2012-11-15T12:08:26-06:00 2011-12-31 264298079 EFP ROTENBERG LLP 280 KENNETH DRIVE ROCHESTER NY 14623 990 2011-01-01 160743979 NICHOLAS H NOYES MEMORIAL HOSPITAL NICH 5853356001 111 CLARA BARTON STREET DANSVILLE NY 14437 AMY POLLARD 5853356001 2012-11-13 1 WILLIAM MCDONALD P01600766 5854278900 2012-11-12 2011 2016-02-24 21:20:13Z AMY POLLARD 111 CLARA BARTON STREET DANSVILLE NY 14437 50679325 0 X WWW.NOYES-HEALTH.ORG X 1927 NY NICHOLAS H. NOYES MEMORIAL HOSPITAL IS A 72 BED HOSPITAL WHICH PROVIDES ACUTE, SUB-ACUTE, EMERGENCY AND OTHER OUTPATIENT CARE AND WHOSE MISSION IS TO SUPPORT AND PROMOTE THE HEALTH OF OUR COMMUNITIES THROUGH COMPASSIONATE QUALITY CARE. 20 12 615 110 607869 -67188 395232 397733 48323463 48996147 72638 69428 796552 1086057 49587885 50549365 0 0 0 0 26607732 27383376 0 0 56889 23900802 23477330 50508534 50860706 -920649 -311341 40642575 39858292 19895660 21013443 20746915 18844849 NICHOLAS H. NOYES MEMORIAL HOSPITAL SUPPORTS AND PROMOTES THE HEALTH OF OUR COMMUNITIES THROUGH COMPASSIONATE QUALITY CARE. 0 0 39742690 49096710 NICHOLAS H. NOYES MEMORIAL HOSPITAL IS A 72 BED HOSPITAL WHICH PROVIDES ACUTE, SUB-ACUTE, AND OUTPATIENT CARE. 39742690 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 85 0 1 615 1 1 1 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X 20 12 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 0 0 NY X X JAY MASLYN 5853354306 111 CLARA BARTON STREET DANSVILLE NY 14437 JAMES CULBERSTON 1.00 X 0 0 0 JOHN LOCKHART 2.00 X 0 0 0 MICHAEL JOHNSEN 2.00 X 0 0 0 LESLIE COLE JR 2.00 X 0 0 0 GEOFFREY MARKOWSKI MD 1.00 X 0 0 0 THOMAS DWYER MD 1.00 X 0 0 0 JOAN FLENDER MD 1.00 X 0 0 0 GRAHAM FRAZER 2.00 X 0 0 0 ROBERT HART 1.00 X 0 0 0 ARIF QURESHI MD 1.00 X 0 0 0 ANDREW LONG 1.00 X 0 0 0 MARILYN MOORE 5.00 X 0 0 0 MAUREEN WOLCOTT 1.00 X 0 0 0 SALLY WEST 1.00 X 0 0 0 MARK LYONS 1.00 X 0 0 0 PETER SOSCIA 1.00 X 0 0 0 LINDSAY QUINTILONE 1.00 X 0 0 0 AMY POLLARD 40.00 X X 160375 0 17312 JAY MASLYN 40.00 X 136854 0 3022 DOUGLAS MAYHLE MD 40.00 X 339945 0 15747 ROBERT CAPECCI MD 40.00 X 591586 0 8372 ASAD MAJID MD 40.00 X 418202 0 15152 ROBERT SUPINSKI 40.00 X 623025 0 18823 ROBERT BONVINO MD 40.00 X 337405 0 12542 BARRY HAICKEN MD 40.00 X 321420 0 15979 JAMES WISSLER 0.00 X 175836 0 11439 3104648 0 118388 9 1 1 0 DANVILLE ANESTHESIA & PAIN MGMT PO BOX 784891 PHILADELPHIA PA 19178 ANESTHESIOLOGIST 790621 ARUP LABORATORIES PO BOX 27964 SALT LAKE CITY UT 84127 LAB TESTING SERVICES 683393 SLEEP INSIGHTS MEDICAL SERVICES 10 HAGEN DRIVESUITE 200 ROCHESTER NY 14625 POLYSOMNOGRAPHY SERVICES 374892 SMA MEDICAL PLLC 85-43 167 STREET JAMAICA NY 11432 INTERNIST 239400 VIRGINIA WOHLTMANN MD 1108 ROOSEVELT RD ROCHESTER NY 14445 PSYCHIATRIST 150579 7 317067 80666 397733 PATIENT SERVICE REVENU 621990 48996147 48996147 48996147 56027 56027 51432 38031 13401 13401 13401 24083 8336 15747 15747 184156 83593 100563 100563 OTHER REVENUE 541380 969329 607451 361878 SEAGATE ALLIANCE, LLC 900000 418 418 969747 50549365 49096710 607869 447053 673254 235992 437262 22473011 18162067 4284975 25969 197492 157953 37656 1883 2537598 2050704 483849 3045 1502021 1124529 375505 1987 13710 12600 1110 73945 73945 38510 38510 63194 63194 3608648 2554221 1054427 227374 52667 165972 8735 9213100 8416447 781383 15270 563252 422439 140813 1196456 508734 687722 16758 1119 15639 103449 39756 63693 485693 37495 448198 2057092 1143530 913562 760587 669195 91392 OTHER PURCHASED SERVICE 1530124 1301501 228623 BAD DEBT 1476797 1476797 EQUIPMENT RENTAL 852699 464682 388017 REPAIRS & MAINTENANCE 762139 636409 125730 433803 273853 159950 50860706 39742690 11061127 56889 4664 4360 2703682 2942979 35300 10313 5520151 5012983 868988 835329 871986 1111004 46457552 30092984 16574893 16364568 1352993 1360784 12709918 12215972 40642575 39858292 4518254 4763456 637872 656700 9189986 9102732 5549548 6490555 19895660 21013443 X 19877759 18068096 125450 33047 743706 743706 20746915 18844849 40642575 39858292 X -311341 -1590725 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10593 10593 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: AS MEMBERS OF 3 ASSOCIATIONS (AHA - AMERICAN HOSPITAL ASSOCIATION, HANYS-THE HEALTHCARE ASSOCIATION OF NEW YORK STATE & RRHA/SEAGATE ALLIANCE) A PORTION OF THE DUES (TOTAL REFLECTED ABOVE) ARE PAID AS PART OF MEMBERSHIP AND REPRESENT AMOUNTS DESIGNATED FOR LOBBYING ACTIVITIES. THESE ASSOCIATE ORGANIZATIONS OF WHICH WE ARE MEMBERS HANDLE THE DIRECT LOBBYING/ADVOCACY ACTIVITIES ON BEHALF OF THEIR MEMBERS. 1434453 24558 9648 1449363 1335945 107551 9043 1434453 1155614 188466 8135 1335945 1614612 -273730 175000 10268 1155614 0.44410 0.55590 0 0 372690 372690 22218909 12035668 10183241 22143089 18057316 4085773 1722864 1722864 16364568 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 9418454 DEBT ORIGINATION COSTS - NET 483270 DUE FROM RELATED ENTITY 432745 MORTGAGE REPAYMENT ESCROW FUNDS 805638 OTHER 1075865 12215972 DUE TO THIRD PARTY PAYORS- LONG TERM 1118401 DUE TO THIRD PARTY PAYORS- SHORT TERM 1100722 LINE OF CREDIT 210000 PENSION LIABILITY 3863752 WORKERS COMPENSATION 197680 6490555 50549365 50860706 -311341 -37347 -1553378 -1590725 -1902066 50549365 0 50549365 0 50549365 50860706 0 50860706 0 50860706 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: EMPLOYEE EDUCATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN ACCORDANCE WITH ASC 740-10-50, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE SYSTEM RECOGNIZES THE TAX BENEFITS FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES. MANAGEMENT BELIEVES THAT THE SYSTEM IS CURRENTLY OPERATING IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS HAS BEEN INCLUDED ON THE SYSTEMS FINANCIAL STATEMENTS. THE EXEMPT SYSTEMS INFORMATIONAL RETURNS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES AND ITS OPEN AUDIT PERIODS ARE 2009 THROUGH 2011. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN FOUNDATION 82,068. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS -1,635,446. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,553,378. GOLF TOURNAMENT 17885 17885 1584 2164 830 FLOWER SALE 6198 6198 3758 24083 24083 1584 2164 4588 8336 15747 1 1 0 1 X 1 1 1 0 1 1 947 612646 0 612646 0.01200 7518 7069634 6083710 985924 0.01940 457 580389 493030 87359 0.00170 8922 8262669 6576740 1685929 0.03310 16 7085 78245 12218 66027 0.00130 3 202 102931 297 102634 0.00200 2 2354 3584892 3018970 565922 0.01110 0 3 1045 57305 13211 44094 0.00090 24 10686 3823373 3044696 778677 0.01530 24 19608 12086042 9621436 2464606 0.04840 1 182 12466 12466 0.00020 1 182 12466 12466 0.00020 0 1476797 381465 8976740 7574035 1402705 X 1 1 1 1 NICHOLAS H NOYES MEMORIAL HOSPITAL

111 CLARA BARTON STREET DANSVILLE NY 14437

X X X NOT REQUIRED 1 1 1 100.000000000000 1 300.000000000000 1 X X X 1 1 X X X X X X 1 X 1 X X X X X 1 X 0 0 5 AFTER HOURS CARE CENTER

4440 LAKEVILLE ROAD GENESEO NY 14454

URGENT CARE CENTER LIVINGSTON HEALTH SERVICES

50 EAST SOUTH STREET GENESEO NY 14454

OUTPATIENT SURGERY AND DIAGNOSTIC MENTAL HEALTH CLINIC

1 MAIN STREET DANSVILLE NY 14437

MENTAL HEALTH CLINIC NOYES CTR FOR KIDNEY DISEASE & DIALYSIS

4616 MELLENIUM DRIVE GENESEO NY 14454

CHRONIC DIALYSIS CENTER AND NEPHROLOGIST OB-GYN ASSOC OF THE FINGER LAKES

253 MAIN STREET DANSVILLE NY 14437

OUTPATIENT PHYSICIAN CLINIC PART II: NOYES HOSPITAL STAFF ACTIVELY PARTICIPATES IN MULTIPLE COMMUNITY COALITIONS AND PARTNERSHIPS TO COLLABORATIVELY ADDRESS THE HEALTH CARE NEEDS OF OUR COMMUNITY. THE FOLLOWING IS A LIST OF AGENCY AND ORGANIZATIONAL COMMITTEES/TEAMS THAT NOYES PARTICIPATES ON TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE: GENESEE VALLEY HEALTH PARTNERSHIP (GVHP): EXECUTIVE BOARD AND GENERAL MEMBERSHIP GVHP LIVINGSTON COUNTY COMMUNITY HEALTH IMPROVEMENT (CHIP) WORK GROUPS: PREVENTION AND MANAGEMENT OF CHRONIC DISEASE (NOYES MEMBER) IMPROVE ACCESS TO HEALTH CARE STRENGTHEN SOCIAL AND EMOTIONAL HEALTH (NOYES MEMBER) PROMOTE SAFE COMMUNITIES (NOYES MEMBER) LIVINGSTON WELLNESS PARTNERSHIP LIVINGSTON COUNTY LONG TERM CARE COUNCIL LIVINGSTON COUNTY MATERNAL CHILD HEALTH COALITION (NOYES LEAD) LIVINGSTON COUNTY DIABETES COALITION (NOYES LEAD) LIVINGSTON COUNTY SEXUAL RESPONSIBILITY COALITION LIVINGSTON COUNTY TOBACCO ACTION COALITION LIVINGSTON COUNTY TRAFFIC SAFETY COALITION LIVINGSTON COUNTY OFFICE FOR AGING ADVISORY BOARD FAITH IN ACTION ADVISORY BOARD NEW ACHIEVE GRANT (ACTION COMMUNITIES FOR HEALTH, INNOVATIONS, AND ENVIRONMENTAL CHANGE) GVHP/DOH/NOYES HEALTH PARTNERSHIP: IN LATE 2010, THE LOCAL DOH APPLIED FOR AND RECEIVED A NACCHO ACHIEVE GRANT IN COLLABORATION WITH GVHP AND NOYES HEALTH TO STRENGTHEN THE COMMUNITY WELLNESS COLLABORATION AND DEVELOP COMMUNITY ACTION PLANS THAT ADDRESS COMPREHENSIVE CHRONIC DISEASE PREVENTION THROUGH POLICY, SYSTEMS, AND ENVIRONMENTAL (PSE) CHANGE STRATEGIES. PART III, LINE 4: COSTING METHOD FOR BAD DEBT EXPENSE AT COST IS RATIO OF PATIENT CARE COST TO CHARGES FROM WORKSHEET 2.THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE IS ESTIMATED USING THE SELF PAY % OF TOTAL BAD DEBT AND MULTIPLYING BY THE DEMOGRAPHICS OF OUR PRIMARY SERVICE AREA FOR THOSE WHO WOULD RECEIVE CHARITY CARE IF GIVEN ENOUGH INFORMATION. PART III, LINE 8: THE SOURCE OF THE MEDICARE ALLOWABLE COSTS IS THE 2009 CMS 2552 WORKSHEET I-4. NOT REQUIRED PART V, SECTION B, LINE 11H: LOWEST COMMERICIAL RATE PART VI, LINE 2: NOYES HEALTH CONTINUES TO BE AN ACTIVE MEMBER OF THE GENESEE VALLEY HEALTH PARTNERSHIP (GVHP) WHOSE MEMBERSHIP INCLUDES OVER 40 AGENCIES AND COMMUNITY MEMBERS INVOLVED WITH HEALTH CARE SERVICES IN LIVINGSTON COUNTY. THE HOSPITAL CEO IS ON THE GENESEE VALLEY HEALTH PARTNERSHIP (GVHP) EXECUTIVE BOARD. THE GVHP COORDINATED THE LIVINGSTON COUNTY COMMUNITY NEEDS ASSESSMENT USING MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS INITIATED IN 2010 TO DEVELOP THE LIVINGSTON COUNTY DOH COMMUNITY HEALTH IMPROVEMENT PLAN 2011-2015. IN 2011, THE MAPP ADVISORY BOARD CHARGED FOUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TEAMS TO FOCUS ON INDICATORS, RESOURCES, BARRIERS, OBJECTIVES, GOALS AND INTERVENTIONS TO ADDRESS THE TOP FOUR COMMUNITY HEALTH NEEDS.NOYES COMMUNITY OUTREACH STAFF ATTENDS THE QUARTERLY GENERAL MEMBERSHIP MEETINGS AND PARTICIPATE ON ONE OR MORE OF THE FOUR CHIP TEAMS THAT FOCUS ON PREVENTION AGENDA PRIORITIES SET IN OUR 2009 NOYES COMPREHENSIVE PLAN: PREVENTION AND MANAGEMENT OF CHRONIC DISEASE IMPROVE ACCESS TO HEALTH CARE STRENGTHEN SOCIAL AND EMOTIONAL HEALTH PROMOTE SAFE COMMUNITIES PART VI, LINE 3: IN 2011, NOYES HEALTH CONTINUED EFFORTS TO EFFECTIVELY COMMUNICATE OUR FINANCIAL AID POLICY. EVERY UNINSURED AND UNDERINSURED PATIENT RECEIVED A FINANCIAL AID PACKET CONSISTING OF THE FINANCIAL AID PROGRAM SUMMARY AND BROCHURE, A FINANCIAL AID (FA) APPLICATION AND INSTRUCTIONS ON HOW TO APPLY, AS WELL AS HOW TO RECEIVE ASSISTANCE IN APPLYING. WE HAVE A SOCIAL WORKER AND A DEDICATED FA BILLING REPRESENTATIVE WHO WORK SPECIFICALLY WITH ALL UNINSURED PATIENTS UPON ADMISSION. WE EMPLOY A FACILITATED ENROLLER FOR PRESUMPTIVE MEDICAID FOR PRENATAL CARE AND EDUCATION/SUPPORT SERVICES. ALL OTHER FACILITATED ENROLLMENT NEEDS ARE REFERRED TO APPROPRIATE COUNTY DEPARTMENT OF SOCIAL SERVICESPATIENTS ARE MAILED FINANCIAL AID INFORMATION WITH THEIR FIRST STATEMENTS. INFORMATION ABOUT THE HOSPITALS FINANCIAL ASSISTANCE PROGRAM IS ALSO POSTED IN ALL PUBLIC AREAS THROUGHOUT THE HOSPITAL. THE FINANCIAL ASSISTANCE COMMITTEE MEETS AS NEED TO REVIEW POLICY AND ADDRESS SPECIAL NEEDS. THE REVENUE CYCLE COMMITTEE MEETS MONTHLY AND INCLUDED FINANCIAL AID DATA REVIEW. PART VI, LINE 4: NOYES MEMORIAL HOSPITAL SERVES A RURAL COMMUNITY IN THE NEW YORK FINGER LAKES AREA. OUR PRIMARY MARKET SHARE ZIP CODE REPORT DEMONSTRATES THAT LIVINGSTON COUNTY IS OUR HEALTH CARE SYSTEMS PRIMARY SERVICE AREA AND WE ALSO SERVE A SMALLER PERCENTAGE OF RESIDENTS IN THE SURROUNDING COUNTIES INCLUDING STEUBEN, ALLEGANY, WYOMING AND ONTARIO RESPECTIVELY. LIVINGSTON COUNTY IS A RURAL COUNTY IN WESTERN NEW YORK COVERING 640 SQUARE MILES WITH POPULATION OF 65,393.HEALTH CARE SERVICES ARE PROVIDED AT THE FOLLOWING LOCATIONS THROUGHOUT LIVINGSTON COUNTY: NICHOLAS H. NOYES MEMORIAL HOSPITAL: A 72-BED ACUTE CARE HOSPITAL LOCATED IN DANSVILLE PROVIDING MEDICAL, SURGICAL, AND EMERGENCY INPATIENT/OUTPATIENT SERVICES THAT ALSO INCLUDE COMMUNITY OUTREACH WELLNESS, EDUCATION AND PREVENTION PROGRAMS. LIVINGSTON HEALTH SERVICES: AN AMBULATORY CARE FACILITY IN GENESEO THAT PROVIDES OUTPATIENT SURGICAL, RADIOLOGY, LABORATORY, PHYSICAL THERAPY, PAIN MANAGEMENT, AND PHYSICIAN SERVICES. NOYES MENTAL HEALTH: AN OUT-PATIENT CLINIC PROVIDING INDIVIDUAL, GROUP AND FAMILY COUNSELING SERVICES. NOYES PHYSICIAN SERVICE OFFICES OB-GYN ASSOCIATES OF THE FINGER LAKES: DANSVILLE AND GENESEO GENESEE REGIONAL ORTHOPEDICS: DANSVILLE CREEKSIDE FAMILY PRACTICE NOYES SURGICAL SERVICS NOYES CENTER FOR KIDNEY DISEASE AND DIALYSIS: A 12 STATION OUTPATIENT DIALYSIS AND RENAL DISEASE MANAGEMENT CENTER IN GENESEO. PART VI, LINE 5: THE NOYES BOARD OF DIRECTORS HAS 14 ACTIVE COMMUNITY REPRESENTATIVES ON THEIR 20 MEMBER BOARD. NOYES HAS AN OPEN MEDICAL STAFF PROVIDING A VARIETY OF MEDICAL SERVICES INCLUDING: CARDIOLOGY, EARS/NOSE/THROAT, FAMILY MEDICINE, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL AND VASCULAR SURGERY, INTERNAL MEDICINE, OB/GYN, NEPHROLOGY, OPHTHALMOLOGY, PEDIATRICS, AND UROLOGY. REPORTS FILED WITH STATES PART VI, LINE 7 NY X X X 1 0 0 0 0 0 0 0 0 AMY POLLARD 157184 0 0 0 3191 0 0 0 17312 0 177687 0 0 0 DOUGLAS MAYHLE MD 333734 0 0 0 6211 0 0 0 15747 0 355692 0 0 0 ROBERT CAPECCI MD 590398 0 0 0 1188 0 0 0 8372 0 599958 0 0 0 ASAD MAJID MD 417932 0 0 0 270 0 0 0 15152 0 433354 0 0 0 ROBERT SUPINSKI 622281 0 0 0 744 0 0 0 18823 0 641848 0 0 0 ROBERT BONVINO MD 336217 0 0 0 1188 0 0 0 12542 0 349947 0 0 0 BARRY HAICKEN MD 319393 0 0 0 2027 0 0 0 15979 0 337399 0 0 0 JAMES WISSLER 40461 0 0 0 135375 0 0 0 11439 0 187275 0 0 0 LIVINGSTON COUNTY INDUSTRIAL DEVELOPMENT AGENCY 161136853 538655AD3 2005-06-29 9471914 SEE PART VI 0 0 0 LIVINGSTON COUNTY INDUSTRIAL DEVELOPMENT AGENCY 161136853 538655AE1 2007-12-20 615060 REFUND OF PRIOR BONDS (06/30/99) 0 0 1 1720000 9763548 805638 625676 189438 6449941 1692856 2006 1 0 1 1 159732 615060 12301 3084 10309 589366 2003 1 0 1 1 0 0 1 1 0 0.02400 0.02400 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 PART I, LINE A, COLUMN (F): ACQUISITION, RENOVATION, CONSTRUCTION AND EQUIPPING OF IMPROVEMENTS TO A HOSPITAL FACILITY; REFUNDING OF PRIOR BONDS (9/17/1998) PART I, LINE B, COLUMN (E) AND PART II, LINES 1 - 12, COLUMN B REPRESENTS AM ALLOCATION OF 12.24% OF THIS BOND ISSUE; THE REMAINING 87.76% IS ALLOCATED TO RED JACKET CENTER, INC., A RELATED ORGANIZATION. PART II, LINE 3, COLUMN A THE TOTAL PROCEEDS DO NOT AGREE WITH THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENTS EARNINGS. NANCY JOHNSON WIFE OF BOARD MEMBER 57825 COMPENSATION 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS REGULARLY REVIEWS THE CONFLICT OF INTEREST POLICY AND ASSURES ITS COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE GOALS AND OBJECTIVES OF THE CEO ALONG WITH COMPARABILITY DATA TO DETERMINE HIS COMPENSATION. THE DELIBERATION AND DECISION IS RECORDED IN THE MINUTES OF THE EXECUTIVE COMMITTEE MEETING. FORM 990, PART VI, SECTION C, LINE 18 BY REQUEST TO THE CEO, CFO OR ADMINISTRATIVE ASSISTANT. ALSO AVAILABLE ON GUIDESTAR WEBSITE. FORM 990, PART VI, SECTION C, LINE 19 BY REQUEST TO THE CEO, CFO OR ADMINISTRATIVE ASSISTANT. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII JAMES CULBERSTON - 5879 DIETER RD, DANSVILLE, NY 14437. JOHN LOCKHART - 32 MAIN STREET, GENESEO, NY 14454. MICHAEL JOHNSEN - 3927 COLTON HILL ROAD, DALTON, NY 14836. LESLIE COLE, JR. - 3186 BRONSON HILL ROAD, LIVONIA, NY 14487. GEOFFREY MARKOWSKI, MD - 50 EAST SOUTH STREET, GENESEO, NY 14454. THOMAS DWYER, MD - 9107 RICKETTS RD, DANSVILLE, NY 14437. JOAN FLENDER, MD - STONY BROOK PEDIATRICS, P.O. BOX 499, DANSVILLE, NY 14437. GRAHAM FRAZER - 8889 REEDS CORNERS ROAD, DANSVILLE, NY 14437. ROBERT HART - 10 MOREY AVENUE, DANSVILLE, NY 14437. ANDREW LONG - 5563 COTTONWOOD DRIVE, CONESUS, NY 14435. MARILYN MOORE - 1856 DUNKLEY RD, LEICESTER, NY 14481. MAUREEN WOLCOTT - 10799 EDMOND ROAD, COHOCTON, NY 14826. SALLY WEST - 14 MAIN STREET, GENESEO, NY 14454. MARK LYONS - 28 EAST MAIN ST, ROCHESTER, NY 14614. PETER SOSCIA - 4458 LATIMER RD, GROVELAND, NY 14462. LINDSAY QUINTILONE - 2 COURT STREET, GENESEO, NY 14454. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -37,347. CHANGE IN INTEREST IN FOUNDATION 82,068. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS -1,635,446. TOTAL TO FORM 990, PART XI, LINE 5: -1,590,725. OVERSIGHT PROCESS PART XII, LINCE 2C THE HOSPITAL DID NOT CHANGE THE OVERSIGHT PROCESS IN THE CURRENT YEAR. THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC 111 CLARA BARTON ST DANSVILLE NY 14437 161584778 TO PROVIDE FUNDS FOR BENEFIT OF THE HOSPITAL NY 501(C)(3) 170(B)(1)(A) (VI) 0 RED JACKET CENTER INC 111 CLARA BARTON ST DANSVILLE NY 14437 161037658 TO MAINTAIN A BUILDING AND LEASE SPACE TO THE HOSPITAL NY 501(C)(3) SECTION 509 (A)(3) 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 RED JACKET CENTER INC P 1295185 FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC O 862440 RED JACKET CENTER INC J 570614