2014-11-14T15:47:03-06:00 2013-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2013-01-01 161533232 KALEIDA HEALTH % JON SWIATKOWSKI KALE 7168598501 726 EXCHANGE STREET Suite 200 BUFFALO NY 14210 Jon Swiatkowski EVP, CFO 5184274600 2014-11-14 true JEFFREY STAGG P01326885 5184274600 2013 2015-11-30 17:44:51Z JODY LOMEO 100 HIGH STREET BUFFALO NY 14203 1198810323 false X WWW.KALEIDAHEALTH.ORG X 1998 NY SEE SCHEDULE O 13 11 9344 1927 3576369 18003436 16833070 1095513299 1094963150 5761717 8682237 18607954 18748226 1137886406 1139226683 1100400 499180 0 0 624258217 659283835 0 0 0 500508726 493783633 1125867343 1153566648 12019063 -14339965 1107799605 1120308222 927906004 857780288 179893601 262527934 X KALEIDA HEALTH IS A VOLUNTARY, NOT-FOR-PROFIT; NEW YORK STATE DEPARTMENT OF HEALTH ARTICLE 28 LICENSED HOSPITAL-BASED HEALTHCARE DELIVERY SYSTEM SERVING THE COMMUNITIES OF WESTERN NEW YORK STATE AT VARIOUS LEVELS AND WITH FACILITIES IN MULTIPLE LOCATIONS THROUGHOUT THE REGION. KALEIDA HEALTH INCLUDES THE BUFFALO GENERAL MEDICAL CENTER (BUFFALO GENERAL), MILLARD FILLMORE SUBURBAN HOSPITAL (MILLARD SUBURBAN), WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO (WOMEN & CHILDREN'S), AND DEGRAFF MEMORIAL HOSPITAL (DEGRAFF). IN ADDITION TO THE FOUR KALEIDA HEALTH (KALEIDA) HOSPITALS, KALEIDA OPERATES TWO SKILLED NURSING FACILITIES, AND NUMEROUS OUTPATIENT CLINICS. THE ABOVE FACILITIES OPERATE UNDER ONE TAX IDENTIFICATION NUMBER. OUR FAMILY OF HEALTH CARE ORGANIZATIONS IS BONDED TOGETHER INTO ONE FRAMEWORK FOR LEADERSHIP, GOVERNANCE, SHARED SERVICES, FINANCIAL INFRASTRUCTURE AND INFORMATION TECHNOLOGY PLATFORMS. COLLECTIVELY, KALEIDA HEALTH'S MARKET SHARE IS 31.2% IN WESTERN NEW YORK, 39.5% IN ERIE COU false false 1037073255 499180 1096101212 See Attachment 1. 1037073255 true true false true false false false false false true true true false true true true true true false false false false false false false false true true true false true true false false false false false true false true true true true false false false true true true true false false true 532 0 true 9344 true true true false false false false false false false false false X 13 11 false true false false false false false true true false false true true true true true true true true true false NY X X JON SWIATKOWSKI 7168598527 726 EXCHANGE ST SUITE 200 BUFFALO NY 14210 ROBERT M ZAK VICE CHAIRMAN 1.0 X 0 0 0 EVAN EVANS MD DIRECTOR 1.0 X 51000 0 0 ROBERT J HALONEN PhD DIRECTOR 1.0 X 0 0 0 DARREN J KING DIRECTOR 1.0 X 0 0 0 JAMES KASKIE PRES/CEO EX-OFFICIO WITH VOTE 38.0 X X 1899154 0 44210 JOHN R KOELMEL CHAIRMAN 1.0 X 0 0 0 DAVID A MILLING MD DIRECTOR 1.0 X 0 0 0 HERMAN S MOGAVERO Jr MD TREASURER 1.0 X 0 0 0 FRANCISCO M VASQUEZ PhD SECRETARY 1.0 X 0 0 0 AMY L CLIFTON DIRECTOR 1.0 X 0 0 0 CHRISTOPHER T GREENE ESQ DIRECTOR 1.0 X 0 0 0 FRANK CURCI DIRECTOR - WCHOB FDN BOD 1.0 2.0 X 0 0 0 GEORGE MATTHEWS DIRECTOR 1.0 X 0 0 0 ROBERT NOLAN GENERAL COUNSEL 38.0 1.0 X 499778 0 35412 JOSEPH KESSLER EVP, CFO 38.0 1.0 X 1355983 0 43375 MARGARET PAROSKI MD EVP, CMO 38.0 X 671841 0 0 TONI BOOKER EVP HUMAN RESOURCES OFFICER 38.0 X 411064 0 138736 CHERYL KLASS SVP OPS BGMC, PRESIDENT WCHOB 38.0 X 706472 0 264295 DONALD BOYD SVP BUSINESS DEVELOPMENT 38.0 1.0 X 613103 0 35006 CHRISTOPHER LANE PRESIDENT-MFS 38.0 X 418352 0 33937 TAMARA OWEN VP OF INTEGRATION 38.0 X 396885 3616 AARON HOFFMAN MD EMPLOYED PHYSICIAN 38.0 X 1092326 0 21418 KAVEH VALI MD EMPLOYED PHYSICIAN 38.0 X 704160 0 4775 KATHRYN BASS MD EMPLOYED PHYSICIAN 38.0 X 615560 0 5487 PUNEET GUPTA MD EMPLOYED PHYSICIAN 38.0 X 401858 0 5508 VINCENT CALLANAN MD EMPLOYED PHYSICIAN 38.0 X 439314 0 42257 CONNIE VARI Former EVP, COO 0.0 0.0 X 731366 13180 11008216 0 691212 506 true true false DIVURGENT LLC 4445 CORPORATION LANE SUITE 228 VIRGINIA BEACH VA 23462 IST SUPPORT SERVICES 1772150 WNY RADIOLOGY LLC PO BOX 4029 BUFFALO NY 14240 RADIOLOGY SERVICES 4695056 SODEXO MANAGEMENT INC PO BOX 81049 WOBURN NY 018131049 CLEANING & LAUNDRY 4897942 NUANCE COMMUNICATIONS INC PO BOX 7247-6924 PHILADELPHIA PA 191706924 DICTATION SERVICES 1642280 PER SE TECHNOLOGIES INC PO BOX 403421 ATLANTA GA 303843421 PHYSICIAN BILLING 1329200 70 1630067 12552621 2650382 1935605 16833070 SERVICE REVENUE 623990 1091703759 1091703759 LABORATORY SERV 621500 3259391 3259391 1094963150 5616223 1714 85134 5529375 0 0 2344937 2344937 0 2344937 58483 2286454 61576742 1072912 59432280 151360 2144462 921552 3066014 3066014 0 0 0 REBATE REVENUE 900099 12491386 12491386 MANAGEMENT & CONSULTING FEES 541610 793781 789306 4475 UNIVERSITY LEASE INCOME 531120 656966 656966 2461156 347042 168886 1945228 16403289 1139226683 1092841821 3576369 25975423 499180 499180 0 0 0 7023632 7023632 0 476652644 442622452 34030192 42399179 38583253 3815926 98179215 89403097 8776118 35029165 32563291 2465874 0 2211274 1106209 1105065 599004 75000 524004 238924 238924 0 0 123272840 111232287 12040553 2132831 953285 1179546 2581849 2026371 555478 0 0 6875887 4117634 2758253 1280976 919992 360984 0 0 15884694 12717783 3166911 0 68343329 54119476 14223853 1365092 296316 1068776 HEALTH CARE SUPPLIES 184704915 184672701 32214 EQUIPMENT RENTAL & MAINT 24871915 11222940 13648975 SERVICE CONTRACTS 9582257 7338760 2243497 UTILITIES 9414226 7555079 1859147 40423620 35048149 5375471 1153566648 1037073255 116493393 0 1457388 1888730 82227233 82767025 0 0 131420998 128810671 11457367 18832367 0 0 0 0 19236308 22934130 10274623 13398661 1413567765 959846264 487514124 453721501 92601963 88428073 78093244 82265135 0 0 0 0 193516357 227261929 1107799605 1120308222 120073296 139788467 0 0 0 0 67953680 66000384 0 0 0 0 246846554 231654591 0 0 493032474 420336846 927906004 857780288 X 89356905 166131003 75136479 80996443 15400217 15400488 179893601 262527934 1107799605 1120308222 X -14339965 3353614 93620684 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false false false true 67712 true 171212 false false 238924 false false GRANTS TO OTHER ORGANIZATIONS & DIRECT CONTACT WITH LEGISLATIVE BODY SCHEDULE C, PART II-B, QUESTIONS 1F AND 1G THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1F REPRESENTS THE PORTION OF THE DUES PAID TO THE GREATER NEW YORK HOSPITAL ASSOCIATION AND THE PORTION OF DUES PAID TO THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1G REPRESENTS PAYMENTS MADE TO ORGANIZATIONS IN AN EFFORT TO ADVOCATE ON THE ORGANIZATION'S BEHALF AT THE NEW YORK STATE AND FEDERAL LEVELS AS IT SPECIFICALLY RELATES TO HEALTH CARE LEGISLATION AND REGULATORY ISSUES. 28644541 1589183 1819135 1965422 30087437 46995623 3133756 2880650 24365488 28644541 72587179 5877436 28660 31497652 46995623 79899854 14188339 2153889 23654903 72587179 23068508 71865683 3656737 18691074 79899854 0.72450 0.27550 false true true 6713867 6713867 480872803 290496656 190376147 910891395 660744371 250147024 15089700 8605237 6484463 453721501 INTECH RISK-MANAGED L CAP FUND 4201124 F MCM CF GLOBAL ALPHA I FUND 2717759 F WTC CTF RESEAR VALUE PUR 4/06 4037133 F BENCHMARK PLUS INST PART L CAP 5221734 F WTC CIF OPPORTUNISTIC FUND 7333170 F CHARITABLE TEMPORARY INVEST FD 10 F KALEIDA MIT COMMON FUND LP 66927 F COMMON CAP VENTURE PTNRS VI 119614 F COMMON FND CAP PRIVATE EQ P V 140436 F KALEIDA MIT REALITY LP 389904 F KALEIDA SI REALITY LP 1419730 F DWS GLOBAL COMMODITIES 5912185 F ROBECO GLOBAL EMERGING MARKETS 4085150 F AQR GLOBAL RISK 9931683 F PANAGORA RISK PARITY TOTAL RET 9427920 F ORCHARD LANDMARK LTD PTNRS 842898 F PICTET LOCAL EMERGING 6980506 F ABERDEEN EMERGING MARKETS 3158211 F PERMAL FIXED INCOME HOLDING 4846211 F CRESTLINE OFFSHORE FUND 4520486 F MACKAY SHIELDS HIGH YIELD LP 6912344 F 82265135 DEFERRED FINANCING 10145039 INTEREST IN NET ASSETS OF FDNS 142051687 OTHER RECEIVABLES 28272279 OTHER ASSETS 14373451 INSURANCE RECOVERIES REC. 4643603 ESTIMATED 3RD PARTY PAYOR REC 27775870 227261929 0 DUE TO THIRD PARTY PAYORS 21794249 SELF INSURANCE LIABILITY 158890858 OTHER LIABILITIES 21493920 PENSION LIABILITY 195059086 ASSET RETIREMENT OBLIGATIONS 11713953 CAPITAL LEASE OBLIGATIONS 11384780 420336846 1135375307 820810 -850106 -29296 1135404603 3822080 3822080 1139226683 1151601226 1151601226 1965422 1965422 1153566648 INTENDED USE OF ENDOWMENTS: SCHEDULE D, PART V, QUESTION 4 THE FOLLOWING ARE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS: 1) CAPITAL EXPANSION AND IMPROVEMENT 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES 3) SUPPORT PEDIATRIC HEALTH CARE SERVICES FIN 48 FOOTNOTE: SCHEDULE D, PART X, QUESTION 2 KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED. SCHEDULE D, PART XI, LINE 2D OTHER REVENUE INCLUDED IN AFS, NOT INCLUDED IN 990: LESS: MINORITY INTEREST IN SUBSIDIARY SHOWN AS A REDUCTION IN GAINS IN AFS <850,106> SCHEDULE D, PART XI, LINE 4B OTHER REVENUE INCLUDED ON 990, NOT IN AFS: CONTRIBUTIONS FOR CAPITAL ACQUISITIONS 1,986,127 RESTRICTED CONTRIBUTIONS 1,589,183 RESTRICTED INVESTMENT INCOME 246,770 TOTAL 3,822,080 SCHEDULE D, PART XII, LINE 4B OTHER EXPENSES INCLUDED ON 990, NOT IN AFS NET ASSETS RELEASED FROM RESTRICTIONS 1,965,422 true true X true X true X true true true false true true 13719153 3461602 10257551 0.00890 311531063 214387951 97143112 0.08420 325250216 217849553 107400663 0.09310 4721435 4721435 0.00410 46571686 23625598 22946088 0.01990 45167196 12503327 32663869 0.02830 175009 175009 0.00020 96635326 36128925 60506401 0.05250 421885542 253978478 167907064 0.14560 true 15243995 951225 174119579 170396650 3722929 X true true MFSC LLC PHYSICIAN SERVICES 0.51000 0.49000 COMMUNITY MEDICAL P PHYSICIAN SERVICES 1.00000 GENERAL PHYSICIANS PHYSICIAN SERVICES 1.00000 HARLEM ROAD LEASING MRI EQUIPMENT LEASING 0.50000 AMTON IMAGING LLC HEALTH CARE SERVICES 0.40000 PARK CLUB LANE LLC HEALTH CARE SERVICES 0.30000 WNY HEALTHENET LLC HEALTH CARE SERVICES 0.14286 CHILD HEALTH INV I HEALTH CARE SERVICES 0.02972 CHILD HEALTH INV II HEALTH CARE SERVICES 0.01207 SITE E LLC REAL ESTATE LEASING CO. 0.50186 Northtowns Venture Health Care Services 0.50000 GNYHA Purchasing All Group Purchasing Organization 0.02590 Altus Management LL Group Purchasing Organization 0.52548 4 1 BUFFALO GENERAL MEDICAL CENTER 100 HIGH STREET BUFFALO NY 14203 1401014H X X X X A 2 WOMEN & CHILDREN'S HOSPITAL OF BUFFAL 219 BRYAN STREET BUFFALO NY 14222 1401014H X X X X X A 3 MILLARD FILLMORE SUBURBAN HOSPITAL 1540 MAPLE ROAD WILLIAMSVILLE NY 14221 1401014H X X X X A 4 DEGRAFF MEMORIAL HOSPITAL 445 TREMONT AVE NORTH TONAWANDA NY 14120 1401014H X X X X A Group A true X X X X X X X X 13 true true true X www.kaleidahealth.org/community/ publications.asp X X X X X false false true true 200. true 400. true X X X X X X true true X X X X X true X false true X false false Part V, Section B, Line 3 In Erie County, Kaleida Health worked with the Erie County Department of Health, The Catholic Health System, Buffalo STate College Center for Health and Social Research, P2 Collaborative of Western New York, United Way of Buffalo & Erie County, and University at Buffalo Family Medicine. While the county began the process by developing the survey tool and its distribution methods in the fall of 2012, the community partners came together in February 2013. The subsequent meetings in March, July, and August 2013 solidified the health department, local hospitals, and academia efforts. In addition to relying on New York State Prevention Agenda data, Erie County conducted A COUNTY-WIDE HEALTH ASSESSMENT WITH A SURVEY AND HELD A LIVING HEALTHY TASK FORCE TOWN HALL MEETING FOR PROFESSIONAL INPUT. KALEIDA ALSO JOINED THE GROUP IN NIAGARA COUNTY, WHERE THE NIAGARA COUNTY HEALTH DEPARTMENT, NIAGARA FALLS MEMORIAL MEDICAL CENTER, MT. ST. MARY'S HOSPITAL, EASTERN NIAGARA HOSPITAL, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH, AND UNIVERSITY AT BUFFALO PREVENTIVE MEDICINE RESIDENCY WITH ASSISTANCE FROM THE P2 COLLABORATIVE OF WESTERN NEW YORK LAUNCHED THEIR EFFORTS IN MARCH 2013 AND HELD SUBSEQUENT MEETINGS IN APRIL, MAY, JULY, AUGUST, SEPTEMBER, AND OCTOBER. NIAGARA COUNTY CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH HAD 1,455 RESPONSES, AND OUTREACH EVENTS INCLUDED HOSTING THREE FOCUS GROUPS AND A COUNTY-WIDE COMMUNITY HEALTH MEETING. IN ADDITION TO THE OUTREACH AND FEEDBACK IN BOTH COUNTIES, KALEIDA HEALTH ALSO REACHED OUT TO OTHER PARTNERS IN THE COMMUNITY INCLUDING, BUT NOT LIMITED TO, THE NEAR EAST AND WEST SIDE (NEWS) TASK FORCE, LASTING EDUCATION FOR WOMEN, ADULTS & CHILDREN (LEWAC) AND GREATER BUFFALO UNITED ACCOUNTABLE HEALTHCARE NETWORK (GBUAHN). PART V, SECTION B, LINE 4 KALEIDA HEALTH IS COMPRISED OF FOUR HOSPITALS - BUFFALO GENERAL MEDICAL CENTER/GATES VASCULAR INSTITUTE, DEGRAFF MEMORIAL HOSPITAL, MILLARD FILLMORE SUBURBAN HOSPITAL, WOMEN & CHILDREN'S HOSPITAL OF BUFFALO. THREE KALEIDA HOSPITALS ARE LOCATED IN ERIE COUNTY AND ONE, DEGRAFF MEMORIAL HOSPITAL, IS LOCATED IN NIAGARA COUNTY LESS THAN ONE MILE FROM THE ERIE COUNTY BORDER. IN ERIE COUNTY, KALEIDA HEALTH WORKED WITH CATHOLIC HEALTH THROUGH THE ERIE COUNTY DEPARTMENT OF HEALTH FOR COMMUNITY COLLABORATION. IN NIAGARA COUNTY, KALEIDA HEALTH WORKED WITH NIAGARA FALLS MEMEORIAL MEDICAL CENTER, MT. ST. MARY'S HOSPITAL AND EASTERN NIAGARA HOSPITAL THROUGH THE NIAGARA COUNTY HEALTH DEPARTMENT. PART V, SECTION B, LINE 7 WITH HOSPITALS LOCATED IN BOTH NIAGARA AND ERIE COUNTIES, KALEIDA HEALTH, WORKING COLLABORATIVELY WITH BOTH COUNTY GROUPS, IDENTIFIED THREE PROJECTS TO UNDERTAKE AS PART OF THE COMMUNITY SERVICE PLAN. IN ERIE COUNTY, KALEIDA HEALTH WILL WORK TO INCREASE BREASTFEEDING RATES AND CARDIOVASCULAR DISEASE SCREENINGS. IN NIAGARA COUNTY, KALEIDA HEALTH WILL ALSO INCREASE CARDIOVASCULAR DISEASE SCREENINGS AND WORK TO REDUCE THE NUMBER OF FALLS FOR THOSE OVER THE AGE OF 65. THESE THREE AFFORMENTIONED INITIATIVES ARE IN ACCORDANCE WITH THE NEEDS IDENTIFIED BY THE COMMUNITY AND SUPPORTED THROUGH THE DETAILED ANAYLSIS OUTLINED IN THE 2014-2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN AVAILABLE AT WWW.KALEIDAHEALTH.ORG/COMMUNITY/PUBLICATIONS.ASP AND ATTACHED TO THIS RETURN. TWO OTHER TOPICS IDENTIFIED BY THE COMMUNITY AS AREAS OF CONCERN WERE CANCER AND BEHAVIORAL HEALTH. ALTHOUGH KALEIDA DOES PROVIDE EXCELLENT CANCER CARE WITHIN ITS VARIOUS SERVICE LINES, BUFFALO IS FORTUNATE TO HAVE THE ROSWELL PARK CANCER INSTITUTE LOCATED ON THE BUFFALO NIAGARA MEDICAL CAMPUS. ROSWELL HOLDS THE NATIONAL CANCER INSTITUTE DESIGNATION AS A COMPREHENSIVE CANCER CENTER AND HAS A PROVEN MULTIDISCIPLINARY APPROACH. KALEIDA HEALTH WORKS WITH ROSWELL, INCLUDING THE PROPOSED INTEGRATED HEMATOLOGY/ONCOLOGY FLOOR IN THE NEW JOHN R. OISHEI CHILDREN'S HOSPITAL. AS SUCH, KALEIDA HEALTH IS CONFIDENT THAT ROSWELL PARK, ALTHOUGH NOT REQUIRED TO SUBMIT A COMMUNITY SERVICE PLAN AS A PUBLIC BENEFIT CORPORATION, IS AN ADEQUATE CANCER RESOURCE FOR THE COMMUNITY. UNDER GREAT LAKES HEALTH, KALEIDA HEALTH JOINTLY DEVELOPED A $25 MILLION REGIONAL BEHAVIORAL CENTER OF EXCELLENCE WITH THE ERIE COUNTY MEDICAL CENTER ON THEIR GRIDER STREET CAMPUS. THE CENTER HOUSES CONSOLIDATED MENTAL HEALTH AND DRUG DEPENDENCY TREATMENT PROGRAMS WITH A 180-BED INPATIENT PSYCHIATRIC PROGRAM AND A COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM. THIS CENTER OF EXCELLENCE IS IN LINE WITH THE BERGER COMMISSION AND SUPPORTED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. PART V, SECTION B, LINE 14G INFORMATION THAT EXPLAINS HOW QUALIFIED PATIENTS CAN ACCESS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL IS INCLUDED ON BILLS AND STATEMENTS TO PATIENTS. APPLICATION MATERIALS INCLUDE A NOTICE TO THE PATIENTS THAT ONCE THEY SUBMIT A COMPLETED APPLICATION AND DOCUMENTATION, THEY MAY DISREGARD ANY BILLS UNTIL THE HOSPITAL HAS RENDERED A WRITTEN DECISION ON THE APPLICATION. THE HOSPITAL MAY NOT FORWARD ACCOUNTS TO COLLECTION WHILE AN APPLICATION IS PENDING. PART V, SECTION B, LINE 16E UPON VERIFICATION OF EMPLOYMENT WAGES, THE AGENCY WILL GARNISH WAGES ON KALEIDA HEALTH'S BEHALF. PART V, SECTION B, LINE 18E NOTIFICATION THROUGH KALEIDA HEALTH WEBSITE AND BROCHURES. PART V, SECTION B, LINE 20D THE AMOUNTS BILLED ARE CALCULATED USING THE MEDICARE RATE, MEDICAID RATE OR HIGHEST VOLUME COMMERICAL PAYOR RATE. 29 HighPointe on Michigan 1031 Michigan Ave Buffalo NY 14203 Inpatient Skilled Nursing Facility Center for Laboratory Medicine 115 Flint Road Amherst NY 14226 Hospital based lab services MFSC LLC Ambulatory Surgery Center 215 Klein Road Williamsville NY 14221 Freestanding surgery Center ELMWOOD OBGYN 239 BRYANT Street Buffalo NY 14222 Hospital based outpatient PRIMARY CARE SERVICES COMMUNITY MENTAL HEALTH CENTER 1010 MAIN STREET Buffalo NY 14203 Hospital based outpatient BEHAVIORAL HEALTH SERVICES NORTH BUFFALO MEDICAL PARKHERTEL ELMWOO 900 HERTEL AVENUE BUFFALO NY 14207 Hospital based outpatient PRIMARY CARE SERVICES WCHOB HODGE PEDIATRICS 125 HODGE STREET Buffalo NY 14222 Hospital based outpatient primary care services ENDOCRINOLOGY CLINIC 115 FLINT ROAD AMHERST NY 14226 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES KALEIDA HEALTH FAMILY PLANNING CENTER 1313 MAIN ST Buffalo NY 14209 FAMILY PLANNING SERVICES WCHOB SPECIALTY CLINICS 140 HODGE STREET BUFFALO NY 14222 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES BUFFALO THERAPY SERVICES 115 FLINT ROAD AMHERST NY 14226 HOSPITAL BASED OUTPATIENT THERAPY SERVICES TOWN GARDEN PEDIATRICS 461 WILLIAM STREET BUFFALO NY 14204 Hospital based outpatient PRIMARY CARE SERVICES STANLEY MAKOWSKI SBHC 1095 JEFFERSON AVENUE BUFFALO NY 14214 SCHOOL BASED PRIMARY CARE SERVICES KENSINGTON OBGYN 462 GRIDER STREET Buffalo NY 14215 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES LANCASTER ADDICTIONS CLINIC 11 WEST MAIN STREET LANCASTER NY 14086 Hospital based outpatient BEHAVIORAL HEALTH SERVICES AMHERST GENERAL 4955 NORTH BAILEY AVE SUITE 207 AMHERST NY 14226 HOSPITAL BASED OUTPATIENT DIAGNOSTIC Services WCHOB CHILD PROTECTION CENTER 556 FRANKLIN STREET BUFFALO NY 14202 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES WESTMINSTER #68 SBHC 72 PAWNEE PARKWAY BUFFALO NY 14215 SCHOOL BASED PRIMARY CARE SERVICES DR M L KING SBHC 487 HIGH STREET Buffalo NY 14211 School based primary care services DR LYDIA WRIGHT SCHOOL OF EXC #89 SBHC 106 APPENHEIMER STREET Buffalo NY 14214 School based primary care services HERMAN BADILLO BILINGUAL ACAD #76 SBHC 315 CAROLINE STREET Buffalo NY 14201 School Based primary care services BENNETT HIGH SBHC 2885 MAIN STREET Buffalo NY 14214 School based primary care services BUFFALO ELEM SCHOOL OF TECHNOLOGY 414 S DIVISION STREET Buffalo NY 14204 School based primary care services BUILD Academy #91 SBHC 340 FOUGERON STREET Buffalo NY 14211 School based primary care services HILLERY PARK SBHC 72 PAWNEE PARKWAY BUFFALO NY 14210 SCHOOL BASED PRIMARY CARE SERVICES LANCASTER OBGYN 6363 TRANSIT ROAD LANCASTER NY 14086 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES MCKINLEY OBGYN 3860 MCKINLEY PARKWAY HAMBURG NY 14219 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES LOCKPORT OBGYN 475 SOUTH TRANSIT ROAD LOCKPORT NY 14094 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES SOUTHTOWNS CLINIC 4535 SOUTHWESTERN BOULEVARD HAMBURG NY 14075 HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES Part I, Line 3C Kaleida Health (Kaleida) has developed, implemented and communicates its Financial Assistance (Charity Care) policy, which assists low income, uninsured or underinsured individuals who lack the financial resources to pay for medical services rendered. Levels of discounts are awarded based upon income and asset verification and in accordance with the Federal Poverty Guidelines as published annually by the U.S. Department of Health and Human Services. Individuals are notified during intake and registration of Kaleida's Charity Care program. After review of income and assets, an individual may be approved for free care (100% discount) or a discount level of 50, 60, 75, or 90%, for medically necessary inpatient, outpatient, emergency room or nursing home services rendered at a Kaleida facility, as follows: Less than 200% of Federal Poverty Guideline is awarded 100% discount 200% - 249% of Federal Poverty Guideline is awarded 90% discount 250% - 299% of Federal Poverty Guideline is awarded 75% discount 300% - 349% of Federal Poverty Guideline is awarded 60% discount 350% - 400% of Federal Poverty Guideline is awarded 50% discount The applicant for free or reduced price care is contacted by a facilitated enroller or a navigator for financial screening and enrollment in a government-funded program, if eligible. PART I, LINE 7 The amounts reported in the table under Part 1, Line 7 were determined using the Health System's Decision Support software program and revenue and expenses from the general ledger. The overall revenue and expenses included in the decision support software program were reconciled to the general ledger which reconciles to the audited financial statements. The decision support software program allocates direct costs to each patient account based on the resources used by that patient within the specific cost center. Indirect costs are allocated using similar stepdown methodology used by CMS in the Institutional Cost Report. Costing Methodology Used in Determining the Amounts Reported on Lines 2 and 3 of Part III and the Rationale for Including a Portion of Bad Debt Amounts as Community Benefit Bad Debt Expense is recorded using the valuation method as outlined in Healthcare Financial Management Association Statement 15, which requires bad debt expense to be recorded at the amount that the payer is expected to pay. In order to report the costs associated with bad debt expense, the reported bad debt expense needs to be adjusted so that the amount expected to be paid reflects gross charges, prior to the application of an RCC. Kaleida Health adjusts bad debt expense prior to the application of an RCC so that the reported bad debt expense at cost, on Part III, line 2 of IRS Form 990, Schedule H reflects the true cost of the bad debts. The organization has a Charity Care Policy, and any write-offs as a result of this policy are recorded as Charity Care Allowances and are a reduction of the New Patient Revenue. Individuals who may quality for Charity Care assistance under the policy, but do not volunteer to complete the application process would not be granted Charity Care assistance. Kaleida also uses a presumptive charity care process, which has determined that 24% of self-pay bad debt expense in 2013 would have been eligible for charity care assistance. Therefore, we believe that the level of charity care included in bad debt expense to be approximately $951,225. We estimated this amount by using the 2013 calculated presumptive eligibility percentage on bad debt write-off's amounts over $500 (26%), and applied this percentage to those bad debt write-off's amounts under $500, to determine the bad debt write-off's that would have been eligible, if they were scored using the presumptive eligibility process. Bad debt is not included as community benefit. PART III, LINE 4 Kaleida provides care to patients who meet certain criteria under its charity care policies without charge or at amounts less than their established rates. Because Kaleida does not anticipate collection of amounts determined to qualify as charity care, they are not reported as revenue. Kaleida grants credit without collateral to patients, most of whom are local residents and are insured by commercial and government insurance plans. Additions to the estimated allowance for doubtful accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental healthcare coverage, and other collection indicators. The provision for bad debts primarily relates to patients without insurance and to those that are either underinsured or without the necessary resources to pay coinsurance and deductible balances. Part III, Line 8 There are no Medicare shortfalls included in the calculation of community benefit. Costing methodology used to determine the Medicare allowable costs reported in the Medicare Cost Report, as reflected in Part III, line 6. Kaleida Health used the filed, but unaudited 2013 CMS Medicare Cost Report to determine the amounts reported on these lines. Part III, Line 9B Only after a patient's liability has been determined following processing of applications for government assistance, charity care, and/or insurance carrier remittance will the patient statement be mailed for payment recovery. Kaleida Health has implemented a pre-collection process for accounts with an insurance balance of zero, a positive patient balance greater than $4.99, and a first bill date older than 60 days but not previously paid in full by the patient (excluding accounts for patients that have submitted a completed application for Charity Care, Medicaid, or Child Health Plus, and an eligibility determination is pending). At the time that a patient expresses a financial concern, the patient will be offered the opportunity to apply for charity care. Once the patient submits the completed charity care application, the account is placed on hold and all collection activities are suspended until an eligibility determination is made. If the patient is eligible for charity care, then the patient is notified of the level of charity care awarded. If 100% charity care is awarded, then no bill is sent to the patient. If less than 100% charity care is awarded, then the patient will receive a bill pursuant to the private pay collection policy. Community Health Needs Assessment Process Kaleida Health assesses the needs of the community through a Community Health Needs Assessment. The CHNA was completed in 2013. A copy of the CHNA can be found on our website at www.kaleidahealth.org/community/publications.asp and is attached to this return. Patient Education of Eligibility for Assistance Kaleida Health informs individuals of available free or reduced price services at the time of registration into the inpatient, outpatient, emergency department, and long-term care facility. Posters informing the patient/family of assistance are available throughout the Kaleida locations. Brochures and pamphlets informing the community are widely distributed in the community at health fairs, churches, schools and other public locations. Information regarding the availability of financial assistance is also available through Kaleida's website. Kaleida Health offers assistance to individuals in our community for accessing affordable health care, including: * NY Health Exchange Navigation: Assists with navigating, selecting, and applying for enrollment in NY Health Exchange offerings. Dedicated and state-trained staff assist individuals in person or via the phone. In addition to offering in-person appointments at Kaleida Health sites, Kaleida Health opened a community-based location in late 2013. * Centers for Medicaid & Medicare Services (CMS): Kaleida Health staff facilitate enrollment with a targeted focus on children up to the age of 21 enrolled in Buffalo Public Schools and throughout Western New York. * Facilitated Enrollment: Assists eligible individuals with health insurance enrollment by offering education and application assistance for Medicaid, Child Health Plus, Prenatal Care Assistance Program, State Aid for Children with Special Needs, and Qualified Health Plans through the Affordable Care Act. A dedicated telephone number is available and information is published in pamphlets at Kaleida sites and at various locations throughout the community. * Financial Assistance Program: As described above, the Kaleida Financial Assistance Program offers free or reduced-prices for patients treated at Kaleida Health hospitals, outpatient, emergency room, or long-term care facilities. Discounts are awarded based upon income and asset verification. Community Information Three Kaleida Health hospitals are located in Erie County and one, DeGraff Memorial Hospital, is located in Niagara County less than one mile from the Erie County border. Erie County According to MedStat Market Expert 2013 data, less than one million people reside in Erie County. The population continues to decline and has done so even since the 2010 census where there were 925,717 residents in comparison to the 922,988 who live in the county today. Similar to New York State, there are more females than males. However, there are fewer children under age 18 and more residents over age 55 in comparison to New York and the United States. Erie County residents also have a lower household income than the New York State average, which is evident in a higher percentage of residents earning less than $25,000 per year and fewer earning over $100,000. In addition, 67 census tracks are identified as medically underserved areas/populations. The largest municipality in Erie County is the City of Buffalo with 277,681 residents. The average household income in the City of Buffalo, $44,979, is significantly less than the state average. Over 42 percent of households earn less than $25,000 per year including 26.8 percent earning less than $15,000 and only 8.4 percent earning over $100,000. A direct correlation can be drawn to income from the fact that over 17 percent of residents over age 25 do not have a high school degree. The population in the City of Buffalo also has a higher percentage of black non-Hispanics and Hispanics as compared to the rest of the county, 35.6 percent to 13 percent respectively. Niagara County According to MedStat Market Expert 2013 data, just over 215,000 people reside in Niagara County. Like other upstate New York municipalities, the population continues to decline and has done so even since the 2010 census where there were 216,149 residents. Also similar to neighboring counties, there are more females than males, a low percentage of children under age 18 and a high percentage of residents over age 55. Niagara County residents also have a lower household income than the New York State and national averages. Here, 21 census tracks are identified as medically underserved areas/populations. The City of Niagara Falls is the largest municipality in Niagara County. Residents in Niagara Falls have an average salary equivalent to the City of Buffalo. Like most inner cities in comparison to the suburbs, there are a high percentage of households, here close to 40 percent, that earn less than $25,000. As compared to North Tonawanda and the county, there are fewer white non-Hispanics, fewer residents over age 25 with a bachelor's degree or higher and a higher percentage of residents that do not have a high school degree. North Tonawanda, where DeGraff is physically located on the Erie County border, has a high percentage of white non-Hispanics and only one percent of non-Hispanic blacks. Residents in North Tonawanda also have a higher average household income in comparison to the rest of the county as more residents have a bachelor's degree and earn over $100,000. However, the average income is still less than the New York State and U.S. averages. During 2013, there were 55,125 inpatient discharges, of which 25% were Medicaid and Medicaid Managed Care, 41% Medicare and Medicare Managed Care, and 1% were uninsured. There are six other hospitals in Erie County and four other hospitals in Niagara County serving the communities. More information can be found in the 2014-2016 Community Health Needs Assessment and Community Service Plan. The CHNA was completed in fall 2013. A copy of the CHNA can be found on our website at www.kaleidahealth.org/community/publications.asp and is attached to this return. Promotion of Community Health Kaleida Health's mission is to advance the health of the community. Kaleida Health's vision is to be the regional health care system providing exceptional quality services, with a commitment to education and research, accessible to all. The Organization's values illustrate how these goals are achieved: Accountability: We take personal responsibility for delivering results. Patient-Centered: We put patients and families first. Integrity: We demonstrate honesty in everything we do. Excellence: As a team, we pursue exceptional performance with passion. To carry out the mission, much of Kaleida Health's community benefit work is focused on the needs of low income, medically underserved populations. Kaleida Health representatives actively engage in various community health collaborations with local health departments, state health department and local not-for-profit health and human service agencies. Poverty trends, community health research and local community health needs are reviewed on a regular basis while planning services and programs. Responsive to community priorities, program development and services fill identified gaps or supplement existing programs. Most Kaleida Health community health outreach programs are offered in partnership with other community organizations or government agencies in order to leverage resources and meet the community's needs. This includes education and active participation in health events with targeted audiences. Information regarding availability of community health programs, assistance with health insurance enrollment and financial assistance for medical care received at Kaleida Health hospitals, emergency departments, outpatient clinics or long-term care facilities is disseminated to the public in the community benefit and triennial community services plan and available on the Kaleida Health website or in print form upon request. The Visiting Nursing Association of Western New York, Inc., Kaleida Health's home care affiliate, also works to promote the health of the community. This includes educating chronic care patients on self-management and personal care in areas such as rehabilitation services, nutrition education and therapy, infection control, falls risk assessment and intervention, and health education related to improved lifestyle choices for individuals and families in their homes and the community. Community-based prevention programs, such as one of the area's largest annual community influenza immunization program, also are offered through the Visiting Nursing Association. Kaleida Health Board of Directors Kaleida Health maintains control over the corporation through its self-perpetuating, 13 member governing board of directors. The board of directors, the majority of whom reside in Western New York, is comprised of community leaders from the faith, business and industry, and healthcare sectors, including physicians who are on the medical staff. Each director serves a three-year term and is not an employee, independent contractor, or family member of Kaleida Health. State in which the organization files a community benefit report New York State PART V, SECTION B, LINE 7 DUE TO LIMITED RESOURCES, KALEIDA HEALTH PRIORITIZES THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. true UB FOUNDATION 3435 MAIN STREET SUNY BUFFALO BUFFALO NY 14231 160865182 501(c)(3) 25500 SPONSORSHIP CANISIUS COLLEGE 2001 MAIN STREET SUITE 107 BUFFALO NY 14208 160743942 501(C)(3) 5180 SPONSORSHIP MERCY FLIGHT INC 100 AMHERST VILLA ROAD BUFFALO NY 14225 222560963 501(c)(3) 15000 SPONSORSHIP Community Foundation for Greater Buffalo 726 Exchange St 525 Buffalo NY 14210 222743917 501(C)(3) 300000 Uncompensated Care WNY CLINICAL INFO EXCHANGE 2568 WALDEN AVE SUITE 107 CHEEKTOWAGA NY 14225 364594483 501(C)(3) 60000 CONTRIBUTION RONALD MCDONALD HOUSE OF BUFFALO 780 WEST FERRY STREET SUITE 125 BUFFALO NY 14222 222438932 501(C)(3) 5500 SPONSORSHIP UPSTATE NEW YORK TRANSPLANT SERVICES 110 BROADWAY STREET BUFFALO NY 14203 161172453 501(C)(3) 8000 SPONSORSHIP WNY HEALTHENET LLC 2568 WALDEN AVE SUITE 107 CHEEKTOWAGA NY 14225 043726634 N/A 80000 CONTRIBUTION 7 1 FORM 990, SCHEDULE I: PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: KALEIDA HEALTH MAKES CONTRIBUTIONS TO ORGANIZATIONS IN WESTERN NEW YORK THAT ALSO HAVE HEALTH CARE RELATED ACTIVITIES. ALL CONTRIBUTIONS MUST BE APPROVED BY THE GOVERNING BODY BEFORE THE MONEY IS DISTRIBUTED. X true true X X X X X X true true false false false false false false false JAMES KASKIE PRES/CEO EX-OFFICIO WITH VOTE 936495 0 630000 0 332659 0 31030 0 13180 0 1943364 0 284028 0 ROBERT NOLAN GENERAL COUNSEL 368258 0 85000 0 46520 0 21784 0 13628 0 535190 0 39020 0 JOSEPH KESSLER EVP, CFO 498120 0 118750 0 739113 0 29568 0 13807 0 1399358 0 731613 0 MARGARET PAROSKI MD EVP, CMO 446154 0 84000 0 141687 0 0 0 0 0 671841 0 116687 0 TONI BOOKER EVP HUMAN RESOURCES OFFICER 326064 0 75000 0 10000 0 132674 0 6062 0 549800 0 0 0 AARON HOFFMAN MD EMPLOYED PHYSICIAN 1092326 0 0 0 0 0 7428 0 13990 0 1113744 0 0 0 KAVEH VALI MD EMPLOYED PHYSICIAN 704160 0 0 0 0 0 3841 0 934 0 708935 0 0 0 KATHRYN BASS MD EMPLOYED PHYSICIAN 615560 0 0 0 0 0 4490 0 997 0 621047 0 0 0 PUNEET GUPTA MD EMPLOYED PHYSICIAN 401858 0 0 0 0 0 4714 0 794 0 407366 0 0 0 VINCENT CALLANAN MD EMPLOYED PHYSICIAN 439314 0 0 0 0 0 28522 0 13735 0 481571 0 0 0 CHERYL KLASS SVP OPS BGMC, PRESIDENT WCHOB 523972 0 175000 0 7500 0 257969 0 6326 0 970767 0 0 0 DONALD BOYD SVP BUSINESS DEVELOPMENT 427654 0 114000 0 71449 0 21325 0 13681 0 648109 0 63949 0 CHRISTOPHER LANE PRESIDENT-MFS 340852 0 75000 0 2500 0 20335 0 13602 0 452289 0 0 0 TAMARA OWEN VP OF INTEGRATION 43780 0 353105 2418 1198 400501 0 CONNIE VARI Former EVP, COO 731366 13180 744546 93386 HEALTH OR SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1A AS PART OF THEIR COMPENSATION PACKAGE, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE ENTITLED TO CHOOSE AS AN EXECUTIVE PERK THE BENEFIT OF BUSINESS RELATED SOCIAL DUES OR INITIATION FEES. SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4A THE FOLLOWING FORMER EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A RECEIVED SEVERANCE PAYMENTS DURING 2013: CONNIE VARI, FORMER COO, $638,809 TAMARA OWEN, FORMER VP OF INTEGRATION, $188,838 EXECUTIVE DEFERRED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B DURING THE YEAR, THE FOLLOWING OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A PARTICIPATED IN THE EXECUTIVE DEFERRED RETIREMENT PLAN: ROBERT NOLAN, CONNIE VARI, JOSEPH KESSLER, JAMES KASKIE, DONALD BOYD, MARGARET PAROSKI, CHERYL KLASS, AND TONI BOOKER. EMPLOYER AND EMPLOYEE CONTRIBUTIONS DURING THE YEAR TO THIS PLAN HAVE BEEN REPORTED, AS REQUIRED, ON SCHEDULE J, PART II COLUMNS (B)(III) AND (C). DURING 2013, THE FOLLOWING OFFICERS RECEIVED PAYMENTS UNDER AN EXECUTIVE DEFERRED RETIREMENT PLAN: JOSEPH KESSLER $731,613 JAMES KASKIE $284,028 MARGARET PAROSKI $116,687 CONNIE VARI $93,386 DONALD BOYD $63,949 ROBERT NOLAN $39,020 A Dormitory Authority - State of New York 146000293 64983Q429 2006-09-21 81810000 RENOVATIONS TO FACILITIES false false false A 10615000 0 86266211 44569941 5074243 0 1213231 1836365 2067415 69802989 0 0 2008 false false true true A false false true true false 0 false false false false A false false false true false false 0 true MBIA INC true true true A true Supplemental Information SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2011 PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4-12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. PART IV, COLUMN B, LINE 5C - CONSTRUCTION FUND - 2.5 YEARS, RESERVE FUND - 4.4 YEARS. Dr Andras Vari See Part V X 18832367 18832367 false true true 18832367 GREATER NEW YORK HOSPITAL ASSOCIATI SEE PART V 115625 SEE PART V false JOCELYN BELISLE SEE PART V 73106 SEE PART V false DAVID VARI SEE PART V 63087 SEE PART V false SUSAN EVANS SEE PART V 74885 SEE PART V false Dr ANDRAS VARI SEE PART V 95047 SEE PART V false LOANS TO INTERESTED PERSONS SCHEDULE L, PART II DR. ANDRAS VARI, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DR. ANDRAS VARI, AN INTERESTED PERSON TO KALEIDA HEALTH, IS FORMER OWNER OF GENERAL PHYSICIANS, P.C. (GPPC). COLUMN C - PURPOSE OF THE LOAN: DURING 2013, KALEIDA HEALTH LOANED GENERAL PHYSICIANS, P.C. MONEY TO RE-ACTIVATE THE PHYSICIAN PRACTICE THAT HAS BEEN DORMANT SINCE 2002. THE LOAN WAS MADE TO ASSIST GENERAL PHYSICIANS, P.C. TO PAY FOR THE COSTS OF ACQUIRING AND EMPLOYING PHYSICIANS AND STAFF AS WELL AS ONGOING OPERATING COSTS OF THE PRACTICE AND WILL BE REPAID TO KALEIDA ONCE GPPC HAS RE-ESTABLISHED ITS PATIENT BASE AND HAS THE ABILITY TO REPAY. BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV GREATER NEW YORK HOSPITAL ASSOCATION, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THE CURRENT PRESIDENT/CEO OF THE FILING ORGANIZATION (KALEIDA HEALTH), JAMES KASKIE, WAS ALSO SERVING AS A BOARD MEMBER OF THE GREATER NEW YORK HOSPITAL ASSOCIATION AT THE TIME OF THE TRANSACTION. COLUMN D - DESCRIPTION OF THE TRANSACTION: DURING 2013, THE ORGANIZATION PAID THE INTERESTED PERSON (GREATER NEW YORK HOSPITAL ASSOCIATION) PARTICIPATION DUES RELATED TO A SUPPLY INITIATIVE PROGRAM. JOCELYN BELISLE, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: JOCELYN BELISLE IS A FAMILY MEMBER OF A FORMER OFFICER OF THE ORGANIZATION, CONNIE VARI, WHO RECEIVED COMPENSATION FROM THE ORGANIZATION IN EXCESS OF $10,000. COLUMN D - DESCRIPTION OF THE TRANSACTION: DURING 2013, THE ORGANIZATION PAID THE INTERESTED PERSON (JOCELYN BELISLE) IN THE NORMAL COURSE OF BUSINESS TO FURNISH SERVICES AS A PERFORMANCE IMPROVEMENT PROJECT COORDINATOR. DAVID VARI, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DAVID VARI IS A FAMILY MEMBER OF A FORMER OFFICER OF THE ORGANIZATION, CONNIE VARI, WHO RECEIVED COMPENSATION FROM THE ORGANIZATION IN EXCESS OF $10,000. COLUMN D - DESCRIPTION OF THE TRANSACTION: DURING 2013, THE ORGANIZATION PAID THE INTERESTED PERSON (DAVID VARI) IN THE NORMAL COURSE OF BUSINESS FOR PERFORMANCE OF SERVICES AS A SENIOR HUMAN RESOURCES GENERALIST. SUSAN EVANS, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: SUSAN EVANS IS A FAMILY MEMBER OF A CURRENT BOARD MEMBER OF THE ORGANIZATION, EVAN EVANS, MD, WHO RECEIVED COMPENSATION FROM THE ORGANIZATION IN EXCESS OF $10,000. COLUMN D - DESCRIPTION OF THE TRANSACTION: DURING 2013, THE ORGANIZATION PAID THE INTERESTED PERSON (SUSAN EVANS) IN THE NORMAL COURSE OF BUSINESS FOR PERFORMANCE OF SERVICES AS A UTILIZATION REVIEW COORDINATOR. DR. ANDRAS VARI, COLUMN B - RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: DR. ANDRAS VARI IS THE HUSBAND OF A FORMER OFFICER OF THE ORGANIZATION, CONNIE VARI, WHO RECEIVED COMPENSATION FROM THE ORGANIZATION IN EXCESS OF $10,000. COLUMN D - DESCRIPTION OF THE TRANSACTION: DURING 2013, THE ORGANIZATION PAID THE INTERESTED PERSON (DR. ANDRAS VARI) SEVERANCE FOR HIS SERVICES AS THE FORMER CHIEF MEDICAL OFFICER OF MILLARD FILLMORE GATES HOSPITAL. X Various Medical equipment 11 1935605 Replacement cost false true false ORGANIZATION'S MISSION KALEIDA HEALTH IS THE LARGEST HEALTHCARE PROVIDER IN WNY, SERVING THE AREA'S 8 COUNTIES WITH COMPREHENSIVE SERVICES & PROGRAMS PROVIDED AT 4 ACUTE CARE, 2 LT CARE, AS WELL AS OUTPATIENT & PRIMARY CARE SITES. DELEGATION OF CMO DUTIES FORM 990, PART VI, SECTION A, QUESTION 3 DURING 2013, THE ORGANIZATION CONTRACTED WITH UNIVERSITY NEUROLOGY FOR THE SERVICES OF MARGARET PAROSKI IN HER CAPACITY AS CHIEF MEDICAL OFFICER (CMO) OF THE ORGANIZATION. PART OF HER ROLE AS CMO IS CONTROL OVER CERTAIN MANAGEMENT DUTIES WITH RESPECT TO EMPLOYED PHYSICIANS THAT CUSTOMARILY ARE PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF OFFICERS OR KEY EMPLOYEES. REVIEW PROCESS FOR FORM 990 Form 990, Part VI, Section B, Line 11B ORGANIZATION'S MANAGEMENT (A TEAM COMPRISED OF REPRESENTATIVES OF THE FINANCE, HUMAN RESOURCES, AND LEGAL DEPARTMENTS) IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, KPMG, REVIEW THE FORM 990. THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE FORM 990 IS FILED WITH THE IRS THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE SAME TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANIZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE A POTENTIAL, ACTUAL, OR EVEN APPEARANCE, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. THE COMPLETED CONFLICTS OF INTEREST AND DISCLOSURE FORMS FOR DIRECTORS ARE RETURNED TO THE ORGANIZATION. COMPENSATION APPROVAL PROCESS FORM 990,PART VI, SECTION B, QUESTION 15A AND B ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES FOR REVIEW AND APPROVAL. SUCH INFORMATION INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE OFFICERS/EXECUTIVE COMMITTEE IS DOCUMENTED. ACCESS TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS OFFICE AT 726 EXCHANGE STREET, SUITE 200, BUFFALO, NY 14210. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. Form 990, Part XI OTHER CHANGES IN NET ASSETS OR FUND BALANCES Minority Interest in Sub. (692,241) Decrease in Pension Liability 85,214,109 Transfer from Kaleida Foundations 109,750 Other Transfers, Net (68,387) Change in Value of Foundations 9,057,453 ------------ TOTAL 93,620,684 KALEIDA MCO LLC 726 EXCHANGE ST SUITE 200 BUFFALO NY 14210 161570311 DORMANT NY KH KALEIDA IPA LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161570380 DORMANT NY KH KALEIDA WNYI LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 453189404 HEALTH CARE NY -203288 1100049 KH MILLARD FILLMORE AMBULATORY SURGERY CTR 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161307129 SUPPORT ORG NY 501(C)(3) 11A KH true VNA HOME CARE SERVICES 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161491203 HOME HLTH CAR NY 501(C)(3) 9 KH true VNA OF WESTERN NEW YORK 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 160743214 HOME HLTH CAR NY 501(C)(3) 9 KH true GENERAL HOME CARE (GHC) 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738425 DORMANT NY 501(C)(3) 9 KH true KALEIDA HEALTH FOUNDATION 726 EXCHANGE STREET BUFFALO NY 14210 161579143 FUNDRAISING NY 501(c)(3) 7 KH true THE WOMEN & CHILDREN'S HOSP OF BFLO FDN 726 EXCHANGE STREET BUFFALO NY 14210 161332044 FUNDRAISING NY 501(c)(3) 7 KH true HARLEM ROAD LEASING LLC 3435 MAIN STREET BUFFALO NY 14214 205588135 EQUIPMENT LEASING NY KH UNRELATED 85134 387434 false true 0.50000 AMTON IMAGING LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE NY 14221 262925470 HEALTH CARE NY KALEIDAWNYI LLC RELATED -195938 1019987 false true 0.50000 PARK CLUB LANE LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE NY 14221 271516155 HEALTH CARE NY KALEIDAWNYI LLC EXCLUDED -7350 80062 false true 0.30000 SITE E LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 272124795 REAL ESTATE MNGT NY KPI EXCLUDED 113528 1654975 false false 0.50177 MFSC LLC 100 HIGH STREET BUFFALO NY 14203 261582864 HEALTH CARE NY KH EXCLUDED 1094389 1447740 false false 0.54196 KALEIDA PROPERTIES INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738483 PROP MGMT SERVICE NY KH C Corp -49554 17584425 1.00000 false WESTLINK CORPORATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161354421 MED & DIAG SERVIC NY KH C Corp -259 101620 1.00000 false KALEIDAHEALTHNOW INC 257 W GENESEE ST BUFFALO NY 14202 462164089 HEALTH CARE NY KALEIDA HEALTH C CORP 975 599015 0.50000 false false false true true false false false false true true true false false false true true true false true VNA OF WESTERN NEW YORK q 1709387 VNA OF WESTERN NEW YORK o 87078 VNA OF WESTERN NEW YORK d 661955 VNA HOME CARE SERVICES q 793282 VNA HOME CARE SERVICES d 146223 KALEIDA PROPERTIES INC d 3703071 KALEIDA PROPERTIES INC q 283249 KALEIDA PROPERTIES INC i 1322436 KALEIDA HEALTH FOUNDATION c 740053 KALEIDA HEALTH FOUNDATION s 1107194 KALEIDA HEALTH FOUNDATION d 154560 WOMENS AND CHILDRENS HOSPITAL OF BUFFALO FDN c 867247 WOMENS AND CHILDRENS HOSPITAL OF BUFFALO FDN s 2117018 SITE E LLC k 233450 MFSC LLC J 594635 MFSC LLC P 500949 TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V, TRANSACTION TYPE C THERE IS A VARIANCE BETWEEN THE AMOUNT REFLECTED ON PART VIII, LINE 1D (AND SCHEDULE B) - GIFTS, GRANTS AND CONTRIBUTIONS FROM THE FOLLOWING RELATED ORGANIZATIONS AND THE AMOUNT INCLUDED ON SCHEDULE R, PART V AS A RESULT OF THE VARIANCE IN TIMING OF THE RECORDING OF THE TRANSFER BETWEEN THE TWO ORGANIZATIONS. KALEIDA HEALTH FOUNDATION RECORDED GRANTS PAID TO THE FILING ORGANIZATION IN THE AMOUNT OF $740,053 (SEE SCHEDULE R, PART V) VERSUS THE $686,967 RECORDED BY THE FILING ORGANIZATION AS GRANTS RECEIVED (SEE PART VIII, LINE 1D AND SCHEDULE B). THE WOMEN & CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION RECORDED GRANTS PAID TO THE FILING ORGANIZATION IN THE AMOUNT OF $867,247 (SEE SCHEDULE R, PART V) VERSUS THE $943,100 RECORDED BY THE FILING ORGANIZATION AS GRANTS RECEIVED (SEE PART VIII, LINE 1D AND SCHEDULE B).