2017-11-15T08:42:11-06:00 2016-12-31 160765486 LUMSDEN & MCCORMICK LLP 369 FRANKLIN STREET BUFFALO NY 14202 990 2016-01-01 160743102 OLEAN GENERAL HOSPITAL OLEA 7163732600 515 MAIN STREET OLEAN NY 14760 TIMOTHY J FINAN PRESIDENT/CEO 7163732600 2017-11-14 1 MICHAEL J GRIMALDI P01295846 7168563300 38.122.36.250 2017-11-14 16:52:08 ES P 87273CE15A7E4D536C246F8BF2CA388F6BFCF293 ECFD8073557412C3490EDC284AF2457AA53A359D 2016 2018-03-14 21:41:22Z TIMOTHY FINAN 515 MAIN STREET OLEAN NY 14760 120437025 0 X WWW.OGH.ORG X 1898 NY THE MISSION OF OLEAN GENERAL HOSPITAL TO PROVIDE EXCELLENT CARE IN RESPONSE TO THE HEALTH CARE NEEDS OF THE COMMUNITY. IN SUPPORT OF THIS MISSION, OLEAN GENERAL HOSPITAL IS COMMITTED TO THE FOLLOWING:- COMPASSION: OUR SYMPATHETIC AWARENESS OF EACH PERSON'S NEEDS- INTEGRITY: OUR DEDICATION TO HONESTY- INNOVATION: OUR PURSUIT OF CREATIVITY- RESPECT: OUR COMMITMENT TO TREAT EVERYONE WITH DIGNITY- COMMUNITY: OUR UNDERSTANDING THAT WE EXIST TO SERVE THOSE AMONG US- EDUCATION: OUR BELIEF THAT KNOWLEDGE FOSTERS EXCELLENCE 17 14 1100 150 0 0 1786285 1859169 112239069 111332561 689599 556622 2320581 4876203 117035534 118624555 0 0 0 0 56930726 58770435 0 0 0 59553456 61207862 116484182 119978297 551352 -1353742 139291362 136157266 45432222 46633129 93859140 89524137 X THE MISSION OF OLEAN GENERAL HOSPITAL IS TO PROVIDE EXCELLENT CARE IN RESPONSE TO THE HEALTH CARE NEEDS OF THE COMMUNITY. IN SUPPORT OF THIS MISSION, OLEAN GENERAL HOSPITAL IS COMMITTED TO THE FOLLOWING:- COMPASSION: OUR SYMPATHETIC AWARENESS OF EACH PERSON'S NEEDS- INTEGRITY: OUR DEDICATION TO HONESTY- INNOVATION: OUR PURSUIT OF CREATIVITY- RESPECT: OUR COMMITMENT TO TREAT EVERYONE WITH DIGNITY- COMMUNITY: OUR UNDERSTANDING THAT WE EXIST TO SERVE THOSE AMONG US- EDUCATION: OUR BELIEF THAT KNOWLEDGE FOSTERS EXCELLENCETHE HOSPITAL IS GOVERNED BY A 17 MEMBER BOARD OF DIRECTORS COMPRISED OF 16 VOLUNTARY INDIVIDUALS WHO RESIDE THROUGHOUT THE OLEAN GENERAL HOSPITAL AND BRADFORD REGIONAL MEDICAL CENTER SERVICE AREAS AND THE CEO OF UPPER ALLEGHENY HEALTH SYSTEM. WITH A LICENSED CAPACITY OF 186 BEDS, THE HOSPITAL PROVIDES THE COMMUNITY WITH VITAL HEALTH CARE SERVICES INCLUDING MEDICAL/SURGICAL, PEDIATRIC AND OBSTETRICAL CARE. THE HOSPITAL ALSO PROVIDES INTENSIVE(CONTINUED) 0 0 100194644 111332561 IN 2016, OLEAN GENERAL HOSPITAL (OGH) DISCHARGED APPROXIMATELY 6,400 PATIENTS AND PROVIDED SERVICES TO APPROXIMATELY 210,000 OUTPATIENT VISITORS.OGH INCLUDES 186 PATIENT ROOMS, TOGETHER WITH COMPREHENSIVE PATIENT, ADMINISTRATIVE AND PHYSICIAN SERVICES AND ACCOMMODATIONS TO MEET THE DIAGNOSTIC, TREATMENT, ADMINISTRATIVE AND EDUCATIONAL NEEDS OF ITS PATIENTS AND MEDICAL STAFF. OGH OFFERS PATIENTS AND THEIR FAMILIES A FULL RANGE OF DIAGNOSTIC AND MEDICAL SERVICES, AS WELL AS MANY SPECIALTY SERVICES. A WIDE ARRAY OF MULTI-SPECIALTY PHYSICIANS AND CLINICIANS OFFER SERVICES RANGING FROM CANCER, CARDIAC AND VASCULAR CARE, OB/GYN, GENERAL SURGERY, UROLOGY, WOMEN'S HEALTH, INTERNAL MEDICINE, PEDIATRICS, SLEEP MEDICINE, AND PSYCHIATRIC CARE.HIGHLIGHTED BELOW ARE SOME OF THE INITIATIVES THAT WERE REALIZED IN 2016 AT OGH.2016 FINANCIAL PERFORMANCE- OGH HAD AN OPERATING LOSS OF ($3.2M) COMPARED WITH A 2015 GAIN OF $1.675M. THE OPERATING LOSS WAS THE RESULT OF TWO PRIMARY FACTORS, A DROP IN INPATIENT VOLUME AND UPWARD PRESSURE ON KEY OPERATING EXPENSES.- IN 2016 OGH'S BOARD OF DIRECTORS VOTED TO BECOME PART OF THE KALEIDA HEALTH SYSTEM, A BUFFALO, NEW YORK-BASED HEALTH SYSTEM. THIS DECISION WAS BASED ON A FIVE YEAR LONG-TERM FINANCIAL PLAN THAT WAS DEVELOPED FOR OGH AND ITS SISTER HOSPITAL UNDER OGH'S PARENT COMPANY - UPPER ALLEGHENY HEALTH SYSTEM (UAHS), WHICH DEMONSTRATED A FUTURE INABILITY TO REMAIN FINANCIALLY VIABLE GIVEN THE DOWNWARD PRESSURES ON REVENUE IN THE HEALTH CARE INDUSTRY AS WELL AS RISING COSTS TO PROVIDE CARE. OGH IS NOT UNIQUE IN THIS VULNERABLE POSITION. HOSPITALS ACROSS AMERICA, ESPECIALLY RURAL HOSPITALS, FACE A DAUNTING CHALLENGE OF SURVIVAL. SIGNIFICANT TIME WAS SPENT ANALYZING OGH'S AND UAHS' FINANCES AND EVALUATING KALEIDA HEALTH AS A PARTNER. A DECISION TO AFFILIATE WAS MADE IN THE FALL OF 2016. OGH'S MANAGEMENT EXPECTS THE AFFILIATION TO BE COMPLETED IN 2017. FINANCIAL IMPROVEMENT OF OVER $10M ANNUALLY AT UAHS IS EXPECTED UNDER THE AFFILIATION PLAN.2016 QUALITY MATTERS:- PHYSICIAN ELECTRONIC DOCUMENTATION (PDOC)- OGH BEGAN ROLLING OUT THIS PHYSICIAN DOCUMENTATION SYSTEM THAT THEN FEEDS INTO THE ELECTRONIC HEALTH RECORD OF OUR PATIENTS. THIS IS A SIGNIFICANT CHANGE FROM DICTATING, SCANNING AND COPYING INTO THE ELECTRONIC HEALTH RECORD. THE FULL ROLL-OUT WILL TAKE WELL INTO 2017 TO COMPLETE.- OGH UNDERWENT A SUCCESSFUL SURVEY BY THE JOINT COMMISSION IN 2016. AMONGST OTHER BENEFITS, THE SURVEY IS REQUIRED IN ORDER TO PARTICIPATE WITH MEDICARE. OGH RECEIVED A FULL THREE YEAR ACCREDITATION.- OGH BEGAN EDUCATION AROUND A "JUST CULTURE ORGANIZATION" IN 2016. THE JUST CULTURE IS A SYSTEM OF SHARED ACCOUNTABILITY WHERE MANAGEMENT IS ACCOUNTABLE FOR THE SYSTEMS THEY HAVE DESIGNED AND TO RESPONDING TO THE BEHAVIORS OF THEIR STAFF IN A FAIR AND EQUITABLE MANNER AND WHERE EMPLOYEES ARE HELD ACCOUNTABLE FOR THE QUALITY OF THEIR CHOICES AND FOR REPORTING ERRORS AND SYSTEM VULNERABILITIES.INFORMATION TECHNOLOGY- OGH CONTINUED TO EXPAND THE USAGE OF ITS PHYSICIAN DOCUMENTATION SOFTWARE MAKING IT AVAILABLE IN THE EMERGENCY DEPARTMENT. ELECTRONIC PHYSICIAN DOCUMENTATION SYSTEMS HELP STANDARDIZE PHYSICIAN DOCUMENTATION TO ENSURE REQUIRED DATA ELEMENTS ARE CAPTURED AND PATIENT CARE IS DELIVERED IN ACCORDANCE WITH EVIDENCE BASED PRACTICE. ALSO, SINCE DATA IS ENTERED AS DISCRETE ELEMENTS, IT ALLOWS FOR IMPROVED QUALITY REPORTING AND MONITORING. FINALLY, ELECTRONIC PHYSICIAN DOCUMENTATION ELIMINATES THE POTENTIAL FOR TRANSCRIPTION ERRORS. - OGH EXPANDED THE USAGE OF ITS ELECTRONIC MEDICATION PRESCRIBING SYSTEM (ERX) TO INCLUDE CONTROLLED SUBSTANCES. ERX SYSTEMS ALLOW HEALTH CARE PROVIDERS TO SEND PRESCRIPTIONS ELECTRONICALLY TO A PATIENT'S PHARMACY. E-PRESCRIBING IS CONVENIENT FOR PATIENTS, HELPS REDUCE TRANSCRIPTION ERRORS, AND CAN REDUCE FRAUD ASSOCIATED WITH TRADITIONAL PAPER PRESCRIPTIONS. - OGH IMPLEMENTED THE MEDITECH EMERGENCY DEPARTMENT MANAGEMENT SOLUTION. THIS ALLOWS ALL CARE PROVIDERS TO DOCUMENT IN THE SAME ELECTRONIC HEALTH RECORD (EHR) THUS ENSURING EVERYONE INVOLVED IN THE PATIENT'S CARE HAS IMMEDIATE ACCESS TO THE LATEST CLINICAL DATA. IT ELIMINATED THE NEED FOR STAFF TO DOCUMENT THE SAME INFORMATION IN TWO SEPARATE SYSTEMS THEREBY ELIMINATING TRANSCRIPTION ERRORS. ALSO, BY CENTRALIZING ALL DATA INTO MEDITECH, IT WILL ALLOW UAHS TO CREATE ENHANCED DATA REPORTS THAT INCORPORATE CLINICAL DATA FROM BOTH THE ED AND INPATIENT STAY.OPERATIONS/PROGRAMS- A COMPREHENSIVE PROGRAM OF EMPLOYEE ENGAGEMENT WAS ORGANIZED AND IMPLEMENTED AT OGH. THE PROGRAM ACKNOWLEDGES THE VALUE OF EACH AND EVERY EMPLOYEE IN TAKING CARE OF OUR PATIENTS AND PROVIDES AN OPPORTUNITY TO INTERACT WITH EMPLOYEES AS THEY DO THEIR JOBS. 100194644 1 1 0 0 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 1 0 0 0 0 0 0 1 0 0 0 1 144 0 1 1100 1 0 0 0 0 0 0 0 0 0 0 X 17 14 1 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X RICHARD G BRAUN JR CPA 7163756190 130 SOUTH UNION ST SUITE 300 OLEAN NY 14760 TIMOTHY FINAN PRESIDENT AND CEO 23.50 16.50 X X 428437 251621 59778 BRENDA MCGEE BOARD CHAIR 2.00 3.50 X X 0 0 0 MUHAMMED JAVED MD BOARD VICE CHAIR 2.00 3.50 X X 70200 0 0 RICHARD ROUPE BOARD SECRETARY 2.00 3.50 X X 0 0 0 MARTIN DIGEL BOARD TREASURER 2.00 3.50 X X 0 0 0 LIVINGSTON ALEXANDER ED D DIRECTOR 2.00 3.50 X 0 0 0 JEFF BELT DIRECTOR 2.00 3.50 X 0 0 0 THOMAS BUFFAMANTE DIRECTOR 2.00 3.50 X 0 0 0 PIERRE DIONNE MD DIRECTOR 2.00 3.50 X 0 0 0 LISA FIORENTINO PH D RN DIRECTOR 2.00 3.00 X 0 0 0 LUIS GONZALEZ MD DIRECTOR 2.00 3.50 X 0 0 0 DANIEL MCCUNE DIRECTOR 2.00 3.50 X 0 0 0 JILL OWENS MD DIRECTOR 2.00 3.50 X 0 148333 0 DAVID PRINCE DIRECTOR 2.00 3.50 X 0 0 0 LYNDA QUICK DIRECTOR 2.00 3.50 X 0 0 0 JEANNINE SCHOENECKER DIRECTOR 2.00 3.50 X 0 0 0 MELISSA SCHOLL OSF DIRECTOR 2.00 3.50 X 0 0 0 RICHARD G BRAUN JR SENIOR VP OF FINANCE/CFO 23.50 15.50 X 227862 133824 50989 TIMOTHY MCNAMARA SENIOR VP OF HUMAN RESOURC 23.50 15.00 X 155340 91232 53373 DR WILLIAM MILLS SENIOR VP OF MEDICAL AFFAI 23.50 15.00 X 198613 116645 43269 JASON YAWORSKY SENIOR VP/CIO 23.50 15.00 X 144729 85000 55326 GAIL BAGAZZOLI VP OF QUALITY 23.50 15.00 X 93380 54843 37335 DENNIS MCCARTHY VP OF COMMUNICATIONS & MAR 23.50 15.00 X 88605 52038 44683 JEFFREY ZEWE VP OF OPERATIONS 23.50 15.00 X 192478 113042 56112 BASIL ARIGLIO VP OF FINANCE 23.50 15.00 X 104380 61303 39494 MELISSA SULLIVAN VP OF CLINICAL & SUPPORT S 23.50 15.00 X 89013 52278 38683 KAREN FOHL VP INSTITUTIONAL ADVANCEME 48.00 12.00 X 66050 53459 27608 VI-ANNE ANTRUM SENIOR VP NURSING PT CARE SRVCS/CNO 37.50 X 49138 0 11817 MOHANED AL-HUMADI PHYSICIAN 37.50 X 1121353 0 73968 SAM JAYANTH SAMUEL PHYSICIAN 37.50 X 418760 0 31598 GARY CARL PHYSICIAN 37.50 X 492682 0 70700 GABRIEL YACOB PHYSICIAN 37.50 X 459800 0 29865 ARTHUR GOLDSTEIN PHYSICIAN 37.50 X 298316 0 75071 4699136 1213618 799669 46 0 1 0 PA MOUNTAIN HEALTHCARE ALLIANCE LLC 150 MCCRACKEN RUN ROAD DUBOIS PA 15801 HEALTH INSURANCE 7250841 COMPLETERX LTD 3100 S GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY MANAGEMENT SERVICES 5812541 APOGEE PHYSICIANS 2525 E CAMELBACK ROAD SUITE 1100 PHOENIX AZ 85016 PHYSICIANS AND HOSPITALISTS SERVICES 1991593 SOUTHERN TIER ANESTHESIOLOGISTS PC 202 N BARRY STREET OLEAN NY 14760 ANESTHESIOLOGY SERVICES 930584 ARAMARK SERVICES INC PO BOX 7548 PHILADELPHIA PA 19101 CAFETERIA FOOD SERVICE 917114 27 1626130 233039 1859169 PATIENT SERVICE REVENUE 621990 111332561 111332561 111332561 241358 241358 165083 0 165083 165083 165083 2127734 1812470 315264 315264 315264 DISCOUNTS/REBATES 900099 821009 821009 CAFETERIA/VENDING 722210 674831 674831 3215280 3215280 4711120 118624555 111332561 0 5432825 2234723 70200 2164523 42101651 35573100 6528551 2773700 2773700 8494617 6067113 2427504 3165744 3165744 324259 324259 6742204 6670679 71525 578944 578944 16811775 16702445 109330 223210 223210 521439 521439 7584709 5309296 2275413 1940099 184000 1756099 PURCHASED SERVICES 17726490 17726490 OTHER 4004080 1201224 2802856 PROVISION FOR BAD DEBTS 2577578 2577578 LEASE/RENT 1658736 1658736 514339 514339 119978297 100194644 19783653 0 9558877 7536381 5312460 513473 15434163 16137482 2332866 2278939 2491011 2097861 151761985 101183171 54483789 50578814 9586422 15272910 2611813 2599468 37479961 39141938 139291362 136157266 14306412 15718993 15967639 14206052 15158171 16708084 45432222 46633129 X 52513537 47057555 17067031 17925296 24278572 24541286 93859140 89524137 139291362 136157266 X -1353742 793121 -3774382 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17616950 556622 17858282 16679420 222204 715326 17616950 15093232 491607 1094581 16679420 14064479 494401 534352 15093232 13723863 85158 255458 14064479 0.65900 0.21700 0.12400 1 0 2025154 2025154 83911282 52014039 31897243 3658122 2835550 822572 61465485 46333582 15131903 701942 701942 50578814 ASSETS HELD BY OTHERS 36027302 OTHER ASSETS 3114636 39141938 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 676342 ACCRUED PENSION LIABILITY 16031742 16708084 116840098 793121 -2577578 -1784457 118624555 0 118624555 117400719 0 117400719 2577578 2577578 119978297 PART V, LINE 4: TO PROVIDE SUPPORT AND RENEW PLANT AND EQUIPMENT BASED ON HOSPITAL NEED. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -2,577,578. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,577,578. 1 1 X 1 X 400.000000000000 1 X 1 1 0 0 1333228 63510 1269718 0.01080 22949643 15005598 7944045 0.06770 24282871 15069108 9213763 0.07850 28 17686 469970 13526 456444 0.00390 1 328956 118408 210548 0.00180 28500 28500 0.00020 29 17686 827426 131934 695492 0.00590 29 17686 25110297 15201042 9909255 0.08440 0 2577578 447210 24537460 25962870 -1425410 X 1 1 1 1 OLEAN GENERAL HOSPITAL 515 MAIN STREET OLEAN NY 14760 X X X X DENTAL CLINIC, RADIATION ONCOLOGY OLEAN GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.OGH.ORG X 1 16 1 WWW.OGH.ORG 0 1 X 400.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X WWW.OGH.ORG X WWW.OGH.ORG X WWW.OGH.ORG X X X X X 1 X 0 X X X X 1 X 0 0 OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 3J: THE HOSPITAL PARTNERED WITH THE CATTARAUGUS COUNTY HEALTH DEPARTMENT (CCHD) TO DEVELOP THE REGION'S COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016. OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL'S EFFORTS ARE DESCRIBED ON PAGES 13-16 OF THE COMMUNITY HEALTH NEEDS ASSESSMENT.IN AN EFFORT TO EXAMINE THE HEALTH NEEDS OF THE RESIDENTS IN THE SERVICE AREAS TO MEET CURRENT IRS GUIDELINES AND REQUIREMENTS, THE METHODOLOGY EMPLOYED BOTH QUALITATIVE AND QUANTITATIVE DATA COLLECTION AND ANALYSIS. OGH, CCHD, STEERING COMMITTEE MEMBERS AND THE CONSULTING TEAM MADE SIGNIFICANT EFFORTS TO ENSURE THAT THE ENTIRE PRIMARY SERVICE TERRITORY, ALL SOCIO-DEMOGRAPHIC GROUPS AND ALL POTENTIAL NEEDS, ISSUES AND UNDERREPRESENTED POPULATIONS WERE CONSIDERED IN THE ASSESSMENT TO THE EXTENT POSSIBLE GIVEN THE RESOURCE CONSTRAINTS OF THE PROJECT. THIS WAS ACCOMPLISHED BY IDENTIFYING FOCUS GROUPS AND KEY STAKEHOLDERS WHO REPRESENTED VARIOUS SUBGROUPS WITHIN THE COMMUNITY. IN ADDITION, THE PROCESS TO COLLECT BOTH THE QUALITATIVE AND QUANTITATIVE DATA INCLUDED EXTENSIVE USE OF NEW YORK STATE DEPARTMENT OF HEALTH'S PREVENTION AGENDA DASHBOARD, CENTERS FOR DISEASE CONTROL AND PREVENTION DATA, AS WELL AS OGH AND CCHD'S PARTICIPATION ON THE STEERING COMMITTEE.THE SECONDARY QUANTITATIVE DATA COLLECTION PROCESS INCLUDED DEMOGRAPHIC AND SOCIO-ECONOMIC DATA OBTAINED FROM THE U.S CENSUS BUREAU - AMERICAN FACTFINDER DEMOGRAPHIC DATABASE. DISEASE INCIDENCE AND PREVALENCE DATA WAS OBTAINED FROM THE NEW YORK STATE DEPARTMENT OF HEALTH'S PREVENTION AGENDA DASHBOARD EXPANDED BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (EBRFSS), THE CENTERS FOR DISEASE CONTROL AND PREVENTION; AMERICAN COMMUNITY SURVEY AND THE HEALTHY PEOPLE 2020 GOALS FROM HEALTHYPEOPLE.GOV. IN ADDITION, VARIOUS HEALTH AND HEALTH RELATED DATA FROM THE FOLLOWING SOURCES WERE ALSO UTILIZED FOR THE ASSESSMENT: THE US DEPARTMENT OF AGRICULTURE, THE NEW YORK DEPARTMENT OF EDUCATION, AND THE COUNTY HEALTH RANKINGS. SELECTED DATA WAS ALSO INCLUDED FROM THE NEW YORK PREVENTION NEEDS ASSESSMENT SURVEY, 2015, MONITORING THE DATA, 2014, BACH HARRISON NORM, 2015. CDC. SELECTED EMERGENCY DEPARTMENT AND INPATIENT UTILIZATION DATA FROM THE HOSPITAL WAS ALSO INCLUDED. ECONOMIC DATA WAS OBTAINED THROUGH THE U.S. CENSUS BUREAU, SMALL AREA INCOME AND POVERTY ESTIMATES DATA PRESENTED ARE THE MOST RECENT PUBLISHED AT THE TIME OF THE DATA COLLECTION.THE PRIMARY DATA COLLECTION PROCESS INCLUDED CONDUCTING TWO COMMUNITY SURVEYS, UTILIZING A MIXED-METHODOLOGY CONVENIENCE SAMPLE, WITH DATA COLLECTION COMPLETED VIA PAPER AND THE INTERNET. OGH AND CCHD PUT A LINK TO THE SURVEY ON THEIR WEBSITES, DISTRIBUTED THE SURVEY LINK VIA EMAIL TO LOCAL RESIDENTS ON THEIR MAILING LIST, RAN ADS IN THE PAPER, AND DISTRIBUTED PAPER SURVEYS IN SELECTED LOCATIONS THROUGHOUT THE COUNTY.THE CCHD COMMUNITY HEALTH SURVEY WAS LAUNCHED ON AUGUST 9, 2016 AND CLOSED ON SEPTEMBER 19, 2016. A TOTAL OF 744 SURVEYS WERE RECEIVED ON HEALTH STATUS, COMMUNITY HEALTH NEEDS, BARRIERS TO HEALTH CARE, AND STRATEGIES OR SUGGESTIONS TO ADDRESS THE COMMUNITY HEALTH NEEDS. REFER TO APPENDIX B (PAGES 163-166) FOR A COPY OF THE CCHD COMMUNITY HEALTH SURVEY.AN ADDITIONAL COMPREHENSIVE CATTARAUGUS COUNTY CSP/CHA/CHIP SURVEY WAS CONDUCTED BEGINNING ON SEPTEMBER 19, 2016 AND ENDING ON OCTOBER 7, 2016. A TOTAL OF 525 SURVEYS WERE COMPLETED BY RESIDENTS OF THE SERVICE AREA. REFER TO APPENDIX C (PAGES 167-180) FOR A COPY OF THE CATTARAUGUS COUNTY CSP/CHA/CHIP SURVEY.THE PRIMARY DATA COLLECTION PROCESS ALSO INCLUDED QUALITATIVE DATA FROM 14 STAKEHOLDER INTERVIEWS, AS SEEN IN TABLE 2, CONDUCTED DURING AUGUST AND SEPTEMBER 2016 BY STAFF MEMBERS OF SSI. REFER TO APPENDIX D (PAGES 181-184) FOR A COPY OF THE INTERVIEW GUIDE. STAKEHOLDERS INTERVIEWED INCLUDED INDIVIDUALS WITH EXPERTISE IN THE FOLLOWING DISCIPLINES AND/OR ORGANIZATIONAL AFFILIATIONS:- AMISH POPULATION- SCHOOL DISTRICTS- UNITED WAY- INTERFAITH CAREGIVERS- ECONOMIC DEVELOPMENT/PLANNING- COUNCIL ON ADDICTION RECOVERY SERVICES (CARES)- LOCAL GOVERNMENT- OLEAN GENERAL HOSPITAL- HEALTHY COMMUNITY ALLIANCE- HEALTH CENTER/MEDICAL CLINIC- HEALTH CARE ACCESS COALITION- DIRECTIONS IN INDEPENDENT LIVINGSTAKEHOLDER INTERVIEWS WERE CONDUCTED WITH ORGANIZATIONS FROM AROUND THE REGION. FIVE FOCUS GROUPS WERE CONDUCTED IN SEPTEMBER AND OCTOBER 2016. INTERVIEWS AND FOCUS GROUPS CAPTURED PERSONAL PERSPECTIVES FROM COMMUNITY MEMBERS, PROVIDERS, AND LEADERS. THEY SHARED THEIR INSIGHT AND EXPERTISE REGARDING THE HEALTH OF A SPECIFIC POPULATION, A SPECIFIC COMMUNITY, OR THE COUNTY OVERALL. REFER TO APPENDIX E. OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 6A: IN DEVELOPING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CATTARAUGUS COUNTY, OLEAN GENERAL HOSPITAL CONSULTED WITH BETRAND CHAFFEE HOSPITAL, A MEMBER OF THE CATTARAUGUS COUNTY HEALTHY LIVABLE COMMUNITIES CONSORTIUM. OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 6B: IN DEVELOPING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CATTARAUGUS COUNTY, OTHER MEMBERS CONSULTED INCLUDED ALLEGANY/W. STEUBEN RURAL HEALTH NETWORK, AMERICAN RED CROSS, CANCER SERVICES PROGRAM (ALLEGANY CO.), CATTARAUGUS COUNTY DEPARTMENT OF THE AGING, CATTARAUGUS COUNTY HEALTH DEPARTMENT, CATTARAUGUS COUNTY YOUTH BUREAU, CITY OF OLEAN YOUTH BUREAU, CORNELL COOPERATIVE EXTENSION, DIRECTIONS IN INDEPENDENT LIVING, EVERYWOMAN OPPORTUNITY CENTER, HEALTH CARE ACCESS COALITION, HEALTHY COMMUNITY ALLIANCE, HEALTHY SCHOOLS NY, P2 COLLABORATIVE OF WNY, SALAMANCA YOUTH BUREAU, SOUTHERN TIER HEALTHCARE SYSTEMS, SOUTHERN TIER WEST, STRAWW, TOBACCO-REALITY CHECK, TOTAL SENIOR CARE, TRICOUNTY TOBACCO COALITION, AND UNIVERA COMMUNITY HEALTH. OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL'S EFFORTS IN ADDRESSING SIGNIFICANT NEEDS ARE DESCRIBED IN ITS 2016-2018 COMMUNITY HEALTH NEEDS EXECUTIVE SUMMARY, PAGE 5. PART I, LINE 7G: SUBSIDIZED PROGRAMS ARE NOT RECORDED AT THIS LEVEL OF DETAIL. ALL COSTS ASSOCIATED WITH THESE PROGRAMS, INCLUDING IP PSYCHIATRIC DEPARTMENT, EMERGENCY DEPARTMENT AND SALAMANCA CLINIC ARE INCLUDED IN THE AMOUNTS PROVIDED. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,577,578. PART II, COMMUNITY BUILDING ACTIVITIES: A RECENT PHYSICIAN WORKFORCE ANALYSIS DEMONSTRATED THAT THE OLEAN AREA HAS SIGNIFICANT PRIMARY CARE AND SPECIALIST SHORTAGES, RESULTING IN LIMITED ACCESS TO CARE FOR PATIENTS. BASED UPON A BENCHMARK OF 61.5 PRIMARY CARE PHYSICIANS PER 100,000 POPULATIONS, OGH'S SERVICE AREA HAS A CRITICAL NEED FOR PRIMARY CARE PHYSICIANS BOTH NOW AND IN THE FUTURE (MINIMUM OF 14 PRIMARY CARE PHYSICIANS OF THE NEXT FOUR YEARS). THE OGH SERVICE AREA ALSO HAS SIGNIFICANT NEED FOR SPECIALISTS. THE MOST PRESSING CURRENT MEDICAL SPECIALTY NEEDS ARE CARDIOLOGY, DERMATOLOGY AND PSYCHIATRY. IN THE NEXT FIVE YEARS, ALLERGY, CARDIOLOGY AND DERMATOLOGY WILL BE CONTINUE TO BE POTENTIAL NEEDS. THE HOSPITAL ALSO PROVIDES CLINICAL ROTATIONS FOR MEDICAL STUDENTS IN INTERNAL AND EMERGENCY MEDICINE THROUGH AN AFFILIATION AGREEMENT WITH LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE. IN ADDITION, ST BONAVENTURE UNIVERSITY PRE-MEDICAL STUDENTS PARTICIPATE IN A 14 WEEK ROTATION PROVIDING EXPOSURE TO VARIOUS CLINICAL SPECIALTIES AND DIAGNOSTIC MODALITIES, FOR AN IN-DEPTH EXPOSURE TO THE REALITIES OF A CAREER IN MEDICINE. PART III, LINE 3: THE RATIONALE USED TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PLAN WAS DETERMINED BY USING THE AVERAGE POVERTY LEVEL OF THE LARGEST SERVICE AREAS COVERED BY THE HOSPITAL. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS 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 HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 HOSPITAL RECORDS A SIGNIFICANT 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 HOSPITAL'S 2016 RCC WAS APPLIED TO THE TOTAL BAD DEBT EXPENSE TO DETERMINE BAD DEBT EXPENSE AT COST. THE BAD DEBT AMOUNTS ABSORBED BY THE HOSPITAL ARE PART OF ITS COMMUNITY BENEFIT DUE TO ITS POLICY TO PROVIDE MEDICAL SERVICE TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. PART III, LINE 8: THE ALLOWABLE COSTS REPORTED ON LINE 6 ARE DIRECTLY FROM THE HOSPITAL'S 2016 MEDICARE COST REPORT, WHICH IS PREPARED USING A RATIO OF CHARGES TO COSTS BASIS (RCC) AS REQUIRED BY MEDICARE. PART III, LINE 9B: COLLECTION PRACTICES:I) OGH WILL NOT CAUSE THE FORCED SALE OR FORECLOSURE ON A PATIENT'S PRIMARY RESIDENCE.II) OGH WILL NOT SEND ACCOUNT TO COLLECTION IF THE PATIENT HAS SUBMITTED A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE, INCLUDING THE REQUIRED DOCUMENTATION, WHILE AN APPLICATION IS PENDING.III) OGH WILL PROVIDE WRITTEN NOTIFICATION TO A PATIENT AT LEAST 30-DAYS BEFORE AN ACCOUNT IS SENT TO COLLECTION. THIS WRITTEN NOTICE MAY BE INCLUDED ON A BILL. IV) OGH REQUIRES THAT A COLLECTION AGENCY HAVE ITS WRITTEN CONSENT PRIOR TO STARTING LEGAL ACTION FOR COLLECTION.V) OGH WILL TRAIN ALL GENERAL HOSPITAL STAFF WHO INTERACT WITH PATIENTS OR HAVE RESPONSIBILITY FOR BILLING AND COLLECTION.VI) OGH WILL MEASURE OUR COMPLIANCE WITH THESE POLICES.VII) OGH REQUIRES ANY COLLECTION AGENCY UNDER CONTRACT TO FOLLOW OUR FINANCIAL ASSISTANCE POLICY AND PROVIDES INFORMATION TO PATIENT'S ON HOW TO APPLY, WHERE APPROPRIATE.VIII) OGH DOES NOT ALLOW COLLECTION ACTIVITY IF THE PATIENT IS DETERMINED ELIGIBLE FOR MEDICAID FOR THE SERVICES THAT WERE RENDERED AND OGH IS ABLE TO COLLECT MEDICAID PAYMENT. PART VI, LINE 2: THE STRATEGIC PLANNING COMMITTEE OF OLEAN GENERAL HOSPITAL IS CHARGED WITH DEVELOPING A LONG-RANGE STRATEGIC PLAN FOR THE HOSPITAL. THE PURPOSE OF THE PLAN IS TO PROVIDE DIRECTION AND CONTEXT FOR HOSPITAL DECISION MAKING AND RESOURCE ALLOCATION CONSISTENT WITH LOCAL HEALTH CARE NEEDS AND MARKET OPPORTUNITIES. TO ACCOMPLISH THIS TASK, THE COMMITTEE CREATED A COMPREHENSIVE, PARTICIPATORY PROCESS TO SOLICIT INPUT FROM ALL LEVELS OF THE ORGANIZATION AND THE COMMUNITY. A MULTI-STEP PLANNING PROCESS WAS INITIATED.STEP 1 INVOLVED THE REVIEW AND REVISION OF THE HOSPITAL'S MISSION AND VISION STATEMENTS. BOTH STATEMENTS WERE MODIFIED FROM WHAT HAD PREVIOUSLY EXISTED. A CONCISE, VALUE DRIVEN MISSION STATEMENT WAS DEVELOPED IN RESPONSE TO THE NEED FOR MISSION STATEMENTS TO DESCRIBE "WHO WE ARE." ADDITIONALLY, SEVERAL CORE VALUES WERE DELINEATED IN SUPPORT OF THE MISSION STATEMENT. THE VISION STATEMENT WAS DEVELOPED IN RESPONSE TO THE QUESTION OF "WHAT DO WE WISH TO BECOME" WITH THE UNDERSTANDING THAT VISION STATEMENTS SHOULD BE REALISTIC, CREDIBLE, AND POSSESS THE ABILITY TO INSPIRE AND MOTIVATE. STEP 2 IDENTIFIED A SERIES OF CRITICAL ISSUES FACING THE HOSPITAL THAT WILL PROVIDE THE CONTEXT FOR THE HOSPITAL'S NEAR TERM OPERATING ENVIRONMENT WITH RESPECT TO CARE DELIVERY, REGULATION, COMPETITION, FINANCE AND KEY PUBLICS. STEP 3 INVOLVED THE DEVELOPMENT OF A COMPREHENSIVE ENVIRONMENTAL ANALYSIS, INCLUDING AN INTERNAL AND EXTERNAL ASSESSMENT OF THE HOSPITAL. THE INTERNAL ASSESSMENT WAS PROVIDED VIA MULTIPLE FOCUS GROUPS - OPEN DISCUSSIONS ABOUT THE HOSPITAL'S STRENGTHS, WEAKNESSES, OPPORTUNITIES AND THREATS. THESE FOCUS GROUPS, FACILITATED BY AN OUTSIDE CONSULTANT RETAINED BY THE HOSPITAL, PROVIDED INPUT FROM PHYSICIANS, EMPLOYEES, VOLUNTEERS AND THE COMMUNITY AND PROVIDED SIGNIFICANT INSIGHT INTO STRENGTHS, WEAKNESSES, AND OPPORTUNITIES FOR IMPROVEMENT. THE EXTERNAL ASSESSMENT WAS DEVELOPED FROM THE COMPILATION OF UTILIZATION, MARKET SHARE DEMOGRAPHIC AND FINANCIAL DATA AND PHYSICIAN WORKFORCE INFORMATION SPECIFIC TO THE HOSPITAL'S SERVICE AREA.STEPS 4, 5 AND 6 IDENTIFIED GOALS, STRATEGIES, AND OBJECTIVES THAT WILL SERVE AS OLEAN GENERAL HOSPITAL'S PRIORITIES THROUGH 2019. THE PLAN WAS REVIEWED IN JUNE 2016 AND INITIATIVES ADDED THAT WERE CARRIED OUT IN 2016. GOALS RESPOND TO THE QUESTION "WHAT ARE THE KEY PRIORITIES?" A SERIES OF STRATEGIES WERE DEVELOPED WHICH RESPOND TO THE QUESTION "HOW DO WE ACHIEVE OUR PRIORITIES?" FINALLY, A NUMBER OF SPECIFIC OBJECTIVES WERE DEVELOPED WHICH RESPOND TO THE QUESTION "WHAT WILL BE ACCOMPLISHED ANNUALLY?" OBJECTIVES WERE GENERATED BY SENIOR MANAGEMENT AND FORM THE BASIS FOR NEAR TERM ADMINISTRATIVE WORKPLANS.ESSENTIAL TO THE SUCCESS OF ANY STRATEGIC PLAN IS THE HOSPITAL'S ABILITY TO BOTH IMPLEMENT RECOMMENDATIONS MADE WITHIN THE PLAN AND TO RECOGNIZE THE DOCUMENT AS A DYNAMIC AND FLEXIBLE TOOL TO BE USED AS A GUIDE FOR THE FUTURE. SPECIFIC GOALS AND STRATEGIES MAY OR MAY NOT BE OBTAINED AND, UPON EVALUATION AND THE AVAILABILITY OF NEW INFORMATION AND DEVELOPMENTS, MAY NEED TO BE MODIFIED. A SUCCESSFUL STRATEGIC PLAN RECOGNIZES THIS POTENTIAL FOR CHANGE AND IS FLEXIBLE ENOUGH TO ACCOMMODATE NEW OR DIFFERENT OPPORTUNITIES AND CHALLENGES.CRITICAL HEALTH CARE ISSUESTHE ENACTED HEALTHCARE REFORM LEGISLATION UNDERSCORES MANY OF THE SIGNIFICANT ISSUES CURRENTLY FACING HOSPITALS. FOLLOWING IS LISTING OF CRITICAL ISSUES THAT WILL IMPACT HOSPITALS OVER THE NEXT SEVERAL YEARS. 1. QUALITY: HEALTH CARE QUALITY AND SAFETY ARE NOW STRATEGICALLY IMPORTANT, NOT JUST PROFESSIONALLY IMPORTANT. THE ADVENT OF WIDESPREAD PUBLIC REPORTING OF HOSPITAL QUALITY RESULTS ASSURES THAT A HOSPITAL'S QUALITY PERFORMANCE IS NO LONGER ONLY VISIBLE TO THE DIRECTOR OF QUALITY, QA COMMITTEE MEMBERS AND VARIOUS REGULATORS. THE NET EFFECT OF THIS TRANSPARENCY TREND OVER THE NEXT 5 YEARS WILL BE THAT THE DEFINITION OF A "GOOD HOSPITAL" WILL SHIFT SIGNIFICANTLY. NO LONGER WILL IT BE ENOUGH TO HAVE ATTRACTIVE FACILITIES, GOOD TECHNOLOGIES AND SKILLED DOCTORS AND NURSES. HOSPITALS WILL NEED TO MARSHAL THOSE RESOURCES INTO A QUALITY AND SAFETY SYSTEM CAPABLE OF RELIABLY PRODUCING MEASURED QUALITY RESULTS. PROVIDER PAYMENTS WILL INCREASINGLY BE A FUNCTION OF QUALITY OUTCOMES AND QUALITY BONUSES WILL BE DRAWN FROM ANNUAL PAYMENT UPDATES. INFORMATION SYSTEMS CAPABLE OF PROVIDING VALID AND RELIABLE QUALITY AND OUTCOME INDICATORS WILL BE A NECESSITY AS WILL THE USE OF EVIDENCE BASED GUIDELINES BY CLINICAL PROVIDERS. CONSUMERS WILL SEEK AND USE PERFORMANCE INFORMATION, INCLUDING PATIENT SATISFACTION INFORMATION, TO GUIDE THEIR CHOICE OF PROVIDERS.2. INFORMATION TECHNOLOGY: HEALTH INFORMATION TECHNOLOGY INCLUDES COMPUTER BASED TOOLS DEVELOPED SPECIFICALLY FOR HEALTH CARE DELIVERY. THESE TOOLS CAN PROVIDE CLINICIANS UP-TO-DATE INFORMATION ON THEIR PATIENTS, ACCESS TO THE LATEST MEDICAL KNOWLEDGE AND BEST PRACTICES THROUGH DECISION SUPPORT SYSTEMS. IT IS UNDERSTOOD THAT INVESTMENTS IN NEW CLINICAL AND INFORMATION TECHNOLOGY CAN SIGNIFICANTLY ENHANCE PATIENT SAFETY AND CLINICAL OUTCOMES. COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE), BAR CODING AND ITS POTENTIAL TO REDUCE MEDICATION ERRORS, AND ELECTRONIC MEDICAL RECORDS (EMRS) AND THEIR POSITIVE IMPACT ON MEDICAL ERRORS ARE ALL EXAMPLES OF HEALTH CARE'S USE OF IT SOLUTIONS TO IMPROVE QUALITY. THE FEDERAL GOVERNMENT HAS HIGHLIGHTED THE ROLE OF HEALTH INFORMATION TECHNOLOGY AS A MEANS TO IMPROVE HEALTH CARE QUALITY, SAFETY AND NOW IS PROVIDING STIMULUS AND INCENTIVE PAYMENTS TO PROVIDERS TO FACILITATE AND HASTEN THEIR ADOPTION INTO THE CARE DELIVERY PROCESS. EMR'S WILL BECOME A PREREQUISITE OF ANY DELIVERY SYSTEM THAT INTENDS TO PROVIDE COORDINATED COST EFFECTIVE CARE.3. PHYSICIANS: PHYSICIANS HAVE EMERGED AS CRITICAL OPERATIONAL AND STRATEGIC PARTNERS TO HOSPITALS. THOSE THAT ARE SUCCESSFUL IN ENGAGING AND COLLABORATING WITH THEIR MEDICAL STAFF WILL BE BEST ABLE TO DEMONSTRATE HIGH QUALITY CARE AND COMPLIANCE WITH HEALTH REFORM'S VALUE BASED PURCHASING AND OTHER QUALITY MANDATES. ADDITIONALLY, GIVEN THE INCREASE IN DEMAND FOR HEALTHCARE SERVICES THAT WILL BE OCCASIONED BY REFORM, THE ABILITY TO SUCCESSFULLY RECRUIT PHYSICIANS WILL BE CRITICAL. AT A TIME WHEN HEALTHCARE REFORM INITIATIVES EMPHASIZE THE ROLE OF PRIMARY CARE, THERE IS A SPECIAL NEED TO INTENSIFY EFFORTS TO RECRUIT PRIMARY CARE PROVIDERS. BECAUSE THE VAST MAJORITY OF NEW PHYSICIANS PREFER EMPLOYMENT AS THEIR PRACTICE PREFERENCE, THE ABILITY OF HOSPITALS TO BE ABLE TO OFFER PHYSICIANS A CONTEMPORARY AND COMPETITIVE "EMPLOYMENT PLATFORM" IS ESSENTIAL.4. FINANCE AND CAPITAL: FINANCIAL PERFORMANCE AND ACCESS TO CAPITAL WILL CONTINUE TO BE AMONG THE MOST CRITICAL ISSUES CONFRONTING HOSPITALS. EVEN WITH HEALTHCARE REFORM, HEALTHCARE COSTS WILL CONTINUE TO OUTPACE INFLATION. INCREASING WAGE AND SALARY COSTS, AND RISING HEALTH CARE COSTS IN GENERAL WILL CONTINUE TO IMPACT OPERATING PERFORMANCE AND PRESS HOSPITALS TO CONTINUE A RELENTLESS FOCUS ON COST MANAGEMENT. ADDITIONALLY, REVENUE STRATEGIES WILL NEED TO BE DEVELOPED TO GENERATE PROFITABLE GROWTH IN PATIENT VOLUME, AS WILL THE NEED TO ENSURE OPTIMAL MANAGEMENT OF ALL REVENUE CYCLE ACTIVITIES. HOSPITALS ARE FACING SIGNIFICANT PAYMENT REDUCTIONS IN TERMS OF DECREASES IN MEDICARE UPDATES, DISPROPORTIONATE SHARE, SNF AND HOMECARE PAYMENTS. AS HOSPITALS CONTINUE TO POST LOW OR NO PROFIT MARGINS, INVESTMENT INCOME WILL BE MORE IMPORTANT THAN EVER. HOWEVER, GIVEN THE FACT THAT INVESTMENT INCOME IS A HIGHLY UNCERTAIN COMPONENT OF A HOSPITAL'S OVERALL FINANCIAL HEALTH, HOSPITALS WILL BE DRIVEN TO PURSUE MORE PHILANTHROPY. HOSPITAL CAPITAL SPENDING WILL BE DRIVEN BY GROWING DEMANDS FOR ADVANCED TECHNOLOGY NEEDED TO ENSURE PATIENT QUALITY AND SAFETY, THE NEED TO REPLACE AND UPDATE AGING FACILITIES, AND THE DESIRE AND NEED TO IMPROVE TECHNOLOGY BASED SERVICES.IN 2016 OGH'S BOARD OF DIRECTORS VOTED TO BECOME PART OF THE KALEIDA HEALTH SYSTEM, A BUFFALO, NEW YORK-BASED HEALTH SYSTEM. THIS DECISION WAS BASED ON A FIVE YEAR LONG-TERM FINANCIAL PLAN THAT WAS DEVELOPED FOR OGH AND ITS SISTER HOSPITAL UNDER OGH'S PARENT COMPANY- UPPER ALLEGHENY HEALTH SYSTEM (UAHS), WHICH DEMONSTRATED A FUTURE INABILITY TO REMAIN FINANCIALLY VIABLE GIVEN THE DOWNWARD PRESSURES ON REVENUE IN THE HEALTH CARE INDUSTRY AS WELL AS RISING COSTS TO PROVIDE CARE. OGH IS NOT UNIQUE IN THIS VULNERABLE POSITION. HOSPITALS ACROSS AMERICA, ESPECIALLY RURAL HOSPITALS, FACE A DAUNTING CHALLENGE OF SURVIVAL. SIGNIFICANT TIME WAS SPENT ANALYZING OGH'S AND UAHS' FINANCES AND EVALUATING KALEIDA HEALTH AS A PARTNER. A DECISION TO AFFILIATE WAS MADE IN THE FALL OF 2016. OGH'S MANAGEMENT EXPECTS THE AFFILIATION TO BE COMPLETED IN 2017. FINANCIAL IMPROVEMENT OF OVER $10M ANNUALLY AT UAHS IS EXPECTED UNDER THE AFFILIATION PLAN.SEE CONTINUATION AT THE END OF PART VI. PART VI, LINE 3: INSURANCE INFORMATION IS GATHERED DURING THE SCHEDULING AND/OR REGISTRATION PROCESS. IF THE PATIENT INDICATES THAT THEY HAVE NO INSURANCE, REGISTRATION STAFF WILL ASK THE PATIENT FOR PERMISSION TO TRANSFER THEM TO SOUTHERN TIER HEALTHCARE SYSTEMS FOR ASSISTANCE WITH SCREENING FOR ELIGIBILITY FOR GOVERNMENT PROGRAMS (I.E. MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS). SOUTHERN TIER HEALTHCARE SYSTEMS' PERSONNEL WILL CONTACT THE PATIENT AND DISCUSS OPTIONS, INCLUDING THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ALL REGISTRATION, CARE MANAGEMENT AND BILLING PERSONNEL ARE EDUCATED ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND CAN DISCUSS AND SHARE INFORMATION WITH PATIENTS AT ANY TIME BEFORE, DURING OR AFTER THE EPISODE OF CARE. BILLING STATEMENTS CONTAIN THE FOLLOWING MESSAGE: IF YOU HAVE ANY QUESTIONS OR WOULD LIKE TO APPLY FOR OUR FINANCIAL ASSISTANCE PROGRAM, PLEASE CALL OUR OFFICE AT ...". THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL WEBSITE TO HELP EDUCATE THE PUBLIC. PART VI, LINE 4: OLEAN GENERAL HOSPITAL IS LOCATED IN OLEAN, NEW YORK, THE LARGEST CITY IN CATTARAUGUS COUNTY. THE HOSPITAL SERVES APPROXIMATELY 100,000 RESIDENTS OF CATTARAUGUS COUNTY AND THE SURROUNDING AREA. THE POPULATION OF THE AREA IS DISTRIBUTED AS FOLLOWS: 22% UNDER THE AGE OF 18, 60% AGE 18 TO 64 AND 18% 65 AND OLDER. THE ANNUAL HOUSEHOLD INCOME WAS DISTRIBUTED AS FOLLOWS: 27% EARNING LESS THAN $25K; 29% EARNING BETWEEN $25-$50K, AND 44% EARNING $50K OR HIGHER. PART VI, LINE 6: OLEAN GENERAL HOSPITAL IS PART OF THE UPPER ALLEGHENY HEALTH SYSTEM (UAHS), AN INTEGRATION OF TWO REGIONAL HOSPITALS UNDER A COMMON PARENT ORGANIZATION. UAHS HAS A MISSION OF COLLABORATIVE HEALTH CARE IN THE TWO COMMUNITIES SERVED BY THE INTEGRATED HOSPITALS TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS AND SURROUNDING AREAS. THIS INTEGRATION ALSO ALLOWS BOTH HOSPITALS TO REALIZE MORE ROBUST PURCHASING POWER AND PHYSICIAN RECRUITMENT OPPORTUNITIES THAN EITHER HOSPITAL COULD GENERATE ON THEIR OWN. PART VI, LINE 7, REPORTS FILED WITH STATES NY PART VI, LINE 2 5. RISK MANAGEMENT AND COMPLIANCE: HEALTHCARE'S TECHNOLOGY HAS NEVER BEEN MORE COMPLICATED, PATIENTS' DEMANDS HIGHER, AND THE BUSINESS CHALLENGES GREATER. ACCORDINGLY, COMPREHENSIVE RISK MANAGEMENT PROGRAM ARE ESSENTIAL IN ASSURING CARE DELIVERY SYSTEMS THAT ARE HIGHLY EFFECTIVE IN TERMS OF ASSURING APPROPRIATE LEVELS OF PATIENT SAFETY AND QUALITY. THE DEPARTMENT OF JUSTICE ESTIMATES THAT THE FEDERAL GOVERNMENT LOSES BILLIONS OF DOLLARS ANNUALLY IN HEALTH CARE FRAUD. CONSEQUENTLY, THE GOVERNMENT'S HEALTHCARE FRAUD ENFORCEMENT ACTIVITIES WITH RESPECT TO ALL HEALTHCARE PROVIDERS CONTINUE TO GROW AND EXPAND. WELL ESTABLISHED CORPORATE COMPLIANCE PROGRAMS ARE ESSENTIAL IN TERMS OF ALLOWING HOSPITALS TO IDENTIFY POTENTIAL AREAS OF LIABILITY AND TO CORRECT PROBLEMS.6. NURSING: NURSES AND NURSING CARE ARE CENTRAL TO THE DELIVERY OF SAFE AND EFFECTIVE PATIENT CARE. ACCORDINGLY, ENSURING AN ADEQUATE NURSING WORKFORCE AND CREATING A WORK ENVIRONMENT THAT SUPPORTS NURSING PRACTICE AND INTERDISCIPLINARY COLLABORATION ARE IMPORTANT PRIORITIES FOR HOSPITALS TODAY. X X X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 TIMOTHY FINAN PRESIDENT AND CEO 428437 251621 0 0 0 0 10611 6232 27049 15886 466097 273739 0 0 RICHARD G BRAUN JR SENIOR VP OF FINANCE/CFO 227862 133824 0 0 0 0 9776 5742 22347 13124 259985 152690 0 0 TIMOTHY MCNAMARA SENIOR VP OF HUMAN RESOURC 155340 91232 0 0 0 0 8743 5134 24882 14614 188965 110980 0 0 DR WILLIAM MILLS SENIOR VP OF MEDICAL AFFAI 198613 116645 0 0 0 0 9776 5741 17484 10268 225873 132654 0 0 JASON YAWORSKY SENIOR VP/CIO 144729 85000 0 0 0 0 10037 5895 24818 14576 179584 105471 0 0 GAIL BAGAZZOLI VP OF QUALITY 93380 54843 0 0 0 0 5692 3343 17829 10471 116901 68657 0 0 DENNIS MCCARTHY VP OF COMMUNICATIONS & MAR 88605 52038 0 0 0 0 3787 2224 24363 14309 116755 68571 0 0 JEFFREY ZEWE VP OF OPERATIONS 192478 113042 0 0 0 0 9774 5740 25577 15021 227829 133803 0 0 BASIL ARIGLIO VP OF FINANCE 104380 61303 0 0 0 0 0 0 24881 14613 129261 75916 0 0 MELISSA SULLIVAN VP OF CLINICAL & SUPPORT S 89013 52278 0 0 0 0 3168 1860 21203 12452 113384 66590 0 0 MOHANED AL-HUMADI PHYSICIAN 1121353 0 0 0 0 0 14193 0 59775 0 1195321 0 0 0 SAM JAYANTH SAMUEL PHYSICIAN 418760 0 0 0 0 0 14192 0 17406 0 450358 0 0 0 GARY CARL PHYSICIAN 492682 0 0 0 0 0 15518 0 55182 0 563382 0 0 0 GABRIEL YACOB PHYSICIAN 459800 0 0 0 0 0 14192 0 15673 0 489665 0 0 0 ARTHUR GOLDSTEIN PHYSICIAN 298316 0 0 0 0 0 15518 0 59553 0 373387 0 0 0 PART I, LINE 4B TIMOTHY FINAN: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN - $18,433. A CATTARAUGUS COUNTY CAPITAL RESOURCES CORPORATION 273458026 2010-10-06 21585000 REFUNDING OF BONDS, FINANCE AND NEW AMBULATORY SURGERY CENTER & HIS 0 0 0 A 21585000 431700 2012 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 JILL OWENS MD DR. OWENS IS THE SPOUSE OF RICHARD G. BRAUN, JR., SENIOR VP OF FINANCE/CFO 148333 DR. OWENS IS COMPENSATED BY A RELATED ORGANIZATION FOR PHYSICIAN SERVICES. 0 RICHARD G BRAUN JR RICHARD G. BRAUN, JR., SENIOR VP OF FINANCE/CFO IS THE SPOUSE OF DR. OWENS. 412675 RICHARD G. BRAUN, JR. IS COMPENSATED BY THE HOSPITAL AND A RELATED ORGANIZATION AS SENIOR VP OF FINANCE/CFO. 0 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:(CONTINUED) AND CORONARY CARE, BEHAVIORAL HEALTH, CHRONIC DIALYSIS, AND 24 HOUR EMERGENCY SERVICES (INCLUDING URGENT CARE AND A CHEST PAIN CLINIC) WITH AN ON-SITE HELICOPTER FOR EMERGENCY TRANSFER OF PATIENTS REQUIRING TERTIARY CARE. ADDITIONAL SERVICES INCLUDE DIAGNOSTIC IMAGING, LABORATORY, CARDIOPULMONARY, OCCUPATIONAL WELLNESS, DIABETES TEACHING, PATIENT EDUCATION, RADIATION ONCOLOGY, A SLEEP DISORDERS CENTER, OUTPATIENT PRIMARY CARE, AND A DENTAL CENTER. OLEAN GENERAL HOSPITAL, IN CONJUNCTION WITH THE STATE UNIVERSITY OF NEW YORK AT BUFFALO, SPONSORS NEW YORK STATE'S ONLY RURAL TRACK POST GRADUATE MEDICAL EDUCATION/RESIDENCY TRAINING PROGRAM. FORM 990, PART VI, SECTION A, LINE 2 JILL OWENS, MD, DIRECTOR, AND RICHARD G. BRAUN, JR., SENIOR VP OF FINANCE/CFO HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 UPPER ALLEGHENY HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE FORM 990 IS REVIEWED FOR ACCURACY AND COMPLETENESS BY THE HOSPITAL'S CHIEF FINANCIAL OFFICER AND SENIOR MANAGEMENT OF UPPER ALLEGHENY HEALTH SYSTEM. IN ADDITION, A FINAL DRAFT COPY OF THE FORM 990 IS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS PRESENTED AND REVIEWED ANNUALLY. EACH MEMBER OF THE BOARD COMPLETES A DISCLOSURE FORM. SEE THE FORMAL POLICY, AS OUTLINED IN THE ORGANIZATION'S BYLAWS, BELOW. CONFLICTS OF INTEREST: EACH DIRECTOR, PRIOR TO TAKING HIS POSITION ON THE BOARD, AND ALL PRESENT DIRECTORS AS SOON AS PRACTICABLE AFTER THE ADOPTION OF THESE BYLAWS, SHALL SUBMIT IN WRITING TO THE CHAIRMAN OF THE BOARD AND THE CHIEF EXECUTIVE OFFICER A LIST OF ALL BUSINESS OR OTHER ORGANIZATIONS OF WHICH HE IS AN OFFICER, DIRECTOR, TRUSTEE, MEMBER, OWNER (EITHER AS SOLE PROPRIETOR OR PARTNER), SHAREHOLDER WITH 5% OR GREATER INTEREST IN ALL OUTSTANDING VOTING SHARE, EMPLOYEE OR AGENT, WIHT WHICH THE CORPORATE HAS, OR MIGHT BE REASONABLY IN THE FUTURE ENTER INTO, A RELATIONSHIP OR A TRANSACTION IN WHICH THE DIRECTOR WOULD HAVE CONFLICTING INTERESTS. EACH WRITTEN STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL DIRECTORS IN ORDER TO GUIDE HIS CONDUCT SHALL A CONFLICT ARISE. THE CHAIRMAN-ELECT OF THE BOARD SHALL BE FAMILIAR WITH THE STATEMENT FILED BY THE CHAIRMAN. SHOULD THE CHAIRMAN-ELECT POSITION BE VACANT, THE MOST SENIOR MEMBER OF THE EXECUTIVE COMMITTEE WILL ASSUME THIS RESPONSIBILITY. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD IN SUCH A WAY AS TO GIVE RISE TO A CONFLICT OF INTEREST, THE AFFECTED DIRECTOR SHALL MAKE KNOWN THE POTENTIAL CONFLICT WHETHER DISCLOSED BY HIS WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED OF HIM, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO A VOTE, THE AFFECTED DIRECTOR SHALL NOT VOTE ON IT. IN THE EVENT THE CONFLICT OF INTEREST AFFECTS THE CHAIRMAN, THE CHAIRMAN-ELECT IN EMPOWERED AND SHALL REQUIRE THAT THE CHAIRMAN REMOVE HIMSELF IN THE SAME MANNER, AND FOR THE DURATION OF DISCUSSION AND ACTION ON THE MATTER THE CHAIRMAN-ELECT SHALL PRESIDE. SHOULD THE CHAIRMAN-ELECT POSITION BE VACANT, THE MOST SENIOR MEMBER OF THE EXECUTIVE COMMITTEE WILL ASSUME THIS RESPONSIBILITY. IF THE MATTER IS THE ITEM OF BUSINESS FOR WHICH A SPECIAL MEETING OF THE BOARD WAS CALLED, THE AFFECTED DIRECTOR SHALL NOT BE COUNTED TO ESTABLISH A QUORUM, NOR SHALL HE PARTICIPATE IN THE DELIBERATIONS OR VOTE ON IT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE HOSPITAL D/B/A THE EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) IS APPOINTED BY THE BOARD OF DIRECTORS TO ASSIST THE BOARD IN ESTABLISHING AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM OF THE HOSPITAL. THE COMMITTEE IS RESPONSIBLE FOR ADHERING TO THE OVERALL COMPENSATION PHILOSOPHY OF THE HOSPITAL. THE COMPENSATION PHILOSOPHY IS A TOTAL COMPENSATION CONCEPT THAT WILL EMPLOY A COMBINATION OF BASE SALARY, VARIABLE OPPORTUNITY, FLEXIBLE BENEFITS, DEFERRED COMPENSATION AND OTHER PERQUISITES AS MAY BE NEEDED FROM TIME TO TIME TO MAINTAIN A COMPETITIVE POSITION WITH PEER INSTITUTIONS IN THE REGION. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL HAS AVAILABLE, UPON REQUEST TO ADMINISTRATION, ITS MOST RECENTLY FILED FORM 990, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS. THE HOSPITAL ALSO REPORTS ANNUALLY ITS COMMUNITY BENEFIT EFFORTS AND ISSUES ANNUAL REPORT THAT INCLUDES FINANCIAL AND OTHER INFORMATION OF INTEREST TO THE PUBLIC. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT -1,853,293. NET ASSET CONTRIBUTION - FORGIVENESS OF ADVANCES TO PHYSICIAN GROUP -1,921,089. FORM 990, PART XII, LINE 2C: THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, AS WELL AS THE CHOICE OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OLEAN GENERAL HOSPITAL FOUNDATION 515 MAIN STREET OLEAN NY 14760 161497087 FUNDRAISING NY 501(C)(3) LINE 12D, III-O N/A 0 UPPER ALLEGHENY HEALTH SYSTEM INC 515 MAIN STREET OLEAN NY 14760 271255425 SOLE CORP MEMBER OF BRADFORD REGIONAL MEDICAL CTR & OLEAN GENERAL HOSPITAL NY 501(C)(3) LINE 12A, I N/A 0 BRADFORD HOSPITAL DBA BRADFORD REGIONAL MEDICAL CENTER 116 INTERSTATE PARKWAY BRADFORD PA 16701 250965270 HOSPITAL PA 501(C)(3) LINE 3 UPPER ALLEGHENY HEALTH SYSTEM INC 0 HEALTH SYSTEM PHYSICIAN PC 130 SOUTH UNION STREET SUITE 300 OLEAN NY 14760 464304317 PHYSICIAN GROUP NY 501(C)(3) LINE 10 N/A 0 OLEAN GENERAL HEALTHCARE SYSTEMS LLC 85 WOODRIDGE DRIVE AMHERST NY 14228 161544460 PROVIDER OF DURABLE MEDICAL EQUIPMENT, HOME CARE PRODUCTS, AND SERVICES NY N/A OLEAN GENERAL SERVICES CORP 515 MAIN STREET OLEAN NY 14760 161447054 JOINT VENTURE HOLDING COMPANY NY OLEAN GENERAL HOSPITAL C 3118998 1.00000 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0