2016-10-17T16:31:21-07:00 2015-12-31 990 2015-01-01 160743905 ARNOT OGDEN MEDICAL CENTER ARNO 6077374235 600 ROE AVENUE ELMIRA NY 14905 Ronald Kintz Senior VP/Chief Financial Officer 6077374235 2016-10-17 2015 2017-02-10 21:41:12Z Robert Lambert 600 Roe Avenue Elmira NY 14905 287341767 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. 18 15 2866 490 -403489 0 1188532 2466614 270538688 261603821 9031350 12557453 1609679 638160 282368249 277266048 0 0 0 0 183155636 196689212 0 0 0 94601166 92697987 277756802 289387199 4611447 -12121151 277712820 261243394 100718728 98196597 176994092 163046797 Arnot Ogden Medical Center is an independent, not-for-profit, 201-bed tertiary medical facility with more than 120 physicians from over 50 specialties. Arnot Ogden Medical Center offers specialty services at the Falck Cancer Center, Heart and Vascular Institute, Stroke Care, Maternity, Surgery. 0 0 236711757 1324508 261159837 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 2015 the Medical Center's 2,121 Full-time equivalent of employees cared for 11,235 inpatient admissions in its 201 staffed beds. The Medical Center provided Outpatient Services to approximately 319,757 Outpatient Visits in its subspecialty services. The approximately 115 Full-time equivalent of physicans provided for 306,642 office visits in the areas of primary care and specialty services. 1071276 0 456177 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 65 students enrolled in 2015. 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 approximatedly 21 students enrolled in 2015. 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 237783033 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 0 0 1 0 0 0 0 0 1 0 0 0 1 2866 0 2866 1 1 1 0 0 0 0 0 X 18 15 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X X Ronald J Kintz 6077374235 Accounting Department 600 Roe Avenue Elmira NY 14905 Michael Hosey Chairman of the Board 1 1 X 0 0 0 Mark J Hagan Vice Chairman 2 1 X 0 0 0 Daniel J Burke Board Member 1 1 X 0 0 0 Kathleen Lucke Board Member 1 1 X 0 0 0 David Dalrymple Board Member 1 1 X 0 0 0 Richard Simons Board Member 1 1 X 0 0 0 S Jan Eberhard Board Member 3 1 X 0 0 0 Scott Sprague Board Member 1 1 X 0 0 0 Jan van den Blink Board Member 1 1 X 0 0 0 Roy A Kyles Board Member 1 1 X 0 0 0 Robert McNamara Board Member 1 1 X 0 0 0 Mary Louise Mitchell Board Member 1 1 X 0 0 0 Pat Rodgers Board Member 1 1 X 0 0 0 Donald Quick Board Member 1 1 X 0 0 0 Melinda Sartori Board Member 1 1 X 0 0 0 Alan Angell Board Member/Physician 40.00 1.00 X 437674 0 93002 Roger Schenone Board Member/Physician 40.00 1 X 355697 0 11456 Kevin OConnor Board Member/Physician 40.00 1 X 317649 0 139751 Robert Lambert Board Member/President 45.00 5.00 X X 527380 0 140068 John R Alexander Secretary 1 1 X 0 0 0 Roberto deBara President AMS 40 0 X 293868 0 139038 Ronald J Kintz Senior VP/CFO 45 5.00 X 331952 0 97340 H Fred Farley Hospital President COO 40.00 10.00 X 353789 0 77377 Nancy ODacre VP Strategic Planning 45.00 5.00 X 63346 0 7907 James Watson President IDMH 1.00 40.00 X X 227391 0 9740 Kenneth HerzlBetz Senior VP/Medical Affairs 50.00 8.00 X 303141 0 30344 Vidyasagar Mokureddy Pain Mgmt Physician 40 0 X 869325 0 93202 Bruno Mazza Gastoentrologist 40 0 X 720821 0 173262 Thomas Boman Orthopediac Surgeon 40 0 X 782382 0 72201 Matthew Brand Orthopediac Surgeon 40 0 X 761218 0 76573 Paul Tinsley ENT Physician 40 0 X 730383 0 57812 7076016 0 1219073 212 1 1 0 ABM Building Solutions 501 Technology Drive Suite 3000 Cannonsburg PA 15317 Energy Contractor 5675585 Streeter Associates P O Box 118 Elmira NY 14902 Construction Contractor 4598768 Navigant Consulting Inc 4511 Paysphere Circle Chicago IL 60674 Physician Billing Consulting 2515240 Medicus Hospitalists Services 22 Roulston Road Windham Road NH 03087 Inpatient Physician Services 1702289 Associated Anesthesiologists Of the Finger Lakes P O Box 1253 Elmira NY 149021253 Surgical Anesthesia Services 1685242 61 0 0 0 0 654252 1812362 0 2466614 Hospital Net Patient Service Revenue 622110 211190666 211190666 0 0 Physician Net Patient Service Revenue 621110 49969171 49969171 0 0 School of Nursing 611600 362148 362148 0 0 School of Radiologic Technology 611600 81836 81836 0 0 0 0 0 0 261603821 3241961 0 0 3241961 0 0 0 0 0 0 0 0 573120 0 667468 0 -94348 0 -94348 283722 -378070 0 9846562 6587114 5689437 1428747 4157125 5158367 9315492 0 0 9315492 88493 0 36805 51688 0 51688 0 0 0 856631 2253262 -1396631 0 0 -1396631 Rebates/Discounts 900000 710779 710779 0 0 Delivery System Reform Incentive - DSRIP 921190 670256 670256 0 0 696416 625800 -25419 96035 2077451 277266048 263894378 -403489 11308545 0 0 0 0 0 0 0 0 2602685 0 2602685 0 0 0 0 0 147540275 125324492 22215783 0 6683765 0 6683765 0 30715603 3240 30712363 0 9146884 7496517 1650367 0 2532880 936385 1596495 0 601272 147742 453530 0 56365 7989 48376 0 29069 0 29069 0 0 0 389596 0 389596 0 11866199 11142850 723349 0 1458367 97636 1360731 0 4277575 2500090 1777485 0 5363237 649929 4713308 0 0 0 0 0 3666846 703500 2963346 0 903363 636976 266387 0 0 0 0 0 170812 148949 21863 0 1463541 0 1463541 0 0 0 0 0 11002745 5528378 5474367 0 3965979 2003979 1962000 0 Medical/Surgical/Pharmaceutical Supplies 37957423 37970902 -13479 0 Maintenance Contracts/Purchased Services 13615250 8308690 5306560 0 Allocation of Expenses to Affiliates -11221581 167993 -11389574 0 Benefit Allocation 0 31214053 -31214053 0 4599049 2792743 1806306 0 289387199 237783033 51604166 0 13159 12773 2665564 1127333 117827 54376 37484672 31968814 0 0 0 0 18197728 703049 1351031 1346735 2042646 1781294 278002189 173942922 92322410 104059267 66578874 61592375 0 0 0 0 726661 830368 56212248 57767010 277712820 261243394 21482622 19225641 0 0 3855 145331 25469532 28821800 0 0 0 0 8621386 7195649 0 0 45141333 42808176 100718728 98196597 X 163059272 150656612 10840886 9420430 3093934 2969755 176994092 163046797 277712820 261243394 X -12121151 -6198973 0 0 0 4372829 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 Schedule C, Part II-B, Line 1 Arnot Ogden Medical Center pays annual dues to the American Hospital Association, AHA and 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 2015 was $29,069. 3093934 0 0 0 124179 0 2969755 2947754 3326 142854 0 0 0 3093934 2827204 0 120550 0 0 0 2947754 2827204 0 0 0 0 0 2827204 2431346 0 395858 0 0 0 2827204 0 1 0 0 0 4676771 0 4676771 120870247 0 57274550 63595697 953320 0 906838 46482 148440287 0 114111036 34329251 3061564 0 1650498 1411066 104059267 Assets limited as to use 29003229 Investment in subsidiaries 4192874 Interest in net assets of foundations 18551068 Due from related parties 6019839 57767010 0 Third Party Liability Reserves 4289645 Self Insurance Reserves 10143291 Minimum Pension Liability 12516016 457 Plan Liability 4828228 Notes Payable Investment Funds held Affiliates 10689920 Deferred Income Covenant Not to Compete 320625 Miscellaneous long term liabilities 20451 42808176 X 279773796 0 0 0 2949028 2949028 276824768 389592 51688 441280 277266048 291983432 0 0 0 0 0 291983432 389592 -2985825 -2596233 289387199 Schedule D, Part V, Line 4 Schedule D, Part V, Line 4 - 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, 2015. 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 Income Taxes: Arnot Ogden Medical Center, AOMC Foundation, the Auxiliary, Ira Davenport, Keuka, SJH, and SJH Foundation are 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. During the year ended December 31, 2014 AMS applied for not-for-profit status. AMS had previous been treated as a Corporation for tax purposes. Ivy Street files corporate tax returns. 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, 2015 and 2014. Schedule D, Part XI, Line 2d Expenses for Cost of providing Nutritional Services Food to Cafeteria for patient and employee meals in the amount of $2,253,262. Expenses of $667,468 for the Cost of Rental repairs and services. Expenses of $28,298 for providing answering services to physician offices. Schedule D, Part XI, Line 4b Childrens Miracle Network Temporarily Restricted Fundraising moved from Fund Balance to Fund Raising Income and Expenses moved to offset the income. Schedule D, Part XII, Line 4b Rental Expenses of $695,766, Fundraising Expenses of $36,805, and Nutritional Services Expenses of $2,253,262 all moved to offset Revenue reported. Golf Tournament 50791 0 50791 0 152 9711 5289 0 5308 Moonlight & Miracles 26059 1500 24559 0 0 295 6597 3355 3637 3 13143 0 13143 0 0 0 0 0 2461 89993 1500 88493 0 152 10006 11886 3355 11406 36805 51688 1 1 X 1 X 1 X 1 1 0 1 1 1 826 986496 17718 968778 0.0033 1 8196 10899959 4034354 6865605 0.0237 1 43462 40708665 20884624 19824041 0.0685 3 52484 52595120 24936696 27658424 0.0955 8 16989 495585 59882 435703 0.001 3 542 7652725 5440407 2212318 0.0076 103 630202 144746741 95689514 49057227 0.1695 0 0 0 0 0 0 3693 9723 0 9723 0.0 114 651426 152904774 101189803 51714971 0.1781 117 703910 205499894 126126499 79373395 0.2736 0 0 0 0 0 0 0 0 0 0 0 0 1 9521 9521 0.00 0 0 0 0 0 0 1 0 1074917 670256 404661 0.0014 1 0 50695 0 50695 0.0002 1 1439 5375 0 5375 0 2 0 154528 0 154528 0 0 0 0 0 0 0 6 1439 1295036 670256 624780 0.0016 0 14550590 0 28906840 40146390 -11239550 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 X 1 15 1 www.arnothealth.org 0 0 1 X 150 400 X X X 1 1 X X X 1 X www.arnothealth.org X www.arnothealth.org X www.arnothealth.org X X X X X 1 X 0 X X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-Group A Arnot Health remains committed to preventing chronic disease in the community through free preventative health screenings, health promotion programs and wellness education. In 2015 Arnot Health participated in over 100 community events and served over 2,500 individuals in Chemung, Steuben and Schuyler Counties. Free health screenings included: blood pressure, blood glucose, diabetes risk assessment, stroke assessments, body fat analysis, body mass index, tobacco use screening, carboxyhemoglobin, and lung age. In addition to community outreach events Arnot Health serves populations at risk for developing chronic disease by offering free monthly health screenings in medically underserved locations such as soup kitchens and senior centers within a medically underserved area. Arnot Health Heart Vascular Institute also offers free weekly blood pressure screenings for the community. Community Health and outreach also includes working with local schools and summer programs to offer highly interactive educational programs on topics such as nutrition, sun safety, physical activity, injury prevention and tobacco use prevention. Arnot Health continues to serve on the Elmira City School District Wellness Committee and collaborated with the school district to develop new wellness policies that included healthier options in vending machines and increased physical activity during class time. Arnot Health continued to inform school officials on important health issues impacting the community and contributed topics for discussion at student forums and interactive community activities. Arnot Health collaborated with health and human service agencies to provide the Graduate Medical Education Residents with community rotations such as Arnot Health HIV Primary Care and Disease Management, Economic Opportunity Program Inc, Head Start Program, Comprehensive Interdisciplinary Developmental Services Inc, Chemung County Home Health Agency and Community Immunization Clinics. Arnot Health's Health Center for Women and the Falck Cancer Center includes working collaboratively with the New York State Cancer Services Program to provide free breast, cervical and colorectal screenings for the un/underinsured. Other cancer prevention strategies include annual skin cancer screenings and a lung cancer screening program for community members with a history of long term tobacco use. Falck Cancer Center offers a wide range of free monthly support groups for cancer survivors in the community. Arnot Health Diabetes Center provides diabetes education, support and management, and served over 350 community members in 2015. Other services provided by the Diabetes Center include insulin pump instruction and nutritional counseling. All diabetes education offered by Arnot Health is provided by Certified Diabetes Educators and is in accordance with the American Diabetes Association Standards of Care. Arnot Health has a leadership role in the multicounty Southern Tier Diabetes Coalition and in the planning and implementation of an annual Diabetes Fair in the fall of each year. In 2015 over 300 community members received diabetes prevention and management education and preventative health screenings. Education and screening opportunities included blood pressure, body fat and blood glucose screenings; foot care education; diabetes risk assessments; nutrition education meal planning and information on diabetes medications and equipment; and information about support groups and chronic disease self management classes. pneumovax and influenza vaccines were also provided. Arnot Health continues to collaborate with preventative health partners in Chemung and Steuben Counties and participates in the promotion and facilitation of evidence based programs such as the Chronic Disease Self Management Program, the Diabetes Self Management Program, and the National Diabetes Prevention Program, and Living Healthy workshops. Lower socioeconomic status is associated with an increased risk of smoking initiation and progression to regular smoking, and a decreased likelihood of successful smoking cessation. Arnot Health is working with local health departments and diverse multicounty partnerships to update the 2013 Community Health Needs Assessment, and engage community members in identifying public health priorities and unmet needs in the community. The process will be completed and an updated Community Health Improvement Plan will be available to the community in December 2016. The following are the obesity prevention strategies implemented and the accomplishments of the CHP partnership over the last five years. Arnot Health and the CHP partnership rehabilitated, maintained and promoted parks and recreation facilities in underserved residential areas to offer safe and accessible opportunities for physical activity for persons of all ages and abilities. CHP partners and the City of Elmira enhanced parks and playgrounds for children to make them safe and accessible in the following locations: McKinnon Park, Grove Park, Millers Pond Park, Eldridge Park, McCanns Park, Blandford Park, Pulaski Park, Quatrano Park, Frank Rhode Park, Woodlawn Playground, and Mark Twain Riverfront Park. CHP partnership worked to improve a seven mile stretch of the Lackawanna Rail Trail by installing a fitness station, solar lights and a informational kiosk with Get Active Elmira maps that were created by the partnership to highlight the 23 parks and playgrounds. Safety assessments of parks and playgrounds were conducted by organizations serving the developmentally disabled populations, seniors and the visually impaired. Other strategies implemented to promote safe access to open spaces for physical activity include installation of visual impact signage at parks, playgrounds, trails and street crossings, installation of video cameras, improved street lighting, installation of cross walks and ADA compliant curb cut outs and tactile ramps and speed reduction with playground warning signs for traffic. To increase access to fresh fruit and vegetables, the CHP partnership created community gardens and enhanced existing vegetable gardens by working with community planning boards, neighborhood associations, schools, persons with disabilities, and senior and low income housing developments. Provided schools and youth community centers with community gardens, installed a tool shed and provided gardening supplies to establish and maintain community gardens in underserved areas, supported the development of a community garden for persons with developmental disabilities and supported the Food Bank of the Southern Tier with fresh fruits and vegetables grown in the community gardens. Community Gardens were established or enhanced in the following locations: Near Westside Victorian Garden, Katy Leary Park, Quatrano Park, and Economic Opportunity Program at Ernie Davis Community Center, Woodlawn Community Garden and the Elmira City School District. Strategies implemented by restaurants and the CHP partnership to prevent obesity and educate the community about healthier eating choices include developing 3 different long running TV ads promoting healthy eating at restaurants, table top displays of eating out health tips for each partnering restaurant and distributed educational materials on healthy food options at community outreach events. Worked with hospital system to adopt Healthy Meeting policy and offer daily Well Being meals in the hospitals cafeterias for employees and the public. Examples of programs offered in 2015 include Community Walking Program, Fit Families of the Southern Tier, Strong Kids Safe Kids, Girls on the Run of the Southern Tier and the Wineglass Marathon. Participants in the free six week Step it Up Community Walking Program receive pre and post program health screenings and over the last five years have had consistent outcomes averaging: 65% reduction in blood pressure, 41% reduction in blood glucose, 69% reduction in weight, 71% reduction in body fat or BMI, 55% reported making healthier food choices as a result of the program. Arnot Health offers the FFIST Program for obese children and their families to teach children how to make healthier food choices, and increase their physical activity through fun activities such as games and active play. Children in the eight week FFIST program also receive pre and post program weight, BMI and strength and endurance fitness testing. As a result of the program, children have shown gains in strength and endurance, and report making healthier food choices. Arnot Health serves on the Chemung County Board of Health, the Community Services Board, the Healthcare Association of New York State Community Health Taskforce and the New York State Department of Health Community Health Needs Assessment Ad Hoc Group. Schedule H, Part V, Section B, Line 6a-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 Ogden Medical Center, located in Elmira, NY and founded in 1888, is a not-for-profit, 256-bed tertiary medical facility offering specialty services including, cardiovascular care, cancer care, women's health services, emergency medicine and surgical services. Ira Davenport Memorial Hospital, located in Bath, NY and founded in 1910, is a not-forprofit 38-bed acute care hospital offer ancillary services and emergency medicine. The campus also hosts a 120-bed skilled nursing facility, Taylor Health Center. St. Joseph's Hospital, located in Elmira, NY and founded in 1908 by the Sisters of St. Joseph of Rochester, New York, is a not-for-profit Catholic 79 acute care hospital specializing in orthopedic care, physical rehabilitation, geriatric medicine, behavioral science and alcohol rehabilitation. The campus also hosts a 111 bed skilled nursing facility. Arnot Medical Services is a multispecialty physician group associated with Arnot Health offering care throughout the Southern Tier of New York and Northern Tier of Pennsylvania in the areas of Cardiology, Cardiovascular Surgery, Endocrinology, ENT, Family Practice, Gastroenterology, Infectious Diseases, Internal Medicine, Nephrology, Neurology, Orthopedics, Pain Management, Rheumatology, Women's Health and Wound Care. Schedule H, Part V, Section B, Line 6b-Group A In 2013, Arnot Health in collaboration with the Chemung County Health Department, Steuben County Public Health and a diverse community partnership conducted a comprehensive Community Health Needs Assessment (CHNA) to identify public health priorities in Chemung and Steuben Counties. The CHNA identified some overlapping areas of public health concerns in Chemung and Steuben Counties. 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 Arnot Health promotes and supports the health in the community in many ways. The system hosts a variety of programs and activities in their facilities to meet specific needs within the community, and donates meeting space for activities such as: Blood Drives, Cancer survivor support groups, Community lectures, health screenings and workshops, Melanoma Monday Skin Cancer Screenings, Maternal, Child Health Education and Breastfeeding Classes, Community lactation rooms , CPR classes, Alcoholics Anonymous meetings, Women's Narcotics Anonymous, Narcotics Anonymous, Community Interfaith Chaplaincy training programs, Suicide prevention trainings, Celiac Disease Support Group, Widow Support Group, Child Life Grief Support Program, Focus groups to gain insight on community needs, Annual MASH Camp for students interested in health professions, Osteopathic Medicine Manipulation Clinics, Healthy Kitchens Program, Amputee Support Group, Hip and Knee Seminars, Functional Assessment Workshops. In addition, Arnot Health aims to improve the health of the community through active participation and leadership in local, regional and state level preventative health coalitions and taskforces. Arnot Health serves on the Chemung County Board of Health, the Community Services Board, the Economic Opportunity Program Board, the Healthcare Association of New York State's (HANYS) Community Health Taskforce and the New York State Department of Health's (NYSDOH) Community Health Needs Assessment Ad Hoc Group. Arnot Health has a leadership role in the Southeastern region of the Finger Lakes Performing Provider System (FLPPS) and the planning and implementation of eleven DSRIP projects designed to meet the complex and challenging medical and social needs of the Medicaid population. Arnot Health's leadership in regional and state initiatives informs key stakeholders of the needs in our community and leverages a broad set of resources to meet those needs. Schedule H, Part V, Section B, Line 20e-Group A Self pay collection staff review all 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 in the Sorian billing system. If insurance is located, the 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 procedures. Self Pay collections staff attempt to collect the full balance due by check of credit card. If they are unable to make the full payment, self pay staff will attempt to make payment arrangements and to notify the 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 the documentation they will need to submit with the application. The self pay collectors document all activity in Sorian, and enter any necessary holds to support resolution. Self pay collections staff enters the payment plan and documents into Sorian. The payment plan statement is demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account or accounts will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections. Schedule H, Part V, Section B, Line 22d-Group A FAP eligible patients receive a percentage discount either charges for the uninsured or patient responsibility for the insured. Schedule H, Part V, Section B, Line 24-Group A Participants in the Medicare System are required to charge all patients the same amount regardless of insurance per the Medicare Participant Guidelines. Schedule H, Part I, Line 6a 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 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 $14,550,590 in bad debt expense from the calculation. Schedule H, Part II Arnot Ogden Medical Center provided the following screenings and educational programs to the community in 2015: Blood Glucose Screenings, Blood Pressure Screenings, Cancer Support Groups for Women, Cancer Community Support and Outreach, Skin Cancer Screenings, Childbirth and Breastfeeding Education Classes, Diabetes Education and Awareness, HIV Prevention and Education, Influenza Clinics, Pulmonary Function Screenings, Tobacco Cessation and Tobacco Cessation Carboxymeter Screenings, Transportation Support Services and Health Education Events. The hospital also particiated in Fit Families in the Southern Tier, Step It Up Walking Program, Strong Kids Safe Kids, Summer Cohesion Program, and Human Motion Institute Community Events. Schedule H, Part III, Section A, Line 4 The Organization's allowance for doubtful accounts decreased from 11.1% of gross accounts receivable at December 31, 2014 to 10.5% of gross accounts receivable at December 31, 2015. In addition, the Organization's bad debt write-offs decreased from $22,828,514 for fiscal year 2014 to $14,550,590 in fiscal year 2015. The decrease in bad debt write-offs is to account for trends experienced in the collection of amounts from self-pay patients in fiscal year 2015. The Organization has not changed its charity care or uninsured discount policies during the fiscal year 2014 or 2015. The Organization does not maintain a material allowance for doubtful accounts from third party payors, not 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 for 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 applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, the self pay collector must verify eligibility for the dates of service. The self pay staff will change the health plan to the correct plan for all covered dates of service and Arnot billing will submit the 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 processes. Self Pay Collection Staff attempts to collect the full balance due by check or credit card. If they are unable to make the full payment, the self pay staff will attempt to make payment arrangements and to notify the patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patients will be sent an aplication for the community care program and will be informed of documentation they will need to submit with the application. The self pay collectors document all activity in Sorian, and enter any necessary hold to support resolution. Self pay collections staff enters the payment plan and document comments in Sorian. Payment plan statements are demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account will go through the standard dunning and collection agency activity. Schedule H, Part VI, Line 2 2015 Update to the Community Health Improvement Plan In 2013, Arnot Health in collaboration with the Chemung County Health Department, Steuben County Public Health and a diverse community partnership conducted a comprehensive Community Health Needs Assessment (CHNA) to identify public health priorities in Chemung and Steuben Counties. The CHNA identified some overlapping areas of public health concerns in Chemung and Steuben Counties. Chemung County Priority: Prevent Chronic Disease 1. Focus area: Reduce obesity in children and adults; and 2. Focus area: Reduce illness, disability, and death related to tobacco use and secondhand smoke exposure. Disparity: Reduce percentage of lower income individuals who smoke, including those with mental health and substance abuse issues. Steuben County Priority: Prevent Chronic Disease 1. Focus area: Reduce obesity in children and adults; and 2. Focus area: Reduce illness, disability and death related to heart disease and hypertension. Disparity: Promote tobacco cessation, especially among low socioeconomic populations and those with mental health illness. Over the last two years, Arnot Health and partners have been implementing and monitoring the effectiveness of the CHIP in Chemung and Steuben Counties. Since implementation of the 2013 CHIP, progress has been made in preventing chronic disease through strategies aimed at reducing obesity in children and adults, and reducing tobacco use. CHIP strategies to prevent chronic disease continued to focus on three key areas: 1) Health promotion activities to encourage healthy living and limit the onset of chronic diseases; 2) Early detection opportunities that include screening populations at risk; 3) Successful management strategies for existing diseases and related complications. Action plan strategies such as increasing physical activity, improving nutrition, and decreasing tobacco use from the core of the Preventing Chronic Diseases Action Plan for the New York State Prevention Agenda have been implemented (http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/docs/prevent_chronic_diseases.pdf). Schedule H, Part VI, Line 3 The Arnot Ogden Medical Center 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 so they are informed of the program details and contact information. Communication of programs with collection agencies and collection attorneys so they can 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 is comprised of three hospitals, Arnot Ogden Medical Center, St. Joseph's Hospital in Elmira, NY, and Ira Davenport Memorial Hospital in Bath, NY. 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. The distribution of patients from this service area, as measured by total patient encounters from system's hospitals is as follows: Chemung 65.0 percent, Steuben 21.0 percent, Schuyler 4.6 percent, Tioga 3.4, Bradford 2.9 percent and all other 3.0 percent. X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 Michael Hosey Chairman of the Board 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mark J Hagan Vice Chairman 0 0 0 0 0 0 0 0 0 0 0 0 0 0 John R Alexander Secretary 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Daniel J Burke Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kathleen Lucke 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 Richard Simons Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 S Jan Eberhard 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 Jan van den Blink 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 Robert McNamara 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 Donald Quick Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Melinda Sartori Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Alan Angell Board Member/Physician 437674 0 62569 0 0 0 0 0 30433 0 530676 0 0 0 Roger Schenone Board Member/Physician 355697 0 0 0 0 0 0 0 11456 0 367153 0 0 0 Kevin OConnor Board Member/Physician 317649 0 102925 0 0 0 0 0 36826 0 457400 0 0 0 Robert Lambert Board Member/President 527380 0 103241 0 0 0 0 0 36827 0 667448 0 0 0 Ronald J Kintz Senior VP/CFO 331952 0 60516 0 0 0 0 0 36827 0 429295 0 0 0 H Fred Farley Hospital President COO 353789 0 40550 0 0 0 0 0 36827 0 431166 0 0 0 Nancy ODacre VP Strategic Planning 63346 0 0 0 0 0 0 0 7907 0 71253 0 0 0 James Watson President IDMH 227391 0 0 0 0 0 0 0 9740 0 237131 0 0 0 Kenneth HerzlBetz Senior VP/Medical Affairs 303141 0 3600 0 0 0 0 0 26744 0 333485 0 0 0 Roberto deBara President AMS 293868 0 125000 0 0 0 0 0 14038 0 432906 0 0 0 Vidyasagar Mokureddy Pain Mgmt Physician 869325 0 60536 0 0 0 0 0 32666 0 962527 0 0 0 Bruno Mazza Gastoentrologist 720821 0 142828 0 0 0 0 0 30434 0 894083 0 0 0 Thomas Boman Orthopediac Surgeon 782382 0 37607 0 0 0 0 0 34594 0 854583 0 0 0 Matthew Brand Orthopediac Surgeon 761218 0 41979 0 0 0 0 0 34594 0 837791 0 0 0 Paul Tinsley ENT Physician 730383 0 26894 0 0 0 0 0 30918 0 788195 0 0 0 Schedule J, Part I, Line 1a The CEO and CFO have their dues paid at the Elmira Country 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 Directors. 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 present in the room. This action then is reviewed with the entire Board in executive session. Schedule J, Part I, Line 7 Officer compensation has a variable component based upon patient experience, quality, and efficiency. Physician compensation has a variable component based upon volume, quality and patient satisfaction scores. A Chemung County Industrial Developmental Agency 166209017 000164019 2004-03-10 19912203 Series A Construction Bond 0 0 0 B Chemung County Industrial Developmental Agency 166209017 000164019 2004-03-10 16959701 Series B Facility Renovation 0 0 0 C Chemung County Capital Resource Corp 611684035 000000000 2015-06-25 29410000 Payoff Series A & B Bonds/Energy Infrastructure Upgrade 0 0 0 A 19912203 0 19912203 0 0 0 419500 0 1802477 16377225 0 0 2006 0 0 1 1 B 16959701 0 16959701 0 4561742 0 328213 0 0 10287552 0 0 2005 0 1 1 1 C 588200 0 29410000 0 0 0 847745 0 0 8066714 0 1280128 2015 1 0 1 1 A 0 0 0 0 0 1 0 1 B 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 1 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 1 0 0 0 1 A 1 B 1 C 1 David Dalrymple Board Member 1255396 Competitively Bid Loans & Investment Fees 0 Form 990, Part VI, Section B, Line 11b Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Directors. 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 B, Line 12c All members of the Board of Directors, 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 has or may have a material financial transaction in excess of $10,000 with Arnot Health, Inc., or expect over the coming year, to receive an remuneration, other than salary if an employee, as a direct result of any business transaction with Arnot Health. 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 Directors. 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 in executive session. 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 VI, Section C, Line 19 Form 990, Part VI, Section C, Line 19 - Arnot Ogden Medical Center's Governing and Conflict of Interest Policies are available to the public upon request. The Financial Statements are available on Guide Star's website and also EMMA Bond Disclosure website and the 990 is available upon request. Form 990, Part XI, Line 9 Pension charge to equity $3,133,150. Net assets released from restrictions $596,970. Net loss on temporarily restricted investments $(206,341). Donations to restricted investments $296,036. Change in net assets of foundation $641,498. CMN Fundraising revenue to income $(88,494). 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 100 100 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 Arnot Ogden Medical Center Foundation o 110283 Arnot Ogden Medical Center provided paid employees to 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 22660 Arnot Ogden Medical Center provided paid employees to Ivy Street Development Corporation to perform Accounting, Administrative and Property Management Services. The method of determining the amount involved was cost. Ivy Street Development Corporation q 135602 Arnot Ogden Medical Center was reimbursed by Ivy Street Development Corporation for Utilities, Maintenance and Insurance expenses. The method of determining the amount involved was cost. Ivy Street Development Corporation k -641746 Arnot Ogden Medical Center leased facilities from Ivy Street Development Corporation. The method of determining the amount involved was cost. Ira Davenport Memorial Hospital Inc o 3258501 Arnot Ogden Medical Center provided paid employees to Ira Davenport Memorial Hospital to perform Accounting, Administrative and Management Information and various Medical Services. The method of determining the amount involved was cost. Keuka Health Care Foundation o -11602 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 7930329 Arnot Ogden Medical Center provided paid employees to Ira Davenport Memorial Hospital to perform Accounting, Administrative and Management Information and various Medical Services. The method of determining the amount involved was cost. St Josephs Hospital o -93407 St. Joseph's Hospital provided paid employees to Arnot Ogden Medical Center to perform Environmental and Pastoral services. The method of determining the amount involved was cost. Arnot Ogden Medical Center was granted a second extension until 11/15/2016.