2017-11-06T09:51:54-07:00 2016-12-31 990 2016-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 Dates Drive Ithaca NY 14850 John Collett VP/CFO 6072744441 2017-09-26 66.152.124.189 2016 2017-02-10 21:41:12Z John Rudd 101 Dates Drive Ithaca NY 14850 240814406 0 X www.cayugamed.org X 1981 NY TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 10 9 1622 167 961294 148576 491259 532842 180651855 194725274 3997251 971238 1366844 2390827 186507209 198620181 4500 4000 0 0 91451751 98208153 0 0 0 90219582 90802114 181675833 189014267 4831376 9605914 259344620 261995416 113056707 106979702 146287913 155015714 TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 0 0 141388234 3000 196301387 PATIENT SERVICE - GENERAL INPATIENT AND OUTPATIENT HOSPITAL CARE. SERVICES ARE PROVIDED TO THOSE IN NEED REGARDLESS OF THE PATIENTS ABILITY TO PAY, RACE, CREED, NATIONAL ORIGIN, LIFE CIRCUMSTANCES, OR DISEASE. CAYUGA MEDICAL CENTER WORKS CLOSELY WITH THE COMMUNITY TO DETERMINE HEALTH NEEDS AND TO SUPPORT THE DEVELOPMENT OF PROGRAMS AND SERVICES THAT IMPROVE THE HEALTH STATUS OF THE COMMUNITY. 1000 1000 0 A HEALTH CAREER SCHOLARSHIP AWARDED TO STUDENTS PURSUING A HEALTHCARE DEGREE. TWO PARTICIPANTS IN 2016 0 0 0 141389234 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 339 0 1622 1 1 1 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JOHN COLLETT 6072744441 101 DATES DRIVE ITHACA NY 14850 LARRY BAUM CHAIR 1 0 X X 0 0 0 BRIAN MCAREE VICE CHAIR 1 0 X X 0 0 0 SAMI HUSSEINI MD SECRETARY 1 0 X X 0 0 0 GREG HARTZ TREASURER 1 0 X X 0 0 0 KENNETH CLARKE DIRECTOR 1 0 X 0 0 0 PAULA E F YOUNGER DIRECTOR 1 0 X 0 0 0 JOHN LAMBERT MD DIRECTOR 1 0 X 0 0 0 JOEL MALINA DIRECTOR 1 0 X 0 0 0 STEVEN ROGERS DIRECTOR 1 0 X 0 0 0 JOHN RUDD PRESIDENT/CEO 40 0 X X 484338 0 12962 JOHN COLLETT VP/CFO 40 0 X 238000 0 6190 TIMOTHY BAEL MD ONCOLOGIST 40 0 X 724005 0 9948 CHARLES GARBO MD ONCOLOGIST 40 0 X 653294 0 11502 JULIE CAMBELL MD ONCOLOGIST 40 0 X 526209 0 10960 SRISATISH DEVAPATLA MD NEONATOLOGIST 40 0 X 420145 0 13460 RAMESH VIDAVALUR NEONATOLOGIST 40 0 X 346831 0 10693 3392822 0 75715 76 0 1 0 NAVIGANT CONSULTING 2875 MICHELLE DRIVE SUITE 250 IRVINE CA 92606 REVENUE CYCLE SERVICES 3300918 CAYUGA ANESTHESIA ASSOCIATES PLLC PO BOX 366 ITHACA NY 14850 ANESTHESIOLOGY SERVICES 2859346 CONWAY CONSTRUCTION 1465 DRYDEN RD FREEVILLE NY 13068 CONSTRUCTION CONTRACTOR 2041142 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY SERVICES 1489577 ROSWELL PARK CANCER INSTITUTE ELM AND CARLTON STREET BUFFALO NY 14263 CANCER SERVICES 1121074 42 0 0 0 0 249428 283414 0 532842 NET PATIENT REVENUE 622000 190408607 190408607 0 0 4316667 4316667 0 0 194725274 2280014 0 146580 2133434 0 0 0 0 0 0 0 0 0 0 40890495 -5046 42194225 0 -1303730 -5046 -1308776 0 0 -1308776 0 OTHER REVENUE 622000 372643 234077 138566 0 CAFETERIA MEALS REVENUE 722212 1342036 1342036 0 0 676148 0 676148 0 2390827 198620181 196301387 961294 824658 0 0 4000 4000 0 0 0 741490 741490 69818154 53151203 16666951 8305951 5847197 2458754 14535148 10949043 3586105 4807410 3622311 1185099 1797477 489290 1308187 448663 336497 112166 195110 195110 79418 79418 166851 166851 15120535 6253876 8866659 895833 895833 38286174 34556201 3729973 2062824 1547118 515706 4130671 2955122 1175549 200264 124066 76198 1062431 1062431 14846239 10621144 4225095 1228300 1044055 184245 PHYSICIAN ADVANCE FORGIVENESS 3246 0 3246 0 LICENSE/CERTIFICATES/PERMIT FEES 132924 86066 46858 0 PURCHASED SERVICES 10145154 9802045 343109 0 189014267 141389234 47625033 0 6864 7087 9032457 14556357 0 0 31956321 31180546 0 0 0 0 183949 228962 7587128 7651071 8997789 11764385 252160626 141308661 114142476 110851965 69150468 70270238 0 0 0 0 1564717 1564717 16722451 13920088 259344620 261995416 21079568 21995223 0 0 0 0 35219870 33942587 0 0 0 0 0 0 0 0 56757269 51041892 113056707 106979702 X 141523091 149883257 3371287 3738922 1393535 1393535 146287913 155015714 259344620 261995416 X 9605914 4463263 0 0 0 -5341376 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 50984 1 28434 0 79418 0 Schedule C, Part II-B, Line 1 CAYUGA MEDICAL CENTER AT ITHACA HAS CONSULTANTS THAT LOBBY ON THE HOSPITAL'S BEHALF AND IT ALSO BELONGS TO AN ORGANIZATION THAT LOBBIES ON THEIR MEMBERS BEHALF. 1711653 30144 181 0 21316 0 1720662 1674520 43088 136 0 6091 0 1711653 1647374 41237 105 0 14196 0 1674520 1734183 261328 97 0 348234 0 1647374 1393535 0 0 0 0 0 1393535 0 0.759 0.241 0 1 1 2829462 0 2829462 141602079 0 64099292 77502787 2517239 0 1651196 866043 95434059 0 71507564 23926495 9777787 0 4050609 5727178 110851965 BENEFICIAL INTEREST IN ASSETS OF FOUNDATION 5763570 INSURANCE RECEIVABLE 2017232 EQUITY IN RELATED PARTIES 4315300 OTHER ASSETS 1823986 13920088 DUE TO THIRD PARTY PAYERS 6364418 FAIR VALUE OF INTEREST RATE SWAP 53870 ACCRUED INSURANCE CLAIMS 2017232 ACCRUED PENSION COST 31211271 ACCRUED POSTRETIREMENT COSTS 11395101 51041892 197742068 4463263 0 0 -5341376 -878113 198620181 0 0 0 198620181 189014267 0 0 0 0 0 189014267 0 0 0 189014267 Schedule D, Part V, Line 4 THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE HOSPITAL'S ONGOING MISSION TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. Schedule D, Part XI, Line 2d PENSION AND POST RETIREMENT CHANGES OF $8,750,331: UNREALIZED GAIN ON INTEREST RATE SWAP OF $188,876: AND RESERVE FOR CMA LOAN OF $14,280,583. 1 1 1 X 1 X 1 1 0 1 1 90911 0 90911 0.0005 26342764 22263590 4079174 0.0216 0 0 0 0 0 0 26433675 22263590 4170085 0.0221 17292440 623976 16668464 0.0882 755878 0 755878 0.004 10783618 6922848 3860770 0.0204 0 0 0 0 74624 0 74624 0.0004 0 0 28906560 7546824 21359736 0.1130 0 0 55340235 29810414 25529821 0.1351 1 6473024 2405376 35033228 50959059 -15925831 X 1 0 1 1 CAYUGA MEDICAL CENTER AT ITHACA 101 DATES DRIVE ITHACA NY 14850 www.cayugamed.org 5401001H X X X CAYUGA MEDICAL CENTER AT ITHACA 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X www.cayugamed.org/docs/CHIP-TOMP-2016-2018.PDF X 1 16 1 www.cayugamed.org/docs/CHIP-TOMP-2016-2018.PDF 0 0 1 X 100 300 X X 1 1 X X X 1 X www.cayugamed.org X www.cayugamed.org X www.cayugamed.org X X X X X X 1 X 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-CAYUGA MEDICAL CENTER AT ITHACA Part V, Section B, Line 5 - As in years past, the qualitative process provided crucial community input into this assessment. Information for this assessment was collected in a different manner this year, as the CHNA and Community Health Improvement Plan (CHIP) was a combined effort with the Local Health Department of Tompkins County. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers, and through panels and presentations by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. For example, data on hospitalizations related to mental health and substance abuse showed steep increases over the last 2-10 years, indicating that mental health and substance abuse continues to be a priority for Tompkins County. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part V, Section B, Line 6b-CAYUGA MEDICAL CENTER AT ITHACA Part V, Section b, Line 6b - Tompkins County Health Department and Human Services Coalition, Alcohol and Drug Council of Tompkins County, Collaborative Solutions Network, Family & Children's Services of Tompkins County, Mental Health Association of Tompkins County, and Tompkins County Mental Health Department. Schedule H, Part V, Section B, Line 11-CAYUGA MEDICAL CENTER AT ITHACA Part V, Section B, Line 11 - Cayuga Medical Center is actively working to address the needs of individuals suffering from mental health and/or substance abuse conditions by improving the care available to this population within the hospital setting and actively collaborating with community-based providers for the outpatient setting. Cayuga Medical Center is directly participating in the Tompkins County CHNA/CHIP Steering Committee, and has representation from our Cayuga Center for Healthy Living, a service within CMC that focuses on chronic disease prevention and treatment. The Health needs not addressed by the document include: % of population (all ages) living in Poverty, % of population (under age 18) living in poverty, % of single parent-households with children under the age of 18 living in the home, Percent of individuals uninsured and the Housing affordability rate. CMC is not directly addressing these health conditions. CMC is however aligned with and supports the United Way in Tompkins County which helps address housing and poverty needs. CMC additionally is aligned with the Health Planning Council which assists in enrolling individuals into Medicaid and other affordable insurance programs and CMC provides space at the hospital for enrollment of individuals into these programs. 8 CAYUGA MEDICAL CENTER 10 ARROWWOOD DRIVE ITHACA NY 14850 URGENT CARE CLINIC, DIAGNOSTIC IMAGING, HEMATOLOGY/ONCOLOGY SERVICES CAYUGA MEDICAL CENTER 1129 COMMONS AVE CORTLAND NY 13045 URGENT CARE CLINIC, DIAGNOSTIC IMAGING, LAB SERVICES, OUTPATIENT PHYSICAL THERAPY CAYUGA MEDICAL CENTER 310 TAUGHANNOCK BLVD ITHACA NY 14850 CARDIAC REHAB, SPORTS MEDICINE, OUTPATIENT REHAB, DIAGNOSTIC, NUTRITIONAL CAYUGA MEDICAL CENTER 201 DATES DRIVE ITHACA NY 14850 HEMATOLOGY AND ONCOLOGY SERVICES CAYUGA MEDICAL CENTER 10 ARROWWOOD DRIVE ITHACA NY 14850 OUTPATIENT SURGICAL SERVICES CAYUGA MEDICAL CENTER 10 BRENTWOOD DRIVE ITHACA NY 14850 OUTPATIENT REHAB SERVICE CAYUGA MEDICAL CENTER 16 BRENTWOOD DRIVE ITHACA NY 14850 DIAGNOSTIC IMAGING CAYUGA MEDICAL CENTER CAYUGA ENDOSCOPY CENTER 2435 NORTH TRIPHAMMER RD ITHACA NY 14850 ENDOSCOPY CENTER Schedule H, Part I, Line 7 Cayuga Medical Center utilized its cost accounting system to obtain the cost of services related to financial assistance and subsidized health services, lines 7a and 7g. All other costs were derived from actual expenses incurred in the period that were directly related to the provision of the service or program. Schedule H, Part I, Line 7, Column f The amount of bad debt expense that was included in Form 990, Part IX, line 25, column (A), but subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f) is $664,139. Schedule H, Part III, Section A, Line 4 * Part III, Line 2: THE MEDICAL CENTER PROVIDES SERVICES THAT ARE PAID FOR BY THIRD-PARTY PAYERS AND INDIVIDUALS. THE MEDICAL CENTER DOES NOT ACCRUE INTEREST ON THESE RECEIVABLES. THE MEDICAL CENTER ESTIMATES THE AMOUNT TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS FOR DOUBTFUL ACCOUTNS BY ANALYZING PATIENT ACCOUNTS FOR COLLECTIBILITY AND APPLYING HISTORICALLY ESTABLISHED PERCENTAGES FOR SELF-PAY AND VARIOUS THIRD-PARTY PAYERS TO THE AGING CATEGORIES IN THE ACCOUNTS RECEIVABLE AGING. ACCOUNTS FOR WHICH NO PAYMENTS HAVE BEEN RECEIVED FOR A SIGNIFICANT AMOUNT OF TIME ARE CONSIDERED DELINQUENT AND THE ACCOUNT IS WRITTEN-OFF WHEN CUSTOMARY COLLECTION EFFORTS ARE EXHAUSTED. * Part III, Line 3: FOR CALCULATING THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY OF THE MEDICAL CENTER, THE DENIAL RATE WAS APPLIED TO THE REPORTED BAD DEBT EXPENSE. THIS ALLOWS THE MEDICAL CENTER TO BE CONSERVATIVE IN THE ESTIMATE OF WHAT AMOUNT THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS. * Part III, Line 4: THE PAGE NUMBER IN THE ATTACHED FINANCIAL STATEMENTS ON WHICH THE FOOTNOTE IS CONTAINED THAT DESCRIBES BAD DEBT IS PAGE 6, FOOTNOTE # 2 - SUMMARY SIGNIFICANT ACCOUNTING POLICIES - NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE. Schedule H, Part III, Section B, Line 8 * Part III, Line 8: THE COST TO CHARGE RATIO OF 53.93% WAS CALCULATED FROM OUR FACILITIES COST ACCOUNTING SYSTEM BASED ON THE TOTAL COST TO TOTAL CHARGES ON MEDICARE ACCOUNT ONLY WAS APPLIED TO THE MEDICARE GROSS PATIENT REVENUE OF $107,425,779. THE RESULT WAS THEN REDUCED BY THE WORKSHEET 6 MEDICARE COSTS OF $6,975,664 FOR THE FY 2016. Schedule H, Part III, Section C, Line 9b * Part III, Line 9b - CMC'S STANDARD OPERATING PRACTICE IS TO STOP ALL COLLECTION EFFORTS AND HOLD ACCOUNTS BACK FROM BAD DEBT UNTIL THE PATIENT IS GIVEN SUFFICIENT TIME TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. REVIEW OF THE APPLICATION WILL BE MADE BY THE HOSPITAL AND PATIENTS ARE NOTIFIED OF DETERMINATION WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. IF A PATIENT DOES NOT QUALIFY FOR EITHER PARTIAL OR FULL ASSISTANCE, THEN A MONTHLY PAYMENT PLAN IS OFFERED TO THE PATIENT FOR ANY REMAINING BALANCES DUE. IF THE PATIENT QUALIFIES FOR ANY FINANCIAL ASSISTANCE, AN ADJUSTMENT IS IMMEDIATELY POSTED TO THE PATIENTS ACCOUNT UPON DETERMINATION OF QUALIFICATION. Schedule H, Part VI, Line 2 Part VI, Line 2 - To determine the health needs of our community, a comprehensive analysis was conducted through quantitative and qualitative methods. In the quantitative analysis, multiple sources provided the reportable statistics including the New York State Community Health Indicators, the County Health Rankings Report, as well as internal data from Cayuga Medical Center. The data collected for the quantitative assessment was then sorted into the following health categories: * Demographics and socioeconomic status * Access to health care * Health Status of overall population and priority populations * Risk factor behaviors and conditions related to top 5 causes of death * Child health * Infectious diseases * Natural environment * Social and Mental Health environment * Resources/Assets. For every indicator, comparisons were made utilizing the mean value for each individual county, the aggregate value for the total community, the New York State w/o New York City (NYC) state value, and the U.S. value where applicable to generate context for interpretation. Information for this assessment was collected in a different manner this year, as the CHNA and Community Health Improvement Plan (CHIP) was a combined effort with the Local Health Department of Tompkins County. The CHNA/CHIP team was comprised of representatives from Tompkins County, Cayuga Medical Center and several community-based non-profit organizations. Much of the information driving the selection/confirmation of our priorities was gathered through conversations with service providers, and through panels and presentations by peers and providers. Key data indicators were reviewed to guide selection decisions for our priority focus areas. For example, data on hospitalizations related to mental health and substance abuse showed steep increases over the last 2-10 years, indicating that mental health and substance abuse continues to be a priority for Tompkins County. Finally, review of chronic disease indicators revealed that Tompkins County is in the second quartile statewide, indicating the need to continue our efforts to focus on underserved populations, particularly in the rural parts of the county. Schedule H, Part VI, Line 3 * Part VI, Line 3 - Patients who request a financial assistance application are provided with the organization's policy and are connected with a financial counselor. Patients receive billing statements that provide information on financial policies and contact information for help with their bills. Patients are called and financial assistance is offered if the bills are unpaid. The organization has facilitated enrollers from Medicaid Managed Care plan on-site and refers patients to them for determination of Medicaid eligibility. In addition, information on the organizations financial assistance policy, Medicare and Medicaid enrollment is available on www.cayugamed.org. Schedule H, Part VI, Line 4 Part VI, Line 4 - Located in the Finger Lakes region, CMC serves populations from six counties, Cayuga, Cortland, Schuyler, Seneca, Tioga and Tompkins Counties. Many of these areas are designated rural counties and Tompkins County is NYS's smallest Metropolitan Statistical Area. The total service area spans approximately 1,000 square miles in the middle of the state with an average population density of fewer than 125 persons per square mile. There are several distinct health and health-related factors affecting residents of this area: A)The Region is home to an older community. According to HANYS, 11.3% of adults are 55-64 years of age. Since the 2000 Census, growth in the 65+ age cohort has ranged from 15% to 32% across the region and is projected to increase by 18% between 2016-2021. Issues with chronic disease and psychological distress are well documented for this demographic. Overall, 22.9% of adults aged 55 and over are likely to be in fair or poor health, ranging from 19.6% of those aged 55-64 to 32.1% of those aged 85 and over (National Health Statistics Reports, Health Characteristics of Adults Aged 55 Years and Over: United States, 2004-2007, CDC, 2009). B) Access to health care professionals within the Region is problematic. Many of the counties have zip codes within that county with Health Professional Shortage Areas (HPSAs) designations for physician, dental, and mental health care for Medicaid beneficiaries. Even when a provider is available, the rural environment, defined by hilly terrains and lakes as geographic barriers, creates transportation challenges that can limit access. C) In aggregate, residents of the service area are fiscally challenged. The median salary within the Region is $52,624, which is $6,645 below the state average (ACS 5-year Estimate, Census Bureau). Schedule H, Part VI, Line 5 Part VI, Line 5 - Cayuga Medical Center now has a mirror board at the Cayuga Health System level, Cayuga Medical Center's active parent holding company. The majority of Cayuga Health System's board of directors are all residents of Tompkins County, Cayuga Medical Center's primary service area. Additionally, any qualified healthcare professional that meets the high quality standards of our credentialing process may apply and secure medical staff privileges within an identified department or specialty. As a 501(c)(3) organization, Cayuga Medical Center reinvests any surplus in annual operating margin to improve medical care for the community, including patient-side and technology improvements, facility structure and infrastructure, and improvements in care delivery. As an example, Cayuga Medical Center is investing in a $6.9 million facilities project to renovate and expand its inpatient Behavioral Services Unit starting in 2017. Part of this project will be funded through a NYS grant ($2.47 million), but the majority of the project will be funded through Cayuga Medical Center's own reserves. Despite the fact that this crucial community resource does not generate surplus revenue, Cayuga Medical Center believes it is a vital service for the community, and as such, continues to invest its limited resources to ensure the community's needs are met. Schedule H, Part VI, Line 6 Part VI, Line 6 - As of September 2014, CMC is now a subsidiary member of Cayuga Health System. Schuyler Hospital is also a subsidiary hospital of Cayuga Health System. Each subsidiary organization has their own separately identified primary and secondary service areas and is responsible for improving the health of those communities. For 2016, Schuyler Hospital collaborated with its local health department to complete its CHNA/CHIP. As of 2017, Cayuga Health System now has a mirror board, with representatives from each of the former subsidiary boards as members. The organizations are exploring a more unified approach to the CHNA/CHIP process in future years. The strategic plan is now aligned at the System level, and the needs of each community have been incorporated across the plan. Schedule H, Part VI, Line 7 * Part VI, Line 7 - New York State X 1 1 X X X X 0 0 0 0 0 1 0 0 0 JOHN RUDD PRESIDENT/CEO 484338 0 0 0 0 0 5300 0 7662 0 497300 0 0 0 JOHN COLLETT VP/CFO 238000 0 0 0 0 0 4760 0 1430 0 244190 0 0 0 TIMOTHY BAEL MD ONCOLOGIST 549848 0 174157 0 0 0 5300 0 4648 0 733953 0 0 0 CHARLES GARBO MD ONCOLOGIST 545998 0 107296 0 0 0 5300 0 6202 0 664796 0 0 0 JULIE CAMBELL MD ONCOLOGIST 431062 0 95147 0 0 0 5300 0 5660 0 537169 0 0 0 SRISATISH DEVAPATLA MD NEONATOLOGIST 397700 0 22445 0 0 0 5300 0 8160 0 433605 0 0 RAMESH VIDAVALUR NEONATOLOGIST 333586 0 13245 0 0 0 3733 0 6960 0 357524 0 0 0 Schedule J, Part I, Line 1a ALL EMPLOYEES ARE ELIGIBLE FOR A HEALTH CLUB MEMBERSHIP SUBSIDY IN WHICH THE HOSPITAL WILL REIMBURSE EMPLOYEES 50% OF THE MONTHLY SINGLE MEMBERSHIP FEE WHEN THEY ATTEND THE HEALTH CLUB AT LEAST 24 TIMES A QUARTER. IF AN EMPLOYEE DOES NOT MEET THE CRIETERA, THEY WILL NOT RECEIVE THE SUBSIDY. Schedule J, Part I, Line 6 THE HOSPITAL HAS A YEAR END BONUS PROGRAM FOR ALL EMPLOYEES BASED ON THE OPERATING MARGIN, PARTICIPATION IN AN ANNUAL SAFETY TRAINING AND REACHING PREDETERMINED CUSTOMER SATISFACTION SCORES. A TOMPKINS COUNTY AREA DEVELOPMENT INC 166058339 2003-10-09 15000000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 B TOMPKINS COUNTY DEVELOPMENT CORP 272290745 890096AA8 2010-08-31 14275000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 C TOMPKINS COUNTY DEVELOPMENT CORP 272290745 2013-04-09 25000000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 A 0 0 15000000 0 0 0 205375 0 369000 14525625 0 0 2003 0 0 1 1 B 0 0 14275000 0 0 0 285500 0 142750 13846750 0 0 2010 0 0 1 1 C 0 0 25000000 0 0 0 613238 0 0 24386762 0 0 2013 0 0 1 1 A 1 1 0 0 0 0.0082 0.0082 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 1 1 1 JP MORGAN 15 0 0 0 0 0 B 1 1 1 DEUTSCHE BANK 12 0 0 0 0 0 C 1 0 0 0 0 0 A 1 B 1 C 1 THE COMPUTING CENTER BOARD CHAIR AND FOUNDER/CFO/MINORITY SHAREHOLDER OF THE COMPUTING CENTER 445547 PAYMENTS TO THE COMPUTING CENTER FOR CERTAIN COMPUTER PRODUCTS, CONSUMABLES, AND SERVICES. TRANSACTIONS ENTERED INTO WERE FAIR, REASONABLE, AND IN THE BEST INTEREST OF THE ORGANIZATION BASED ON ONGOING ANALYSIS OF VALUE, LOCAL SERVICES, AND HISTORY OF QUALITY SERVICE. THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY WAS FOLLOWED RELATED TO THESE TRANSACTIONS. 0 Form 990, Part VI, Section B, Line 11b THE FORM IS REVIEWED WITH THE FINANCE, AUDIT AND PERSONNEL COMMITTEE AND IS MADE AVAIALBE TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part VI, Section B, Line 12c CAYUGA MEDICAL CENTER AT ITHACA MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMEBERS ARE REQUIRED TO SIGN ANNUALLY. THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATEMENTS FOR CONFLICTS, IDENTIFYING DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDINGS RELATED TO A CONFLICT OF INTEREST TRANSACTION. Form 990, Part VI, Section B, Line 15 CAYUGA MEDICAL CENTER AT ITHACA DETERMINES COMPENSATION OF THE CEO AND OTHER OFFICERS BY UTILIZING INDEPENDENT COMPENSTAITON CONSULTANTS AND/OR COMPENSTTION SURVEYS. A FORMAL WRITTEN CONTRACT FOR THE CEO IS REVEIWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section C, Line 19 THE FORM IS REVIEWED WITH THE FINANCE, AUDIT AND PERSONNEL COMMITTEE AND IS MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part XI, Line 9 UNREALIZED GAIN ON INTEREST RATE SWAP OF $188,876; PENSION AND POST RETIREMENT RELATED CHANGES OF $8,750,331; INVESTMENT IN CMA OF ($14,280,583) CAYUGA MEDICAL CENTER FOUNDATION 101 DATES DRIVE ITHACA NY 14850 161072414 SUPPORT NY 501(C)(3) 11 CAYUGA MEDICAL CENTER AT ITHACA 0 CAYUGA MEDICAL ASSOCIATES 1301 TRUMANSBURG ROAD ITHACA NY 14850 204356115 MEDICAL PRACTICE NY 501(C)(3) 9 N/A 0 SCHUYLER HOSPITAL 220 STEUBEN STREET MONTOUR FALLS NY 14865 150533564 HOSPITAL NY 501(C)(3) 3 N/A 0 CAYUGA HEALTH SYSTEM INC 101 DATES DRIVE ITHACA NY 14850 471899601 TO BRING TOGETHER ORGANIZATIONS TO SERVE COMMUNITIY HEALTHCARE NEEDS NY 501(C)(3) 12 N/A CAYUGA MEDICAL OFFICE BUILDING 101 DATES DRIVE ITHACA NY 14850 161261492 BUILDING MANAGEMENT NY N/A Related 186635 1339406 0 1085 1 0.58 TOMPKINS OFFICE MANAGEMENT SYSTEM 101 DATES DRIVE ITHACA NY 14850 161437217 OFFICE MANAGEMENT NY CAYUGA MEDICAL CENTER AT ITHACA C 132301 1156488 1 1 CAYUGA AREA PLAN INC 101 DATES DRIVE ITHACA NY 14850 161298390 HEALTHCARE NY N/A C 0 0 0.5 0 CAYUGA AREA PREFERRED INC 101 DATES DRIVE ITHACA NY 14850 161542122 HEALTHCARE NY N/A C -7594 618175 0.5 0 ISLAND HEALTH & FITNESS 310 TAUGHANNOCK BLVD ITHACA NY 14850 203036206 FITNESS NY TOMPKINS OFFICE MANAGMENT SYSTEM C 0 0 0 0 RASA SPA 310 TAUGHANNOCK BLVD ITHACA NY 14850 204467386 HOLISTIC HEALTH NY ISLAND HEALTH & FITNESS C 0 0 0 0 1 1 1 0 0 0 1 0 0 1 1 1 1 0 0 0 1 0 0 CAYUGA MEDICAL ASSOCIATES b 14280583 ACKNOWLEDGEMENT LETTER CAYUGA MEDICAL ASSOCIATES g 236691 COST CAYUGA MEDICAL ASSOCIATES j 83695 CONTRACT CAYUGA MEDICAL ASSOCIATES k 21206 CONTRACT CAYUGA MEDICAL ASSOCIATES m 2443391 CONTRACT CAYUGA MEDICAL ASSOCIATES l 524068 CONTRACT TOMPKINS OFFICE MANAGEMENT SYSTEM a-i 1990 CONTRACT TOMPKINS OFFICE MANAGEMENT SYSTEM l 58640 CONTRACT CAYUGA AREA PREFERRED INC l 1050667 CONTRACT CAYUGA MEDICAL OFFICE BUILDING k 440226 CONTRACT CAYUGA MEDICAL OFFICE BUILDING l 94900 CONTRACT SCHUYLER HOSPITAL l 406142 CONTRACT SCHUYLER HOSPITAL q 762273 COST SCHUYLER HOSPITAL m 98871 CONTRACT CAYUGA MEDICAL CENTER FOUNDATION c 531031 CASH TRANSFER CAYUGA MEDICAL CENTER FOUNDATION l 270300 CONTRACT