2019-05-14T18:38:06-05:00 2018-06-30 990 2017-07-01 150532221 Our Lady of Lourdes Memorial Hospital Inc OURL 3147338000 169 Riverside Drive Binghamton NY 13905 Tonya Mershon Tax Officer 2019-05-14 2017 2019-02-21 02:37:17Z Sean Mills 169 Riverside Drive Binghamton NY 13905 367389104 false 0928 X www.lourdes.com X 1936 NY To improve the health and well-being of all people in the communities we serve. 13 11 2865 295 129981 -178301 4617605 3115044 318768665 355707155 8994965 5190466 6475349 3221359 338856584 367234024 60772 23925 0 165163906 181884422 0 0 0 163052397 186220666 328277075 368129013 10579509 -894989 406205422 401851510 146765224 139705721 259440198 262145789 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 275231263 23925 356299862 OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is a 154-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. treated 9,577 adults and children for a total of 36,554 patient days of service. The hospital also provided services for 1,394,054 outpatient visits, which included 11,273 outpatient surgeries and 45,717 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 275231263 true true false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true true false true 281 0 true 2865 true true true false false false false false true false false false X 13 11 false false false false true true true true true false false false true true true true true false true true false NY X Sara O'Brien 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 DAVID CAHILL CHAIR 1.0 1.0 X X 0 0 0 FRANK GRECO JR VICE CHAIR 1.0 1.0 X X 0 0 0 STEPHEN VANNOSTRAND SECRETARY 1.0 1.0 X X 0 0 0 ROBERT FISHER TREASURER 1.0 1.0 X X 0 0 0 KATHRYN CONNERTON PRESIDENT & CEO 50.0 2.0 X X 753562 0 28289 KEVIN DRUMM PHD BOARD MEMBER 1.0 1.0 X 0 0 0 MICHAEL FARRELL MD BOARD MEMBER 1.0 1.0 X 0 0 0 CATHERINE MALIWACKI BOARD MEMBER 1.0 1.0 X 0 0 0 KIM MYERS BOARD MEMBER 1.0 1.0 X 0 0 0 JAMES ORBAND BOARD MEMBER 1.0 1.0 X 0 0 0 BRIAN ROSE BOARD MEMBER 1.0 1.0 X 0 0 0 JAMES STEINMETZ MD BOARD MEMBER/PHYSICIAN 50.0 1.0 X 537280 0 43103 SISTER ELLEN REILLY BOARD MEMBER 1.0 0 X 0 0 0 SEAN MILLS VP-FINANCE/CFO 50.0 2.0 X 259762 0 31281 DEBORAH S MICAN VP-NURSING (END 3/2018) 50.0 0 X 241196 0 33459 LISA YVETTE HARRIS SR VP MEDICAL AFFAIRS/CMO (END 8/2018) 50.0 0 X 358858 0 30784 CHAD A PATTON VP-PHYSICIAN NETWORK 50.0 0 X 239620 0 40822 RICHARD BLANSKY MD CHIEF MEDICAL OFFICER 50.0 0 X 605231 0 19567 ANNE E WOLANSKI FORMER KEY EMPLOYEE (END 12/2016) 0.0 0 X 187151 0 5290 DEBORAH BLAKENEY VP-CONTINUUM CARE 50.0 0 X 207857 0 10464 SANJIV PATEL PRESIDENT MEDICAL STAFF 50.0 0 X 235631 0 16402 MARY E HUGHS CHRO 50.0 0.0 X 0 229110 31298 RATNAKISHORE PALLAPOTHU PHYSICIAN 50.0 0 X 650531 0 43803 JOHN DIMENNA MD PHYSICIAN 50.0 0 X 531268 0 30023 JOYLEEN EARLE MD PHYSICIAN 50.0 0 X 517333 0 30318 CHARLES CAMPBELL MD PHYSICIAN 50.0 0 X 513213 0 35122 ELDAD EINVA MD PHYSICIAN 50.0 0 X 504813 0 41680 DAVID F CLEMENTS FORMER OFFICER (END 8/2016) 0.0 0.0 X 211707 0 16994 LINDA A MCCORMACK-MILLER FORMER OFFICER (END 11/2016) 0.0 0 X 231716 0 1772 6786730 229110 490471 204 true true false RIVERSIDE ASSOCIATES IN ANESTHESIA PC 40 FRONT STREET BINGHAMTON NY 13905 PHYSICIAN SERVICES 3411810 COGENT MEDICAL CARE PC PO BOX 742936 LOS ANGELES CA 900742936 MEDICAL SERVICES 2487416 ARUP LABORATORIES 500 S CHIPETA WAY SALT LAKE CITY UT 841081221 LABORATORY SERVICES 1202185 BROOME OBSTETRICS AND GYNECOLOGY PC 161 RIVERSIDE DR STE 109 BINGHAMTON NY 13905 PHYSICIAN SERVICES 620535 PIPPA ADAMS 564 HALL ROAD FRIENDSVILLE PA 18818 ENVIRONMENTAL SERVICES 604470 40 X 2845461 269583 3115044 Net Patient Service Revenue 621990 312256547 312256547 Pharmacy Revenue 446110 39018816 39018816 DSRIP & Care Compass 621990 2309911 2309911 Government Incentives 900099 829424 829424 Rental Income from Affiliates 531120 680145 680145 612312 732011 -119699 0 355707155 5248109 5248109 416006 40 416006 40 416046 416046 57643 0 -57643 -57643 -57643 503544 97437 406107 406107 Cafeteria/Vending Revenue 722514 864119 864119 Fitness Club Revenue 713940 42474 42474 Medical Staff Dues 900099 33780 33780 1458833 473008 249680 736145 2399206 367234024 356299862 129981 7689137 23925 23925 3693169 3323852 369317 143575646 129343177 14232469 6295032 5670972 624060 18576873 16735122 1841751 9743702 8777623 966079 521934 521675 259 36976 36976 104995 104995 4674 4674 15608148 5289859 10318289 0 364848 100662 264186 1556928 728010 828918 573831 143804 430027 10152109 7469621 2682488 888965 780824 108141 585716 407782 177934 1380731 1380731 12333197 4985571 7347626 2877261 867006 2010255 Medical Supplies 59989275 59989275 Purchased Services 27523772 13413925 14109847 Management Fee to Affiliate 33226362 33226362 Contract Labor 8321922 8076075 245847 10169022 8582503 1586519 0 368129013 275231263 92897750 0 8205345 26599 197287125 12101360 516023 793150 34519076 41561826 0 0 0 0 4892242 4852807 1822514 1798830 218954290 114778355 105643797 104175935 0 605733 204281 3362509 2746880 49351058 233589842 406205422 401851510 23975176 22621432 0 0 122790048 117084289 146765224 139705721 X 234670308 236701186 12155025 12829738 12614865 12614865 259440198 262145789 406205422 401851510 X -894989 1678260 1922320 X false true X true false X false false false false false false false false true 4674 4674 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 544659 544659 139798535 71931725 67866810 3035189 1912091 1123098 59388853 37896730 21492123 16187054 3037809 13149245 104175935 Other Assets Other Current Assets 139614 Due from Affiliates 5931271 Other Receivables 6145776 Deferred Compensation/Retirement/Pension Asset 14545217 Physician Guarantee Asset 492500 Security Deposit 20450 Beneficial Interest in Foundation 25174505 Estimated 3rd Party Payor Settlements 2472478 Interest in Investments Held by Ascension Health Alliance 178526598 Cash Surrender Value of Life Insurance 141433 233589842 0 Pension Liability Self Insurance IBNR Savings Plan Liability Asset Retirement Obligation 516449 Due to Affiliates 51043719 Deferred Compensation/Retirement/Pension Liability 14611012 Other Current Liabilities 4098510 Estimated 3rd Party Payor Settlement 3756631 Physician Guarantee Liability 257646 Recovery Tail Liability 2246719 Accrued Tax Liability 7631 Debt with Ascension Health Alliance 40545972 117084289 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true X true X 250 true X true true true false true true 5070925 5070925 0.0138 60388633 34890844 25497789 0.0693 0 0.0 0 0 65459558 34890844 30568714 0.0830 2447397 2447397 0.0066 3794541 3794541 0.0103 48478709 28480702 19998007 0.0543 0 0.0 875 875 0.0000 0 0 54721522 28480702 26240820 0.0713 0 0 120181080 63371546 56809534 0.1543 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1326 1326 0.0000 0 0.0 0 0.0 0 0.0 0 0 1326 0 1326 0.0000 4238580 907934 -199630925 -179355123 -20275802 X true true 1 1 Our Lady of Lourdes Memorial Hospital Inc 169 Riverside Drive Binghamton NY 13905 www.lourdes.com 03011001H X X X X Our Lady of Lourdes Memorial Hospital Inc 1 false false true X X X X X X X X X 15 true true true true X https://www.lourdes.com/about-us/community-service-plan/ X true 15 true https://www.lourdes.com/about-us/community-service-plan/ false true X 250.0 400.0 X X X X true true X X X true X https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/ X https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/ X https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E To better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; opportunities for partnership; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. ELICITED INPUT OF REPRESENTATIVES WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH BY ENGAGING PERSONS WHO REPRESENT THE COMMUNITY SERVED BY LOURDES AND THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH WERE INCLUDED IN THE EVALUATION OF COMMUNITY HEALTH NEEDS, IDENTIFICATION OF HEALTH PRIORITIES AND GOALS AND OBJECTIVES OF THE IMPLEMENTATION STRATEGY. THE PUBLIC PARTICIPATED IN THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THROUGH INTERVIEWS, SURVEYS, INTERACTIVE PRESENTATIONS AND COMMUNITY MEETINGS. Identification of community health status themes, September 2015- May 2016. 2. Community health status prioritization, May-July 2016. 3. Development of Community Health Improvement Plan, July-August 2016; 4. Lourdes Board of Directors approval, September 2016. 5. Submission of CHNA/CHIP to the New York State Department of Health, December 30, 2016. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.. UHS HOSPITAL Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.. RMS HEALTHCARE Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Our Lady of Lourdes Memorial Hospital, INc.. Our Lady of Lourdes Memorial Hospital, Inc. (Lourdes) identified several needs needs during the Community Health Needs Assessment for the 2016-2018 period. The following is a listing of the needs that Lourdes is addressing and how they are being addressed. Behavioral Health (Mental Health & Substance Abuse): Goal: lower barriers to mental health and substance use services Ways Addressed in FY 2018: - Our Lady of Lourdes Memorial Hospital, INc. YOUTH SERVICES PROVIDED SERVICES TO AT-RISK ADOLESCENTS THROUGH TWO PROGRAMS: 1) THE LOURDES MENTAL HEALTH JUVENILE JUSTICE (MHJJ) PROJECT WORKED SUCCESSFULLY TO KEEP 100% (52 TOTAL PARTICIPANTS, AN INCREASE IN PARTICIPATION OVER FY2017) OF THE YOUTH SERVED OUT OF DETENTION AND OUT OF HOME PLACEMENT. 2) THE DETENTION ALTERNATIVE AFTER SCHOOL PROGRAM (DAASP) KEPT 100% OF THE YOUTH SERVED OUT OF PLACEMENT (32 TOTAL PARTICIPANTS). - Our Lady of Lourdes Memorial Hospital, INc. CONTINUED TO OFFER SUICIDE INTERVENTION TRAINING PROGRAMS; LEAD A Our Lady of Lourdes Memorial Hospital, INc. SPECIFIC SUBSTANCE ABUSE AND MENTAL HEALTH TASK FORCE; SERVED OVER 14,500 PEOPLE THROUGH ITS STUDENT ASSISTANCE PROGRAM (SAP) AND ALCOHOL & DRUG EDUCATION PREVENTION TEAM (ADEPT); ADMINISTERED SUICIDE PREVENTION SCREENING; PROVIDED INPATIENT AND EMERGENCY DEPARTMENT SCREENING FOR ALCOHOL AND SUBSTANCE ABUSE. Obesity Prevention, Wellness & Chronic Disease Goal: lower barriers to healthy life style choices Ways Addressed in FY 2018: - DIABETES PREVENTION AND EDUCATION: Our Lady of Lourdes Memorial Hospital, INc. IS CARRYING OUT A DIABETES PREVENTION PROJECT AND IS COLLABORATING WITH 95% OF Our Lady of Lourdes Memorial Hospital, INc. PRIMARY CARE PROVIDERS TO IDENTIFY AND INTERVENE ON INDIVIDUALS IDENTIFIED AS PRE-DIABETICS. THE PROJECT AIMS TO DELAY OR AVOID THE PROGRESSION TO TYPE 2 DIABETES IN AN AT-RISK POPULATION. AT THE CLOSE OF 2018, THERE WERE 900 INDIVIDUALS ENROLLED IN THE PROJECT. -Our Lady of Lourdes Memorial Hospital, INc. OFFERS THE CDC'S NATIONAL DIABETES PREVENTION PROGRAM ON CAMPUS. 19 INIDIVIDUALS REGULARLY ATTEND CLASSES IN THE YEAR LONG PROGRAM (AN INCREASE FROM FY2017. - Our Lady of Lourdes Memorial Hospital, INc. ASSOCIATE HEALTH OFFERS DIABETES RISK ASSESSMENTS WITH ANNUAL PHYSICALS. - FIT AND FUN MEALS WERE PROVIDED AT THE Our Lady of Lourdes Memorial Hospital, INc. ALL SPICE CAFE - SUPPORTING A HEALTHY START FOR NEWBORNS, PATIENTS ARE ENCOURAGED TO BREAST FEED Socioeconomic Poor & Vulnerable Goal: Focus on the poor and vulnerable with special attention to those enrolled in the Medicaid program. Ways Addressed in FY 2018: - Our Lady of Lourdes Memorial Hospital, INc. CONTINUES TO PARTICIPATE IN A FEDERAL DRUG DISCOUNT PROGRAM CALLED 340B, WHICH HELPS HOSPITALS TO SERVE THE MEDICATION NEEDS OF RURAL COMMUNITIES; UNDER THE PROGRAM HOSPITALS RECEIVE PHARMACEUTICALS AT DISCOUNTED PRICES FROM DRUG COMPANIES. - Our Lady of Lourdes Memorial Hospital, INc. CONTINUES TO OFFER THE PATIENT FINANCIAL ASSISTANCE PROGRAM (PFAP) TO PATIENTS WHO MEET CERTAIN INCOME GUIDELINES THAT MAY HAVE DIFFICUTLY COVERING THEIR COPAYS, DEDUCTIBILES AND/OR OTHER MEDICAL-RELATED EXPENSES. - The Mission in Motion mobile mammography van provides no charge screening to those in need Our Lady of Lourdes Memorial Hospital, INc. recognizes that no one organization can address the entire health care needs of the community. Our Lady of Lourdes Memorial Hospital, INc. is conscious of its stewardship of resources to best meet the needs of our community. As such, Our Lady of Lourdes Memorial Hospital, INc. will focus resources in those areas in which Our Lady of Lourdes Memorial Hospital, INc. can impact community health most. Our Lady of Lourdes Memorial Hospital, INc. practice is to maximize resources with existing programs, new services planned, to avoid duplication of services, and to establish metrics and tools which foster continuous improvement. For those reasons, the needs identified that will not be addressed are: - Improve Health Status and Health Disparities - Promote a Health and Safe Environment - Preventing Chronic Disease - Promoting Healthy Women, Infants, and Children Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.. OUR LADY OF LOURDES MEMORIAL HOSPITAL USED THE FOLLOWING ADDITIONAL CRITERIA TO DETERMINE ELIGIBILITY FOR FREE DISCOUNTED CARE: - MEDICAID/MEDICARE - STATE REGULATIONS 18 Center for Family Health 303 Main Street Binghamton NY 13905 Primary Care Office Lourdes Pediatrics 161 Riverside Drive Suite 206 Binghamton NY 13905 Primary Care Office Lourdes at Home 4102 Old Vestal Road Vestal NY 13850 Home Care Internal Medicine 3101 Shippers Road Suite 202 Vestal NY 13850 Primary Care Office Primary Care Associates 276-280 Robinson Street Binghamton NY 13904 Primary Care Office Primary Care Associates 415 East Main Street Endicott NY 13760 Primary Care Office Riverside Surgical 169 Riverside Drive Binghamton NY 13905 Primary Care Office Hospice at Lourdes 4102 Old Vestal Road Vestal NY 13850 End of Life Care Family Medicine 3101 Shippers Road Suite 203 Vestal NY 13850 Primary Care Office Riverside Medical 161 Riverside Drive Suite 306 Binghamton NY 13905 Primary Care Office Lourdes Family Practice 500 5th Avenue Owego NY 13827 Primary Care Office Lourdes Gastroenterology 161 Riverside Drive Suite 210 Binghamton NY 13905 Primary Care Office Lourdes Family Practice 1130 Upper Front Street Binghamton NY 13901 Primary Care Office Lourdes Vascular Surgery 161 Riverside Drive Suite 105 Binghamton NY 13905 Primary Care Office Lourdes Dermatology 3101 Shippers Road Suite 102 Binghamton NY 13850 Primary Care Office Lourdes Family Practice 2660 Main Street Whitney Point NY 13862 Primary Care Office Lourdes Family Practice 39 East Main Street Hancock NY 13783 Primary Care Office North Tioga Center for Family Health 13293 Route 38 Richford NY 13835 Primary Care Office Schedule H, Part I, Line 7g Subsidized Health Services THE ORGANIZATION HAD NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities RESEARCH SHOWS THAT SOCIAL DETERMINANTS AND QUALITY OF LIFE PLAY A MAJOR ROLE IN THE HEALTH STATUS OF INDIVIDUALS AND COMMUNITIES. COMMUNITY BUILDING ACTIVITIES, WHICH FOCUS ON IMPROVING THE QUALITY OF LIFE WITHIN A COMMUNITY, ULTIMATELY INFLUENCE AND IMPROVE HEALTH STATUS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $12,110,228 at charges, ($4,238,580 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. Schedule H, Part V, Section B, Line 16a FAP website - Our Lady of Lourdes Memorial Hospital, Inc.: Line 16a URL: https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/; Schedule H, Part V, Section B, Line 16b FAP Application website - Our Lady of Lourdes Memorial Hospital, Inc.: Line 16b URL: https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Our Lady of Lourdes Memorial Hospital, Inc.: Line 16c URL: https://www.lourdes.com/patient-guide/billing/financial-assistance/pfap/; Schedule H, Part VI, Line 2 Needs assessment OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. recognizes that Public Participation is an important aspect of the Community Health Needs Assessment (CHNA). The Broome County Community Health Needs Assessment is the result of collaboration and the basis for the Public Health Priorities framing OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.'s CHNA. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. provides an update to the community on the implementation strategies in the CHNA annually in the Community Service Plan (CSP). WHILE MAINTAINING OUR PROGRESS TOWARDS ADDRESSING THE HEALTHCARE ISSUES IN OUR TARGET AREAS THAT WERE IDENTIFIED IN THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT (2016-2018) AND WHOSE PROGRESS IS COMMUNICATED IN THE MOST RECENT CSP, WE UNDERSTAND THE DYNAMIC NATURE OF OUR HEALTHCARE LANDSCAPE WE OPERATE IN. IN THAT RESPECT, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. IS CURRENTLY ENGAGED IN CONDUCTING A NEW AND UPDATED COMMUNITY HEALTH NEEDS ASSESSMENT, TO DETERMINE WHETHER THE ISSUES STATED IN THE PREVIOUS CHNA REMAIN HIGH-PRIORITY NEEDS IN THE COMMUNITIES WE SERVE-OR IF NEWER, MORE CRITICAL CHALLENGES HAVE EMERGED. THIS WORK WILL RESULT IN AN UPDATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT WILL GUIDE OUR ONGOING EFFORTS TO REMOVE BARRIERS TO CARE AND IMPROVE HEALTH OUTCOMES IN OUR POPULATION, OVER THE NEXT THREE (3) YEARS (BEGINNING IN 2019). This comprehensive plan reflects extensive communication and interaction with stakeholders from many sectors, to identify and prioritize unmet community needs and strategies for addressing them. As recommended by the New York State Department of Health, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. was involved in the Community Health Needs Assessment and planning process of the local health department (Broome County), Outreach to health and human service organizations, consumers, community groups and facility advisory boards were accomplished in collaboration with the Broome County Health Department Community Health Assessment Steering Committee. This collective collaboration enabled the community to have more public participation in identifying community need than could have been accomplished independently by OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Additionally, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. provided input to the Tioga County Health Department's Community Health Assessment through active participation on the Tioga County Community Health Needs Assessment Steering Committee. IN ADDITION TO CARRYING OUT ITS OWN CHNA, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. PARTICIPATED IN THE DEVELOPMENT OF A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF THE NYS DELIVERY SYSTEM REDESIGN INCENTIVE PAYMENT PROGRAM (DSRIP) PLANNING GRANT IN 2014. This extensive CHNA was for a ten county Southern Tier Rural Integrated Performing Provider System (STRIPPS) region, which included OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Primary Service Area of Broome County, The CHNA focused on the health issues of Medicaid Beneficiaries, the uninsured (low and non-utilizers). 2,011 persons participated in this CHNA, representing providers, beneficiaries, community based organizations, and the community at large. Ninety in depth interviews were conducted and 15 focus groups with 127 Medicaid beneficiaries were held. Participants self-identified to participate in an on-going Panel which will continue to inform STRIPPS in the design of interventions (projects) to address Community Health status, This CHNA validated key health issues for the Medicaid and Uninsured population to be obesity prevention & associated cardiovascular chronic disease and mental health/substance abuse. To ensure that the CHNA is effective, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. assesses the community's health care needs annually through several venues: - Broome County Community Health Assessment Steering Committee: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. participates as a member of a multi-agency collaborative Community Health Assessment Steering Committee". This over-sight committee meets or communicates monthly to assess community health status/needs and identify and monitor interventions. The Steering Committee, under the guidance of the local Health Department and the New York State Health Department, addresses public health issues and underlying causes contributing factors to health status and chronic disease, and reviews current interventions and outcomes. Efforts to coordinate interventions and share best practices occur through these interactive meeting. Oversight and monitoring during 2014 also occurred through the design and development of the aforementioned DSRIP work: - Active participation on community committees, boards and coalitions: Key partners that OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. works with to achieve the Community Public Health Priorities include but are not limited to the American Cancer Association, American Diabetes Association, American Heart Association, Broome County Health Department Community Health Needs Assessment (CHNA), Steering Committee, Broome County Health Department, local health departments in whose county OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. provides services, Action for Older Persons, Binghamton VA Outpatient Clinic, the Dr, Garrabed A, Fattal Community Free Clinic (Broome County based), Community Alternative Systems Agency (CASA), Communities Joined in Action, Department of Social Services, Mothers & Babies Perinatal Network of SCNY, Office of Mental Health, Rural Health Network of South Central New York, United Way, Binghamton University School of Nursing, HEALTH-E-CONNECTIONS (REGIONAL HEALTH INFOMRATION ORGANIZATION, BROOME COUNTY OFFICE FOR THE AGING, AND THE AMERICAN CIVIC ASSOCIATION: - Patient and provider satisfaction surveys/feedback - OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient and Family Advisory Council Community Focus Groups - New York State SPARCS data - New York State registries which provide prevalence and incidence rates of disease. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance During registration insurance coverage for each patient is verified, If the patient is registered as self-pay (uninsured) OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Financial Counseling program is designed to assess each patient's eligibility for a NY healthcare program (Child Health Plus, NY Medicaid or a Qualified Health Plan through NY state) and the OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program. The process varies based on patient type and location of service, an overview of the existing process is summarized as follows: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Emergency Room: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Financial Counselors are on-site within the ER, they meet with each ER patient after treatment and prior to discharge. The Financial Counselor reviews insurance coverage with each patient. For each uninsured patient we attempt to conduct a face to face eligibility interview. The eligibility interview takes 5 minutes to determine if the patient is eligible for a NY State healthcare program and/or OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program. We also help patients complete applications for OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program and assist in enrolling into Medicaid or during open enrollment, a Qualified Health Plan. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Primary Care Network: Uninsured patients are called by the Financial Counselors and interviewed for eligibility. Based on results we provide assistance for NY program or OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program enrollment. All Other Patient Types: The Business Office runs a monthly extract to identify account balances due from self-pay patients that are over 30 days old which indicates possible financial hardship, The Business Office Financial Counselors attempt to contact these patients by phone to determine if financial assistance is needed. Where ever possible we conduct eligibility interview over the phone. Based on results we provide assistance for NY program or OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program enrollment. Appointments are made as needed for facilitated enrollment into Affordable Care Act Medicaid programs or Qualified Health Plans. Patient Education: Brochures on the OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program are available at all OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. patient care sites and on the OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. internet web site. Schedule H, Part VI, Line 4 Community information OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is based in Binghamton, New York. For community and local health planning purposes, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Community Health Needs Assessment (CHNA) addresses the needs of the residents of Broome County, as over 80% of those served by OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. reside in Broome County. This primary service area definition is consistent with physician needs assessment methodologies based on qualitative standards established by the Internal Revenue Service (IRS Final Revenue Ruling on Physician Recruitment: Revenue Rule 97-21, Source: Fall 2014 AmeriMed Consulting Medical Staff Development Plan for Our Lady of Lourdes Memorial Hospital, Executive Summary, page 1). A status report to the community is provided annually through OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Community Service Plan (CSP) WITH THE MOST RECENT REPORT BEING ISSUED FOR ACTIVITIES CARRIED OUT IN CALENDAR YEAR 2018. While OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. CHNA and CSP address residents in Broome County, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. extends its services and sphere of influence to the residents of Tioga, Delaware, and Chenango, New York, and to the residents of Susquehanna, Pennsylvania. Persons are served through OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. comprehensive range of primary care OFFERED AT 11 LOCATIONS THROUGHOUT THREE COUNTIES (IN ADDITION, OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. HAS INTEGRATED SOCIAL WORKERS AT ALL PRIMARY CARE SITES TO BOLSTER BEHAVIORAL HEALTH CAPACITY), five walk-in clinics, Endocrinology & Diabetes Centers of Excellence, outpatient diagnostic services, outpatient physical therapy (4 locations), mobile van services (mammography & dental care}, regional cancer center services, specialty care, acute care, home health care, durable medical equipment company, hospice care, youth behavioral health and development, oral health, occupational health services and worker's compensation preferred provider organization programs, as well as health education and outreach programs. Schedule H, Part VI, Line 5 Promotion of community health (1) OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. evaluates existing infrastructure and location of services to ensure the community health needs are met. Results of these evaluations have resulted in the following: - Bone density testing and podiatry services were expanded to the rural community of Hancock - Lourdes Vestal: a project begun in 2012 was designed to bring many existing services together in one physical location, with the addition of some new services, the project was completed in calendar year 2014. The building and services were designed with the current and future health care needs of our patients and the community in mind, for persons of all ages, Our goal has always been to be true to our mission to create a positive patient and family experience, in a healing environment. The Lourdes Vestal services are convenient and accessible, are on bus routes; and will continue to provide safe, high quality care, Primary Care is provided by internal medicine and family practice providers from 4 existing Lourdes primary care practices. Not all of our existing sites have the same ancillary services, such as lab, x-ray, mammography, or physical therapy; hence location of these services will improve access for patients, Women's health services include screening and diagnostic mammography. Breast ultrasound and access to a Breast Surgeon on site was a new service begun in 2014. Occupational Health services was relocated from the hospital to Vestal to increase community access: - Other new services located at Lourdes vestal were also, based on community need and include, (a) bone densitometry for the evaluation of fracture risk and osteoporosis for women and men, This service is also available at the hospital, (b) Community Room- which will offer education supportive of community health priorities identified in the CHNA; (c) A dermatology practice; (d) Walk-in services and (e) Retail Pharmacy, - Lourdes Pediatric Walk-in services were added in 2014 to increase appropriate access for pediatric patients needing evening appointments, (2)OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is considered a disproportionate share hospital for Medicaid purposes, Unique financial assistance programs that OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. offers or participates in include: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Patient Financial Assistance Program (PFAP), prompt pay program, Medicaid, Hope Dispensary, Lourdes Care Plus, Prenatal care Assistance Program, Child Health Plus, Medicaid and Medicaid Managed Care. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. increased the employment of financial counselors from 8 to 11 to assist uninsured persons in determining eligibility for health care coverage and have implemented an "out bound call" program. All financial counselors became Certified Applications Counselors. (3) OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. participates in Health Prevention Initiatives through Breast, Cervical and Colorectal Cancer screening. OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. administers over $2.1 million annually in grant programs for at risk children and youth. Also active in promoting the health and well-being of the community are nearly 500 voluntary members of the medical staff and 15 volunteer community board members (which excludes senior leadership). OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is active in medical staff development recruitment and succession planning. THIS YEAR ACCESS TO PRIMARY AND SPECIALTY CARE WAS EXPANDED THROUGH THE HIRING OF SEVERAL NEW PROVIDERS. THROUGHOUT THE YEAR WE CONTINUED TO PRESS FORWARD TO ADDRESS ACCESS NEEDS FOR CHILDREN'S ORAL HEALTH, PHARMACEUTICALS, AND BEHAVIORAL HEALTH SERVICES FOR YOUTH. THE LOURDES CENTER FOR MENTAL HEALTH (LCMH) SERVED OVER 1,350 CLIENTS, WITH OVER 16,500 TOTAL VISITS IN 2018 (A 2.3% INCREASE OVER 2017). THE OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. STUDENT ASSISTANCE PROGRAM AND ALCOHOL AND DRUG eDUCATION PREVENTION TEAM PROVIDED ALCOHOL AND DRUG ABUSE PREVENTION SERVICES TO OVER 14,750 STUDENTS AND PARENTS IN 2018 THROUGH A VARIETY OF EVIDENCED BASED PROGRAMS. NO SBIRT TRAININGS (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT) WERE PROVIDED TO OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. ASSOCIATES IN 2018, HOWEVER OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. REMAINS COMMITTED TO THE TREATMENT OF sUBSTANCE ABUSE AND CONTINUES TO LOOK FOR WAYS TO ENGAGE AT-RISK POPULATIONS FOR SUBSTANCE ABUSE-PARTICULARLY THOSE SUFFERING FROM OPIOID USE DISORDER (OUD). (4) Volunteering - As a OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Volunteer, you become an integral part of the hospital team. Volunteers' efforts benefit the hospital in continuing its commitment to excellence while providing them with the personal satisfaction of contributing to the welfare of those in need. Each year, hundreds of volunteers find fulfillment, practical work experience and companionship within OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. There are volunteer opportunities for Adults and Juniors. Volunteers provide many of the services that improve the quality of patient stays and support medical and administrative staff at OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. The following are some, but not all of the opportunities volunteers can take part in: OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Auxiliary Gift Shop & Cafe DePaul: Two to four hour assignments in the Gift Shop (gift suggestions/register) and Cafe DePaul (food preparation/serving). All proceeds from the Gift Shop & Cafe DePaul benefit OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. patients. Patient Care: Areas where volunteers provide hospitality and conversation while assisting the staff with general tasks - Emergency Room - Physical Therapy - Occupational Therapy - Speech Therapy - Ambulatory Surgery - Breast Care Center - Spiritual Care (Eucharistic Minister) - Patient Floors - Primary Care Facilities - Laser/Eye Center or Holding Area - Patient Reading Program - Diagnostic Imaging - Diabetic Education Clerical Areas: Volunteers assist the staff with clerical duties which may include photocopying, filing, faxing, telephones, collating, data entry and typing in the following departments: - Administration - Business Office - Pharmacy - Medical Staff Office - Nursing Education - Facilities Management - Public Relations - Human Resources - Purchasing Department - Volunteer Services - Physician Offices - Pre-Admission Testing - Patient Floor Clerical - Library - Diabetes Education - Information Systems - Laser/Eye Unit OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. Physician Practices: A wide variety of volunteer opportunities are available in many different departments throughout the hospital and at the Primary Care sites: - Blood Pressure Screening - Pharmacy Deliveries - Admit/Registration Escorting - Sterile Processing Department - Laboratory - Food & Nutrition (Dietary) - Information Desk - Flower Room - Laundry Services - Information Systems Schedule H, Part VI, Line 6 Affiliated health care system OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC, AND AFFILIATES (THE HOSPITAL) IS A MEMBER OF ASCENSION HEALTH. ASCENSION HEALTH ALLIANCE, DOING BUSINESS AS ASCENSION, IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC, NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE MORE THAN 1,900 LOCAL HEALTH CARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 24 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. IN ADDITION TO SERVING AS THE SOLE CORPORATE MEMBER OF ASCENSION HEALTH. ASCENSION SERVES AS THE MEMBER OR SHAREHOLDER OF VARIOUS OTHER SUBSIDIARIES, ASCENSION, ITS SUBSIDIARIES, AND HEALTH MINISTRIES ARE REFERRED COLLECTIVELY FROM TIME TO TIME HEREAFTER AS THE SYSTEM. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL IN THE UNITED STATES, ST. LOUISE PROVINCE, THE CONGREGATION OF ST. JOSEPH, THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET, THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE-AMERICAN PROVINCE, AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI-US/CARIBBEAN PROVINCE. THE HOSPITAL, LOCATED IN BINGHAMTON, NEW YORK, IS A NONPROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF BROOME COUNTY AND THE SURROUNDING COMMUNITIES. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. ALSO INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS ARE CORBETT CORPORATION (CORBETT) , A FOR PROFIT, WHOLLY OWNED SUBSIDIARY OF THE HOSPITAL FORMED TO CONSTRUCT AND RENOVATE BUILDINGS IN THE HOSPITAL' S PROXIMITY, AND LOURDES REALTY, INC. (REALTY), A NONPROFIT REAL ESTATE COMPANY FORMED TO ACQUIRE AND RENOVATE OFFICE SPACE IN THE HOSPITAL' S PROXIMITY. THE HOSPITAL IS THE SOLE CORPORATE MEMBER OF REALTY. THE HOSPITAL IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF ASCENSION HEALTH AND ITS SPONSORED ORGANIZATIONS ARE RELATED TO PROVIDING HEALTH CARE SERVICES. MISSION THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES USED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE ACOMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME - COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. " DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF TOTAL OPERATING EXPENSES TO BILLED CHARGES FOR PATIENT CARE. Schedule H, Part VI, Line 7 State filing of community benefit report NY true EVANS STREET BASEBALL PO BOX 598 BINGHAMTON NY 13902 462306815 10000 OPERATING SUPPORT 0 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. DOCUMENTATION IS SUBMITTED BY THE REQUESTING ORGANIZATION BEFORE FUNDS ARE ISSUED. true true false false false false false false false KATHRYN CONNERTON PRESIDENT & CEO 357232 0 334930 0 61401 0 15900 0 12389 0 781851 0 0 0 JAMES STEINMETZ MD BOARD MEMBER/PHYSICIAN 437581 0 94353 0 5346 0 13500 0 29603 0 580383 0 0 0 DAVID F CLEMENTS FORMER OFFICER (END 8/2016) 190994 0 19149 0 1564 0 13766 0 3228 0 228701 0 0 0 LINDA A MCCORMACK-MILLER FORMER OFFICER (END 11/2016) 447 0 0 0 231269 0 0 0 1772 0 233488 0 0 0 SEAN MILLS VP-FINANCE/CFO 209471 0 36790 0 13501 0 5156 0 26125 0 291043 0 0 0 DEBORAH S MICAN VP-NURSING (END 3/2018) 192560 0 37536 0 11100 0 14138 0 19321 0 274655 0 0 0 LISA YVETTE HARRIS SR VP MEDICAL AFFAIRS/CMO (END 8/2018) 170787 0 52936 0 135135 0 10766 0 20018 0 389642 0 0 0 CHAD A PATTON VP-PHYSICIAN NETWORK 192345 0 38684 0 8591 0 15285 0 25537 0 280442 0 0 0 RICHARD BLANSKY MD CHIEF MEDICAL OFFICER 571625 0 30698 0 2908 0 13500 0 6067 0 624798 0 0 0 ANNE E WOLANSKI FORMER KEY EMPLOYEE (END 12/2016) 13646 0 0 0 173505 0 194 0 5096 0 192441 0 0 0 DEBORAH BLAKENEY VP-CONTINUUM CARE 174893 0 25160 0 7804 0 0 0 10464 0 218321 0 0 0 SANJIV PATEL PRESIDENT MEDICAL STAFF 220833 0 14096 0 702 0 13262 0 3140 0 252033 0 0 0 MARY E HUGHS CHRO 0 191657 0 32100 0 5353 0 13280 0 18018 0 260408 0 0 RATNAKISHORE PALLAPOTHU PHYSICIAN 340502 0 308325 0 1704 0 14257 0 29546 0 694334 0 0 0 JOHN DIMENNA MD PHYSICIAN 475977 0 46500 0 8791 0 6750 0 23273 0 561291 0 0 0 JOYLEEN EARLE MD PHYSICIAN 465042 0 44250 0 8041 0 14850 0 15468 0 547651 0 0 0 CHARLES CAMPBELL MD PHYSICIAN 466286 0 42750 0 4177 0 6750 0 28372 0 548335 0 0 0 ELDAD EINVA MD PHYSICIAN 459744 0 41750 0 3319 0 13696 0 27984 0 546493 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION: LINDA MCCORMACK-MILLER - $225,061 ANNE E WOLANSKI - $161,635 LISA Y HARRIS - $107,888 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column F in the year paid. NO PAYMENTS WERE MADE TO LISTED PERSONS IN PART VII UNDER THE VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE YEAR. Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTS The activity of OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE PRESIDENT & CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders Our Lady of Lourdes Hospital, Inc. has a single corporate member, Ascension Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Our Lady of Lourdes Memorial Hospital, Inc. has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Our Lady of Lourdes Memorial Hospital, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Our Lady of Lourdes Memorial Hospital, Inc.'s. financial information or corporation as a whole are subject to approval by its sole corporate member, Ascension Health. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part VIII, Line 2f Other Program Service Revenue Services to Affiliates - Total Revenue: 83327, Related or Exempt Function Revenue: 83327, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Income from Joint Ventures - Total Revenue: -392202, Related or Exempt Function Revenue: -272503, Unrelated Business Revenue: -119699, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Management Fees - Total Revenue: 7050, Related or Exempt Function Revenue: 7050, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Consulting Fees - Total Revenue: 59481, Related or Exempt Function Revenue: 59481, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Contracted Services Revenue - Total Revenue: 90751, Related or Exempt Function Revenue: 90751, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Billing Service Revenue - Total Revenue: 302421, Related or Exempt Function Revenue: 302421, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Occupational Health - Total Revenue: 398981, Related or Exempt Function Revenue: 398981, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Research - Total Revenue: 62503, Related or Exempt Function Revenue: 62503, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Community Services - Total Revenue: 10875, Related or Exempt Function Revenue: 10875, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Escheatment Revenue - Total Revenue: 4954, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 4954; Medical Records Fees - Total Revenue: 20040, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 20040; Miscellaneous Revenue - Total Revenue: 1422964, Related or Exempt Function Revenue: 462133, Unrelated Business Revenue: 249680, Revenue Excluded from Tax Under Sections 512, 513, or 514: 711151; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Beneficial Interest in Foundation - 1844564; Transfers with Alpha Fund - 77756; Form 990, Part XII, Line 2c AUDIT COMMITTEE OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. Ascension Health Alliance PO Box 45998 St Louis MO 631455998 453358926 National Health System MO 501(c)(3) Type I NA false Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO 501(c)(3) Type I Ascension Health Alliance false Lourdes Realty Corporation Inc 169 Riverside Drive Binghamton NY 13905 222873637 Rental of Health Care Facilities NY 501(c)(2) Our Lady of Lourdes Memorial Hospital Inc true SOUTHERN TIER MEDICAL CARE - NY PC 169 RIVERSIDE DRIVE BINGHAMTON NY 13905 821103087 HEALTHCARE NY 501(c)(3) 3 OUR LADY OF LOURDES MEMORIAL HOSPITAL INC true Lourdes Health Support LLC 333 Butternut Drive Suite 100 Dewitt NY 13214 161611707 Medical Equipment Provider NY Our Lady of Lourdes Memorial Hospital Inc Excluded -275599 310895 false -131384 false 0.6 Corbett Corporation 169 Riverside Drive Binghamton NY 13905 161268267 Property Management NY Our Lady of Lourdes Memorial Hospital Inc C Corporation 128980 2174711 1 true false false false false false false false false false true true true true false true true true true true CORBETT CORPORATION L 3284172 FAIR MARKET VALUE CORBETT CORPORATION O 121560 FAIR MARKET VALUE LOURDES REALTY COMPANY J 680145 FAIR MARKET VALUE LOURDES REALTY COMPANY K 466202 FAIR MARKET VALUE LOURDES REALTY COMPANY L 3514574 FAIR MARKET VALUE LOURDES REALTY COMPANY O 120177 FAIR MARKET VALUE LOURDES REALTY COMPANY Q 71236 FAIR MARKET VALUE