2015-11-12T07:04:12-07:00 2014-12-31 990 2014-01-01 160743029 UNITED MEMORIAL MEDICAL CENTER UNIT 5853445249 127 North Street Batavia NY 14020 Robert Chiavetta Vice President Finance 5853445249 2015-11-13 2014 2016-04-25 22:37:26Z United Memorial Medical Center 127 North Street Batavia NY 14020 90399855 0 X www.ummc.org X 1944 NY United Memorial Medical Center is the only acute care hospital in Genesee County, with 131 licensed acute care beds that provide the necessary healthcare services to a regional population of over 93,000 residents and operates the only inpatient alcohol and substance abuse program in a four county area. United Memorial Medical Center is dedicated to providing the very best healthcare possible to the residents of the Genesee Region. We strive to build a culture of excellence focusing on the fact that we are doing more than just treating patients - we are caring for our neighbors, our friends and our families every day. Our mission is working together to promote, enhance and restore health for the patients of our community. 14 12 856 96 1157806 58067 1477797 1360888 77195036 84117655 369322 748217 873049 1249926 79915204 87476686 0 0 0 0 42763451 43906258 0 0 0 34667159 37860052 77430610 81766310 2484594 5710376 75583915 80383196 44591204 49583908 30992711 30799288 United Memorial Medical Center has been established as a general acute care community hospital, serving an estimated 93,000 residents of Genesee County and adjacent areas. Its purpose is to operate inpatient and outpatient services, oriented toward general medical/surgical, pediatric, maternity and emergency care. The hospital continually monitors the needs of the community and develops services to maximize benefits to the community, consistent with the financial resources available to the hospital. In 2014, UMMC served 4,426 inpatients and 219,959 outpatients. The hospital accepts all patients, regardless of ability to pay. The Hospital has a Charity Care Program that is designed to assist those patients who do not have the resources available to reimburse the hospital for medical services rendered. The total amount of charity care rendered by the hospital totaled approximately $5,905,940 for 2014. 0 0 68343306 0 84562676 Healthcare Programs, General/Other: United Memorial Medical Center has been established as a general acute community hospital, serving an estimated 93,000 residents of Genesee County and adjacent areas. Its purpose is to operate inpatient and outpatient services, oriented towards general medical/surgical, pediatric, maternity and emergency care. The hospital continually monitors the needs of the community and develops services to maximize benefits to the community, consistent with the financial resources available to the hospital. In 2014, UMMC served 4,426 inpatients and 219,959 outpatients. The hospital accepts all patients, regardless of ability to pay. The Hospitals Charity Care Program is designated to assist those patients who do not have the resources available to reimburse the hospital for the services it provides. Discounts will be awarded based according to the Federal Poverty Guidelines as published annually by the Department of Health and Human Services. Charity care rendered by the hospital totaled approximated $5,905,940 for calendar year ending December 31, 2014. The hospital currently applies a 60% reduction in charges to all self-pay patients regardless of their abilities to pay for their service. UMMC is committed to enhancing the health of the residents in its primary service area, so it offers an in-patient alcohol and substance abuse program serving a four county area. United Memorial Medical Center is dedicated to providing the very best healthcare possibilities to residents of the Genesee Region. We strive to build a culture of excellence focusing on the fact that we are doing more than just treating patients - we are caring for our neighbors, our friends and our families every day. Our mission is working together to promote, enhance and restore health for the people of our community. 0 0 0 68343306 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 39 0 1 856 1 1 1 0 0 0 0 0 0 0 0 0 X 14 12 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X X Robert L Chiavetta 5853445249 127 North Street Batavia NY 14020 Betty Lapp Chairman 5 0 X X 0 0 0 Mary Raymond Vice Chairman 5 0 X X 0 0 0 Barton Dambra Treasurer 5 0 X X 0 0 0 Peter Call Secretary 5 0 X X 0 0 0 Alan Barcomb MD Board Member 5 0 X 24250 0 0 Joseph Forsyth Board Member 5 0 X 0 0 0 William Fritts Board Member 5 0 X 0 0 0 James Fulmer Board Member 5 0 X 0 0 0 Thomas Houseknecht Board Member 5 0 X 0 0 0 Lalit Jain MD Board Member 5 0 X 0 0 0 Jerry Reinhart Board Member 5 0 X 0 0 0 Barry Rosenberg MD Board Member and Radiologist 40 0 X 100000 0 0 Augusta Welsh Board Member 5 0 X 0 0 0 Christian Yunker Board Member 0 0 X 0 0 0 Mark Schoell CEO 40 0 X 355650 0 44433 Daniel Ireland President 40 0 X 254421 0 25250 Robert Chiavetta Vice President of Finance/CFO 40 0 X 230859 0 24729 Mary Beth Bowen Vice President Nursing/Chief Nursing Officer 40 0 X 178592 0 13084 Michael Merrill MD VP of Medical Affairs 40 0 X 341258 0 26187 Kurt Calman CIO/ VP of Technology and Clinical Services 40 0 X 155301 0 12042 Sonja Gonyea VP of Human Resources 40 0 X 133007 0 17833 Jin Chang MD Anesthesialogoist 40 0 X 458365 0 26490 Anthony Froix MD Surgeon 40 0 X 356800 0 17961 Anupa Seth MD Physician 40 0 X 291188 0 17297 Andrea Zucchiatti MD Surgeon 40 X 287390 0 12376 Michele Odrobina MD Obstetrician 40 0 X 271477 0 12285 3438558 0 249967 22 0 1 0 Summit Rehabilitation Services 99 Medtech Drive Batavia NY 14020 Physical & Occupantional Therapy Services 1290843 Aramark Service Master PO Box 33170 Newark NJ 07188 Facilities Management Service 979355 Rochester General Hospital PO Box 10758 Rochester NY 14610 Pathology Services 845868 Genesee Hospitalist 4201 Buffalo Road Orchard Park NY 14217 Hospitalist Services 811127 Quest Diagnostic PO Box 740709 Atlanta GA 30374 Reference Lab Services 532875 25 0 0 0 653330 706558 1000 0 1360888 Inpatient Revenue 622110 27159591 27159591 0 0 Outpatient Revenue 622110 55805433 54647627 1157806 0 Health Information Technology 622110 1152631 1152631 0 0 0 0 0 0 84117655 297230 0 0 297230 0 0 0 0 0 0 0 0 378232 0 410247 0 -32015 0 -32015 0 0 -32015 2804024 105785 2401155 57667 402869 48118 450987 0 0 450987 0 57885 54100 3785 3785 0 0 Cqfeteria Sales 722210 408303 408303 0 0 Lab Payments 621500 122559 122559 0 0 Contracted Pharmacy Sales 622110 794347 794347 0 0 -47053 273833 0 -320886 1278156 87476686 84562676 1157806 395316 0 0 0 0 0 0 0 0 1812646 559121 1253525 0 0 0 0 0 32030973 27034886 4996087 0 2082517 1697956 384561 0 5611723 4575454 1036269 0 2368399 1931047 437352 0 3848447 3642910 205537 0 85288 0 85288 0 107255 9250 98005 0 0 0 0 0 0 0 0 0 0 0 3870976 3726933 144043 0 284048 233021 51027 0 164084 130469 33615 0 2185917 1763132 422785 0 0 0 0 0 914253 720979 193274 0 208689 119845 88844 0 0 0 0 0 81921 81921 0 0 993570 801891 191679 0 0 0 0 0 4442115 3511282 930833 0 904117 862103 42014 0 Supplies 4438282 3808172 630110 0 Purchased Services 4949492 3727139 1222353 0 Surgical Supplies 5224484 5224484 0 0 Drugs 2397614 2397614 0 0 2759500 1783697 975803 0 81766310 68343306 13423004 0 7666465 14142338 103240 102575 337043 231765 9584727 7047123 0 0 0 1141105 1257174 1247841 1125543 95653899 55246548 41898087 40407351 7329117 10154961 0 0 0 0 0 0 6276290 5914366 75583915 80383196 9011858 9108408 0 0 0 0 9640000 8755000 0 0 0 0 13491410 12939804 0 0 12447936 18780696 44591204 49583908 X 27992825 28552844 2713110 1959668 286776 286776 30992711 30799288 75583915 80383196 X 5710376 0 0 0 0 -5903799 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1749280 0 70831 0 0 0 1820111 1534386 0 214894 0 0 0 1749280 1393290 0 141096 0 0 0 1534386 1388741 0 4549 0 0 0 1393290 1271721 0 117020 0 0 0 1388741 0.86 0.14 0 0 0 0 592242 592242 0 54860550 23274642 31585908 0 0 0 0 0 40201107 31971906 8229201 0 0 0 0 40407351 Prepaid Pension Cost 3610057 Interest In Net Assets of Foundation 1356932 Deferred Financing Bond Issue 425432 Deferred Financing OR Note 375973 Merger Organizational Cost 79731 Deferred Compensation Assets 32595 Covenant Not To Compete 28646 Long-term Asset USDA 5000 5914366 0 Minimum Pension Liability 16292156 Estimated amoutns due to third-parties, net 1906416 Current Portion of estimates due to third-parties 582124 18780696 X 87286703 0 0 0 464347 464347 86822356 0 654330 654330 87476686 82230657 0 0 0 464347 464347 81766310 0 0 0 81766310 Schedule D, Part V, Line 4 The hospitals endowment fund is comprised of two parts. The first part is a permanently restricted donation totaling $261,353 and the second part is unrestricted investment returns since the inception of the original donation that totals $1,558,758. The unrestricted portion of the endowment fund has no restrictions place on how the funds can be used. The hospital currently has not designated any use for the funds. Schedule D, Part X, Line 2 The Center is a not-for-profit corporation as described in Section 501(c) (3) of the Internal Revenue Code (the Code), and accordingly, is exempt from Federal income taxes on related income pursuant to Section 501 (a) of the Code. JRD was formed as an S Corporation for both federal and state income tax purposes. The Center and JRD account for uncertain tax positions in accordance with US GAAP, which requires the recognition and measurement of uncertain tax positions that the Center and JRD have taken or expects to take in the Center of JRD's tax returns. Accordingly, no provisions for income taxes has been reflected in the accompanying consolidated financial statements. The Center and JRD are no longer subject to federal and NYS income tax examination for years prior to 2011. Schedule D, Part XI, Line 2d Rental Expenses $410,247 plus Cost of Goods Sold $54,100. Schedule D, Part XI, Line 4b Contribution for purchase of property, plant, and equipment $654,330. Schedule D, Part XII, Line 2d Rental Expenses $410,247, plus Cost of Goods Sold $54,100. 1 1 1 X 3 1 X 1 1 0 0 0 0 2904456 977897 1926559 0.0236 0 0 15701838 13758536 1943302 0.0238 0 0 96091 81367 14724 0.0001 0 0 18702385 14817800 3884585 0.0475 0 0 299666 24948 274717 0.0034 0 0 30750 0 30750 0.0004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68742 0 68742 0.0008 0 0 399158 24948 374209 0.0046 0 0 19101543 14842748 4258794 0.0521 0 0 39883 0 39883 0.0005 0 0 0 0 0 0 0 0 39503 0 39503 0.0005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79386 0 79386 0.0010 1 3505018 94495 11565511 13012647 -1447136 X 1 1 1 1 Unted Memorial Medical Center 127 North Street Batavia NY 14020 www.ummc.org 1801000H X X X X Unted Memorial Medical Center 1 0 0 1 X X X X X X X X 13 1 1 1 1 X www.ummc.org X www.co.genesee.ny.us/docs/health/Gen_Orl_WyoCHA_2013.pdf X 1 13 1 www.ummc.org 0 0 1 X 300 300 1 1 1 X X X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Unted Memorial Medical Center United Memorial Medical Center cooperates with many community groups and agencies to assess the needs of the community. The Hospital uses the following reports, documents, and surveys in developing its assessment: *Press Ganey Patient Satisfaction Surveys *TREO Solutions *Genesee County Health Department Community Health Assessment * United States Census Data * New York State Department of Health * New York State Department of Labor * American Cancer Society * New York State Cancer Registry *National Immunization Program. The Hospital continually monitors local data related to the types of services community members are receiving and whether these services are available locally to sufficiently meet community need. United Memorial uses reports from the State and County Departments of Health, internal committees and task forces, weekly administrative planning sessions and current industry publications to appropriately identify community needs. Schedule H, Part V, Section B, Line 6a-Unted Memorial Medical Center United Memorial Medical Center, Medina Memorial Hospital/Orleans Community Health and Wyoming County Community Health System. Schedule H, Part V, Section B, Line 6b-Unted Memorial Medical Center Genesee County Department of Health, Orleans County Department of Health, Wyoming County Department of Health, and Lake Plains Community Network. Schedule H, Part V, Section B, Line 11-Unted Memorial Medical Center Significant community health needs identified for all three counties included Cancer (45.7%), Heart Disease/Heart Health/Blood Pressure/Stroke (44%) and Depression/Mental Health/Stress (41.7%). United Memorial is addressing these issues in a number of ways. Currently under construction, United Memorial Medical Center in association with the Rochester Regional Lipson Cancer Center, will open a new, patient- focused cancer center in January 2016. This $6.5 million project at the hospital's main campus will provide chemotherapy, infusion and radiation oncology treatments to residents of Genesee, Orleans and Wyoming Counties. This greatly improves access to specialized care and services and eliminates the need to travel distances of 30 miles or more for care. While United Memorial currently provides outpatient infusion and chemotherapy services, the addition of radiation oncology and other supportive services will provide our rural region with comprehensive care that is not offered at any other hospital in our tri-county region. To address issues related to Heart Disease/Heart Health/Blood Pressure/Stroke, United Memorial recruited a second non-invasive cardiologist to our Medical Staff. Ahmet Guler, DO practices in the Cardiology and Internal Medicine office operated by United Memorial. United Memorial continues to offer a Phase II Cardiac Rehabilitation program and will expand the services in Cardiac Rehab in January 2016. "Ask a Nurse" is a free community health program held twice each month at the hospital and at our outpatient campus. It is advertised and promoted locally for people to ask health questions of a registered nurse who also provides free blood pressure screenings and education materials. Free blood pressure screenings are provided at all local community health fairs and events throughout the year. In 2014, United Memorial also became a New York State designated Stroke Center. Education about the risks and symptoms of stroke are provided at community events, on free magnets distributed to the community, on posters within the organization and was featured in a local advertising campaign involving print media and billboards. Heart health and stroke awareness have also been frequent topics on a weekly radio program featuring United Memorial Medical Center. Depression/Mental Health/Stress and other diagnosis related to behavioral health continue to challenge United Memorial. There is a determined lack of providers and resources within the county however we continue to address this issue with our local health partners at the county level with the Genesee County Office of Mental Health, the Mental Health Association of Genesee County, and the County Health Department. United Memorial has been part of a multi-agency task force aimed at reducing deaths by suicide, The Suicide Prevention Coalition. Schedule H, Part V, Section B, Line 16a-Unted Memorial Medical Center www.ummc.org Schedule H, Part V, Section B, Line 16c-Unted Memorial Medical Center www.ummc.org Schedule H, Part I, Line 7 The hospital used the Ratio of Cost to Charges methodology to calculate the cost for each of the programs listed in Part I. The hospital used the Worksheet #2 provided in the 990 Schedule H instructions to calculate the Ratio of Cost to Charges. Schedule H, Part I, Line 7, Column f The hospital did not include any subsidized health services on Line 7(g). Schedule H, Part I, Line 7g The amount omitted from Form 990, Part IX, Line 25, column (A) was $3,505,018 for bad debt expense. Schedule H, Part II United Memorial Medical Center cooperates with many community groups and agencies to assess the needs of the community. The Hospital uses the following reports, documents, and surveys in developing its assessment: *Press Ganey Patient Satisfaction Surveys *TREO Solutions *Genesee County Health Department Community Health Assessment * United States Census Data * New York State Department of Health * New York State Department of Labor * American Cancer Society * New York State Cancer Registry *National Immunization Program. The Hospital continually monitors local data related to the types of services community members are receiving and whether these services are available locally to sufficiently meet community need. United Memorial uses reports from the State and County Departments of Health, internal committees and task forces, weekly administrative planning sessions and current industry publications to appropriately identify community needs. Schedule H, Part III, Section A, Line 4 Accounts Receivable: The Center carries its accounts receivable at anticipated amounts due from private pay patients and third-party payers. Periodically, the Center adjusts the allowance for doubtful accounts based upon prior history and current developments. The Center does not charge interest on past due accounts. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Center analyzes their past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Center analyzes contractually due amounts and provides an allowance for doubtful and a provision for bad debts, if necessary, for receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Center records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have be exhausted is charged off against the allowance for doubtful accounts. The Center's allowance for doubtful accounts increased form 11% of gross accounts receivable at December 31, 2013 to 13% of gross accounts receivable at December 31, 2014. In addition, the Center's bad debt write-offs increased by approximately $390,000 from $3,115,000 for fiscal year 2013 to $3,505,000 for fiscal year end 2014. Both increases were to account for negative trends experienced in the collection of amounts from self-pay patients in fiscal year 2014. The Center has not changed its charity care or uninsured discount policies during fiscal years 2013 and 2014. In 2013, the Center changed its uninsured discount policy from 50% to 60%. The Center does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third party payors. The amount included as bad debt from patients that qualify for charity care is calculated by based on the portion of the patients account balance that is remaining after the amount awarded the patient for charity care is applied. The remaining balances have not been paid by the patient and are written off as a bad debts. Schedule H, Part III, Section B, Line 8 The hospital believes that the shortfall in Medicare payments on patients that it serves should be treated as a community benefit because the hospital provides medical care to all its patients regardless of their ability to pay and does not restrict access or the level of services to patients based on the reimbursement that it receives for those services. The hospital has the ability to negotiate reimbursement rates with commercial insurances but the hospital is restricted from negotiating rates for its Medicare patients. Medicare reimbursement is set by Centers for Medicare Services and cannot be negotiated by the hospital. The hospital feels that any shortfall in reimbursement for services it is required to provide to patients under a government sponsored program where the rate is not negotiable should be included as a community benefit. The hospital used its 2013 Medicare Cost Report to determine the shortfall in Medicare Payments. Schedule H, Part III, Section C, Line 9b The Express Registration Department receives a listing of all inpatient admissions from the previous day. Monday's listing will include admissions from the previous Friday thru Sunday. A Self Pay report is compiled daily to identify all outpatients self-pay patients by the cashiers and given to Express Registration. Both the inpatient and outpatient report is reviewed to identify possible third party payer information. If third party payer information is identified, it is verified and applied to the account. If no third party payer information is identified, the outpatient report is forwarded to the cashiers to apply the appropriate NYS surcharge once the account has final billed. The Eligibility Department is notified on all inpatient accounts that no third party payer information is identified. The Eligibility Department will interview the patient to determine possible eligibility with Federal or State programs and/or UMMC's Financial Assistance Program. Schedule H, Part VI, Line 2 United Memorial Medical Center cooperates with many community groups and agencies to assess the needs of the community. The Hospital uses the following reports, documents, and surveys in developing its assessment: *Press Ganey Patient Satisfaction Surveys *TREO Solutions *Genesee County Health Department Community Health Assessment * United States Census Data * New York State Department of Health * New York State Department of Labor * American Cancer Society * New York State Cancer Registry *National Immunization Program. The Hospital continually monitors local data related to the types of services community members are receiving and whether these services are available locally to sufficiently meet community need. United Memorial uses reports from the State and County Departments of Health, internal committees and task forces, weekly administrative planning sessions and current industry publications to appropriately identify community needs. Schedule H, Part VI, Line 3 The hospital makes available its Financial Assistance program to patients by posting it on the hospitals website, providing it in writing to patients upon admission to the hospital, available upon request and is available through published brochure of the hospital. The hospital has also done education session with the local radio station. Schedule H, Part VI, Line 4 United Memorial is the only acute care facility in Genesee County and defines as its service area all of the County and the neighboring border communities. Genesee County is centrally located between the more metropolitan areas of Buffalo and Rochester in upstate New York. Considered largely rural, Genesee County had an estimated 2012 population of 59,977. With the inclusion of adjacent communities, United Memorial serves a total population of approximately 93,000 residents. Of the estimated 2010 county population, 93.4% are considered White, Non-Hispanics; 5.5% were under the age of 5; 21.7% were under the age of 18 and 15.9% were age 65 and older. In Genesee County, 11.7% (2006-2010) of the population lives below the poverty level. The median household income is $50,861. Within Genesee County is the Tonawanda Seneca Nation. United Memorial manages primary care services for the residents of the nation through a contract with New York State. For Orleans County, United Memorial began operation of an OB/GYN physician office in Medina, NY when the Orleans County community hospital ended maternity services in July 2011. Women in that county continue to have access to physician services and deliveries are performed at United Memorial in Batavia. Orleans County had a 2012 population estimate of 42,836, of which 50.3% is female. The median household income in Orleans County was $47,788 (2006-2010) Schedule H, Part VI, Line 5 United Memorial aspires to be a great hospital, employer of choice, and a good community partner. To achieve this we engage in a number of community building activities. In 2013, several members of our senior leadership and management team volunteered for the United Way's Make a Difference Day and worked at a Habitat for Humanity Home. Hospital leaders served as active members of the local chapters of Rotary, Kiwanis, and the Office for the Aging Advisory Counsel, and many are members of the Board of Directors for the Chamber of Commerce, YMCA, and Justice for Children GLOW Foundation, Leadership Genesee, and Tonawanda Valley Federal Credit Union. Members of the hospital staff have formed the Outreach Committee which collects school supplies for the Migrant Outreach Daycare Center in Batavia, Christmas stocking stuffers for the Salvation Army, eyeglasses for the Lions Club, and personal care products for military personnel serving overseas. The organization is an active financial supporter of fitness activities such as community walks and 5K runs, health awareness events and health fairs. United Memorial also works collaboratively with a community based coalition to address childhood obesity. Spear headed by a local pediatrician, the Get Fit Program offers nutritional, social and physician education for families in order to improve and promote healthy lifestyles. United Memorial works closely with the Genesee County Emergency Management Office for disaster readiness. United Memorial's Healthy Living Department also engages in a number of activities and programs to improve the well-being of our community. The MOMs (Medicaid Obstetrical Maternity) program saw 104 participants. The Healthy Living Department also cooperates with other community agencies such as the Genesee County Alcohol and Substance Abuse (GCASA) prevention coalition, to promote smoking cessation through the Smoke Free initiative. United Memorial is also actively engaged with the Diabetes Coalition and participates with the many activities of the American Diabetes Association. Healthy Living is responsible for the Cancer Services Program (CSP) of Genesee and Orleans County. In 2013, this NYS Department of Health grant funded program provided free clinical screenings and mammograms to women 18-64 and free colorectal cancer screenings to men and women age 50 and above who are uninsured or underinsured. In 2013, the CSP assisted 137 individuals with important life-saving diagnostic screenings. The CSP partners with the local Zonta Chapter to provide funding for treatment and services related to the diagnostic outcomes of CSP clients (i.e. follow doctor's appointments and further diagnostic testing.) United Memorial also enjoys strong partnerships with Genesee Community College for workforce development by allowing the clinical training for nursing and respiratory therapy students to be conducted at the hospital and providing staff mentors. The clinical pharmacy, radiology and physical therapy departments were also host to a number of students from SUNY Brockport, Daemen College, and the University of Buffalo. Each summer, United Memorial hosts middle school aged children from local schools who demonstrate an interest in health careers. They participate in a 2 day MASH Camp experience which exposes them to the many professional facets of healthcare. United Memorial also serves as a day session host for Genesee Community College's BioTechnology students and as the clinical site for the BOCES Health Careers Academy for Junior and Senior High School students. United Memorial Medical Center has a 14 member board comprised of community members in areas it serves. No member of the board is compensated for the services they provide as a board member, however one member of the board is an employee of the hospital and another is an independent contractor of the hospital. Both of these board members are compensated by the hospital based on services that they provide to the hospital patients. The medical staff of United Memorial Medical Center is organized to serve the members of the community. Medical staff privileges are open and available to all qualified physicians and we currently have over 175 members of the Medical Staff. The hospital operates a 24 hour a day emergency room which provides emergency services to the community regardless of their ability to pay for services. No part of the hospital's income inures to the benefit of any private individual nor is a private interest being services. The hospitals surplus finds are reinvested into the facility, equipment or programs of the hospital to improve the quality of patient care, and expand the services the hospital provides. The hospital provides valuable services to the community it serves and continues to demonstrate its mission by providing support for health fairs, health screening programs, educational programs, and allowing hospital staff to serve on community wide boards and organizations. We also provide a very successful volunteer program for adults and teenagers. The medical staff of United Memorial Medical Center is organized to serve the members of the community. Medical staff privileges are open and available to all qualified physicians and we currently have 95 active medical staff and 17 associate. The hospital provides 24 hour a day emergency room which provides emergency services to the community regardless of their ability to pay for services. No part of the hospitals income inures to the benefit of any private individual nor is a private interest being served. The hospitals surplus funds are reinvested into the facility, equipment or programs of the hospital to improve the quality of patient care, and expand the services the hospital provides. The hospital provides valuable services to the community it serves and continues to demonstrate its mission by providing support for health fairs, health screening programs, educational programs, and allowing hospital staff to serve on community wide boards and organizations. We also provide a very successful volunteer program which offers the community a great opportunity to volunteer. Schedule H, Part VI, Line 6 Not applicable. On January 1, 2015 the hospital became a member of the Rochester Regional Health System. Schedule H, Part VI, Line 7 The hospital completes and files with the New York State Department of Health an Annual Report which includes community benefits that the hospital provides. X X X X X 0 0 0 0 0 1 0 0 0 Jin Chang MD Anesthesialogoist 452078 0 0 0 6287 0 11700 0 14790 0 484855 0 0 0 Mark Schoell CEO 350766 0 2500 0 2384 0 29200 0 15233 0 400083 0 0 0 Anthony Froix MD Surgeon 286310 0 70080 0 410 0 11700 0 6261 0 374761 0 0 0 Michael Merrill MD VP of Medical Affairs 308253 0 32294 0 711 0 11700 0 14487 0 367445 0 0 0 Anupa Seth MD Physician 206194 0 84799 0 195 0 9150 0 8147 0 308485 0 0 0 Andrea Zucchiatti MD Surgeon 287169 0 0 0 221 0 0 0 12376 0 299766 0 0 0 Michele Odrobina MD Obstetrician 252512 0 18746 0 219 0 11700 0 585 0 283762 0 0 0 Daniel Ireland President 242586 0 11500 0 335 0 11434 0 13816 0 279671 0 0 0 Robert Chiavetta Vice President of Finance/CFO 219600 0 10793 0 466 0 10458 0 14271 0 255588 0 0 0 Mary Beth Bowen Vice President Nursing/Chief Nursing Officer 169907 0 8355 0 330 0 6832 0 6252 0 191676 0 0 0 Kurt Calman CIO/ VP of Technology and Clinical Services 148003 0 7193 0 105 0 6973 0 5069 0 167343 0 0 0 Sonja Gonyea VP of Human Resources 126756 0 6160 0 91 0 5494 0 12339 0 150840 0 0 0 Schedule J, Part I, Line 3 Review of executive compensation is done annually by the Board of Directors. The hospital uses a compensation committee to determine what the CEO will be paid. This committee gathers information from an outside consultant who gathers information on comparable CEO salaries and provides a compensation report to the compensation committee. The hospital's Board of Directors has to approve the recommendations of the compensation committee before the CEO compensation is implemented. Schedule J, Part I, Line 6 A portion of executive pay is based upon meeting the level of net earnings established in the Board approved annual operating budget. A portion of executive incentive compensation is based upon meeting certain criteria relating to quality of patient care, patient satisfaction, patient safety, employee satisfaction and certain financial indicators such as measurement of cash and debt service coverage ratios. A Genesee County Industrial Developement Agency 161139027 371672AD8 2007-04-27 14704494 Renovation of outpatient diagnostic center and physicians offices 0 0 0 A 0 0 14704494 1176970 0 0 294090 0 0 13233434 0 0 2007 0 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 0 0 0 0 1 A 1 James Fulmer Board Member 464694 See Part V 0 William Fritts Board Member 25893 See Part V 0 Schedule L, Part IV James Fulmer is President of The Bank of Castile which the hospital has its banking relationship with. The total amount paid to The Bank of Castile in 2014 was $464,694 and represents the total interest paid on outstanding indebtedness the hospital has with The Bank of Castile. William Fritts is the owner of Lawley Genesee Insurance Company which provides consulting services on insurance policies that the hospital has. The total amount paid to Lawley Genesee in 2014 was $25,893. Form 990, Part VI, Section A, Line 3 During 2014 the hospital had management contracts for the following areas in which the contracted manager reported directly to an officer or key employee of the hospital: facilities management, bio-medical services, housekeeping, dietary, pharmacy and wound care. Form 990, Part VI, Section A, Line 6 The Genesee Memorial Hospital Group, Inc. is the sole member of United Memorial Medical Center. Form 990, Part VI, Section A, Line 7a The Genesee Memorial Hospital Group, Inc. has the right to elect all members of the United Memorial Medical Center Board of Directors. Form 990, Part VI, Section A, Line 9 MaryBeth Bowen, 15 Vale Drive, Batavia, NY 14020 Form 990, Part VI, Section B, Line 11b The hospital issues the final Form 990 to all member of the hospital's board before their monthly meeting and the Vice President of Finance reviews the Form 990 at this meeting and answers any questions that may arise. Form 990, Part VI, Section B, Line 12c The Conflict of Interest Policy and Questionnaire is distributed to the Board members on an annual basis. The Governance Committee is provided with a summary of any duality of interest or possible conflict of interest for their review. The Conflict of Interest summary is then disclosed to the full Board for review. Form 990, Part VI, Section B, Line 15 Review of executive compensation is done annually by the Board of Directors. The hospital uses a compensation committee to determine what the CEO will be paid. This committee gathers information from an outside consultant who gathers information on comparable CEO salaries and provides a compensation report to the compensation committee. The hospital's Board of Directors has to approve the recommendations of the compensation committee before the CEO compensation is implemented. All compensation decisions are based on independent market data obtained from a variety of sources. Other employee compensation is recommended by the CEO on a similar basis to the Board and after discussion with the compensation committee. Form 990, Part VI, Section C, Line 19 The hospital currently makes available its governing documents, conflict of interest policy, and financial statements to the public by formal request. The hospital financial statements are included with hospitals annual report which is located on the hospitals website. Form 990, Part XI, Line 9 Change in unrestricted interest in net assets of Foundation ($129,461) less Minimum pension liability adjustment ($5,350,649) minus change in temporarily restricted interest in net assets of Foundation ($682,611) for a total of $5,903,799. United Memorial Medical Center Foundation Inc 207 Summit Street Batavia NY 14020 222611543 Receive and administer gifts on behalf of United Memorial Medical Center NY 501 (c) (3) 509 (a) (3) Type III N/A 0 Genesee Memorial Hospital Group Inc 127 North Street Batavia NY 14020 222611545 Approve the Board of Directors of United Memorial Medical Cener NY 501 (c) (3) 170 (b) (1) (A) (VI) United Memorial Medical Center 1 Jerome Center Redevelopment Inc 127 North Street Batavia NY 14020 900461497 Noncontrolling member of Bank Street Senior Housing NY N/A Related 0 0 0.00005 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 United Memorial Medical Center Foundation Inc c 653330 Total amount of cash transferred from United Memorial Medical Center Foundation, Inc. to United Memorial Medical Center for capital additions. United Memorial Medical Center Foundation Inc n 1426 The actual average cost per square foot of the building the Foundation is located in, multiplied by the total square feet that the Foundation occupies. United Memorial Medical Center Foundation Inc q 74240 Total expenses paid by United Memorial Medical Center on behalf of the Foundation and then reimbursed by the Foundation back to United Memorial Medical Center.