2015-11-05T13:02:09-06:00 2014-12-31 990 2014-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 DATES DRIVE ITHACA NY 14850 JOHN B RUDD PRESIDENT/CEO 6072744441 2015-10-27 2014 2016-02-25 16:41:14Z JOHN B RUDD 101 DATES DRIVE ITHACA NY 14850 175881013 0 X WWW.CAYUGAMED.ORG X 1981 NY TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 13 11 1547 157 1392636 58893 490182 464475 171681227 165211198 7987250 8835206 1891702 1241298 182050361 175752177 8650 6750 0 0 88489906 89539701 0 0 0 81929749 88926772 170428305 178473223 11622056 -2721046 302594841 275899511 108446079 106052369 194148762 169847142 TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 0 0 134578583 6250 165072952 PATIENT SERVICE - GENERAL INPATIENT AND OUTPATIENT HOSPITAL CARE. SERVICES ARE PROVIDED TO THOSE IN NEED REGARDLESS OF THE PATIENTS ABILITY TO PAY, RACE, CREED, NATIONAL ORIGIN, LIFE CIRCUMSTANCES, OR DISEASE. CAYUGA MEDICAL CENTER WORKS CLOSELY WITH THE COMMUNITY TO DETERMINE HEALTH NEEDS AND TO SUPPORT THE DEVELOPMENT OF PROGRAMS AND SERVICES THAT IMPROVE THE HEALTH STATUS OF THE COMMUNITY. 500 500 A HEALTH CAREER SCHOLARSHIP AWARDED TO STUDENTS PURSUING A HEALTHCARE DEGREE. ONE PARTICIPANT IN 2014. 134579083 1 1 0 1 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 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 144 0 1 1547 1 1 1 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JOHN COLLETT VPCFO 6072744441 101 DATES DRIVE ITHACA NY 14850 JOHN B RUDD PRESIDENT/CEO 40.00 X X 469701 0 28111 LARRY BAUM CHAIR 1.00 X X 0 0 0 JOANNE DESTEFANO DIRECTOR 1.00 X 0 0 0 TONY EISENHUT DIRECTOR 1.00 X 0 0 0 SAMI HUSSEINI MD SECRETARY 1.00 X X 0 0 0 BRIAN MCAREE VICE CHAIR 1.00 X X 0 0 0 JOHN NEUMAN DIRECTOR 1.00 X 0 0 0 PAULA YOUNGER DIRECTOR 1.00 X 0 0 0 GREG HARTZ TREASURER 1.00 X X 0 0 0 JOHN LAMBERT MD DIRECTOR 1.00 X 0 0 0 REV KEVIN CLARK DIRECTOR 1.00 X 0 0 0 HENRY D GERSON MD DIRECTOR/PSYCHIATRIST 40.00 X 328982 0 10311 STEVEN A ROGERS MD DIRECTOR 1.00 X 0 0 0 JOHN COLLETT VP/CFO 40.00 X 251466 0 23000 TIMOTHY BAEL MD DIRECTOR/ONCOLOGIST 40.00 X 628849 0 11248 CHARLES GARBO MD ONCOLOGIST 40.00 X 565788 0 10311 JULIE CAMPBELL MD ONCOLOGIST 40.00 X 467022 0 10311 DAVID EVELYN MD MEDICAL DIRECTOR/V.P 40.00 X 334234 0 28111 SRISATISH DEVAPATLA MD NEONATOLOGIST 40.00 X 405025 0 11091 3451067 0 132494 68 0 1 0 LP CIMINELLI 2421 MAIN ST BUFFALO NY 14214 CONSTRUCTION SERVICES 7200022 CAYUGA ANESTHESIA ASSOCIATES PLLC PO BOX 366 ITHACA NY 14850 ANESTHESIOLOGY SERVICES 3021951 LECHASE CONSTRUCTION SERVICES 205 INDIGO CREEK DR ROCHESTER NY 14626 CONSTRUCTION SERVICES 1933510 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 LABORATORY SERVICES 1738540 GE HEALTHCARE PO BOX 640944 PITTSBURGH PA 15264 EQUIPMENT LEASING 1423955 35 216333 248142 464475 NET PATIENT SERVICE RE 900099 162575003 162575003 CAFETERIA MEALS REVENU 722210 1331489 1331489 MEDICAL SERVICES REVEN 621400 816611 816611 ATHLETIC TRAINING REVE 621990 363984 363984 RENTAL INCOME 531120 83840 83840 40271 40271 165211198 3592863 83627 34385 3474851 20304 23916 -3612 -3612 -3612 5347263 0 104920 5347263 -104920 5242343 -104920 5347263 PROFESSIONAL SERVICES 541200 1178705 1178705 OTHER OPERATING REVENU 900099 66205 -116953 183158 1244910 175752177 165072952 1392636 8822114 6750 6750 1111571 1111571 62273495 47885904 14387591 7086111 5353388 1732723 14655160 11071623 3583537 4413364 3337425 1075939 2451695 974817 1476878 448034 336026 112008 145955 145955 27797 27797 70000 70000 10372201 5066181 5306020 918250 918250 39020024 35031172 3988852 2407140 1805355 601785 4286951 2894225 1392726 277943 132821 145122 1217156 1217156 13313201 7378385 5934816 1488873 1293235 195638 PURCHASED SERVICES 7387222 7049358 337864 BAD DEBT EXPENSE 4875953 4875953 PHYSICIAN ADVANCE FORGI 111315 111315 LICENSE/CERTIFICATES/PE 107062 86465 20597 178473223 134579083 43894140 0 6535 6634 9908975 7401730 45358471 31993873 324314 227544 7010742 7120805 10115671 11224685 231555669 113762534 111331517 117793135 101008061 82786909 1529995 1564717 16000560 15779479 302594841 275899511 54779951 56887967 41698508 38542601 11967620 10621801 108446079 106052369 X 189927037 165311435 2828190 3142172 1393535 1393535 194148762 169847142 302594841 275899511 X -2721046 -3720730 -4970565 -12889279 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 27779 0 27779 0 1647374 41237 105 14196 1674520 1734183 261328 97 348234 1647374 1393535 1393535 1393535 1393535 1393535 1393535 0.83220 0.16780 0 0 2829462 2829462 126662970 51467594 75195376 2420481 1363133 1057348 84873645 57584158 27289487 14769111 3347649 11421462 117793135 BENEFICIAL INTEREST IN ASSETS OF FOUNDATION 5788434 EQUITY IN RELATED PARTIES 3956211 INSURANCE RECEIVABLE 5107097 UNAMORTIZED BOND COSTS 927737 15779479 DUE TO THIRD PARTY PAYERS 7196167 FAIR VALUE OF INTEREST RATE SWAP 472291 ACCRUED INSURANCE CLAIMS 2953343 10621801 X 154290131 -3720730 -17741316 -21462046 175752177 0 175752177 173621186 23916 23916 173597270 4875953 4875953 178473223 PART V, LINE 4: THE INTENDED USE FOR THE ENDOWMENT FUND OF THE CAYUGA MEDICAL CENTER AT ITHACA IS TO SUPPORT THE HOSPITAL'S ONGOING MISSION TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. PART X, LINE 2: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER HAS ALSO BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS AN ENTITY THAT IS NOT A PRIVATE FOUNDATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INTEREST RATE SWAP 225,055. PENSION AND POST RETIREMENT RELATED CHANGES -2,072,745. RENTAL EXPENSES 23,916. TRANSFERS TO RELATED PARTIES -11,041,589. BAD DEBT EXPENSE -4,875,953. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 23,916. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,875,953. 1 1 1 X 1 X 1 1 0 1 1 118099 0 118099 0.00070 21722369 17043028 4679341 0.02620 21840468 17043028 4797440 0.02690 14002030 743544 13258486 0.07430 732108 732108 0.00410 9615502 4703100 4912402 0.02750 71324 71324 0.00040 24420964 5446644 18974320 0.10630 46261432 22489672 23771760 0.13320 1 4875953 1597362 35682511 54379174 -18696663 X 1 0 1 1 CAYUGA MEDICAL CENTER AT ITHACA 101 DATES DRIVE ITHACA NY 14850 WWW.CAYUGAMED.ORG 5401001H X X X CAYUGA MEDICAL CENTER AT ITHACA 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.CAYUGAMED.ORG/DOCS/CHNA_FNAL.PDF X 1 14 1 WWW.CAYUGAMED.ORG/DOCS/2014COMMBENEFITSREPORTS.PDF 0 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X X X X X X X X 1 X 0 X X X X 1 X 0 0 CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 5: THE QUALITATIVE PROCESS PROVIDED CRUCIAL COMMUNITY INPUT INTO THIS ASSESSMENT. INFORMATION FOR THIS ASSESSMENT WAS COLLECTED THROUGH FOUR MEANS. FIRST, CMC CONDUCTED A META-REVIEW OF THE QUALITATIVE INFORMATION GATHERED FROM THE SIX LOCAL HEALTH DEPARTMENTS. SECOND, CMC PARTICIPATED IN AND USED THE INFORMATION GATHERED THROUGH THE TOMPKINS COUNTY HEALTH PLANNING COUNCIL'S COMMUNITY HEALTH SURVEY. THE SURVEY WAS RELEASED IN MAY 2013 TO AN ONLINE LISTSERV TO SOLICIT INPUT FROM NUMEROUS COMMUNITY ORGANIZATIONS TO DETERMINE PRIORITY HEALTH FOCUS AREAS. THIRD, CAYUGA MEDICAL CENTER CONDUCTED SEVERAL FOCUS GROUPS DURING THE SUMMER OF 2013 WITH MEMBERS OF OUR PRIMARY SERVICE AREA. THE FOCUS GROUPS THAT CAYUGA MEDICAL CENTER HELD SERVED TO TARGET HARDER TO REACH POPULATIONS IN ORDER TO UNDERSTAND SOME OF THE KEY NEEDS ASSOCIATED WITH THEIR LOCAL ENVIRONMENT. FINALLY, ACROSS OUR ORGANIZATION MANY OF OUR 35 DIRECTORS AND ALL OF OUR SENIOR LEADERSHIP STRUCTURE PARTICIPATE IN LOCAL COMMUNITY BOARDS. AS SUCH, THIS LEVEL OF INVOLVEMENT AND PARTICIPATION PROVIDES CMC WITH AN UNDERSTANDING OF COMMUNITY CONCERNS AND HEALTH NEEDS THROUGH DIFFERING COMMUNITY LENSES. CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 11: CMC HAS FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COUNCIL TO ADDRESS THE SIX NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT PROCESS. HEALTH NEEDS NOT ADDRESSED BY THE DOCUMENT INCLUDE: % OF POPULATION (ALL AGES) LIVING IN POVERTY, % OF POPULATION (UNDER AGE 18) LIVING IN POVERTY, % OF SINGLE PARENT-HOUSEHOLDS WITH CHILDREN UNDER THE AGE OF 18 LIVING IN THE HOME, PERCENT OF INDIVIDUALS UNINSURED AND THE HOUSING AFFORDABILITY RATE. CMC IS NOT DIRECTLY ADDRESSING THESE HEALTH CONDITIONS. CMC IS HOWEVER ALIGNED WITH AND SUPPORTS THE UNITED WAY IN TOMPKINS COUNTY WHICH HELPS ADDRESS HOUSING AND POVERTY NEEDS. CMC ADDITIONALLY IS ALIGNED WITH THE HEALTH PLANNING COUNCIL WHICH ASSISTS IN ENROLLING INDIVIDUALS INTO MEDICAID AND OTHER AFFORDABLE INSURANCE PROGRAMS AND CMC PROVIDES SPACE AT THE HOSPITAL FOR ENROLLMENT OF INDIVIDUALS INTO THESE PROGRAMS. CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 22D: THE HOSPITAL USED THE RATES NEGOTIATED WITH ITS HIGHEST VOLUME COMMERCIAL PAYOR. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 16A WEBSITE: WWW.CAYUGAMED.ORG CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 16B WEBSITE: WWW.CAYUGAMED.ORG CAYUGA MEDICAL CENTER AT ITHACA PART V, SECTION B, LINE 16C WEBSITE: WWW.CAYUGAMED.ORG PART III, LINE 2: THE MEDICAL CENTER PROVIDES SERVICES THAT ARE PAID FOR BY THIRD-PARTY PAYERS AND INDIVIDUALS. THE MEDICAL CENTER DOES NOT ACCRUE INTEREST ON THESE RECEIVABLES. THE MEDICAL CENTER ESTIMATES THE AMOUNT TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS FOR DOUBTFUL ACCOUNTS BY ANALYZING PATIENT ACCOUNTS FOR COLLECTIBILITY AND APPLYING HISTORICALLY ESTABLISHED PERCENTAGES FOR SELF-PAY AND VARIOUS THIRD-PARTY PAYERS TO THE AGING CATEGORIES IN THE ACCOUNTS RECEIVABLE AGING. ACCOUNTS FOR WHICH NO PAYMENTS HAVE BEEN RECEIVED FOR A SIGNIFICANT AMOUNT OF TIME ARE CONSIDERED DELINQUENT AND THE ACCOUNT IS WRITTEN-OFF WHEN CUSTOMARY COLLECTION EFFORTS ARE EXHAUSTED. PART III, LINE 3: FOR CALCULATING THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY OF THE MEDICAL CENTER, THE DENIAL RATE WAS APPLIED TO THE REPORTED BAD DEBT EXPENSE. THIS ALLOWS THE MEDICAL CENTER TO BE CONSERVATIVE IN THE ESTIMATE OF WHAT AMOUNT THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS. PART III, LINE 4: THE PAGE NUMBER IN THE ATTACHED FINANCIAL STATEMENTS ON WHICH THE FOOTNOTE IS CONTAINED THAT DESCRIBES BAD DEBT IS PAGE 5, FOOTNOTE # 2 - SUMMARY SIGNIFICANT ACCOUNTING POLICIES - NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: THE COST TO CHARGE RATIO OF 56% WAS CALCULATED FROM OUR FACILITIES COST ACCOUNTING SYSTEM BASED ON THE TOTAL COST TO TOTAL CHARGES ON MEDICARE ACCOUNT ONLY WAS APPLIED TO THE MEDICARE GROSS PATIENT REVENUE OF $98,554,933. THE RESULT WAS THEN REDUCED BY THE WORKSHEET 6 MEDICARE COSTS OF $811,588 FOR THE FY 2014. 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. 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 O ACCESS TO HEALTH CARE * HEALTH STATUS OF OVERALL POPULATION AND PRIORITY POPULATIONS * RISK FACTOR BEHAVIORS AND CONDITIONS RELATED TO TOP 5 CAUSES OF DEATH * CHILD HEALTH * INFECTIOUS DISEASES * NATURAL ENVIRONMENT * SOCIAL AND MENTAL HEALTH ENVIRONMENT * RESOURCES/ASSETS FOR EVERY INDICATOR, COMPARISONS WERE MADE UTILIZING THE MEAN VALUE FOR EACH INDIVIDUAL COUNTY, THE AGGREGATE VALUE FOR THE TOTAL COMMUNITY, THE NEW YORK STATE W/O NEW YORK CITY (NYC) STATE VALUE, AND THE U.S. VALUE WHERE APPLICABLE TO GENERATE CONTEXT FOR INTERPRETATION. THE QUALITATIVE PROCESS PROVIDED CRUCIAL COMMUNITY INPUT INTO THIS ASSESSMENT. INFORMATION FOR THIS ASSESSMENT WAS COLLECTED THROUGH FOUR MEANS. FIRST, CMC CONDUCTED A META-REVIEW OF THE QUALITATIVE INFORMATION GATHERED FROM THE SIX LOCAL HEALTH DEPARTMENTS. SECOND, CMC PARTICIPATED IN AND USED THE INFORMATION GATHERED THROUGH THE TOMPKINS COUNTY HEALTH PLANNING COUNCIL'S COMMUNITY HEALTH SURVEY. THIRD, CAYUGA MEDICAL CENTER CONDUCTED SEVERAL FOCUS GROUPS DURING THE SUMMER OF 2013 WITH MEMBERS OF OUR PRIMARY SERVICE AREA. FINALLY, FEEDBACK FROM DIRECTORS AND SENIOR LEVEL EXECUTIVES WITH COMMUNITY BOARD INVOLVEMENT ABOUT COMMUNITY CONCERNS AND HEALTH NEEDS THROUGH DIFFERING COMMUNITY LENSES. PART VI, LINE 3: PATIENTS WHO REQUEST A FINANCIAL ASSISTANCE APPLICATION ARE PROVIDED WITH THE ORGANIZATION'S POLICY AND ARE CONNECTED WITH A FINANCIAL COUNSELOR. THE ORGANIZATION HAS FACILITATED ENROLLERS FROM MEDICAID MANAGED CARE PLANS ON-SITE AND REFERS PATIENTS TO THEM FOR DETERMINATION OF MEDICAID ELIGIBILITY. IN ADDITION, INFORMATION ON THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY, MEDICARE, AND MEDICAID ENROLLMENT IS AVAILABLE ON WWW.CAYUGAMED.ORG. PART VI, LINE 4: LOCATED IN THE FINGER LAKES REGION, CMC SERVES POPULATIONS FROM SIX COUNTIES, CAYUGA, CORTLAND, SCHUYLER, SENECA, TIOGA AND TOMPKINS COUNTIES. MANY OF THESE AREAS ARE DESIGNATED RURAL COUNTIES AND TOMPKINS COUNTY IS NYS'S SMALLEST METROPOLITAN STATISTICAL AREA. THE TOTAL SERVICE AREA SPANS APPROXIMATELY 1,000 SQUARE MILES IN THE MIDDLE OF THE STATE WITH AN AVERAGE POPULATION DENSITY OF FEWER THAN 125 PERSONS PER SQUARE MILE.THERE ARE SEVERAL DISTINCT HEALTH AND HEALTH-RELATED FACTORS AFFECTING RESIDENTS OF THIS AREA:*THE REGION IS HOME TO AN OLDER COMMUNITY. ACCORDING TO 2012 CENSUS ESTIMATES, 14% OF ADULTS ARE 55-59 YEARS OF AGE (COMPARED TO 7% OF ADULTS IN NYS AND 6% OF ADULTS NATIONALLY). SINCE THE 2000 CENSUS, GROWTH IN THE 65+ AGE COHORT HAS RANGED FROM 15% TO 32% ACROSS THE REGION AND IS PROJECTED TO INCREASE BETWEEN 14% AND 19% OVER THE NEXT FIVE YEARS. FROM 2000 - 2013 THERE HAS BEEN ASTOUNDING GROWTH-FROM 45% TO 78%-OF ADULTS AGED 55 - 64; THIS POPULATION IS PROJECTED TO INCREASE ANOTHER 4% BY 2018. ISSUES WITH CHRONIC DISEASE AND PSYCHOLOGICAL DISTRESS ARE WELL DOCUMENTED FOR THIS DEMOGRAPHIC. OVERALL, 22.9% OF ADULTS AGED 55 AND OVER ARE LIKELY TO BE IN FAIR OR POOR HEALTH, RANGING FROM 19.6% OF THOSE AGED 55-64 TO 32.1% OF THOSE AGED 85 AND OVER (NATIONAL HEALTH STATISTICS REPORTS, HEALTH CHARACTERISTICS OF ADULTS AGED 55 YEARS AND OVER: UNITED STATES, 2004-2007, CDC, 2009). *ACCESS TO HEALTH CARE PROFESSIONALS WITHIN THE REGION IS PROBLEMATIC. MANY OF THE COUNTIES HAVE ZIP CODES WITHIN THAT COUNTY WITH HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) DESIGNATIONS FOR PHYSICIAN, DENTAL, AND MENTAL HEALTH CARE FOR MEDICAID BENEFICIARIES. EVEN WHEN A PROVIDER IS AVAILABLE, THE RURAL ENVIRONMENT, DEFINED BY HILLY TERRAINS AND LAKES AS GEOGRAPHIC BARRIERS, CREATES TRANSPORTATION CHALLENGES THAT CAN LIMIT ACCESS.*IN AGGREGATE, RESIDENTS OF THE SERVICE AREA ARE FISCALLY CHALLENGED. THE MEDIAN SALARY WITHIN THE REGION IS $48,424, WHICH IS $9,000 BELOW THE STATE AVERAGE. THE MEDIAN HOUSEHOLD INCOME FOR NEARLY 75% OF CMC'S SERVICE AREA IS BELOW THE SELF-SUFFICIENCY STANDARD. OF NOTE, AGRICULTURE AND SEASONAL TOURISM ARE SIGNIFICANT INDUSTRIES WITHIN THIS REGION. PART VI, LINE 5: *THE MAJORITY OF CAYUGA MEDICAL CENTER'S BOARD OF DIRECTORS ARE ALL RESIDENTS OF TOMPKINS COUNTY-CMC'S PRIMARY SERVICE AREA.*ANY QUALIFIED HEALTH CARE PROFESSIONAL THAT MEETS THE HIGH QUALITY STANDARDS OF OUR CREDENTIALING PROCESS MAY APPLY AND SECURE MEDICAL STAFF PRIVILEGES WITHIN AN IDENTIFIED DEPARTMENT OR SPECIALTY.*AS A 501C(3) ORGANIZATION, CMC REINVESTS ANY SURPLUS IN FUNDS TO IMPROVEMENTS IN MEDICAL CARE, INCLUDING PATIENT-SIDE AND TECHNOLOGY IMPROVEMENTS, FACILITY STRUCTURE AND INFRASTRUCTURE, AND IMPROVEMENTS IN CARE DELIVERY. PART VI, LINE 6: AS OF OCTOBER 2014, CMC IS NOW A SUBSIDIARY MEMBER OF CAYUGA HEALTH SYSTEM. ALL SUBSIDIARY ORGANIZATIONS HAVE THEIR OWN SEPARATELY IDENTIFIED PRIMARY AND SECONDARY SERVICE AREAS AND ARE RESPONSIBLE FOR IMPROVING THE HEALTH OF THOSE COMMUNITIES. EACH SUBSIDIARY ORGANIZATION MAINTAINS ITS OWN BOARD OF DIRECTORS AND SEPARATE MEDICAL STAFFS. FIDUCIARY RESPONSIBILITIES ARE ADDITIONALLY SEPARATE AND DISTINCT. IN THE STRATEGIC PLAN OF EACH ORGANIZATION, THERE IS ALIGNMENT WITH THE IDENTIFIED COMMUNITY HEALTH NEEDS OF EACH ORGANIZATION'S PRIMARY SERVICE AREA. PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 EMPLOYEE DISASTER FUND 13 6250 BOOK KOMARMI SCHOLARSHIP 1 500 BOOK PART I, LINE 2: THE EMPLOYEE DISASTER FUND (EDF) IS TO PROVIDE TEMPORARY AID TO EMPLOYEES WITH A DISASTER OR OTHER EMERGENCY HARDSHIP SITUATION. THE EDF COMMITTEE IS COMPRISED OF HOSPITAL EMPLOYEES, WITH A MAJORITY OF THE MEMBERS BEING IN A NON-MANAGEMENT POSITION. TO BE ELIGIBLE FOR ASSISTANCE, APPLICANTS MUST MEET CERTAIN CRITERIA AS SPECIFIED IN THE EDF POLICY. THE EDF COMMITTEE MAKES AWARDS BASED ON THE MERITS OF EACH CASE IN ACCORDANCE WITH THE POLICY. THE EDF COMMITTEE MAINTAINS COMPLETE AND ACCURATE MINUTES OF ITS PROCEEDINGS. THE KOMARMI SCHOLARSHIP IS A HEALTH CAREER SCHOLARSHIP THAT IS ADMINISTERED BY A COMMITTEE MADE UP OF TWO VOLUNTEER COMMUNITY MEMBERS, A REPRESENTATIVE FROM THE BOARD OF DIRECTORS AND A MEMBER OF THE ADMINISTRATIVE TEAM. THE COMMITTEE IDENTIFIES SPECIFIC AREAS EACH YEAR IN THE HOSPITAL WHICH ARE EXPERIENCING OR ANTICIPATING RECRUITMENT DIFFICULTIES RELATED TO THE SHORTAGE OF QUALIFIED CANDIDATES. THE COMMITTEE WORKS WITH THE ITHACA HIGH SCHOOL ADMINISTRATION TO IDENTIFY A GRADUATING SENIOR WHO IS PLANNING ON PURSUING A CAREER IN THE SELECTED HEALTH PROFESSION. THE AMOUNT OF THE SCHOLARSHIP CAN BE UP TO $1,000, TO BE AWARDED AT GRADUATION. X 1 1 X X X 0 0 0 0 0 1 0 0 0 JOHN B RUDD PRESIDENT/CEO 398476 0 71225 0 0 0 23000 0 5111 0 497812 0 0 0 HENRY D GERSON MD DIRECTOR/PSYCHIATRIST 328982 0 0 0 0 0 5200 0 5111 0 339293 0 0 0 JOHN COLLETT VP/CFO 222666 0 28800 0 0 0 23000 0 0 0 274466 0 0 0 TIMOTHY BAEL MD DIRECTOR/ONCOLOGIST 544941 0 83908 0 0 0 5200 0 6048 0 640097 0 0 0 CHARLES GARBO MD ONCOLOGIST 536721 0 29067 0 0 0 5200 0 5111 0 576099 0 0 0 JULIE CAMPBELL MD ONCOLOGIST 424770 0 42252 0 0 0 5200 0 5111 0 477333 0 0 0 DAVID EVELYN MD MEDICAL DIRECTOR/V.P 291746 0 42488 0 0 0 23000 0 5111 0 362345 0 0 0 SRISATISH DEVAPATLA MD NEONATOLOGIST 385025 0 20000 0 0 0 5200 0 5891 0 416116 0 0 0 PART I, LINE 1A PART I, LINE 1A: ALL EMPLOYEES ARE ELIGIBLE FOR A HEALTH CLUB MEMBERSHIP SUBSIDY, CAYUGA MEDICAL CENTER WILL REIMBURSE EMPLOYEES 50% OF THE SINGLE MONTHLY MEMBERSHIP FEE WHEN THEY ATTEND THE HEALTH CLUB AT LEAST 24 TIMES A QUARTER. IF AN INDIVIDUAL DOES NOT MEET THE CRITERIA, THEY WILL NOT RECEIVE THE SUBSIDY. PART I, LINE 6 YEAR END BONUS PROGRAM FOR ALL EMPLOYEES WAS BASED ON THE OPERATING MARGIN, PARTICIPATION IN THE ANNUAL SAFETY TRAINING AND REACHING PREDETERMINED CUSTOMER SATISFACTION SCORES. BONUSES PAID TO JOHN RUDD, JOHN COLLETT AND DAVID EVELYN, M.D. WERE EARNED IN 2013. PAYMENT OF THE 2013 MANAGEMENT BONUSES TOOK PLACE IN 2014 ONCE THE AUDITED FINANCIAL STATEMENTS WERE MADE AVAILABLE. STAFF BONUSES EARNED IN 2013 WERE PAID TO STAFF IN 2013. NO BONUSES WERE AWARDED TO ANY EMPLOYEE IN 2014. A TOMPKINS COUNTY AREA DEVELOPMENT INC 166058339 2003-10-09 15000000 FINANCE CONSTRUCTION & PURCHASE EQUIPMENT 0 0 0 B TOMPKINS COUNTY DEVELOPMENT CORP 272290745 890096AA8 2010-08-31 14275000 FINANCE CONSTRUCTION & PURCHASE EQUIPMENT 0 0 0 C TOMPKINS COUNTY DEVELOPMENT CORP 272290745 2013-04-09 25000000 FINANCE CONSTRUCTION & PURCHASE EQUIPMENT 0 0 0 A 15000000 205375 269000 14525625 2003 0 0 1 1 B 14275000 285500 142750 13846750 2010 0 0 1 1 C 25000000 613238 24386762 0 0 1 1 A 0 0 1 1 0 0.00820 0.00820 1 0 1 B 0 0 0 0 1 0 1 C 0 0 0 0 1 0 1 A 1 1 1 JP MORGAN 15.000000000000 0 0 0 0 0 B 1 1 1 DEUTSCHE BANK 12.000000000000 0 0 0 0 0 C 1 0 0 0 0 0 A 0 B 0 C 0 LARRY BAUM BOARD CHAIR & CEO OF THE COMPUTING CENTER 491726 PAYMENTS TO THE COMPUTING CENTER FOR CERTAIN COMPUTER PRODUCTS, CONSUMABLES AND SERVICE 0 GREGORY HARTZ BOARD DIRECTOR & PRESIDENT/CEO OF TOMPKINS TRUST COMPANY (TTC) 174011 PAYMENTS TO TTC FOR BANK FEES 0 STEVEN ROGERS MD DIRECTOR & OWNER OF TRIPHAMMER MEDICAL REALTY 146118 PAYMENTS TO TRIPHAMMER MEDICAL REALTY FOR RENTAL OF SPACE 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM IS REVIEWED WITH THE FINANCE, AUDIT AND PERSONNEL COMMITTEE AND IS MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CAYUGA MEDICAL CENTER AT ITHACA MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN ANNUALLY. THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATEMENTS ANNUALLY FOR CONFLICTS, IDENTIFYING DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDING RELATED TO A CONFLICT OF INTEREST TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 CAYUGA MEDICAL CENTER AT ITHACA DETERMINES COMPENSATION OF THE CEO AND OTHER OFFICERS BY UTILIZING INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEYS. FORMAL WRITTEN CONTRACT FOR CEO IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 CAYUGA MEDICAL CENTER AT ITHACA FOLLOWS THE IRS DISCLOSURE REQUIREMENTS AND ALL REQUIRED DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION AND POST RETIREMENT RELATED CHANGES -2,072,745. UNREALIZED GAIN ON INTEREST RATE SWAP 225,055. RESERVE FOR CMA LOAN -11,041,589. 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