2016-11-14T13:52:27-06:00 2015-12-31 160765486 LUMSDEN & MCCORMICK LLP 369 FRANKLIN STREET BUFFALO NY 14202 990 2015-01-01 160743102 OLEAN GENERAL HOSPITAL OLEA 7163732600 515 MAIN STREET OLEAN NY 14760 TIMOTHY J FINAN PRESIDENT/CEO 7163732600 2016-11-11 1 MICHAEL J GRIMALDI P01295846 7168563300 2015 2017-02-10 21:41:12Z TIMOTHY FINAN 515 MAIN STREET OLEAN NY 14760 118731909 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 1141 150 0 0 2251972 1786285 108804242 112239069 1097131 689599 4701578 2320581 116854923 117035534 0 0 0 0 54632921 56930726 0 0 0 58715754 59553456 113348675 116484182 3506248 551352 146792149 139291362 45158177 45432222 101633972 93859140 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 97430929 112697069 IN 2015, OLEAN GENERAL HOSPITAL DISCHARGED APPROXIMATELY 6,600 PATIENTS AND PROVIDED SERVICES TO APPROXIMATELY 210,000 OUTPATIENT VISITORS.OLEAN GENERAL HOSPITAL (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 2015 AT OGH.2015 FINANCIAL PERFORMANCE- OGH HAD OPERATING INCOME OF $1,675,943 AGAINST A BUDGET OF $1,178,139. THIS WAS THE NINTH CONSECUTIVE YEAR THAT OGH RECORDED AN OPERATING SURPLUS.- THE FIRM FREED MAXICK WAS ENGAGED TO ASSIST IN THE IMPLEMENTATION OF A TRANSFORMATIONAL MANAGEMENT OFFICE WHAT FOLLOWS AN OPERATIONAL ASSESSMENT OF BRMC (IN 2014) TO IDENTIFY PRODUCTIVITY IMPROVEMENT AND REVENUE CYCLE ENHANCEMENT OPPORTUNITIES AT THE HOSPITAL IN LIGHT OF ANTICIPATED REVENUE REDUCTIONS OVER THE NEXT FIVE YEARS. THE TRANSFORMATION MANAGEMENT OFFICE WAS CREATED TO ASSURE THE REQUISITE DISCIPLINE AND RIGOR WITH RESPECT TO THIS EFFORT.QUALITY- INITIATION OF SAFETY CHAMPION PROGRAM: EMPLOYEES ACROSS OGH NOW RECEIVE ONGOING SAFETY TRAINING AND ARE ACTIVE PARTICIPANTS IN NUMEROUS PATIENT SAFETY INITIATIVES AND SERVE ON VARIOUS HOSPITAL SAFETY COMMITTEES. THE PROGRAM HAS SIGNIFICANTLY ENHANCED STAFF'S AWARENESS AND SENSITIVITY TO PATIENT SAFETY AT OGH AND THE EFFECTIVENESS OF OUR SAFETY INITIATIVES. THIS PROGRAM IS A KEY COMPONENT OF THE EFFORT TO ENHANCE OUR HOSPITAL'S CULTURE OF SAFETY.- IN 2014 THE HOSPITAL ENGAGED ITS PATIENTS IN A PATIENT SPEAK-UP CAMPAIGN. IN 2015 A CAMPAIGN PROGRAM FOR HOSPITAL STAFF WAS IMPLEMENTED: THE "STOP THE LINE" PROGRAM. THIS INITIATIVE ALLOWS ANY MEMBER OF THE TEAM TO "STOP THE LINE" ON ANY ACTIVITY IF THEY ARE CONCERNED ABOUT SAFETY FOR OUR PATIENTS AND STAFF.- PUBLICATION OF TOTAL HARM SCORE: 2015 MARKED THE FIRST FULL YEAR WHERE OGH BEGAN TO PUBLISH ON THE INTRANET THE NUMBER AND TYPE OF PATIENT HARM EVENTS THAT OCCUR IN THE HOSPITAL. A PATIENT HARM EVENT IS AN EVENT THAT "HARMS" A PATIENT. PATIENT FALLS WITH INJURY, ADVERSE DRUG EVENTS, OR A HOSPITAL ACQUIRED INFECTION ARE EXAMPLES OF HARM EVENTS. THE POSTING OF HARM SCORES HAS PROVEN TO BE VERY USEFUL TO HOSPITALS BECAUSE IT ENHANCES STAFF AWARENESS OF PATIENT SAFETY ISSUES AND CONCERNS. THE TRANSPARENCY INHERENT IN POSTING THE HARM SCORE FOR ALL STAFF TO SEE IS CRITICAL TOWARDS THE DEVELOPMENT OF AN ENHANCED CULTURE OF PATIENT SAFETY AT OUR HOSPITAL.INFORMATION TECHNOLOGY- OGH SUCCESSFULLY IMPLEMENTED PHYSICIAN DOCUMENTATION SOFTWARE IN ITS INTENSIVE CARE UNIT. 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. - AN ELECTRONIC MEDICATION PRESCRIBING SYSTEM (ERX) WAS IMPLEMENTED AT OGH AND BRMC. 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. - BRMC AND OGH'S DATA STORAGE ARCHITECTURE WAS UPGRADED. THE UPGRADE ALLOWS THE HOSPITALS TO IMPROVE THE SECURITY OF PATIENT DATA USING ADVANCED DATA ENCRYPTION AND IMPROVED BACKUP AND DATA ARCHIVAL FUNCTIONS. - BRMC AND OGH CONTINUED TO EXPAND THE USAGE OF ITS COMPUTERIZED PHYSICIAN ORDER ENTRY SYSTEM (CPOE). CPOE SYSTEMS HELP ELIMINATE MEDICAL ERRORS BY AUTOMATICALLY CHECKING ORDERS WITH PATIENT INFORMATION INCLUDING LAB RESULTS, ALLERGIES AND DIAGNOSES AND FACILITATE THE USE OF STANDARD ORDER SETS TO HELP ENSURE THAT PATIENTS CARE IS DELIVERED IN ACCORDANCE WITH EVIDENCE BASED PRACTICE.OPERATIONS/PROGRAMS- THE MILLIMEN RADIATION MEDICAL PROGRAM IMPLEMENTED A $1 MILLION UPGRADE TO ITS LINEAR ACCELERATOR EQUIPMENT ENSURING THAT WE PROVIDE STATE OF THE ART TREATMENT TO TREAT CANCER PATIENTS.- EMPLOYEE SATISFACTION/ENGAGEMENT SURVEYS WERE COMPLETED AT OGH. 97430929 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 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 1 167 0 1 1141 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 417611 245264 56858 DANIEL MCCUNE BOARD CHAIR 2.00 4.50 X X 0 0 0 BRENDA MCGEE BOARD VICE CHAIR 2.00 3.50 X X 0 0 0 MUHAMMED JAVED MD BOARD SECRETARY 2.00 3.50 X X 40000 0 0 MARTIN DIGEL BOARD TREASURER 2.00 3.50 X X 0 0 0 LIVINGSTON ALEXANDER EDD 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 LUIS GONZALEZ MD DIRECTOR 2.00 3.50 X 0 0 0 RICHARD MCDOWELL PHD DIRECTOR 2.00 3.50 X 0 0 0 JILL OWENS MD DIRECTOR 2.00 3.50 X 0 143333 0 DAVID PRINCE DIRECTOR 2.00 3.50 X 0 0 0 LYNDA QUICK DIRECTOR 2.00 3.50 X 0 0 0 RICHARD ROUPE 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 227314 133502 47148 TIMOTHY MCNAMARA SENIOR VP OF HUMAN RESOURC 23.50 15.00 X 154785 90906 48775 WILLIAM MILLS SENIOR VP OF MEDICAL AFFAI 23.50 15.00 X 189002 111001 40913 GARRETT HOOVER VP OF OPERATIONS 23.50 14.00 X 142416 0 20173 JASON YAWORSKY SENIOR VP/CIO 23.50 15.00 X 139178 81740 50320 GAIL BAGAZZOLI VP OF QUALITY 23.50 15.00 X 86813 50985 32605 DENNIS MCCARTHY VP OF COMMUNICATIONS & MAR 23.50 15.00 X 85638 50295 40858 JEFFREY ZEWE SENIOR VP PATIENT CARE SER 23.50 14.50 X 168685 99069 48096 BASIL ARIGLIO VP OF FINANCE (BEGINNING 11/2015) 23.50 15.00 X 14925 8766 5685 KENNETH MCNEIL VP OF FINANCE (THROUGH 7/2015) 23.50 15.00 X 87034 51115 19816 MELISSA SULLIVAN VP OF CLINICAL & SUPPORT SERVICES 33.50 4.00 X 72698 25003 27591 KAREN FOHL VP INSTITUTIONAL ADVANCEMENT 48.00 12.00 X 96437 23122 17260 MOHANED AL-HUMADI PHYSICIAN 37.50 X 1016684 0 72917 SAM JAYANTH SAMUEL PHYSICIAN 37.50 X 508342 0 25462 GARY CARL PHYSICIAN 37.50 X 491618 0 67983 TARA MANCL PHYSICIAN 37.50 X 321988 0 61046 ROBERT KRALL CHIEF OF PATHOLOGY 37.50 X 341845 0 37896 4603013 1114101 721402 43 0 1 0 PA MOUNTAIN HEALTHCARE ALLIANCE LLC 150 MCCRACKEN RUN ROAD DUBOIS PA 15801 HEALTH INSURANCE 6660822 COMPLETERX LTD 3100 S GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY MANAGEMENT SERVICES 6054878 APOGEE PHYSICIANS 2525 E CAMELBACK ROAD SUITE 1100 PHOENIX AZ 85016 PHYSICIANS AND HOSPITALISTS SERVICES 1448805 ARAMARK SERVICES INC PO BOX 7548 PHILADELPHIA PA 19101 CAFETERIA FOOD SERVICE 1122189 SOUTHERN TIER ANESTESIOLOGISTS PC 202 N BARRY STREET OLEAN NY 14760 ANESTHESIOLOGY SERVICES 900000 25 1543929 242356 1786285 PATIENT SERVICE REVENUE 621990 112239069 112239069 112239069 540446 540446 187720 0 187720 187720 187720 1845528 1670648 25727 174880 -25727 149153 149153 CAFETERIA/VENDING 722210 757175 757175 DISCOUNTS/REBATES 900099 537785 537785 MEANINGFUL USE INCENTIVE 621990 458000 458000 379901 379901 2132861 117035534 112697069 0 2552180 2230238 40000 2190238 42004346 35607414 6396932 2434235 2434235 7128380 5157081 1971299 3133527 3133527 209305 209305 5901228 5734775 166453 566679 566679 15845137 15586953 258184 148059 148059 485620 485620 7941963 5559374 2382589 1553551 273465 1280086 PURCHASED SERVICES 16840576 16840576 OTHER 4574234 1372270 3201964 PROVISION FOR BAD DEBTS 2989082 2989082 LEASE/RENT 1913630 1551106 362524 584392 584392 116484182 97430929 19053253 0 8754321 9558877 5239524 5312460 15868447 15434163 2243638 2332866 2598248 2491011 148095428 93611639 57008901 54483789 9976165 9586422 2835742 2611813 42267163 37479961 146792149 139291362 14184461 14306412 16207644 15967639 14766072 15158171 45158177 45432222 X 57500964 52513537 19213391 17067031 24919617 24278572 101633972 93859140 146792149 139291362 X 551352 -1568715 -6757469 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16679420 222204 715326 17616950 15093232 491607 1094581 16679420 14064479 494401 534352 15093232 13723863 85158 255458 14064479 15240483 233814 488971 -2239405 13723863 0.65900 0.21700 0.12400 1 0 2025154 2025154 81445909 47683605 33762304 5633861 3606251 2027610 58761040 42321783 16439257 229464 229464 54483789 ASSETS HELD BY OTHERS 34970186 OTHER ASSETS 2509775 37479961 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 832389 ACCRUED PENSION LIABILITY 14325782 15158171 X 112477737 -1568715 -2989082 -4557797 117035534 0 117035534 113495100 0 113495100 2989082 2989082 116484182 PART V, LINE 4: TO PROVIDE SUPPORT AND RENEW PLANT AND EQUIPMENT BASED ON HOSPITAL NEED. PART X, LINE 2: THE HOSPITAL IS A 501(C)(3) ORGANIZATION EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL BELIEVES IT IS NO LONGER SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR YEARS PRIOR TO 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS -2,989,082. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,989,082. 1 1 X 1 X 400.000000000000 1 X 1 1 0 0 1034595 -59756 1094351 0.00960 22147803 16052478 6095325 0.05370 23182398 15992722 7189676 0.06330 54 61734 303916 41775 262141 0.00230 5 6112 794042 324257 469785 0.00410 2 4702 4702 0.00000 61 67846 1102660 366032 736628 0.00640 61 67846 24285058 16358754 7926304 0.06970 0 1221059 211243 27039153 28369054 -1329901 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 13 1 1 1 1 X WWW.OGH.ORG X 1 13 1 WWW.OGH.ORG 1 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 1 X 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 AND HEALTHY LIVABLE COMMUNITIES CONSORTIUM TO CREATE THE REGION'S COMMUNITY HEALTH ASSESSMENT IN 2013. THE CHNA APPEARS AS ATTACHMENT A TO THE OLEAN GENERAL HOSPITAL COMMUNITY SERVICE REPORT 2013-2015. OLEAN GENERAL HOSPITAL PART V, SECTION B, LINE 5: OLEAN GENERAL HOSPITAL WAS A PARTNER IN DEVELOPING A COMMUNITY CONVERSATIONS PROGRAM AND CATTARAUGUS COUNTY COMMUNITY HEALTH ASSESSMENT SURVEY HELD ACROSS THE REGION IN EARLY 2013, COORDINATED BY THE CATTARAUGUS COUNTY HEALTHY LIVABLE COMMUNITIES CONSORTIUM, OF WHICH OLEAN GENERAL HOSPITAL IS A MEMBER. THE CONSORTIUM CONSISTS OF COMMUNITY, SOCIAL, AND GOVERNMENT ORGANIZATIONS FROM THE ACROSS THE COUNTY AND FACILITATES A DIALOGUE AND DISCUSSION ABOUT LOCAL PUBLIC HEALTH AND SAFETY ISSUES. THE CONSORTIUM WAS INITIATED IN 2011 BY KEY LEADERS IN CATTARAUGUS COUNTY IN RESPONSE TO SHARED NEEDS AND POOR COUNTY HEALTH RANKINGS. 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, 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 2013-2015 COMMUNITY SERVICE REPORT. 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 $ 2,989,082. 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 2013 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: NO SHORTFALL IS TREATED AS COMMUNITY BENEFIT. THE ALLOWABLE COSTS REPORTED ON LINE 6 ARE DIRECTLY FROM THE HOSPITAL'S 2015 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 2013. THE PLAN WAS REVIEWED IN SEPT 2014 AND INITIATIVES ADDED THAT WERE CARRIED OUT IN 2015. 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 RECENTLY 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.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. 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. 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 X X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 TIMOTHY FINAN PRESIDENT AND CEO 417611 245264 0 0 0 0 9645 5665 26175 15373 453431 266302 0 0 RICHARD G BRAUN JR SENIOR VP OF FINANCE/CFO 227314 133502 0 0 0 0 9645 5665 20058 11780 257017 150947 0 0 TIMOTHY MCNAMARA SENIOR VP OF HUMAN RESOURC 154785 90906 0 0 0 0 8365 4912 22364 13134 185514 108952 0 0 WILLIAM MILLS SENIOR VP OF MEDICAL AFFAI 189002 111001 0 0 0 0 9645 5665 16130 9473 214777 126139 0 0 GARRETT HOOVER VP OF OPERATIONS 142416 0 0 0 0 0 20173 0 0 0 162589 0 0 0 JASON YAWORSKY SENIOR VP/CIO 139178 81740 0 0 0 0 9309 5467 22393 13151 170880 100358 0 0 GAIL BAGAZZOLI VP OF QUALITY 86813 50985 0 0 0 0 4835 2840 15706 9224 107354 63049 0 0 DENNIS MCCARTHY VP OF COMMUNICATIONS & MAR 85638 50295 0 0 0 0 3362 1974 22379 13143 111379 65412 0 0 JEFFREY ZEWE SENIOR VP PATIENT CARE SER 168685 99069 0 0 0 0 7901 4641 22399 13155 198985 116865 0 0 KENNETH MCNEIL VP OF FINANCE (THROUGH 7/2015) 87034 51115 0 0 0 0 0 0 12484 7332 99518 58447 0 0 MOHANED AL-HUMADI PHYSICIAN 1016684 0 0 0 0 0 14010 0 58907 0 1089601 0 0 0 SAM JAYANTH SAMUEL PHYSICIAN 508342 0 0 0 0 0 13373 0 12089 0 533804 0 0 0 GARY CARL PHYSICIAN 491618 0 0 0 0 0 15310 0 52673 0 559601 0 0 0 TARA MANCL PHYSICIAN 321988 0 0 0 0 0 12202 0 48844 0 383034 0 0 0 ROBERT KRALL CHIEF OF PATHOLOGY 341845 0 0 0 0 0 19210 0 18686 0 379741 0 0 0 PART I, LINES 4A-B TIMOTHY FINAN: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN - $18,433. KENNETH MCNEIL: SEVERANCE WAGES - $52,982. 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 1980000 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 143333 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. 407964 RICHARD G. BRAUN, JR. IS COMPENSATED BY THE HOSPITAL 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 11 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 -1,113,815. NET ASSET CONTRIBUTION - FORGIVENESS OF DEBT FROM BRMC -1,852,000. NET ASSET CONTRIBUTION - FORGIVENESS OF ADVANCES TO PHYSICIAN GROUP -3,791,654. 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 11D, 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 11A, 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 9 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 3035742 1.00000 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0