400 Srisatish Devapatla MD Neonatologist 38 0 X 439416 0 20700 David Evelyn VP of Medical Affairs 40 0 X 407248 0 125300 Martin Stallone MD VP of Physician Operations 40 0 X 390940 0 0 Ramesh Vidavalur MD Neonatologist 34 0 X 358396 0 10500 Auguste Duplan MD Psychologist 40 0 X 354124 0 17900 7252375 323282 251200 88 0 1 0 Navigant Consulting 150 North Riverside Plaza Suite 2100 Chicago IL 60606 Revenue Cycle Services 2932167 The Hayner Hoyt Corporation 625 Erie Blvd W Syracuse NY 13204 Commercial Construction 2826020 Cayuga Anesthesia Associates PLLC 101 Dates Drive Ithaca NY 14850 Anesthesiology Services 2509089 Ithaca Medical Group PLLC 1301 Trumansburg Rd P Ithaca NY 14850 Oncology Medical Services 2147633 Mayo Collaborative Services Inc PO Box 4100 Rochester MN 55903 Laboratory services 2100304 51 0 0 0 0 1169959 65201 0 1235160 PATIENT REVENUE 622000 227554668 227554668 0 0 10400044 10400044 0 0 237954712 2324425 0 277374 2047051 0 0 0 0 0 0 0 0 0 0 9835620 1496734 9630956 1648013 204664 -151279 53385 0 0 53385 0 CAFETERIA MEALS REVENUE 722212 1415045 0 0 1415045 4328942 4166349 162593 0 5743987 247311669 242121061 439967 3515481 6750 6750 5315437 5315437 73181802 56951521 16230281 9236015 7196209 2039806 17075460 13311126 3764334 5510869 4288667 1222202 1089471 485462 604009 520966 192757 328209 223200 223200 131958 131958 70000 70000 17487143 9336604 8150539 1202099 1202099 53469526 48017090 5452436 2807287 2161087 646200 4847771 2684809 2162962 294946 116952 177994 841097 841097 13152425 7211214 5941211 1194146 1015024 179122 Physician Forgiveness Program 50144 0 50144 0 Licenses/Certification/Permit Fees 116754 92263 24491 0 Purchased Services 14951985 14585084 366901 0 222777251 167652619 55124632 0 7313 7311 15664425 15639322 0 0 24654747 24034313 0 0 0 0 303645 282238 8039143 8327090 8991214 13203035 282276549 165623117 117101935 116653432 72772255 68517551 0 0 1564717 1529995 15811720 15443382 264911114 263637669 22859917 25745018 0 0 0 0 29889856 25783185 0 0 0 0 0 0 0 0 56508315 62032549 109258088 113560752 X 150264474 144707059 3995017 0 1393535 5369858 155653026 150076917 264911114 263637669 X 24534418 -7033049 0 0 0 -23077478 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 131958 0 0 131958 0 Schedule C, Part II-B, Line 1 Cayuga Medical Center has consultants that lobby on the hospital's behalf and it also belongs to an organization that lobbies on their members' behalf. 1703145 35761 199 0 10904 0 1728201 1720662 97 193 0 17807 0 1703145 1711653 30144 181 0 21316 0 1720662 1674520 43088 136 0 6091 0 1711653 1647374 41237 105 0 14196 0 1674520 0 0.8 0.2 0 1 1 12899485 0 12899485 155116284 0 77339142 77777142 2528371 0 1874361 654010 102600495 0 82192725 20407770 9131914 0 4216889 4915025 116653432 Beneficial Interest in Assets of Foundation 6188437 Insurance Receivable 2786655 Equity in Related Parties 4937015 Other Assets 1531275 15443382 0 Accrued Pension Costs 38993135 Accrued Other Post-employment Retirement Costs 11225389 Due to Third Party Payors 8990516 Accrued Insurance Claims 2786655 Fair Value of Interest Rate Swaps 36854 62032549 217201142 -7033049 0 0 -23077478 -30110527 247311669 0 0 0 247311669 222777251 0 0 0 0 0 222777251 0 0 0 222777251 Schedule D, Part V, Line 4 The intended use of the endowment funds is to support Cayuga Medical Center's ongoing mission to deliver the highest quality healthcare in partnership with our community, one person at a time. Schedule D, Part XI, Line 2d Unrealized gain on interest rate swap: $67,324; Other changes in pension and other post-employment retirement benefits: ($4,995,902); Transfers to related parties: ($18,148,900) 1 1 1 X 1 X 1 1 0 0 476343 0 476343 0.0021 32684460 20417094 12267366 0.0551 0 0 0 0 0 0 33160803 20417094 12743709 0.0572 22865117 552310 22312807 0.1002 1041013 37316 1003697 0.0045 14420704 9798785 4621919 0.0207 0 0 0 0 39852 0 39852 0.0002 0 0 38366686 10388411 27978275 0.1256 0 0 71527489 30805505 40721984 0.1828 1 5828634 4954987 43817741 60568212 -16750471 X 1 1 1 1 CAYUGA MEDICAL CENTER AT ITHACA INC 101 DATES DRIVE ITHACA NY 14850 WWW.CAYUGAMED.ORG 5401001H X X X X CAYUGA MEDICAL CENTER AT ITHACA INC 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X WWW.CAYUGAMED.ORG/wp-content/uploads/2017/08/CHIP-TOMP-2016-2018.PDF X 1 16 1 WWW.CAYUGAMED.ORG/wp-content/uploads/2017/08/CHIP-TOMP-2016-2018.PDF 0 0 1 X 100 300 X 1 1 X X X 1 X WWW.CAYUGAMED.ORG X WWW.CAYUGAMED.ORG X WWW.CAYUGAMED.ORG X X X X X X 1 X 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-CAYUGA MEDICAL CENTER AT ITHACA INC As in years past, the qualitative process provided crucial community input into this assessment. Information for this assessment was collected in a different manner this year, as the CHNA and Community Health Improvement Plan (CHIP) was a combined effort with the Local Health Department of Tompkins County. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center, and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers and through panels and presentation by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. For example, data on hospitalizations related to mental health and substance abuse showed steep increases over the last 2-10 years, indicating that mental health and substance abuse continues to be a priority for Tompkins County. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part V, Section B, Line 6b-CAYUGA MEDICAL CENTER AT ITHACA INC Tompkins County Health Department, Tompkins County Human Services Coalition, Alcohol and Drug Council of Tompkins County, Collaborative Solutions Network, Family & Children's Services of Tompkins County, Mental Heath Association of Tompkins County, and Tompkins County Mental Health Department. Schedule H, Part V, Section B, Line 11-CAYUGA MEDICAL CENTER AT ITHACA INC Cayuga Medical Center (CMC) is actively working to address the needs of individuals suffering from mental health and/or substance abuse conditions by improving the care available to this population within the hospital setting and actively collaborating with community-based providers for the outpatient setting. Cayuga Medical Center is directly participating in the Tompkins County CHNA/CHIP Steering Committee and has representation from our Cayuga Center for Health Living, a service within CMC that focuses on chronic disease prevention and treatment. The health needs not addressed by the document include: percent of population (all ages) living in poverty, percent of population (under age 18) living in poverty, percent of single parent households with children under the age of 18 living in the home, percent of individuals uninsured and the housing affordability rate. CMC is not directly addressing these health conditions. CMC is however, aligned with and supports the United Way in Tompkins County which helps address housing and poverty needs. CMC additionally is aligned with the Health Planning Council which assists in enrolling individuals into Medicaid and other affordable insurance programs and CMC provides space at the hospital for enrollment of individuals into these programs. Schedule H, Part I, Line 7 Cayuga Medical Center utilized its cost accounting system to obtain the cost of services related to financial assistance and subsidized health services, lines 7a and 7g. All other costs were derived from actual expenses incurred in the period that were directly related to the provision of the service or program. Schedule H, Part III, Section A, Line 4 Schedule H, Part III, Section A, Line 4 - Part III, Line 2: The medical center provides services that are paid for by third-party payers and individuals. The medical center does not accrue interest on these receivables. The medical center estimates the amount to be recognized in the financial statements for doubtful accounts by analyzing patient accounts for collectability and applying historically established percentages for self-pay and various third-party payers to the aging categories in the accounts receivable aging. Accounts for which no payments have been received for a significant amount of time are considered delinquent and the account is written-off when customary collection efforts are exhausted. Part III, Line 3: For calculating the bad debt expense attributable to patients eligible under the financial assistance policy of the medical center, the denial rate was applied to the reported bad debt expense. This allows the medical center to be conservative in the estimate of what amount the organization's bad debt attributable to patients eligible for financial assistance is. Part III, Line 4: The page number in the attached financial statements on which the footnote is contained that describes bad debt is page 6, footnote # 2 - summary of significant accounting policies - net patient service revenue and patient accounts receivable. Schedule H, Part III, Section B, Line 8 The cost to charge ratio of 51.08% was calculated from our facilities cost accounting system based on the total cost to total charges on medicare account only was applied to the medicare gross patient revenue of $132,914,798. The result was then reduced by the worksheet 6 medicare costs of $5,662,665 for the FY 2018. The "cost" of bad debt is calculated by our cost accounting system at actual cost. Only the bad debt for the community benefit programs with losses which qualified for worksheet 6 inclusion was included in community benefit. Schedule H, Part III, Section C, Line 9b CMC's standard operating practice is to stop all collection efforts and hold accounts back from bad debt until the patient is given sufficient time to complete a financial assistance application. Review of the application will be made by the hospital and patients are notified of determination within 30 days of receipt of a completed application. If a patient does not qualify for either partial or full assistance, then a monthly payment plan is offered to the patient for any remaining balances due. If the patient qualifies for any financial assistance, an adjustment is immediately posted to the patients account upon determination of qualification. The accounts for patient's qualifying for financial assistance are earmarked as "charity." Such accounts do not qualify for collection. Schedule H, Part VI, Line 2 To determine the health needs of our community, a comprehensive analysis was conducted through quantitative and qualitative methods. In the quantitative analysis, multiple sources provided the reportable statistics including the New York State Community Health Indicators, the County Health Rankings Report, as well as internal data from Cayuga Medical Center. The data collected for the quantitative assessment was then sorted into the following health categories: Demographics and socioeconomic status, Access to healthcare, Health status of overall population and priority populations, Risk factor behaviors and conditions related to top 5 causes of death, child health, Infectious diseases, Natural environment, Social and mental health environment, and Resources/Assets. For every indicator, comparisons were made utilizing the mean value for each individual county, the aggregate value for the total community, the New York State without New York City state value and the U.S. value where applicable to generate context for interpretation. Information for this assessment was collected in a different manner this year, as the CHNA and Community Health Improvement Plan (CHIP) was a combined effort with the Local Health Department of Tompkins County. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center, and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers and through panels and presentation by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. For example, data on hospitalizations related to mental health and substance abuse showed steep increases over the last 2-10 years, indicating that mental health and substance abuse continues to be a priority for Tompkins County. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part VI, Line 3 There is signage in all patient registration areas at Cayuga Medical Center (CMC), as well as in other patient waiting areas, advising patients that financial assistance is available. Financial assistance brochures are also available at all registration areas. Patients who request financial assistance are provided with the CMC policy and an application. Financial counselors are available to assist patients in completion of the application and to answer any questions. Self-pay billing statements provide information on financial assistance policies, as well as the contact information to call for assistance. CMC's call center contacts patients regarding unpaid bills and advises patients of the availability of financial assistance. The Financial Assistance Policy and application are posted and available on the CMC website at www.cayugamed.org. CMC has facilitated enrollers from Medicaid Managed Care Plans on-site. Patients are referred to the facilitated enrollers for determination of Medicaid eligibility. Information regarding the on-site facilitated enrollers is also available on CMC's website. Schedule H, Part VI, Line 4 Located in the Finger Lakes region, Cayuga Medical Center serves populations from six counties: Cayuga, Cortland, Schuyler, Seneca, Tioga, and Tompkins Counties. Many of these areas are designated rural counties and Tompkins County is New York State's smallest Metropolitan Statistical Area. The total service area spans approximately 1,000 square miles in the middle of the state with an average population density of fewer than 125 persons per square mile. There are several distinct health and health-related factors affecting residents of this area: A) The region is home to an older community. According to the Healthcare Association of NY State (HANYS), 11.3% of adults are 55-64 years of age. Since the 2000 Census, growth in the 65+ age cohort has ranged from 15% to 32% across the region and is projected to increase by 18% between 2016 and 2021. Issues with chronic disease and psychological distress are well documented for this demographic. Overall, 22.9% of adults aged 55 and over are likely to be in fair or poor health, ranging from 19.6% of those aged 55-64 to 32.1% or those aged 85 and over (National Health Statistics Reports, Health Characteristics of Adults Aged 55 Years and Over: United States, 2004-2007, CDC, 2009). B) Access to health care professionals within the region is problematic. Many of the counties have zip codes within that county with Health Professional Shortage Areas (HPSA's) designations for physician, dental, and mental health care for Medicaid beneficiaries. Even when a provider is available, the rural environment, defined by hilly terrains and lakes as geographic barriers, creates transportation challenges that can limit access. C) In aggregate, residents of the services are fiscally challenged. The median salary within the region is $52,624, which is $6,645 below the state average (ACS 5-Year Estimate, Census Bureau). Schedule H, Part VI, Line 5 Cayuga Medical Center (CMC) has a mirror board at the Cayuga Health System (CHS) level, CMC's active parent holding company. The majority of the CHS board of directors are all residents of Tompkins County, CMC's primary service area. Additionally, any qualified healthcare professional that meets the high quality standards of our credentialing process may apply and secure medical staff privileges within an identified department or specialty. As a 501(c)(3) organization, CMC reinvests any surplus in annual operating margin to improve the medical care for the community, including patient-side and technology improvements, facility structure and infrastructure, and improvements in care delivery, As an example, CMC is investing in a $6.9 million facilities project to renovate and expand its inpatient Behavioral Services Unit staring in 2017. Part of this project will be funded through a NYS grant ($2.47 million), however the majority of the project will be funded through CMC's own reserves. Despite the fact that this crucial community resource does not generate surplus revenue, CMC believes it is a vital service for the community, and as such, continues to invest its limited resources to ensure the community's needs are met. Schedule H, Part VI, Line 6 As of September 2014, Cayuga Medical Center is a subsidiary member of Cayuga Health System. Schuyler Hospital is also a subsidiary member of Cayuga Health System. Each subsidiary organization has their own separately identified primary and secondary service areas and is responsible for improving the health of those communities. For 2016, Schuyler Hospital collaborated with its local health department to complete its CHNA/CHIP. As of 2017, Cayuga Health System has a mirror board with representatives from each of the former subsidiary boards as members. The organizations are exploring a more unified approach to the CHNA/CHIP process in future years. The strategic plan is now aligned at the System level, and the needs of each community have been incorporated across the plan. Schedule H, Part VI, Line 7 New York State 1 EMPLOYEE DISASTER FUND 14 5000 0 book KOMARMI SCHOLARSHIP 1 500 0 Book Schedule I, Part I, Line 2 The employee disaster Fund (EDF) is to provide temporary aid to employees with a disaster or other emergency hardship situation. The EDF Committee is comprised of hospital employees, with a majority of the members being in a non-management position. To be eligible for assistance, applicants must meet certain criteria as specified in the EDF policy. The EDF Committee makes awards based on the merits of each case in accordance with the policy. The EDF committee maintains complete and accurate minutes of its proceedings. The Komarmi scholarship is a health career scholarship that is administered by a committee made up of two volunteer community members, a representative from the Board of Directors, and a member of the administrative team. The committee identifies specific areas each year in the hospital which are experiencing or anticipating recruitment difficulties related to the shortage of qualified candidates. The committee works with the Ithaca High School Administration to identify a graduating senior who is planning on pursing a career in the selected health profession. The amount of the scholarship can be up to $1,000, to be awarded at graduation. X 1 1 X X X X 0 1 0 0 0 1 0 0 0 John Rudd President/CEO 542332 0 148499 0 4270753 0 23400 0 8068 0 4993052 0 0 0 David Evelyn VP of Medical Affairs 348362 0 58886 0 0 0 125300 0 6638 0 539186 0 0 0 Srisatish Devapatla MD Neonatologist 437856 0 1560 0 0 0 20700 0 7418 0 467534 0 0 0 Martin Stallone MD VP of Physician Operations 362815 0 28125 0 0 0 0 0 7158 0 398098 0 0 0 John Collett CFO/VP 290570 0 50097 0 0 0 53400 0 0 0 394067 0 0 0 Ramesh Vidavalur MD Neonatologist 356836 0 1560 0 0 0 14337 0 6638 0 379371 0 0 0 Auguste Duplan MD Psychologist 352564 0 1560 0 0 0 23400 0 6118 0 383642 0 0 0 Jim Watson Schuyler Hospital President & CEO 0 323282 0 0 0 0 0 0 0 0 0 323282 0 0 Schedule J, Part I, Line 1a All employees are eligible for a health club membership subsidy for which Cayuga Medical Center will reimburse employees 50% of the monthly single membership fee when they attend the health club at least 24 times a quarter. If an employee does not meet the criteria for a quarter, they will not receive the subsidy for that quarter. Schedule J, Part I, Line 4 John Rudd, President and CEO, received a pension plan lump sum distribution of $4,270,753 that was due at retirement per his employment contract. The contract was reviewed by a third party consultant and approved by the Board of Directors Schedule J, Part I, Line 6 Cayuga Medical Center has a year end bonus program for all employees based on the organization's operating margin compared to targets, employee participation in annual safety training, and reaching predetermined customer satisfaction scores. Schedule J, Part II Other reportable compensation for John Rudd consisted of a pension plan lump sum distribution that was due at retirement per his employment contract. The contract was reviewed by a third party consultant and approved by the Board of Directors. A Tompkins County Development Corporation 272290745 890096AA8 2010-08-31 14275000 Finance construction and purchase of equipment 0 0 0 B Tompkins County Development Corporation 272290745 890096AA8 2013-04-09 25000000 Finance construction and purchase of equipment 0 0 0 A 0 0 14275000 0 0 0 285500 0 142750 13846750 0 0 2010 0 0 1 1 B 0 0 25000000 0 0 0 613238 0 0 24386762 0 0 2013 0 0 1 1 A 0 0 0 0 0 0 0 1 0 1 B 0 0 0 0 0 0 0 1 0 1 A 1 1 1 Deutshe Bank 12 0 0 0 0 0 B 1 0 0 0 0 0 Greg Hartz Board Member 1065253 Greg Hartz is the President & CEO of Tompkins Trust Company. Tompkins Trust Company and its subsidiaries provide banking, investing, and insurance services to Cayuga Medical Center. Transactions entered into were fair, reasonable, and in the best interest of the Hospital based on ongoing analysis of value, local services, and history of quality service. The hospital's conflict-of-interest policy was followed related to these transactions. 0 Larry Baum Board Member 273612 Larry Baum is the Board Chair/Founder, CFO/Minority Shareholder of the Computing Center. Payments to the Computing Center for certain computer products, consumables, and services were made in 2018. Transactions entered into were fair, reasonable, and in the best interest of the Hospital based on ongoing analysis of value, local services, and history of quality service. The hospital's conflict-of-interest policy was followed related to these transactions. 0 Form 990, Part VI, Section B, Line 11b Reviewed by Controller, External Accountants, CFO, and then all Board Members, in that order. Form 990, Part VI, Section B, Line 12c Cayuga Medical Center (CMC) maintains a conflict of interest policy which board members are required to sign annually. CMC regularly and consistently monitors and enforces compliance with the policy by reviewing statement for conflicts, identifying disqualified persons, and recording all proceedings related to a conflict of interest transactions. Form 990, Part VI, Section B, Line 15 Cayuga Medical Center determines compensation of the CEO and other officers by utilizing independent compensation consultants and/or compensation surveys. A formal written contract for the CEO is reviewed and approved by the executive committee of the Board of Directors. Form 990, Part VI, Section C, Line 19 Form 990 is reviewed with the Finance, Audit, and Personnel Committees and is made available to the entire Board of Directors prior to filing. Form 990, Part XI, Line 9 Unrealized gain on interest rate swap: $67,324; Other changes in pension and other post-employment retirement benefits: ($4,995,902); Transfers to related parties: ($18,148,900) Cayuga Health System Inc 101 Dates Drive Ithaca NY 14850 471899601 Support community healthcare NY 501(c)(3) 12 N/A 0 Schuyler Hospital 220 Steuben Street Montour Falls NY 14865 150533564 Hospital NY 501(c)(3) 3 N/A 0 Cayuga Medical Associates 1301 Trumansburg Road Ithaca NY 14850 204356115 Medical Practice NY 501 (c)(3) 9 N/A 0 Cayuga Medical Center Foundation 101 Dates Drive Ithaca NY 14850 161072414 Support NY 501(c)(3) 11 Cayuga Medical Center at Ithaca 0 Cayuga Medical Office Building 101 Dates Drive Ithaca NY 14850 161261492 Building Management NY N/A Related 277374 1561665 0 1131 1 0.58 Tompkins Office Management System 101 Dates Drive Ithaca NY 14850 161437217 Office Management NY Cayuga Medical Center at Ithaca C 158552 1572165 1 1 Island Health & Fitness 310 Taughannock Blvd Ithaca NY 14850 203036206 Fitness NY Tompkins Office Management System C 0 0 0 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 1 0 0 Cayuga Medical Associates b 18148900 Acknowledgement Letter Cayuga Medical Associates j 91076 Contract Cayuga Medical Associates k 21206 Contract Cayuga Medical Associates m 3116723 Contract Cayuga Medical Associates l 1871126 Contract Schuyler Hospital l 603637 Contract Schuyler Hospital m 79459 Contract Schuyler Hospital q 914337 Cost Tompkins Office Management System l 64651 Contract Cayuga Medical Center Foundation l 384945 Contract Cayuga Medical Center Foundation c 350506 Contract Cayuga Medical Office Building l 104819 Contract Cayuga Medical Office Building k 485612 Contract See Extension