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      <UnableToProvideCareInd>0</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>460209</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>460209</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00250</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>37885970</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>24377649</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13508321</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.07280</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>38346179</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>24377649</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13968530</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.07530</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>38346179</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>24377649</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>13968530</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.07530</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>7885154</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>460209</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>75724259</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>89998199</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-14273940</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>17 LANSING STREET</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </HospitalFacilityName>
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        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>22</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>0</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>0</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>HTTPS://WWW.AUBURNHOSPITAL.ORG/ABOUT-US/</OwnWebsiteURLTxt>
        <OtherWebsiteInd>X</OtherWebsiteInd>
        <OtherWebsiteURLTxt>HTTPS://WWW.CAYUGACOUNTY.US/1760/COMMUNITY-HEALTH-ASSESSMENT</OtherWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>22</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>HTTPS://WWW.AUBURNHOSPITAL.ORG/ABOUT-US/</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>HTTPS://AUBURNHOSPITAL.ORG/PATIENTS-AND-VISITORS/PATIENT-POLICIES-AND-FORMS</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>HTTPS://WWW.AUBURNHOSPITAL.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>HTTPS://WWW.AUBURNHOSPITAL.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitLegalJudicialProcessInd>X</PermitLegalJudicialProcessInd>
        <CollectionActivitiesInd>1</CollectionActivitiesInd>
        <EngagedLegalJudicialProcessInd>X</EngagedLegalJudicialProcessInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <ProspectiveMedicareMedicaidInd>X</ProspectiveMedicareMedicaidInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>AUBURN COMMUNITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: THIS COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COVERING THREE YEARS REFLECTS THE COLLABORATIVE PARTNERSHIP PROCESS BETWEEN AUBURN COMMUNITY HOSPITAL (ACH), CAYUGA COUNTY HEALTH DEPARTMENT (CCHD), KEY COMMUNITY STAKEHOLDERS AND RESIDENTS OF CAYUGA COUNTY. THE CHNA DEMONSTRATES ACH'S CURRENT AND FUTURE COMMITMENT, BOTH CLINICALLY AND FINANCIALLY, TO IMPROVE THE COMMUNITY'S HEALTH STATUS BY FULFILLING ITS MISSION TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF THE COMMUNITY. THE HEALTH OF THE COMMUNITY IS DEFINED BY THE MENTAL, PHYSICAL, SOCIAL, AND SPIRITUAL WELL-BEING OF ITS RESIDENTS. UNDERSTANDING HOW DIFFERENT DETERMINANTS AFFECT HEALTH AND FINDING WAYS TO IMPROVE UPON THEM IS CRUCIAL IN PROMOTING AND SUSTAINING HEALTH WITHIN A COMMUNITY. THE CHNA, WHICH IS GUIDED BY COMMUNITY INPUT, SERVES AS A SYSTEMATIC TOOL IN THE APPROACH TO RETRIEVING, EXAMINING, AND USING DATA TO IDENTIFY THE KEY HEALTH PRIORITIES WITHIN THE COMMUNITY. THIS CHNA REPORT SERVES AS THE FOUNDATION FOR IMPROVING HEALTH, WELLNESS AND THE QUALITY OF LIFE FOR RESIDENTS IN CAYUGA COUNTY. ACH UNDERSTANDS THE SIGNIFICANCE OF IDENTIFYING AND PRIORITIZING HEALTH NEEDS IN DRIVING IMPACTFUL AND POSITIVE CHANGE IN HEALTH RISK FACTORS OF THE COMMUNITY. FINDINGS WITHIN THE CHNA ALLOW ACH TO UNDERSTAND AND ANTICIPATE SERVICES WHICH ARE MOST DESIRED AND EFFECTIVE AS IT RELATES TO GLOBAL HEALTHCARE DELIVERY, PATIENT-CENTERED CARE AND POSITIVE HEALTH OUTCOMES. NEW YORK STATE PREVENTION AGENDA OBJECTIVES AND NEW YORK STATE COMMUNITY HEALTH INDICATOR REPORTS (CHIRS) FOR CAYUGA COUNTY WERE REFERENCED DURING A REVIEW OF SECONDARY RESEARCH, ALONG WITH PRIMARY RESEARCH CONDUCTED BY RMS HEALTHCARE, A DIVISION OF RESEARCH &amp; MARKETING STRATEGIES, INC. (RMS HEALTHCARE). THE QUANTITATIVE RESEARCH INCLUDED THE COLLECTION AND ANALYSIS OF ON-LINE SURVEY DATA FROM THE VARIOUS STAKEHOLDER GROUPS. THE QUALITATIVE WORK INCLUDED: IN-DEPTH INTERVIEWS (IDI'S) WITH KEY COMMUNITY STAKEHOLDERS RESIDING IN CAYUGA COUNTY. THE COMBINATION OF PRIMARY AND SECONDARY RESEARCH FINDINGS WAS USED AS A KEY REFERENCE GUIDE FOR THE 2022-2024 CHNA DEVELOPMENT. OVER TIME, THE PRIORITIES OF ACH HAVE CHANGED TO REFLECT THE GROWING HEALTHCARE NEEDS AND CHANGING DEMOGRAPHICS OF CAYUGA COUNTY RESIDENTS. THE ISSUES BROUGHT TO LIGHT IN THIS REPORT REPRESENT THE CULMINATION OF COMMUNITY COLLABORATION TO IMPROVE THE SOCIAL ENVIRONMENT IN WHICH RESIDENTS RESIDE AND WHERE SERVICES ARE PROVIDED. ACH REMAINS COMMITTED IN TRANSITIONING ITS CARE MODEL TO SUPPORT MANAGING POPULATIONS OF PATIENTS, WITH SPECIFIC ATTENTION TO SOCIAL DETERMINANTS OF HEALTH, RECOGNIZING THAT HEALTH AND WELL-BEING ARE SHAPED NOT ONLY BY BEHAVIOR CHOICES OF INDIVIDUALS, BUT ALSO BY COMPLEX FACTORS THAT INFLUENCE INDIVIDUAL CHOICES. THROUGHOUT 2022, 2023, AND 2024, AUBURN COMMUNITY HOSPITAL CONTINUES TO WORK CLOSELY WITH CAYUGA COUNTY TO MONITOR AND EVALUATE THE CONTINUED NEEDS OF THE COMMUNITY INCLUDING REGULAR MEETINGS AND CONTACT WITH INTERESTED MEMBERS OF THE COMMUNITY.IN THE LATEST ASSESSMENT THE COMBINATION OF DATA COLLECTION AND ANALYSIS, ALONG WITH THOUGHTFUL REVIEW OF WHAT LOCAL COMMUNITY RESOURCES AND PROGRAMS ARE ALREADY IN PLACE, WERE USED AS KEY REFERENCES FOR THE DEVELOPMENT OF THE CCHD AND ACH'S 2022-2024 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND COMMUNITY SERVICES PLAN (CSP). THE 2022-2024 CHIP/CSP WILL ADDRESS THE FOLLOWING PREVENTION AREAS:1) PREVENT CHRONIC DISEASES;2) PROMOTE A HEALTHY &amp; SAFE ENVIRONMENT;3) PROMOTE WELL-BEING AND PREVENT MENTAL &amp; SUBSTANCE USE DISORDERS; AND4) PROMOTE HEALTHY WOMEN, INFANTS, &amp; CHILDREN.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>AUBURN COMMUNITY HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 20E: AUBURN COMMUNITY HOSPITAL DOES NOT MAKE PRESUMPTIVE ELIGIBILITY DETERMINATIONS. THE HOSPITAL ONLY DETERMINES ELIGIBILITY FROM COMPLETED APPLICATIONS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>3</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - FINGER LAKES CENTER FOR LIVING</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>20 PARK AVENUE</AddressLine1Txt>
            <CityNm>AUBURN</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13021</ZIPCd>
          </USAddress>
          <FacilityTxt>SHORT-TERM REHABILITATION AND LONG-TERM RESIDENTIAL CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - FINGER LAKES MEDICAL CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>303 GRANT AVENUE</AddressLine1Txt>
            <CityNm>AUBURN</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13021</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - URGENT MEDICAL CARE OF SKANEATELES</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>803 GENESEE STREET</AddressLine1Txt>
            <CityNm>SKANEATELES</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>13152</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6A:</FormAndLineReferenceDesc>
        <ExplanationTxt>AUBURN COMMUNITY HOSPITAL (ACH) IS LOCATED IN AUBURN, NY, AND IS A NOT-FOR-PROFIT, 99-BED ACUTE CARE HOSPITAL SERVING A MOSTLY RURAL POPULATION OF APPROXIMATELY 80,000 COMMUNITY MEMBERS THROUGHOUT AUBURN, CAYUGA COUNTY, THE WESTERN BORDERS OF ONONDAGA COUNTY, EASTERN EDGES OF SENECA COUNTY AND THE NORTHERN BORDERS OF TOMPKINS COUNTY. THE HOSPITAL IS THE LARGEST EMPLOYER IN CAYUGA COUNTY WITH OVER 1400 EMPLOYEES. AUBURN IS BOTH A SAFETY NET AND SOLE COMMUNITY PROVIDER HOSPITAL PROVIDING INPATIENT MEDICAL CARE, EMERGENCY MEDICINE, INPATIENT PSYCHIATRIC CARE, BIRTHING SERVICES AND A SUITE OF OUTPATIENT SERVICES TO THE COMMUNITIES IT SERVES INCLUDING CANCER CARE. ADDITIONALLY, AUBURN OPERATES THE FINGER LAKES CENTER FOR LIVING, A 5 STAR RATED, 80-BED SKILLED NURSING FACILITY CONNECTED TO THE HOSPITAL. AUBURN ALSO OPERATES TWO URGENT CARE CENTERS IN ITS COMMUNITIES: FINGER LAKES MEDICAL CARE CENTER AND URGENT MEDICAL CARE OF SKANEATELES. AUBURN ALSO OPERATES A MULTI-SPECIALTY PHYSICIAN GROUP (AUBURN MEMORIAL MEDICAL SERVICES), A PRACTICE THAT BRINGS CONVENIENT AND HIGH-QUALITY ACCESS TO 24 SPECIALTY CARE TO THE GREATER AUBURN COMMUNITY.AUBURN COMMUNITY HOSPITAL ALSO OPERATES OUR SPECIALIZED PHYSICIAN PRACTICE, AUBURN MEMORIAL MEDICAL SERVICES, PC, (AMMS) WHICH PROVIDES SPECIALIZED CARE SUCH AS NEUROLOGY, ORTHOPEDICS, OBGYN, NEPHROLOGY, PSYCHOLOGY, ENT, GASTROENTEROLOGY, SURGICAL SERVICES, PODIATRY, PULMONOLOGY, ENDOCRINOLOGY, UROLOGY, URGENT CARE AND PRIMARY CARE SERVICES. MANY OF THESE PHYSICIAN SERVICES WOULD BE UNAVAILABLE IN THE GREATER CAYUGA COUNTY COMMUNITY IF THE HOSPITAL DID NOT ASSUME THE LOSSES ASSOCIATED WITH OPERATING SOME OF THESE PRACTICES. AMMS,PC IS ALSO A NON-PROFIT ENTITY THAT SHARES THE HOSPITAL'S MISSION OF PROVIDING THE BEST CARE TO EVERY PATIENT, EVERY TIME. WE DO THIS BY PROVIDING PATIENTS COMPASSIONATE, LOW-COST HIGH-QUALITY CARE TO IMPROVE THE HEALTH OF OUR COMMUNITY. UNLESS MANY PRIVATE PRACTICES, ACH AND AMMS PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY. NO PATIENT IS EVER TURNED AWAY FOR FINANCIAL REASONS. AMMS,PC PROVIDED CARE FOR 36,925 PATIENTS THROUGHOUT THE PRACTICES WITH 149,964 TOTAL VISITS IN 2024. PROVIDING THESE SERVICES TO THE COMMUNITY RESULTED IN A LOSS OF $15,866,112 FOR 2024 OF WHICH THE HOSPITAL FUNDED $15,866,112 AS NOTED ON SCHEDULE R OF THE 990.AS A COMMUNITY HOSPITAL, ACH WORKS COLLABORATIVELY WITH MANY ENTITIES IN THE COMMUNITY TO ENSURE THAT HEALTHCARE AND ASSOCIATED SOCIAL DETERMINANTS OF HEALTH NEEDS ARE MET FOR FRIENDS, FAMILY AND NEIGHBORS. THROUGHOUT THE YEAR, ACH PROVIDES OR SUPPORTS NUMEROUS EVENTS, LEARNING OPPORTUNITIES AND EDUCATIONAL OFFERINGS THAT STRENGTHEN THOSE WE SERVE. THIS WORK IS REQUIRED AS PART OF OUR CHARTER AS A COMMUNITY HOSPITAL. AUBURN COMMUNITY HOSPITAL CONTINUES TO PARTNER WITH THE SAINT AGATHA FOUNDATION. THE SAINT AGATHA FOUNDATION WAS ESTABLISHED IN 2004 TO PROVIDE FINANCIAL ASSISTANCE TO INDIVIDUALS LIVING OR RECEIVING TREATMENT IN CENTRAL NEW YORK STATE WHO ARE AFFLICTED WITH BREAST CANCER. THE FOUNDATION IS DEDICATED TO PROVIDING SUPPORT, COMFORT, AND CARE TO BREAST CANCER PATIENTS THROUGH FINANCIAL ASSISTANCE PROGRAMS. IN 2024, ACH STAFF ATTENDED THE ANNUAL MEETING IN SYRACUSE FOR UPDATES, CURRENT INITIATIVES &amp; NETWORKING WITH PARTNERS OF THE PROGRAM. IN 2024, ACH PROVIDED PASS THROUGH FUNDING TO PATIENTS COVERING ITEMS SUCH AS PROSTHETIC BREASTS, WIGS, MEDICAL CO-PAYS, UTILITY BILLS, ETC. AUBURN COMMUNITY HOSPITAL PARTNERS WITH AUBURN ENLARGED CITY SCHOOL DISTRICT, AUBURN HIGH SCHOOL AND CAYUGA COMMUNITY COLLEGE TO PROVIDE A PAID WORK STUDY PROGRAM FOR STUDENTS INTERESTED IN THE MEDICAL FIELD TO GET HANDS ON EXPERIENCE. AUBURN COMMUNITY HOSPITAL PARTNERS WITH MANY LOCAL AND REGIONAL COLLEGES TO PLACE INTERNS IN VARIOUS ROLES, BOTH DURING THE TRADITIONAL SCHOOL YEAR AND DURING WINTER AND SUMMER RECESSES. IN 2024, THOSE INTERNS WORKED IN VARIOUS DEPARTMENTS INCLUDING DEVELOPMENT, MARKETING, AND IMAGING, ACH PARTNERS WITH THE CAYUGA COMMUNITY COLLEGE NURSING PROGRAM FOR RN CLINICALS AND WITH CAYUGA ONONDAGA BOCES FOR LPN AND CNA CLINICALS. THIS ALLOWS STUDENTS TO PERFORM THEIR CLINICAL REQUIREMENT NEEDED FOR THEIR LICENSE CLOSE TO HOME. ACH PROVIDES SPACE WITHIN THE HOSPITAL TO THE CAYUGA-ONONDAGA BOCES NEW VISIONS STUDENTS, PROVIDING AN INSIDE LOOK AT MEDICAL PROFESSIONS FOUND IN HOSPITALS AND ANCILLARY HEALTH CARE FACILITIES. THROUGH DAILY INVOLVEMENT WITH VARIOUS MEDICAL STAFF, STUDENTS LEARN WHAT IS REQUIRED OF HEALTH CARE PROFESSIONALS AND THE APPLICATION OF THEIR EDUCATION TO REAL-LIFE SITUATIONS ON THE JOB. STUDENTS WILL GAIN A BETTER UNDERSTANDING OF THE RESPONSIBILITIES AND PROFESSIONAL DEMANDS OF A BUSY TECHNICAL ENVIRONMENT AND WILL SEE HOW WORKING TOGETHER AS A TEAM CAN PROVIDE QUALITY PATIENT CARE. THIS HELPS STUDENTS DETERMINE AREAS OF INTEREST AND ALSO HELPS TO FILL THE ACH EMPLOYMENT PIPELINE. ACH PARTNERS WITH THE AUBURN YMCA ON THEIR "LIVE STRONG" PROGRAM, ENABLE CANCER PATIENTS TO BENEFIT FROM HEALTH AND WELLNESS SERVICES. AUBURN ORTHOPAEDICS AND THE ACH CONCUSSION CLINIC WORK WITH THE AUBURN SCHOOL DISTRICT TO PROVIDE ATHLETIC TRAINERS FOR SPORTING EVENTS AND HAVE STARTED BASELINE TESTING FOR ATHLETES TO ENABLE BETTER CARE FOR CONCUSSION TREATMENT. ACH CONTINUES TO SPONSOR MEDICALLY SPEAKING EVENTS IN THE COMMUNITY ON CLINICAL TOPICS OF INTEREST TO COMMUNITY MEMBERS. ACH HOSTS "HOPE AFTER STROKE" MEETINGS WHERE THE HOSPITAL STAFF IS AVAILABLE TO STROKE PATIENTS TO SUPPORT THE UNDERSTANDING OF STROKE PREVENTION, REHABILITATION, RECOVERY, AND OVERALL WELLNESS. MONTHLY MEETINGS ARE HELD AT THE HOSPITAL WITH OUR OCCUPATIONAL THERAPY STAFF. ACH SPONSORS MANY COMMUNITY EVENTS BY PROVIDING BOTH VOLUNTEERS FROM OUR ACH AND AMMS AND MONETARY SUPPORT. IN 2024, THE HOSPITAL PROVIDED OVER $40,000 IN ORGANIZATIONAL SPONSORSHIPS AND PARTNERSHIPS TO ORGANIZATIONS SUCH AS UPSTATE FOUNDATION, BOOKER T. WASHINGTON CENTER, ST. JOSEPH'S HOSPITAL FOUNDATION, LORETTO FOUNDATION, THE RESUE MISSION, MATTHEW HOUSE (HOSPICE), HOSPICE OF CNY, E. JOHN GAVRAS CENTER, CHAMPIONS FOR LIFE, AUBURN NAACP, AND TOMATO FEST (FOOD PANTRIES). IN 2024, ACH BEGAN A RURAL RESIDENCY PROGRAM WITH UPSTATE MEDICAL UNIVERSITY. AS PART OF THIS NEW PROGRAM, UPSTATE FAMILY MEDICINE RESIDENTS SPEND YEAR 1 IN SYRACUSE AND YEARS 2 AND 3 IN AUBURN, ROTATING THROUGH ACH SPECIALTIES AND STAFFING THE RURAL RESIDENCY CLINIC. THIS PARTNERSHIP PROVIDES A PIPELINE OF NEW PRIMARY CARE PHYSICIANS TO CARE FOR OUR COMMUNITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COST-TO-CHARGE RATIO. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7, COLUMN (F):</FormAndLineReferenceDesc>
        <ExplanationTxt>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 $ 7,885,154.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO CALCULATE THE CURRENT BAD DEBT EXPENSE, A PERCENTAGE OF THE SELF-PAY ACCOUNTS ARE RESERVED BASED ON THE AGING BY BILLED DATE AT MONTH END. SELF-PAY ACCOUNTS FROM ZERO TO 60 DAYS ARE RESERVED AT 60%, 61 TO 90 DAYS ARE RESERVED AT 70%, 91 TO 180 DAYS ARE RESERVED AT 75%, AND OVER 180 DAYS IS RESERVED AT 90%. ALL OTHER ACCOUNTS NET OF THE CONTRACTUAL ALLOWANCE AGED AT 91 TO 180 DAYS ARE RESERVED AT 25%, WHILE THE ACCOUNTS AGED OVER 180 DAYS ARE RESERVED AT 75%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, FIRST A RATIO OF PATIENT CARE COST TO CHARGES IS CALCULATED FROM THE TOTAL OPERATING EXPENSE TO THE GROSS PATIENT CHARGES. THIS PERCENTAGE IS THEN MULTIPLIED BY THE GROSS PATIENT CHARGES THAT WERE WRITTEN OFF PURSUANT TO THE CHARITY CARE POLICIES OF THE HOSPITAL. THE RESULT IS THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE FOOTNOTES 3(K) ON PAGES 12-18 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SHORTFALL SHOWN ABOVE SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS ALL PATIENTS WILL BE SEEN AND TREATED AT AUBURN COMMUNITY HOSPITAL REGARDLESS OF ABILITY TO PAY. THEREFORE, THE FACT THAT THE COSTS TO TREAT MEDICARE PATIENTS EXCEEDED THE REVENUES GENERATED FROM MEDICARE PATIENTS SHOULD ALL BE VIEWED AS A BENEFIT TO THE MEDICARE PATIENTS OF THE COMMUNITY. THE AMOUNT ABOVE WAS CALCULATED BY MULTIPLYING THE GROSS MEDICARE CHARGES FOR THE YEAR BY THE RATIO OF PATIENT CARE COST TO CHARGES AS CALULATED ON WORKSHEET 2.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENTS ELIGIBLE ARE REASSESSED AT EACH ADMISSION AND NO FURTHER COLLECTIONS ARE PURSUED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>A STRATEGIC PLANNING PROCESS WHICH INCLUDES AN ANALYSIS BY RESEARCH &amp; MARKETING STRATEGIES, INC (RMS) IS USED TO HELP DETERMINE THE NEEDS OF OUR GEOGRAPHIC AREA. THIS ANALYSIS HELPS AUBURN COMMUNITY HOSPITAL IN DETERMINING WHETHER WE HAVE ADEQUATE PHYSICIAN STAFFING TO PROVIDE THE APROPRIATE LEVEL OF CARE TO OUR COMMUNITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>PATIENTS OF AUBURN COMMUNITY HOSPITAL ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION UPON BEING ADMITTED TO THE HOSPITAL, BOTH INPATIENT AND OUTPATIENT. FINANCIAL ASSISTANCE IS EVALUATED EVERY TIME A PERSON PRESENTS AT THE FACILITY. PACKETS ARE PROVIDED TO EVERY PATIENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>AUBURN COMMUNITY HOSPITAL SERVES THE AUBURN, NY COMMUNITY AS WELL AS THE IMMEDIATE SURROUNDING AREAS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>AUBURN COMMUNITY HOSPITAL PARTNERS WITH AUBURN ENLARGED CITY SCHOOL DISTRICT, AUBURN HIGH SCHOOL AND CAYUGA COMMUNITY COLLEGE TO PROVIDE A PAID WORK STUDY PROGRAM FOR STUDENTS INTERESTED IN THE MEDICAL FIELD TO GET HANDS ON EXPERIENCE.AUBURN COMMUNITY HOSPITAL PARTNERS WITH MANY LOCAL AND REGIONAL COLLEGES TO PLACE INTERNS IN VARIOUS ROLES, BOTH DURING THE TRADITIONAL SCHOOL YEAR AND DURING WINTER AND SUMMER RECESSES. IN 2024, THOSE INTERNS WORKED IN VARIOUS DEPARTMENTS INCLUDING DEVELOPMENT, MARKETING, AND IMAGING, AUBURN COMMUNITY HOSPITAL PARTNERS WITH THE CAYUGA COMMUNITY COLLEGE NURSING PROGRAM FOR RN CLINICALS AND WITH CAYUGA ONONDAGA BOCES FOR LPN AND CNA CLINICALS. THIS ALLOWS STUDENTS TO PERFORM THEIR CLINICAL REQUIREMENT NEEDED FOR THEIR LICENSE CLOSE TO HOME. AUBURN COMMUNITY HOSPITAL PROVIDES SPACE WITHIN THE HOSPITAL TO THE CAYUGA-ONONDAGA BOCES NEW VISIONS STUDENTS, PROVIDING AN INSIDE LOOK AT MEDICAL PROFESSIONS FOUND IN HOSPITALS AND ANCILLARY HEALTH CARE FACILITIES. THROUGH DAILY INVOLVEMENT WITH VARIOUS MEDICAL STAFF, STUDENTS LEARN WHAT IS REQUIRED OF HEALTH CARE PROFESSIONALS AND THE APPLICATION OF THEIR EDUCATION TO REAL-LIFE SITUATIONS ON THE JOB. STUDENTS WILL GAIN A BETTER UNDERSTANDING OF THE RESPONSIBILITIES AND PROFESSIONAL DEMANDS OF A BUSY TECHNICAL ENVIRONMENT AND WILL SEE HOW WORKING TOGETHER AS A TEAM CAN PROVIDE QUALITY PATIENT CARE. THIS HELPS STUDENTS DETERMINE AREAS OF INTEREST AND ALSO HELPS TO FILL THE ACH EMPLOYMENT PIPELINE.AUBURN COMMUNITY HOSPITAL PARTNERS WITH THE AUBURN YMCA ON THEIR "LIVE STRONG" PROGRAM, ENABLE CANCER PATIENTS TO BENEFIT FROM HEALTH AND WELLNESS SERVICES. AUBURN ORTHOPAEDICS AND THE AUBURN COMMUNITY HOSPITAL CONCUSSION CLINIC WORK WITH THE AUBURN SCHOOL DISTRICT TO PROVIDE ATHLETIC TRAINERS FOR SPORTING EVENTS AND HAVE STARTED BASELINE TESTING FOR ATHLETES TO ENABLE BETTER CARE FOR CONCUSSION TREATMENT.AUBURN COMMUNITY HOSPITAL CONTINUES TO SPONSOR MEDICALLY SPEAKING EVENTS IN THE COMMUNITY ON CLINICAL TOPICS OF INTEREST TO COMMUNITY MEMBERS.AUBURN COMMUNITY HOSPITAL HOSTS "HOPE AFTER STROKE" MEETINGS WHERE THE HOSPITAL STAFF IS AVAILABLE TO STROKE PATIENTS TO SUPPORT THE UNDERSTANDING OF STROKE PREVENTION, REHABILITATION, RECOVERY, AND OVERALL WELLNESS. MONTHLY MEETINGS ARE HELD AT THE HOSPITAL WITH OUR OCCUPATIONAL THERAPY STAFF.AUBURN COMMUNITY HOSPITAL SPONSORS MANY COMMUNITY EVENTS BY PROVIDING BOTH VOLUNTEERS FROM OUR ACH AND AMMS AND MONETARY SUPPORT. IN 2024, THE HOSPITAL PROVIDED OVER $40,000 IN ORGANIZATIONAL SPONSORSHIPS AND PARTNERSHIPS TO ORGANIZATIONS SUCH AS UPSTATE FOUNDATION, BOOKER T. WASHINGTON CENTER, ST. JOSEPH'S HOSPITAL FOUNDATION, LORETTO FOUNDATION, THE RESUE MISSION, MATTHEW HOUSE (HOSPICE), HOSPICE OF CNY, E. JOHN GAVRAS CENTER, CHAMPIONS FOR LIFE, AUBURN NAACP, AND TOMATO FEST (FOOD PANTRIES).THE HOSPITAL ALSO ALLOWS FOR THE AMMSPC TO PROVIDE SPECIALTY CARE TO THE COMMUNITY WHICH RESULTS IN A LOSS OF OPERATIONS DURING THE YEAR THAT THE HOSPITAL FUNDS TO ENSURE OUR COMMUNITY HAS ACCESS TO THE BEST CARE POSSIBLE CLOSE TO HOME.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>AUBURN COMMUNITY HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>NY</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
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      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <TotalCompensationRltdOrgsAmt>588947</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MUKESH SHARMA</PersonNm>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>573424</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOSEPH GRANEY</PersonNm>
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        <BonusRelatedOrganizationsAmt>64481</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>558641</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
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        <CompensationBasedOnRltdOrgsAmt>301298</CompensationBasedOnRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>66521</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>470362</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES SYRETT</PersonNm>
        <TitleTxt>MEDICAL DIRECTOR</TitleTxt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BRANDON KIRSHNER</PersonNm>
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        <PersonNm>GEORGE BEN</PersonNm>
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        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
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        <PersonNm>DANIEL ROSSI</PersonNm>
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    </IRS990ScheduleJ>
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        </BusinessName>
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        <BalanceDueAmt>80848</BalanceDueAmt>
        <DefaultInd>0</DefaultInd>
        <BoardOrCommitteeApprovalInd>1</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>1</WrittenAgreementInd>
      </LoansBtwnOrgInterestedPrsnGrp>
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      <BusTrInvolveInterestedPrsnGrp>
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          <PersonNm>WILLIAM FRANCESCHELLI</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SON OF CHAIRMAN (ANTHONY FRANCESCHELLI)</RelationshipDescriptionTxt>
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        <TransactionDesc>COMPENSATION PAYMENTS FROM RELATED ORGANIZATION (AMMSPC)</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>CHRISTINE VASILE</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>SISTER IN LAW OF BOARD TRUSTEE (CHRISTINA CORNELL)</RelationshipDescriptionTxt>
        <TransactionAmt>12021</TransactionAmt>
        <TransactionDesc>COMPENSATION PAYMENTS</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>ROBERT LOTKOWICTZ</PersonNm>
        </NameOfInterested>
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        <TransactionDesc>COMPENSATION PAYMENTS</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>JASON LESCH</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>OWNER OF CNY BUSINESS ADVISORS</RelationshipDescriptionTxt>
        <TransactionAmt>431375</TransactionAmt>
        <TransactionDesc>FINANCIAL CONSULTING SERVICES</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>ACH OUTSOURCES THE CFO POSITION TO JASON LESCH, WHO IS THE OWNER OF CNY BUSINESS ADVISORS. CNY BUSINESS ADVISORS WAS PAID $431,375 IN 2024 FOR CFO SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS, OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST FORMS AND SIGN THEM ANNUALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS DETERMINE THE PRESIDENT/ CEO COMPENSATION. OTHER TOP OFFICIALS' COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS, CEO AND IS ALSO BASED OFF OF EXPERIENCE, COMPENSATION SURVEYS AND OTHER QUALIFICATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>COPIES OF THE 990 WILL BE AVAILABLE TO THE PUBLIC UPON REQUEST</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>UPON REQUEST, COPIES OF DOCUMENTS WILL BE PROVIDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 29,742,072. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,742,072. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,096,028. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,096,028.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>EQUITY TRANSFER TO AFFILIATE -34,338.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 3B</FormAndLineReferenceDesc>
        <ExplanationTxt>AS OF THE REQUIRED FILING DATE OF THIS RETURN, AUBURN COMMUNITY HOSPITAL'S AUDITED FINANCIAL STATEMENTS HAVE NOT BEEN RELEASED. AUBURN COMMUNITY HOSPITAL WILL PROVIDE THE 2024 AUDITED FINANCIAL STATEMENTS AS SOON AS THEY BECOME AVAILABLE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY COMPANIES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>17 LANSING STREET</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <EIN>223271881</EIN>
        <PrimaryActivitiesTxt>PROVIDES NURSING HOME ACCOMMODATIONS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 9</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO BOX 918</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <EIN>161599892</EIN>
        <PrimaryActivitiesTxt>PROVIDES FUNDS TO AUBURN COMMUNITY HOSPITAL, INC. AND RELATED ENTITIES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 11</PublicCharityStatusTxt>
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        </DirectControllingEntityName>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ACH PROPERTIES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5-19 LANSING STREET</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <EIN>161335941</EIN>
        <PrimaryActivitiesTxt>PROMOTE AND SUPPORT CHARITABLE PURPOSE OF AUBURN COMMUNITY HOSPITAL, INC.</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
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        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>17 LANSING STREET</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <EIN>261193842</EIN>
        <PrimaryActivitiesTxt>PRACTICE OF MEDICINE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 11</PublicCharityStatusTxt>
        <DirectControllingEntityName>
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      <IdRelatedOrgTxblCorpTrGrp>
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          <BusinessNameLine1Txt>AUBURN MEDICAL PC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>17 LANSING STREET</AddressLine1Txt>
          <CityNm>AUBURN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13021</ZIPCd>
        </USAddress>
        <EIN>205111805</EIN>
        <PrimaryActivitiesTxt>ANESTHESIOLOGY SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>AUBURN MEMORIAL MEDICAL SERVICES PC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>15866112</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AUBURN MEDICAL PC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>1658476</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>117922</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>1931286</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>AUBURN COMMUNITY HOSPITAL FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>34338</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>