2018-09-06T16:19:33-07:00 2017-12-31 990 2017-01-01 160743905 ARNOT OGDEN MEDICAL CENTER ARNO 6077374235 600 ROE AVENUE ELMIRA NY 14905 Ronald Kintz Senior VP/Chief Financial Officer 6077374235 2018-09-06 162.223.206.130 2017 2018-06-14 16:35:46Z Ronald J Kintz 600 Roe Avenue Elmira NY 14905 306907453 0 X www.arnothealth.org X 1889 NY Arnot Ogden Medical Center is a community based hospital with an open emergency room and selected highly specialized services that are part of a high quality health care delivery system that serves Chemung County, NY and the Twin Tier Regions of New York and Pennslyvania. 14 11 2885 383 -109523 -109523 1737448 4605064 275516613 282708099 7293655 4476300 2106784 1898342 286654500 293687805 0 0 0 0 202058953 207937169 0 0 0 91902284 87447421 293961237 295384590 -7306737 -1696785 250313124 259823619 90804264 99109146 159508860 160714473 X Arnot Ogden Medical Center is an independent, not-for-profit, 225-bed tertiary medical facility with more than 115 physicians from over 50 specialties. Arnot Ogden Medical Center offers specialty services at the Wilmot Cancer Center, Heart and Vascular Institute, Stroke Care, Maternity, Surgery. 0 1 236400775 0 281736042 The Arnot Ogden Medical Center continues to provide of health care related services since it opened in 1889, serving Chemung County and the Twin Tier Regions of New York and Pennsylvania. The Medical Center specialzied in the fields of Cardiology, Oncology, Renal, Neonatology, Bariatrics and Emergency Care. Other sub specialized services include but are not limited to Anesthesiology, Surgery, Laboratory, Imaging, Physical Therapy, Obstetrics, and Gynecology. In 2017 the Medical Center's 2,132 full-time equivalent of employees cared for 10,716 inpatient admissions in its 225 staffed beds. The Medical Center provided Outpatient Services to approximately 317,656 Outpatient Visits in its subspecialty services. The approximately 117 full-time equivalent of physicans provided for 308,904 office visits in the areas of primary care and specialty services. 1072098 0 487545 The Arnot Ogden Medical Center School of Nursing began in 1889 and continues to offer a three year diploma program accredited by the National League for Nursing with approximately 55 students enrolled in 2017. The Arnot Ogden School of Radiologic Sciences began in 1953 continues to offer a two year certificate program which is accredited by the Joint Review Commission on Education in Radiologic Technology with approximately 19 students enrolled in 2017. Upon completion of their program of study, students are eligible to take the NYS licensing examinations for Registered Nurse or Radiologic Technologist. 0 0 0 237472873 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 1 202 0 1 2885 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 11 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 NY X X Ronald J Kintz 6077374235 600 ROE AVENUE ELMIRA NY 14905 Anders Tomson Board Member 1 0 X 0 0 0 David Dalrymple Board Member 0 0 X X 0 0 0 Jan van den Blink Board Member 1 0 X 0 0 0 Jeffrey Streeter Board Member 1 0 X 0 0 0 Kevin Corliss Board Member 1 0 X 0 0 0 Louis DiFabio Board Member 1 0 X 0 0 0 Mary Louise Mitchell Board Member 0 0 X X 0 0 0 Michael Hosey Board Member 1 0 X 0 0 0 Richard Simons Board Member 1 0 X 0 0 0 Robert McNamara Board Member 2 0 X 0 0 0 Roy A Kyles Board Member 1 0 X X 0 0 0 Scott Sprague Board Member 1 0 X 0 0 0 Donald Quick CPA Board member / Chairman 2 0 X 0 0 0 Mark J Hagan Board member / Vice Chairman 2 0 X 0 0 0 Robert Lambert MD Board Member/CEO 59 3 X X 537129 0 39636 Kathleen Lucke PhD Board Member/Education Director 51 0 X 0 0 0 Alan Angell MD Board Member/Physician 61 0 X 402772 0 51303 Roger Schenone MD Board Member/Physician 40 0 X X 283649 0 21534 Jonathan Lawrence Chief Operating Officer 37 16 X 253302 0 9942 John R Alexander Secretary 1 0 X 0 0 0 Ronald J Kintz DHA Senior VP/CFO 46 6 X 336405 0 39638 Richard Cleland Site Administrator IDMH 0 40 X 245016 0 8404 Sandra McCarthy PhD Chief Nursing Officer 32 8 X 257115 0 30612 Roberto deBara MD President AMS 40 0 X X 420850 0 30724 Kenneth HerzlBetz MD Senior VP/Medical Affairs 48 3 X 297488 0 30896 Nancy ODacre VP Planning 40 0 X X 43526 0 4924 Paul Tinsley MD ENT Physician 54 0 X 758756 0 35081 Bruno Mazza MD Gastoentrologist 40 0 X 892454 0 27680 Matthew Brand MD Orthopediac Surgeon 65 0 X 795846 0 62093 Thomas Boman MD Orthopediac Surgeon 60 0 X 760463 0 62093 Vidyasagar Mokureddy MD Pain Mgmt Physician 45 0 X 923539 0 45819 7208310 0 500379 245 1 1 0 ABM Healthcare Support Services PO Box 935695 Atlanta GA 311935695 Equipment Maintenance Service Contracts 4035642 Strong Memorial Hospital 601 Elmwood Avenue Box 608 Rochester NY 14642 Physician & Staffing Cancer Center Services 3476681 GEBBS Healthcare Solutions 600 Corporate Pointe Suite 1250 Culver City CA 90230 Coding Physician Medical Records for billing 1909892 Associated Anesthesiologists of Finger Lakes P O Box 1253 Elmira NY 149021253 Anesthesiology Physician Services 1525849 Mayo Medical Laboratories P O Box 4100 Business Office Rochester MN 559034100 Patient Medical Lab Testing 1383533 55 0 0 0 0 600307 4004757 0 4605064 Hospital Net Patient Service Revense 622110 229216518 229216518 0 0 Physician Net Patient Service Revenue 621110 53007069 53007069 0 0 School of Nursing 611600 407968 407968 0 0 School of Radiologic Technology 611600 76544 76544 0 0 0 0 0 0 282708099 2095850 0 0 2095850 0 0 0 0 0 0 0 0 510283 0 729500 0 -219217 0 -219217 -109694 -109523 0 12678999 0 10298217 332 2380782 -332 2380450 0 0 2380450 131650 0 25287 106363 0 106363 0 0 0 0 0 0 831213 2166312 -1335099 -1335099 0 0 Education 611600 176664 176664 0 0 Rebates & Discounts 900099 496474 496474 0 0 Delivery System Reform Incentive - DSRIP 921190 1941459 1941459 0 0 731698 731698 0 0 3346295 293687805 284609601 -109523 4582663 0 0 0 0 0 0 0 0 6227984 0 6227984 0 0 0 0 0 152309014 130358340 21950674 0 5354392 0 5354392 0 34320639 0 34320639 0 9725140 7843779 1881361 0 2674460 943758 1730702 0 245358 7810 237548 0 110487 3750 106737 0 28159 0 28159 0 0 0 0 0 0 0 11151247 10050722 1100525 0 500756 327630 173126 0 3932266 2335237 1597029 0 6616501 3816288 2800213 0 0 0 0 0 2529732 591060 1938672 0 497791 440300 57491 0 0 0 0 0 258210 242316 15894 0 1047692 0 1047692 0 0 0 0 0 11672330 5334618 6337712 0 3325317 2141484 1183833 0 Medical/Surgical/Pharmaceutical Supplies 44697058 44641995 55063 0 Maintenance Contracts & Purchased Services 14731654 9582756 5148898 0 Benefit Allocation to Program Services 0 32623118 -32623118 0 Allocation of Expenses to Affiliate Hospitals -20013469 -15362247 -4651222 0 3441872 1550159 1891713 0 295384590 237472873 57911717 0 11582 12682 2730361 8027196 35708 56474 34290191 27961777 0 0 0 0 296860 741598 1467436 1600137 1787433 1426900 288399088 185457026 105631966 102942062 51082082 72087919 0 0 0 0 0 0 52979505 44966874 250313124 259823619 21071255 20419869 0 0 153908 247251 27645400 26469000 0 0 0 0 6182476 5392005 0 0 35751225 46581021 90804264 99109146 X 146139647 149779462 10392258 7954021 2976955 2980990 159508860 160714473 250313124 259823619 X -1696785 4020071 0 212250 0 -1329923 X 1 X 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 28159 28159 0 Schedule C, Part II-B, Line 1 Arnot Ogden Medical Center pays annual dues to the Hospital Association of New York State - HANYS, and Rochester Regional Healthcare Association - RRHA, of which a percentage is for lobbying fees. The total lobbying fees paid to all in 2017 was $28,159. 2976955 4035 0 0 0 0 2980990 2969755 7200 0 0 0 0 2976955 3093934 0 0 0 124179 0 2969755 2947754 3326 142854 0 0 0 3093934 2827204 0 120550 0 0 0 2947754 0 1 0 0 0 6410329 0 6410329 118522518 0 63470480 55052038 951364 0 933655 17709 159443846 0 119078788 40365058 3071031 0 1974103 1096928 102942062 457 Plan Investment Funds 6698136 Workers Comp Short Term Investment 1118118 A/R Workers Comp Excess Insurance 682219 Chart Malpractice Investment Value 2610458 Bond Payment Fund 1970218 Investment in Subsidiary 4534100 Due From Affiliated Companies 5109501 Interest in Net Assets of Foundation 22244124 44966874 0 Note Payable Investments AOMC Foundation 17292119 Minimum Pension Liability 9401934 457 Plan Long Term Liability 6690336 3rd Party Liabilities 3190099 Workers Compensation Reserve Long Term 2722684 Pools & Surcharges Payable NYS 234389 Malpractice Liability Reserve 5931944 Note Payable Fosterhouse Practice Purchase 835206 Note Payable Auxiliary Investment 157389 Note Payable Investment SJH Education Funds 283525 Covenant Not to Compete Davita Dialysis Sale 253125 Due To - Due From Subsidiary Companies -477020 NYS Abandoned Property 14691 Federal Student Financial Aid Fund Balance 11419 Note Payable AHMS Pension Liability 39181 46581021 X 292811661 0 0 0 3133349 3133349 289678312 0 4009493 4009493 293687805 298305688 0 0 0 2921098 2921098 295384590 0 0 0 295384590 Schedule D, Part V, Line 4 The organization has interpreted the NYS Prudent Management of Institutional Funds Act Law, NYPMIFA as requiring the preservation of the historical dollar value of the corpus of the permanent restricted endowment funds absent of donor stipulations to the contrary. The net appreciation of the permanent restricted endowment funds absent of the donor stipulations to the contrary. The net appreciation of the permanently restricted net assets is considered temporarily restricted net assets until those amounts are appropriated for expenditure by the Organization in a manner consistent with the standard of prudence prescribed by NYPMIFA. If the fair value of the investments assets falls below the level of the donor, NYSMIFA requires the Center to retain the fund in perpetual duration. There were no such deficiencies as of December 31, 2017. To ensure the preservation of the corpus of the permanently restricted endowment funds, the total fair value of all commingled investment assets are classified first to the level of the permanently restricted endowment funds corpus, an endowment fund deficiency receivable from the unrestricted net assets would be recognized until the deficiency is recovered. Schedule D, Part X, Line 2 Arnot Ogden Medical Center is organized as not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the code) and accordingly, are exempt from Federal income taxes on related income pursuant to Section 501(a) of the Code. The Organization accounts for uncertain tax positions in accordance with US GAAP, which requires the recognition and measurement of uncertain tax positions that the Organization has taken or expects to take in the Organization's tax returns. Management believes there are no significant uncertain tax positions not reflected in the accompanying consolidated financial statements as of December 31, 2017 and 2016. Schedule D, Part XI, Line 2d Expenses deducted from revenue: Children's Miracle Network Fundraising $25,286, Rental Expenses $729,500, Nutritional Services Expenses $2,166,312, and Investment Expenses $212,250. Schedule D, Part XI, Line 4b Arnot Ogden Medical Center and Arnot Ogden Children's Miracle Network donations to purchase capital equipment and funding toward building construction in the amount of $4,004,757 has been re-classed from Net Assets for 990 reporting. K-1 Book to Tax Revenue $4,736. Schedule D, Part XII, Line 2d Expenses moved to offset Revenue: Rental Expenses $729,500, Nutritional Services Expenses $2,166,312 and Children's Miracle Network fundraising expenses $25,286. Schedule D, Part XII, Line 4b Expenses added back from audit revenue offset: Children's Miracle Network Fundraising $25,286. Golf Tournament 55882 0 55882 0 800 6425 3615 0 4635 Moonlight & Miracles 25120 0 25120 0 0 0 3505 3275 2191 1 50648 0 50648 0 0 0 492 200 149 131650 0 131650 0 800 6425 7612 3475 6975 25287 106363 1 1 X 1 X 1 X 1 1 1 0 1 1 933 236545 27289 209256 0.0007 6659 3536735 4274212 -737477 0 48805 37569306 16601685 20967921 0.071 0 56397 41342586 20903186 20439700 0.0717 118 4309 219818 7172 212646 0.0007 21 232 1268080 640293 627787 0.0021 2 7981 3291396 3132958 158439 0.0005 0 0 0 0 0 0 0 0 0 0 0 0 141 12522 4779294 3780423 998872 0.0033 141 68919 46121880 24683609 21438572 0.0750 0 0 0 0 0 0 0 0 0 0 0 0 3 390 1268 0 1268 0 0 0 0 0 0 0 1 0 128 0 128 0 10 0 5358 0 5358 0 3 0 5944 0 5944 0 0 0 0 0 0 0 7 835 487625 0 487625 0.0017 24 1225 500323 0 500323 0.0017 0 14512327 4767299 66480577 83421963 -16941386 X 1 1 Ivy Street Development Corp Collection of Services & Rentals 1 0 0 1 1 Arnot Ogden Medical Center 600 Roe Avenue Elmira NY 14905 www.arnothealth.org 0701000H X X X X Hospital with Open Emergency Room. A 2 Arnot Ogden Medical Center Health Center for Women 600 Fitch Street Elmira NY 14905 www.arnothealth.org X Hospital Extension Clinic - Diagnostic Radiology A 3 Arnot Ogden Medical Center Horseheads Campus 100 John Rommelt Drive Horseheads NY 14845 www.arnothealth.org X Clinical Laboratory Service & Radiology Diagnostic Outpatient. A A 0 0 1 X X X X X X X X 15 1 1 1 1 X www.arnothealth.org X 1 16 1 www.arnothealth.org 0 0 1 X 150 400 1 1 X X X 1 X www.arnothealth.org X www.arnothealth.org X www.arnothealth.org X X X X X X 1 X 0 X X X 1 0 1 Schedule H, Part V, Section B, Line 5-Group A In 2015, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. A new CHNA will be conducted and completed for 2018. Schedule H, Part V, Section B, Line 6a-Group A Arnot Ogden Medical Center prepares the Community Benefit Report for three hospitals- Arnot Ogden Medical Center, St. Joseph's Hospital, both in Elmira, NY and also for Ira Davenport Memorial Hospital in Bath, NY. Schedule H, Part V, Section B, Line 6b-Group A Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the communities it serves. Schedule H, Part V, Section B, Line 7d-Group A Arnot Ogden Medical Center will use a variety of methods to disseminate the community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPs for Chemung and Steuben Counties: Web site documents will be posted on the healthcares system web site at the following URL: http://www.arnothealth.org/about us. Arnot Health developed a section of the system's web site dedicated to community outreach in 2016, budget permitting to bring community service work to a more prominent place within the website. This can be accessed at: https://www.arnothealth.org/community-service-plans. Partner web sites Chemung and Steuben counties will post links to their CHA and CHIP on their web sites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies. Schedule H, Part V, Section B, Line 11-Group A During the 2017 calendar year Arnot Ogden Medical Center conducted the following programs that had community benefit and created the expenses associated with our filing: Telehealth, Childbirth classes, Healthy Kitchens and Mommy and Me Cooking Classes in the Community, HIV and PREP Community Partners Meetings, HIV Testing Day Event, MASH Camp for High School Students seeking education in the healthcare fields, Blood Pressure and Diabetes Screenings at Arnot Mall and City of Elmira Block Party, Breast Cancer Screenings for Underinsured and Uninsured, Home Visits, Nutrition Supplements at Wilmot Cancer Center, Flu Shot Clinics at Elmira Housing Authority Buildings, Cancer Treatment Transportation Services, Creating Healthy Schools and Communities, Schedule H, Part V, Section B, Line 24-Group A Participants in the Medicare System are required to charge all patients the same amount for services regardless of insurance per the Medicare participation guidelines. Schedule H, Part I, Line 6a The Community Service Plan explains in detail the involvement of members of the community in determining & identifying community needs. St. Joseph's Hospital in Elmira, NY and Ira Davenport Memorial Hospital in Bath, NY were included in the Community Service Plan that is available on our website, www.arnothealth.org. Schedule H, Part I, Line 7 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The Medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. Schedule H, Part I, Line 7, Column f Arnot Ogden Medical Center excluded $14,512,327 in Bad Debt Expense from the calculation. Schedule H, Part II During the 2017 calendar year Arnot Ogden Medical Center conducted the following programs that had community benefit and created the expenses associated with our filing: Telehealth, Childbirth classes, Healthy Kitchens and Mommy and Me Cooking Classes in the Community, HIV and PREP Community Partners Meetings, HIV Testing Day Event, MASH Camp for High School Students seeking education in the healthcare fields, Blood Pressure and Diabetes Screenings at Arnot Mall and City of Elmira Block Party, Breast Cancer Screenings for Underinsured and Uninsured, Home Visits, Nutrition Supplements at Wilmot Cancer Center, Flu Shot Clinics at Elmira Housing Authority Buildings, Cancer Treatment Transportation Services, Creating Healthy Schools and Communities. Schedule H, Part III, Section A, Line 4 The Organization carries its patient and resident accounts receivable at anticipated amounts due from private pay patients and third party payors. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Organization analyzes their past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Organization analyzes contractually due amounts and provides an allowance for doubtful accounts, if necessary, for receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill). The Organization records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Organization's allowance for doubtful accounts decreased from 13.5% of gross accounts receivable at December 31, 2016 to 10.1% of gross accounts receivable at December 31, 2017. In addition, the Organization's bad debt write-offs increased approximately $250,000 from approximately $18,800,000 for fiscal year end 2016 to approximately $19,050,000 for fiscal year end 2017. The Organization has not changed its charity care or uninsured discount policies during the fiscal year 2017 and 2016. The Organization does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third-party payors. Schedule H, Part III, Section B, Line 8 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. Schedule H, Part III, Section C, Line 9b Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, self pay collector must verify eligibility for the date of service. The Self pay staff will change the health plan to the correct one for all covered dates of service and ARNOT Billing will submit claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing process. Self Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self pay staff will attempt to make payment arrangements and to notify patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The Self Pay Collectors documents all activity in Soarian, and enters any necessary hold to support resolution. Self pay collections staff enters the payment plan and documents comments in Soarian. Payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections. Schedule H, Part VI, Line 2 In the Fall of 2015, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. The year-long process of assessing community health needs was facilitated by consultants contracted by the Chemung County Health Department from the S2AY Rural Health Network. Arnot Health, in partnership with this dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership) to collect and analyze data from a variety of sources. Valuable input was gained from data retrieved and analyzed by the Finger Lakes Health System Agency from the New York State Prevention Agenda Dashboard, multi-payer claims data, EBRFSS, SPARCS and additional sources. Also, input was gained from diverse community focus groups made of both Chemung and Steuben County residents. The focus group meetings were facilitated by S2AY, Chemung and Steuben County Health Departments, Arnot Health and other partnership members. The residents were engaged in discussions concerning their current health status and opinions on specific county-wide health challenges. Areas of disparity were assessed within each county. Findings from the Community Health Assessment (CHA) data and community focus groups identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties. This report and survey will be redone in 2018, Arnot Health has entered into an agreement with S2AY Rural Health Network to conduct the Community Health Assessment and Community Service Plan for 2019 through 2021 for Arnot Ogden Medical Center and St. Joseph's Hospital covering Chemung County, and Ira Davenport in Steuben County. Schedule H, Part VI, Line 3 The Arnot Health communicates our Community Care Program in the following ways: Signage in waiting rooms, brochures in waiting rooms and Admission Packets, notations on billing notices, staff education so they can share availability of program and contact information with patients. Communication and education of our Certified Application Counselor for patient insurance enrollment are done so they are informed of the program details and contact information. Communication is also done with collection agencies and collection attorneys so they can also share the availability of the program and contact information with prospective enrollees. The information is also posted on our website at: www.arnothealth.org. Schedule H, Part VI, Line 4 Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. The Chemung County Health Priority Partnership (HP2) has expanded to include insurance navigators. The Steuben County Health Priority Team (SHPT) worked to brand their coalition and has the new name, Smart Steuben. Both coalitions include organizations that are committed to improving the health of Chemung and Steuben County residents. The groups have met on a bi-monthly basis in Chemung County and monthly basis in Steuben County since Fall of 2015 to conduct a Community Health Needs Assessment (CHNA) and develop a Community Health Improvement Plan (CHIP)/Community Service Plan (CSP). The members of HP2 and Smart Steuben have agreed to continue expanding their partnerships, and meet on a regular basis to ensure that the initiatives outlined in the Community Health Improvement and Community Service Plans are implemented, monitored, and evaluated. Schedule H, Part VI, Line 5 Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. Schedule H, Part VI, Line 6 Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. Schedule H, Part VI, Line 7 Arnot Ogden Medical Center will use a variety of methods to disseminate the community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPs for Chemung and Steuben Counties: Web site documents will be posted on the healthcares system web site at the following URL: http://www.arnothealth.org/about us. Arnot Health developed a section of the system's web site dedicated to community outreach in 2016, budget permitting to bring community service work to a more prominent place within the website. This can be accessed at: https://www.arnothealth.org/community-service-plans. Partner web sites Chemung and Steuben counties will post links to their CHA and CHIP on their web sites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies. X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 Anders Tomson Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 David Dalrymple Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jan van den Blink Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Jeffrey Streeter Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kevin Corliss Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Louis DiFabio Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mary Louise Mitchell Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Michael Hosey Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Richard Simons Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Robert McNamara Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Roy A Kyles Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Scott Sprague Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Donald Quick CPA Board member / Chairman 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mark J Hagan Board member / Vice Chairman 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Robert Lambert MD Board Member/CEO 537129 0 0 0 0 0 0 0 39636 0 576765 0 0 0 Kathleen Lucke PhD Board Member/Education Director 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Alan Angell MD Board Member/Physician 384323 0 18449 0 0 0 0 0 51303 0 454075 0 0 0 Roger Schenone MD Board Member/Physician 269465 0 13884 0 0 0 0 0 32578 0 315927 0 0 0 Sandra McCarthy PhD Chief Nursing Officer 257115 0 0 0 0 0 0 0 30612 0 287727 0 0 0 Jonathan Lawrence Chief Operating Officer 253302 0 0 0 0 0 0 0 9942 0 263244 0 0 0 Paul Tinsley MD ENT Physician 758756 0 0 0 0 0 0 0 35081 0 793837 0 0 0 Bruno Mazza MD Gastoentrologist 882454 0 10000 0 0 0 0 0 27680 0 920134 0 0 0 Matthew Brand MD Orthopediac Surgeon 770846 0 25000 0 0 0 0 0 62093 0 857939 0 0 0 Thomas Boman MD Orthopediac Surgeon 735463 0 25000 0 0 0 0 0 62093 0 822556 0 0 0 Vidyasagar Mokureddy MD Pain Mgmt Physician 913119 0 10420 0 0 0 0 0 45819 0 969358 0 0 0 Roberto deBara MD President AMS 420850 0 0 0 0 0 0 0 30724 0 451574 0 0 0 John R Alexander Secretary 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Ronald J Kintz DHA Senior VP/CFO 336405 0 0 0 0 0 0 0 39638 0 376043 0 0 0 Kenneth HerzlBetz MD Senior VP/Medical Affairs 297488 0 0 0 0 0 0 0 30896 0 328384 0 0 0 Richard Cleland Site Administrator IDMH 245016 0 0 0 0 0 0 0 8404 0 253420 0 0 0 Nancy ODacre VP Planning 43526 0 0 0 0 0 0 0 4924 0 48450 0 0 0 Schedule J, Part I, Line 1a The CEO has his dues paid at the Elmira City Club. The personal use portion is reported under taxable income. Schedule J, Part I, Line 3 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Managers. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Schedule J, Part I, Line 4 Roberto deBara, MD, President of Arnot Medical Services, received severance pay in 2017 in the amount of $77,885. A Chemung County Capital Resource Corp 611684035 000000000 2015-06-25 29410000 Payoff Series A & B Bonds/Energy Infrastructure Upgrade 0 0 0 A 3472400 0 29410000 0 0 0 847745 0 0 8066714 0 0 2015 1 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 1 0 0 0 1 A 1 Louis DeFabio Executive Officer of Chemung Canal Trust Company 126824 Competitevly Bid Loan 0 Jeffrey Streeter Owner of Streeter Associates Inc. Construction Company 107162 Streeter Associates performed several smaller projects for Arnot Health and expect to in the future. Mr. Streeter also makes donations to our Foundation. 0 Form 990, Part III, Line 3 Arnot Ogden Medical Center has entered into a collaborative agreement with the University of Rochester Medical Center to jointly run our Cancer Center, now officially named the Wilmot Cancer Center. Our local medical, radiation and surgical oncology team of fellowship trained doctors have advanced cancer-focused education and experience. We provide coordinated treatment using the most advanced technology in a comfortable environment. Through this collaboration with UR Medicine's Wilmot Cancer Institute, we can assure patients have access to specialists, clinical trials and an even broader range of services. The Wilmot Cancer Center provides cancer care for Breast, Colorectal, Lung and Prostate Cancer, along with support services for patients and their caregivers provide comfort care and peace of mind. Our goal is to help the patient achieve the best possible outcome with the latest medical technology including non-invasive treatments like radiation therapy and chemotherapy. Form 990, Part VI, Section B, Line 11b Upon completion of the Form 990 it is reviewed by the Medical Center's Senior Vice President of Finance and then made available to the Audit and Finance Committees of the Board of Managers. The return is made available to all Board Members for review and questions. Form 990, Part VI, Section B, Line 12c All members of the Board of Managers, Officers and Management employees are required annually to file a Disclosure Statement setting forth any respect in which such a person, or any person associated with such person, has or may have any interest in a transaction in which there may be, or appear to be, a conflict between the interests of such person and the Arnot Ogden Medical Center. An Associate included (1) a spouse, a descendant or an ancestor, or a spouse of a descendant or ancestor; (2) an organization in which the person or an associate is a partner or employee, or such person or an associate owns a more that 10% beneficial interest; (3) a trust in which such a person is a trustee, or such person or an associate holds a more than 10% beneficial interest; and (4) a corporation in which such person or an associate is an officer or director or employee, or such person or an associate is an owner of more that 10% of any class of securities. Form 990, Part VI, Section B, Line 15 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Managers. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Form 990, Part VI, Section C, Line 19 Form 990, Part VI, Section C, Line 18 - Upon request the 990 Form is made available to the public and also via www.guidestar.com. Financial Statements are posted to the Electronic Municipal Market Access website. Form 990, Part XI, Line 9 Change in Net Assets of Arnot Ogden Foundation $2,643,516. Pension Charge to Equity $(1,352,940). Net Assets Released From Restriction $(2,216,800), Realized Gain/Loss on Temp Restricted Investments $(398,963), and Book to Tax K-1's $(4,736). Arnot Ogden Medical Center Foundation Accounting Dept 600 Roe Avenue Elmira NY 14905 161109472 Contribution Management NY 501(c)(3) 11B N/A 0 Arnot Ogden Medical Center Auxiliary 600 Roe Avenue Elmira NY 14905 510192902 Fund Raising NY 501(c)(3) 11B N/A 0 Ira Davenport Memorial Hospital Inc Accounting Dept 7571 State Route 54 Bath NY 14810 160835446 Affiliate NY 501(c)(3) 3 N/A 0 Keuka Health Care Foundation Accounting Dept 7571 State Route 54 Bath NY 14810 161461215 Affiliate NY 501(c)(3) 11B N/A 0 St Josephs Hospital Accounting Dept 555 St Josephs Blvd Elmira NY 14901 160743163 Affiliate NY 501(c)(3) 3 N/A 0 Arnot Health 600 Roe Avenue Elmira NY 14845 453049405 Parent Organization NY 501(c)(3) 11B Arnot Ogden Medical Center St Josephs Hospital 0 Ivy Street Development Corporation 600 Ivy Street Elmira NY 14905 161009245 Real Estate NY N/A C 1 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 0 0 Arnot Ogden Medical Center Foundation o 76884 Arnot Ogden Medical Center provided paid employees to the Arnot Ogden Medical Center Foundation to perform Accounting, Administrative and Materials Management functions. The method of determining the amount involved was cost. Ivy Street Development Corporation o 5169 Arnot Ogden Medical Center provided paid employees to Ivy Street Development Corporation to perform Property Management Services. The method of determining the amount involved was cost. Ivy Street Development Corporation p 93764 Arnot Ogden Medical Center was reimbursed by Ivy Street Development Corporation for Maintenance and Insurance expenses. The method of determining the amount involved was cost. Ivy Street Development Corporation k -372636 Arnot Ogden Medical Center leased facilities from Ivy Street Development Corporation. The method for determining the amount was cost. Ira Davenport Memorial Hospital Inc o 3009873 This report and survey will be redone in 2018, Arnot Health has entered into an agreement with S2AY Rural Health Network to conduct the Community Health Assessment and Community Service Plan for 2019 through 2021 for Arnot Ogden Medical Center and St. Joseph's Hospital covering Chemung County, and Ira Davenport in Steuben County. Keuka Health Care Foundation o 14328 Arnot Ogden Medical Center provided paid employees to Keuka Health Care Foundation to perform Accounting, Administrative functions. The method of determining the amount involved was cost. St Josephs Hospital o 16820293 Arnot Ogden Medical Center provided paid employees to St. Joseph's Hospital to perform Accounting, Administrative, Management Information Services, and various Medical Services. The method of determining the amount involved was cost. Arnot Ogden Medical Center did file Form 8868 Request For Extension of Time to File an Exempt Organization Return and received our Approval Letter dated 4/19/2018 granting our Extension of Time to File to November 15, 2018.