2025-11-17T12:39:16-06:00 2024-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2024-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 DATES DRIVE ITHACA NY 14850 REBECCA GOULD CFO 6072744441 2025-11-17 1 1 AIMEE JOZIC P01329472 5853811000 2025-11-16 2024 2025-03-06 01:10:19Z ROBERT LAWLIS 101 DATES DR ITHACA NY 14850 426189431 0 X HTTPS://CAYUGAHEALTH.ORG/ X 1981 NY TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 16 14 2383 250 0 338603 12868713 10000815 323222615 398853311 1868951 14008901 354600 3326404 338314879 426189431 34535537 39736151 0 0 164589241 187319013 0 0 0 166032733 191714283 365157511 418769447 -26842632 7419984 380755220 426836305 206587828 217794071 174167392 209042234 X CAYUGA MEDICAL CENTER WILL REMAIN THE REGION'S LEADING HOSPITAL, HEALTHCARE PROVIDER, AND MOST TRUSTED DRIVER OF INTEGRATED HEALTH SERVICES, TOGETHER WITH VALUED PARTNERS. WE EMPOWER OUR PEOPLE AND EMPLOY OUR CAPABILITIES TO EQUITABLY IMPROVE THE WELL-BEING OF THE COMMUNITIES WE SERVE. 0 0 336585656 39736151 402179715 PATIENT SERVICE - GENERAL INPATIENT AND OUTPATIENT HOSPITAL CARE. SERVICES ARE PROVIDED TO THOSE IN NEED REGARDLESS OF THE PATIENTS' ABILITY TO PAY, RACE, CREED, NATIONAL ORIGIN, LIFE CIRCUMSTANCES, OR DISEASE. CAYUGA MEDICAL CENTER WORKS CLOSELY WITH THE COMMUNITY TO DETERMINE HEALTH NEEDS AND SUPPORT THE DEVELOPMENT OF PROGRAMS AND SERVICES THAT IMPROVE THE HEALTH STATUS OF THE COMMUNITY. 49680906 49680906 336585656 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 426 0 1 2383 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X REBECCA GOULD 6072744441 101 DATES DRIVE ITHACA NY 14850 TOM LIVIGNE CHAIR 1.00 4.00 X X 28750 0 0 GARY KORETZKY VICE CHAIR 1.00 4.00 X X 0 0 0 PAUL STREETER TREASURER 1.00 4.00 X X 18938 0 0 SUZANNE BLOWERS SECRETARY 1.00 4.00 X X 0 0 0 KAREN CALLANAN DIRECTOR 1.00 4.00 X 0 0 0 YVETTE CONYERS DIRECTOR 1.00 4.00 X 19250 0 0 CRIS DONOVAN DIRECTOR 1.00 4.00 X 20250 0 0 LAJERNE CORNISH DIRECTOR 1.00 4.00 X 0 0 0 BROOKE HOLLIS DIRECTOR 1.00 4.00 X 21500 0 0 SANDRA IBERGER DIRECTOR 1.00 4.00 X 23000 0 0 JOEL MALINA DIRECTOR 1.00 4.00 X 15250 0 0 LAURIE MANTE DIRECTOR 1.00 4.00 X 20750 0 0 JOHN-PAUL MEAD DIRECTOR 1.00 39.00 X 42207 425538 19535 EUNICE NAYO DIRECTOR 1.00 4.00 X 12000 37200 0 MELISSA SCHMIDT DIRECTOR 1.00 4.00 X 13750 0 0 JENNIFER WHITAKER DIRECTOR 1.00 4.00 X 19500 0 0 MARTIN STALLONE PRESIDENT 39.00 1.00 X 932253 0 43631 JEFFERY PENOYER COO 39.00 1.00 X 419368 0 9209 REBECCA GOULD CFO 39.00 1.00 X 0 482472 20073 TRACY GATES COO 39.00 1.00 X 424400 0 10115 SRISATISH DEVAPTLA NEONATOLOGIST 40.00 X 528153 0 24694 ANDREIA PEREIRA DE LIMA SERRA VICE PRESIDENT 40.00 X 450420 0 19406 JUSTIN PETER RUNKE VICE PRESIDENT 39.00 1.00 X 453962 0 15290 RAMESH VIDAVALUR NEONATOLOGIST 40.00 X 443283 0 20701 MICHAEL BERLIN ASST. VP 39.00 1.00 X 378800 0 19810 4285784 945210 202464 284 0 1 0 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 LAB SERVICES 5083048 MEDUIT HEALTH SERVICES 8085 KNUE RD INDIANAPOLIS IN 46250 OUTSOURCED REVENUE CYCLE 2236844 HOWELL LABRATORE & ASSOC INC 50 PENNSYLVANIA AVE ELMIRA NY 14904 MARKETING 1261214 EPIC SYSTEMS CORPORATION 1979 MILK WAY VERONA WI 53593 SOFTWARE 1233290 CAYUGA ENT HEAD AND NECK 2 ASCOT PLACE ITHACA NY 14850 PHYSICIAN SERVICES 1119553 8 10000815 10000815 PATIENT REVENUE 622000 349172405 349172405 OTHER OPERATING REVENUE 900099 36218696 36218696 PHARMACY REVENUE 456110 13462210 13462210 398853311 7879288 7879288 6129613 0 6129613 6129613 6129613 MISCELLANEOUS INCOME 900099 3326404 3326404 3326404 426189431 402179715 0 14008901 39736151 39736151 1166715 1166715 134661408 105663851 28997557 4981876 3909095 1072781 44656837 35061048 9595789 1852177 1453335 398842 4048315 497898 3550417 1279200 473304 805896 242147 242147 15340 15340 82000 82000 35022975 25064815 9958160 1372210 1372210 78231338 71326542 6904796 18800263 15216530 3583733 10471402 5767146 4704256 226897 153140 73757 1324581 1324581 14400853 7911044 6489809 700010 595009 105001 PURCHASED SERVICES 25352701 23688717 1663984 LICENSES AND PERMITS 144051 68031 76020 418769447 336585656 82183791 0 4360 4360 5912166 7231316 30020089 40801730 11774996 11975817 18396124 19861161 386549969 240112880 116716804 146437089 86639188 83860165 1529995 1529995 109761498 115134672 380755220 426836305 62125747 72671653 6906 30616784 29110893 113845297 116004619 206587828 217794071 X 167715103 197460417 6452289 11581817 174167392 209042234 380755220 426836305 X 7419984 -2470259 29925117 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 15340 0 15340 0 PART I-A, LINE 1: CAYUGA MEDICAL CENTER BELONGS TO ORGANIZATIONS THAT LOBBY ON THE BEHALF OF THEIR MEMBERS. THIS INCLUDES HANYS AND IROQUOIS HEALTHCARE ASSOCIATION. 2669118 113172 2782290 2467580 201538 2669118 1770578 982867 -285865 2467580 1764186 6391 1 1770578 1750507 16066 129 2516 1764186 0.49616 0.50384 0 1 1 2829462 2829462 207156895 120169370 86987525 8982685 7602377 1380308 127897162 109495462 18401700 39683765 2845671 36838094 146437089 BENEFICIAL INTEREST IN ASSETS OF FOUNDATION 10201353 ROU ASSETS 72230242 LIFE INSURANCE 3398844 EQUITY IN RELATED PARTIES 24880971 OTHER ASSETS 4423262 115134672 ACCRUED POSTRETIREMENT 7403681 DUE 3RD PARTY PAYORS 25605694 LEASE LIABILITY 72616287 ACCRUED PENSION COST -20505408 DUE TO CHSS 30884365 116004619 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT CAYUGA MEDICAL CENTER'S ONGOING MISSION TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 1 1 X 1 X 1 X 1 0 0 541142 776191 0 0.00000 54565229 31474139 23091090 0.05510 55106371 32250330 23091090 0.05510 48697446 7133322 41564124 0.09930 4769355 4769355 0.01140 29297865 29708640 0 0.00000 7453 7453 0.00000 82772119 36841962 46340932 0.11070 137878490 69092292 69432022 0.16580 1 12343939 391769 20290033 46269040 -25979007 X 1 1 1 1 CAYUGA MEDICAL CENTER AT ITHACA 101 DATES DRIVE ITHACA NY 14850 WWW.CAYUGAMED.ORG 5401001H X X X X CAYUGA MEDICAL CENTER AT ITHACA 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X HTTPS://CAYUGAHEALTH.ORG/COMMUNITY/COMMUNITY-HEALTH-ASSESSMENT/ 1 22 1 HTTPS://CAYUGAHEALTH.ORG/COMMUNITY/COMMUNITY-HEALTH-ASSESSMENT/ 0 1 X 100.000000000000 400.000000000000 X 1 1 X X X 1 X HTTPS://WWW.CAYUGAMED.ORG/VISITING-US/PAYING-FOR-YOUR-CARE/ X HTTPS://WWW.CAYUGAMED.ORG/VISITING-US/PAYING-FOR-YOUR-CARE/ X HTTPS://WWW.CAYUGAMED.ORG/VISITING-US/PAYING-FOR-YOUR-CARE/ X X X X X 1 X 0 X X X 1 X 0 0 CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 5: CAYUGA MEDICAL CENTER AT ITHACA - AS IN YEARS PAST, THE QUALITATIVE PROCESS PROVIDED CRUCIAL COMMUNITY INPUT INTO THIS ASSESSMENT. THE CHNA/CHIP TEAM WAS COMPRISED OF REPRESENTATIVES FROM TOMPKINS COUNTY, CAYUGA MEDICAL CENTER, AND SEVERAL COMMUNITY-BASED NON-PROFIT ORGANIZATIONS. MUCH OF THE INFORMATION DRIVING THE SELECTION/CONFIRMATION OF OUR PRIORITIES WAS GATHERED THROUGH CONVERSATIONS WITH SERVICE PROVIDERS AND THROUGH PANELS AND PRESENTATION BY PEERS AND PROVIDERS. KEY DATA INDICATORS WERE REVIEWED TO GUIDE SELECTION DECISIONS FOR OUR PRIORITY FOCUS AREAS. FINALLY, REVIEW OF CHRONIC DISEASE INDICATORS REVEALED THAT TOMPKINS COUNTY IS IN THE SECOND QUARTILE STATEWIDE, INDICATING THE NEED TO CONTINUE OUR EFFORTS TO FOCUS ON UNDERSERVED POPULATIONS, PARTICULARLY IN THE RURAL PARTS OF THE COUNTY. CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 6B: CAYUGA MEDICAL CENTER AT ITHACA - TOMPKINS COUNTY HEALTH DEPARTMENT, TOMPKINS COUNTY MENTAL HEALTH, OFFICE FOR THE AGING, CAYUGA HEALTH SYSTEM, HEALTH PLANNING COUNCIL, HORN RESEARCH CONSULTING, ITHACA COLLEGE, CORNELL UNIVERSITY, HUMAN SERVICES COALITION, AND CORNELL COOPERATIVE EXTENSION OF TOMPKINS COUNTY. CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 11: CAYUGA MEDICAL CENTER AT ITHACA - CAYUGA MEDICAL CENTER (CMC) IS ACTIVELY WORKING TO ADDRESS THE NEEDS OF INDIVIDUALS SUFFERING FROM MENTAL HEALTH AND/OR SUBSTANCE ABUSE CONDITIONS BY IMPROVING THE CARE AVAILABLE TO THIS POPULATION WITHIN THE HOSPITAL SETTING AND ACTIVELY COLLABORATING WITH COMMUNITY-BASED PROVIDERS FOR THE OUTPATIENT SETTING. CAYUGA MEDICAL CENTER IS DIRECTLY PARTICIPATING IN THE TOMPKINS COUNTY CHNA/CHIP STEERING COMMITTEE AND HAS REPRESENTATION FROM OUR CAYUGA CENTER FOR HEALTHY LIVING, A SERVICE WITHIN CMC THAT FOCUSES ON CHRONIC DISEASE PREVENTION AND TREATMENT. THE HEALTH NEEDS NOT ADDRESSED BY THE DOCUMENT INCLUDE: PERCENT OF POPULATION (ALL AGES) LIVING IN POVERTY, PERCENT OF POPULATION (UNDER AGE 18) LIVING IN POVERTY, PERCENT OF SINGLE PARENT HOUSEHOLDS WITH CHILDREN UNDER THE AGE OF 18 LIVING IN THE HOME, PERCENT OF INDIVIDUALS UNINSURED AND THE HOUSING AFFORDABILITY RATE. CMC IS NOT DIRECTLY ADDRESSING THESE HEALTH CONDITIONS. CMC IS HOWEVER, ALIGNED WITH AND SUPPORTS THE UNITED WAY IN TOMPKINS COUNTY WHICH HELPS ADDRESS HOUSING AND POVERTY NEEDS. CMC ADDITIONALLY IS ALIGNED WITH THE HEALTH PLANNING COUNCIL WHICH ASSISTS IN ENROLLING INDIVIDUALS INTO MEDICAID AND OTHER AFFORDABLE INSURANCE PROGRAMS AND CMC PROVIDES SPACE AT THE HOSPITAL FOR ENROLLMENT OF INDIVIDUALS INTO THESE PROGRAMS. 16 1 - CAYUGA MEDICAL CENTER - CHOA 10 ARROWWOOD DRIVE ITHACA NY 14850 DIAGNOSTIC IMAGING, HEMATOLOGY/ONCOLOGY SERVICES 2 - CAYUGA MEDICAL CENTER - URGENT CARE CORT 1129 COMMONS AVE CORTLAND NY 14850 URGENT CARE, DIAGNOSTIC IMAGING, LAB SERVICES, OUTPATIENT PHYSICAL THERAPY. 3 - CAYUGA MEDICAL CENTER - CAYUGA WELLNESS 310 TAUGHANNOCK BLVD ITHACA NY 14850 CARDIAC REHAB, OUTPATIENT PHYSICAL THERAPY, BARIATRIC CLINIC & NUTRI SVCS 4 - CAYUGA MEDICAL CENTER - CHOA 201 DATES DRIVE ITHACA NY 14850 HEMATOLOGY & ONCOLOGY SERVICES 5 - CAYUGA MEDICAL CENTER - SURGICARE 10 ARROWWOOD DRIVE ITHACA NY 14850 OUTPATIENT SURGICAL SERVICES 6 - CAYUGA MEDICAL CENTER - BRENTWOOD PT 10 BRENTWOOD DRIVE ITHACA NY 14850 OUTPATIENT REHABILITATION SERVICES 7 - CAYUGA MEDICAL CENTER - BRENTWOOD IMAGIN 10 BRENTWOOD DRIVE ITHACA NY 14850 DIAGNOSTIC IMAGING SERVICES 8 - CAYUGA MEDICAL CENTER - CAYUGA ENDOSCOPY 2435 N TRIPHAMMER RD ITHACA NY 14850 ENDOSCOPY SERVICES 9 - CAYUGA MEDICAL CENTER - DRYDEN DRAW STAT 5 EVERGREEN ST DRYDEN NY 13053 LAB DRAW STATION 10 - CAYUGA MEDICAL CENTER - CRAFT ROAD LAB D 1020 CRAFT RD SUITE B ITHACA NY 14850 LAB DRAW STATION 11 - CAYUGA MEDICAL CENTER - CAYUGA HEIGHTS L 905 HANSHAW ROAD ITHACA NY 14850 LAB DRAW STATION 12 - CAYUGA MEDICAL CENTER - IT OFFICES 767 WARREN ROAD ITHACA NY 14850 INFORMATION & TECHNOLOGY SYSTEMS. 13 - CAYUGA MEDICAL CENTER - MASS SAMPLING SI 40 CATHERWOOD DRIVE ITHACA NY 14850 COVID COLLECTION SITE AND INVENTORY WAREHOUSING 14 - CAYUGA MEDICAL CENTER - LAB PROCESSING 53 BROWN RD ITHACA NY 14850 LAB PROCESSING 15 - CAYUGA MEDICAL CENTER - CORTLAND MOB 1123 COMMONS AVE CORTLAND NY 13045 MEDICAL OFFICES 16 - CAYUGA MEDICAL CENTER - CORTLAND CHOA 1081 COMMONS AVE CORTLAND NY 13045 HEMATOLOGY & CANCER SERVICES PART III, LINE 4: THE MEDICAL CENTER RECOGNIZES PATIENT SERVICE REVENUE AT AMOUNTS THAT REFLECT THE CONSIDERATION TO PATIENT SERVICE PERFORMANCE OBLIGATIONS GENERALLY RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR AND AS A RESULT, THEY HAVE ELECTED UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH ITS FINANCIAL AID POLICIES, AND IMPLICIT PRICE CONCESSIONS. ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE DETERMINED BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. FOR OBLIGATIONS FROM ADMISSION TO THE POINT WHEN THERE ARE NO FURTHER SERVICES REQUIRED FOR THE PATIENT, WHICH IS GENERALLY THE TIME OF DISCHARGE. THE PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F). THROUGH THE EMERGENCY DEPARTMENT, THE INCREASED BURDEN OF CO-PAYS, CO-INSURANCE AMOUNTS AND DEDUCTIBLES TO BE MADE BY PATIENTS WITH OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES. THE MEDICAL CENTER MEASURES PERFORMANCE TO PAY FOR THE SERVICES PROVIDED. THUS, THE MEDICAL CENTER RECORDS AN IMPLICIT PRICE CONCESSION TO REDUCE ACCOUNTS TO THEIR NET REALIZABLE THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. ESTIMATES OF IMPLICIT PRICE CONCESSIONS ARE DETERMINED BASED ON HISTORICAL COLLECTION PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCUR WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD. THE MEDICAL CENTER DETERMINES THE ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE TRENDS AND THE ESTIMATION PROCESS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO VALUE AT THE TIME MANAGEMENT BELIEVES IT IS PROBABLE A RECEIVABLE WILL NOT BE RECOVERED. THERE ARE VARIOUS FACTORS THAT CAN IMPACT COLLECTION INSURANCE, AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, UNEMPLOYMENT RATES, THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE VOLUME OF PATIENTS THROUGH THE EMERGENCY DEPARTMENT, THE INCREASED BURDEN OF CO-PAYS, CO-INSURANCE AMOUNTS AND DEDUCTIBLES TO BE MADE BY PATIENTS WITH INSURANCE, AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. ESTIMATES OF IMPLICIT PRICE CONCESSIONS ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE WITH THESE CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN AS INDIVIDUAL CONTRACTS. THE FINANCIAL STATEMENT EFFECT OF USING THIS PRACTICAL EXPEDIENT ARE NOT MATERIALLY DIFFERENT FROM AN INDIVIDUAL CONTRACT APPROACH. HOSPITALS ARE TYPICALLY PAID FOR SERVICES AT AMOUNTS THAT ARE NEGOTIATED WITH INSURANCE COMPANIES OR ARE SET BY THE GOVERNMENT. THE MEDICAL CENTER HAS CONTRACTUAL RATE AGREEMENTS WITH THIRDPARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM ESTABLISHED CHARGES. THESE CONTRACTUAL RATE AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM ESTABLISHED CHARGES. THESE CONTRACTUAL RATE AGREEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE OR VISIT, COST-BASED REIMBURSEMENT, DISCOUNTED CHARGES, PER DIEM PAYMENTS AND FEE-FOR-SERVICE PAYMENTS. THE MEDICAL CENTER RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF THESE CONTRACTUAL RATES FOR THE SERVICES RENDERED. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE CONTRACTUAL AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN (THAT IS, AS NEW INFORMATION BECOMES AVAILABLE), OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. AGREEMENTS WITH THIRD-PARTY PAYORS TYPICALLY PROVIDE FOR PAYMENTS AT AMOUNTS LESS THAN ESTABLISHED CHARGES. THE MEDICAL CENTER GRANTS UNSECURED CREDIT TO ITS PATIENTS, MOST OF WHO ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE MEDICAL CENTER DOES NOT BELIEVE SIGNIFICANT AUDIT RISKS EXISTS FOR GOVERNMENT PAYORS, COMMERCIAL AND OTHER THIRD-PARTY PAYORS. WHEN THE MEDICAL CENTER HAS UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED AND UNBILLED ACCOUNTS FOR WHICH THE MEDICAL CENTER HAS THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THE CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION OF PATIENT ACCOUNTS RECEIVABLE RATHER THAN AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMOUNT ON LINE 2 IS TOTAL IMPLICIT CONTRACT CONCESSIONS MULTIPLIED BY THE PERCENTAGE OF COST VS CHARGES FOR CHARITY CARE PER OUR AUDITED FINANCIAL STATEMENT FOOTNOTES. THE AMOUNT ON LINE 3 IS THE AMOUNT FROM LINE 2 MULTIPLIED BY THE PERCENT OF FINANCIAL ASSISTANCE GROSS PATIENT CHARGES DIVIDED BY TOTAL GROSS PATIENT CHARGES. THIS ELIGIBLE PORTION IS IMMATERIAL AND ONLY THE COST OF THE CHARITY CARE IS INCLUDED IN OUR REPORTED COMMUNITY BENEFIT. PART III, LINE 8: THE COST TO CHARGE RATIO OF 54% WAS CALCULATED FROM OUR FACILITIES COST ACCOUNTING SYSTEM BASED ON THE TOTAL COST TO TOTAL CHARGES ON MEDICARE ACCOUNT. ALL OF THE SHORTFALL IS COSIDERED COMMUNITY BENEFIT AS NONE OF IT IS INCLUDED IN PART I LINE 7 AND REFLECTS SERVICES PROVIDED AT A LOSS IN OUR COMMUNITY. PART III, LINE 9B: CMC'S STANDARD OPERATING PRACTICE IS TO STOP ALL COLLECTION EFFORTS AND HOLD ACCOUNTS BACK FROM BAD DEBT UNTIL THE PATIENT IS GIVEN SUFFICIENT TIME TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. REVIEW OF THE APPLICATION WILL BE MADE BY THE HOSPITAL AND PATIENTS ARE NOTIFIED OF DETERMINATION WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. IF A PATIENT DOES NOT QUALIFY FOR EITHER PARTIAL OR FULL ASSISTANCE, THEN A MONTHLY PAYMENT PLAN IS OFFERED TO THE PATIENT FOR ANY REMAINING BALANCES DUE. IF THE PATIENT QUALIFIES FOR ANY FINANCIAL ASSISTANCE, AN ADJUSTMENT IS IMMEDIATELY POSTED TO THE PATIENTS ACCOUNT UPON DETERMINATION OF QUALIFICATION. THE ACCOUNTS FOR PATIENT'S QUALIFYING FOR FINANCIAL ASSISTANCE ARE EARMARKED AS "CHARITY." SUCH ACCOUNTS DO NOT QUALIFY FOR COLLECTION. SCHEDULE H, PART VI, LINE 2 TO DETERMINE THE HEALTH NEEDS OF OUR COMMUNITY, A COMPREHENSIVE ANALYSIS WAS CONDUCTED THROUGH QUANTITATIVE AND QUALITATIVE METHODS. IN THE QUANTITATIVE ANALYSIS, MULTIPLE SOURCES PROVIDED THE REPORTABLE STATISTICS INCLUDING THE NEW YORK STATE COMMUNITY HEALTH INDICATORS, THE COUNTY HEALTH RANKINGS REPORT, AS WELL AS INTERNAL DATA FROM CAYUGA MEDICAL CENTER. THE DATA COLLECTED FOR THE QUANTITATIVE ASSESSMENT WAS THEN SORTED INTO THE FOLLOWING HEALTH CATEGORIES: DEMOGRAPHICS AND SOCIOECONOMIC STATUS, ACCESS TO HEALTHCARE, HEALTH STATUS OF OVERALL POPULATION AND PRIORITY POPULATIONS, RISK FACTOR BEHAVIORS AND CONDITIONS RELATED TO TOP 5 CAUSES OF DEATH, CHILD HEALTH, INFECTIOUS DISEASES, NATURAL ENVIRONMENT, SOCIAL AND MENTAL HEALTH ENVIRONMENT, AND RESOURCES/ASSETS. FOR EVERY INDICATOR, COMPARISONS WERE MADE UTILIZING THE MEAN VALUE OF EACH INDIVIDUAL COUNTY, THE AGGREGATE VALUE FOR THE TOTAL COMMUNITY, THE NEW YORK STATE WITHOUT NEW YORK CITY STATE VALUE AND THE U.S. VALUE WHERE APPLICABLE TO GENERATE CONTEXT FOR INTERPRETATION. SCHEDULE H, PART VI, LINE 3 THERE IS SIGNAGE IN ALL PATIENT REGISTRATION AREAS AT CAYUGA MEDICAL CENTER (CMC), AS WELL AS IN OTHER PATIENT WAITING AREAS, ADVISING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. FINANCIAL ASSISTANCE BROCHURES ARE ALSO AVAILABLE AT ALL REGISTRATION AREAS. PATIENTS WHO REQUEST FINANCIAL ASSISTANCE ARE PROVIDED WITH THE CMC POLICY AND AN APPLICATION. FINANCIAL COUNSELORS ARE AVAILABLE TO ASSIST PATIENTS IN COMPLETION OF THE APPLICATION AND TO ANSWER ANY QUESTIONS. SELF-PAY BILLING STATEMENTS PROVIDE INFORMATION ON FINANCIAL ASSISTANCE POLICIES, AS WELL AS THE CONTACT INFORMATION TO CALL FOR ASSISTANCE. CMC'S CALL CENTER CONTACTS PATIENTS REGARDING UNPAID BILLS AND ADVISES PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED AND AVAILABLE ON THE CMC WEBSITE AT WWW.CAYUGAMED.ORG. CMC HAS FACILITATED ENROLLERS FROM MEDICAID MANAGED CARE PLANS ON-SITE. PATIENTS ARE REFERRED TO THE FACILITATED ENROLLERS FOR DETERMINATION OF MEDICAID ELIGIBILITY. INFORMATION REGARDING THE ON-SITE FACILITATED ENROLLERS IS ALSO AVAILABLE ON CMC'S WEBSITE. SCHEDULE H, PART VI, LINE 4 LOCATED IN THE FINGER LAKES REGION, CAYUGA MEDICAL CENTER SERVES POPULATIONS FROM SIX COUNTIES: CAYUGA, CORTLAND, SCHUYLER, SENECA, TIOGA, AND TOMPKINS COUNTIES. MANY OF THESE AREAS ARE DESIGNATED RURAL COUNTIES AND TOMPKINS COUNTY IS NEW YORK STATE'S SMALLEST METROPOLITAN STATISTICAL AREA. THE TOTAL SERVICE AREA SPANS, APPROXIMATELY 1,000 SQUARE MILES IN THE MIDDLE OF THE STATE WITH AN AVERAGE POPULATION DENSITY OF FEWER THAN 125 PERSONS PER SQUARE MILE. THERE ARE SEVERAL DISTINCT HEALTH AND HEALTH-RELATED FACTORS AFFECTING RESIDES OF THIS AREA: A) THE REGION IS HOME TO AN OLDER COMMUNITY. SINCE THE 2000 CENSUS, GROWTH IN THE 65+ AGE COHORT HAS RANGED FROM 15% TO 32% ACROSS THE REGION AND IS PROJECTED TO INCREASE BY 18% BETWEEN 2016 AND 2021. ISSUES WITH CHRONIC DISEASE AND PSYCHOLOGICAL DISTRESS ARE WELL DOCUMENTED FOR THIS DEMOGRAPHIC. OVERALL, 22.9% OF ADULTS AGED 55 AND OVER ARE LIKELY TO BE IN FAIR OR POOR HEALTH, RANGING FROM 19.6% OF THOSE AGED 55-64 TO 32.1% OR THOSE AGED 85 AND OVER (NATIONAL HEALTH STATISTICS REPORTS, HEALTH CHARACTERISTICS OF ADULTS AGED 55 YEARS AND OVER: UNITED STATES, 2004-2007, CDC, 2009). B) ACCESS TO HEALTH CARE PROFESSIONALS WITHIN THE REGION IS PROBLEMATIC. MANY OF THE COUNTIES HAVE ZIP CODES WITHIN THAT COUNTY WITH HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA'S) DESIGNATIONS FOR PHYSICIAN, DENTAL, AND MENTAL HEALTH CARE FOR MEDICAID BENEFICIARIES. EVEN WHEN A PROVIDER IS AVAILABLE, THE RURAL ENVIRONMENT, DEFINED BY HILL TERRAINS AND LAKES AS GEOGRAPHIC BARRIERS, CREATES TRANSPORTATION CHALLENGES THAT CAN LIMIT ACCESS. C) IN AGGREGATE, RESIDENTS OF THE SERVICES ARE FISCALLY CHALLENGED. THE MEDIAN HOUSEHOLD WITHIN THE REGION IN 2019 WAS $58,743, WHICH WAS $6,580 BELOW THE STATE AVERAGE (QUICKFACTS, CENSUS BUREAU). SCHEDULE H, PART VI, LINE 7 NEW YORK STATE 0 CAYUGA MEDICAL ASSOCIATES 1301 TRUMANSBURG RD ITHICA NY 14850 204356115 501C3 39736151 0 SUBSIDY 1 SCHEDULE I PART I LINE 2 THE MEDICAL CENTER PROVIDES FUNDS TO ORGANIZATION TO COLLABORATE FOR NURSING PROGRAMS. THE GRANTS OPERATE UNDER INDIVIDUAL AGREEMENTS WITH DEFINED TERMS AND CONDITIONS ON WHICH AN ORGANIZATION IS GRANTED FUNDS. THE GRANTEES ARE REQUIRED TO REPORT THE EXPENDITURES AND OUTCOMES. THE MEDICAL CENTER MAINTAINS THE BOOKS AND RECORDS CONSISTENT WITH ITS RECORD RETENTION POLICY. X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 MARTIN STALLONE PRESIDENT 863905 0 0 0 68348 0 31846 0 11785 0 975884 0 0 0 SRISATISH DEVAPTLA NEONATOLOGIST 506103 0 0 0 22050 0 8383 0 16311 0 552847 0 0 0 REBECCA GOULD CFO 0 482472 0 0 0 0 0 13800 0 6273 0 502545 0 0 JOHN-PAUL MEAD DIRECTOR 42207 376625 0 2055 0 46858 0 10350 0 9185 42207 445073 0 0 ANDREIA PEREIRA DE LIMA SERRA VICE PRESIDENT 450420 0 0 0 0 0 6978 0 12428 0 469826 0 0 0 JUSTIN PETER RUNKE VICE PRESIDENT 453962 0 0 0 0 0 6918 0 8372 0 469252 0 0 0 RAMESH VIDAVALUR NEONATOLOGIST 430133 0 0 0 13150 0 7031 0 13670 0 463984 0 0 0 TRACY GATES COO 424400 0 0 0 0 0 6574 0 3541 0 434515 0 0 0 JEFFERY PENOYER COO 398868 0 0 0 20500 0 9209 0 0 0 428577 0 0 0 MICHAEL BERLIN ASST. VP 378800 0 0 0 0 0 0 0 19810 0 398610 0 0 0 PART I, LINE 4B CEO DR. MARTIN STALLONE PARTICIPATES IN AN ECONOMIC REGIME COLLATERAL ASSIGNMENT SPLIT-DOLLAR LIFE INSURANCE PLAN WITH CMC. THE MEDICAL CENTER MAKES ANNUAL FIXED PREMIUM PAYMENTS ON THE POLICY FOR THE NEXT 2 YEARS. CEO DR. MARTIN STALLONE RECEIVED $23,000 IN 457(B) PLAN PAYMENTS. A TOMPKINS COUNTY DEVELOPMENT CORPORATION 272290745 NONEAVAIL 2024-05-30 8325000 FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES 0 0 0 B TOMPKINS COUNTY DEVELOPMENT CORPORATION 272290745 NONEAVAIL 2022-07-28 21825000 FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES 0 0 0 A 8325000 122512 2442972 1 0 1 1 B 4416588 21825000 172432 21652568 2024 0 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE ACCOUNTANT OF CAYUGA MEDICAL CENTER. THE 990 IS THEN REVIEWED BY THE CONTROLLER, EXTERNAL ACCOUNTANTS, CFO, AND THEN ALL MEMBERS OF THE BOARD, IN THAT ORDER. FORM 990, PART VI, SECTION B, LINE 12C CAYUGA MEDICAL CENTER MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN ANNUALLY. CMC REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATEMENT FOR CONFLICTS, IDENTIFYING DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDS RELATED TO CONFLICT OF INTEREST TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 CAYUGA MEDICAL CENTER MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN ANNUALLY. CAYUGA MEDICAL CENTER REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATEMENT FOR CONFLICTS, IDENTIFYING DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDINGS RELATED TO CONFLICT OF INTEREST TRANSACTIONS. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, CONFLICT OF INTEREST STATEMENT, FINANCIAL STATEMENTS, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST TO ANY COMMUNITY MEMBERS. FORM 990, PART XI, LINE 9: PENSION BENFIT AND CHANGES IN PENSION AND POST RETIREMENT OBLIGATIONS 29,925,117. FORM 990. PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED THE OVERSIGHT PROCESS OR THE SELECTIONS PROCESS DURING THE TAX YEAR. CAYUGA HEALTH TRANSPORT 101 DATES DRIVE ITHACA NY 14850 920296304 EMERGENCY MANAGEMENT SERVICES NY CAYUGA HEALTH SYSTEM INC CAUUGA HEALTH SYSTEM INC 101 DATES DRIVE ITHACA NY 14850 471899601 SUPPORT COMMUNITY HEALTHCARE NY 501(C)(3) LINE 12A, I NA 0 SCHUYLER HOSPITAL 220 STEUBEN STREET MONTOUR FALLS NY 14865 150533564 HOSPITAL NY 501(C)(3) 3 CAYUGA HEALTH SYSTEM INC 0 CAYUGA MEDICAL ASSOCIATES 1301 TRUMANSBURG ROAD ITHACA NY 14850 204356115 MEDICAL PRACTICES NY 501(C)(3) LINE 9 CAYUGA MEDICAL CENTER AT ITHACA 1 CAUUGA MEDICAL CENTER FOUNDATION 101 DATES DRIVE ITHACA NY 14850 161072414 CHARITABLE SUPPORT NY 501(C)(3) LINE 7 NA 0 ITHACA ALPHA HOUSE CENTER INC 334 W STATE STREET ITHACA NY 14850 160991369 OPERATE SUBSTANCE ABUSE/ALCOHOL ABUSE PROGRAM NY 501(C)(3) LINE 7 CAYUGA HEALTH SYSTEM INC 0 VISITING NURSE SERVICE OF ITHACA AND TOMPKINS COUNTY INC 138 CECIL A MALONE DRIVE ITHACA NY 14850 222588448 HOME NURSING SERVICE NY 501(C)(3) LINE 10 CAYUGA HEALTH SYSTEM INC 0 CANCER RESOURCE CENTER OF THE FINGER LAKES 612 WEST STATE STREET ITHACA NY 14850 161453042 RESOURCE CENTER FOR CANCER PATIENTS AND THEIR FAMILIES NY 501(C)(3) LINE 10 CAYUGA HEALTH SYSTEM INC 0 CAYUGA MEDICAL OFFICE BUILDING ASSOCIATION 201 DATES DRIVE ITHACA NY 14850 161261492 BUILDING MANAGEMENT NY RELATED 0 1 0.73000 TOMPKINS OFFICE MANAGEMENT SYSTEM 101 DATES DRIVE ITHACA NY 14850 161437217 OFFICE MANAGEMENT NY CAYUGA MEDICAL CENTER AT ITHACA C 1.00000 1 ISLAND HEALTH AND FITNESS 310 TAUGHANNOCK BLVD ITHACA NY 14850 203036206 FITNESS NY TOMPKINS OFFICE MANAGEMENT SYSTEM C 0.70000 0 CAYUGA HOLDINGS INC 101 DATES DRIVE ITHACA NY 14850 853812779 MEDICAL LAB AND EQUIPMENT NY CAYUGA HEALTH SYSTEM INC C 0 FINGER LAKES ASSURANCE COMPANY LTC PO BOX 69 GRAND CAYMAN CJ 981747937 SELF INSURANCE CJ CAYUGA HEALTH SYSTEM INC C 0 ARLEO EYE ASSOCIATES 100 UPTOWN ROA ITHACA NY 14850 PHYSICIAN OFFICE NY CAYUGA MEDICAL CENTER AT ITHACA C 1.00000 1 CAYUGA AREA PREFERRED 101 DATES DRIVE ITHACA NY 14850 161542122 ACO NY CAYUGA MEDICAL CENTER AT ITHACA C 0.50000 1 CAYUGA AREA PLAN 101 DATES DRIVE ITHACA NY 14850 161298389 HEALTHCARE SERVICES NY CAYUGA MEDICAL CENTER AT ITHACA C 0.40000 1 CAYUGA PHYSICAN THERAPY 10 BRENTWOOD DRIVE ITHACA NY 14850 844286787 THERAPY SERVICES NY CAYUGA MEDICAL CENTER AT ITHACA C 1.00000 1 CAPTNER PARK APARTMENTS CMM LLC 101 DATES DRIVE ITHACA NY 14850 874003628 REAL ESTATE NY CAYUGA MEDICAL CENTER AT ITHACA C 1.00000 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 CAYUGA MEDICAL ASSOCIATES B 39736151 SUBSIDY CAYUGA MEDICAL ASSOCIATES J 3324474 LEASES CAYUGA MEDICAL ASSOCIATES K 157234 LEASES CAYUGA MEDICAL ASSOCIATES M 8968008 CONTRACTED SERVICES CAYUGA MEDICAL ASSOCIATES L 6212173 CONTRACTED SERVICES CAYUGA MEDICAL OFFICE BUILDING ASSOC K 555397 RENT CAYUGA MEDICAL CENTER FOUNDATION Q 242851 CONTRACTED SERVICES CAYUGA MEDICAL CENTER FOUNDATION M 114441 FUNDRAISING SERVICES TOMPKINS OFFICE MANAGEMENT SYSTEM K 56175 LEASES CAYUGA MEDICAL OFFICE BUILDING ASSOC P 194176 MAINTENANCE FEES CAYUGA MEDICAL OFFICE BUILDING ASSOC P 199366 CONTRACTED SERVICES CAYUGA MEDICAL EQUIPMENT L