2012-11-10T12:21:38-06:00 2011-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2011-01-01 161471634 ROME MEMORIAL HOSPITAL ROME 1500 NORTH JAMES STREET ROME NY 13440 NICHOLAS MAYHEW 3153387000 2012-11-06 1 ANGELA M FRANCO P00589741 3154463600 2011 2016-02-24 21:20:13Z BASIL ARIGLIO 1500 NORTH JAMES ST ROME NY 13440 90638142 0 X ROMEHOSPITAL.ORG X 1995 NY PROVIDE QUALITY HEALTHCARE WITH COMPASSION. 10 10 1211 145 248782 -8843 432566 671957 84821455 87265361 142569 169516 1034217 853414 86430807 88960248 0 0 0 0 48494172 50792045 0 0 0 37880995 38547911 86375167 89339956 55640 -379708 61433977 68210140 37037193 44543290 24396784 23666850 X ABOUT ROME MEMORIAL HOSPITAL: OVERALL, ROME MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, SKILLED NURSING, AND EMERGENCY CARE SERVICES PRIMARILY FOR THE RESIDENTS OF ROME AND THE SURROUNDING AREAS. 0 1 34396392 33482625 INPATIENT CARE SERVICES, INPATIENT NURSING UNITS CONSIST OF THE FOLLOWING:ACUTE PHYSICAL REHABILITATION-4TH FLOOR,INTENSIVE CARE-2ND FLOOR, MATERNITY-4TH FLOOR, 2 EAST MEDICAL/SURGICAL-2ND FLOOR, 2 NORTH MEDICAL/SURGICAL WITH CARDIAC MONITORING-2ND FLOOR, PEDIATRICS-2ND FLOOR, AND SENIOR BEHAVIORIAL HEALTH- 2ND FLOOR.2011 INPATIENT DISCHARGES: 4,9302011 BIRTHS: 6332011 PATIENT DAYS: 22,237 10656077 8008610 RESIDENTIAL HEALTHCARE FACILITY (RHCF)BECAUSE OF OUR COMMITTMENT TO SERVE THE UNIQUE NEEDS OF SENIORS, WE HAVE AN 80-BED RESIDENTIAL HEALTH CARE FACILITY AND INPATIENT UNIT FOR SENIOR BEHAVIORIAL HEALTH CARE. OUR RESIDENTIAL HEALTHCARE FACILITY CONSISTS OF THE FOLLOWING: LONG-TERM NURSING HOMECARE, SHORT-TERM SUB-ACUTE REHABILITATION, AND RESPITE CARE- ALL LOCATED ON THE 3RD FLOOR.2011 PATIENT DAYS = 26,3532011 OCCUPANCY PERCENTAGE = 90.25% 6709012 9555077 EMERGENCY DEPARTMENT (ED)ROME MEMORIAL HOSPITAL EMERGENCY DEPARTMENT IS A SAFETY NET FOR THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN 2011, APPROXIMATELY 45% OF THE PATIENTS TREATED WERE LISTED AS UNINSURED OR UNDER INSURED. FOR LOWER LEVEL EMERGENCY DEPARTMENT VISITS, THIS POPULATION REPRESENTED MORE THAN 61% OF THE VISITS BECAUSE MANY PRIMARY CARE PHYSICIANS DO NOT ACCEPT MEDICAID.2011 ED ADMISSIONS: 3,0222011 ED VISITS: 25,918 23652349 36219049 ALL OTHER ACHIEVEMENTS PROVIDE QUALITY, COMPASSIONATE CARE IN A SAFE ENVIRONMENT TO SERVE THE HEALTHCARE NEEDS OF THE PEOPLE OF ROME AND THE SURROUNDING COMMUNITIES. 23652349 36219049 75413830 1 1 0 1 0 0 0 0 0 1 1 0 0 0 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 1 1 1 1 0 0 0 0 1 0 0 0 0 1 41 0 1 1211 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X NICHOLAS MAYHEW CFO ROME MEMORIAL 3153387024 1500 NORTH JAMES STREET ROME NY 13440 CHESTER PATRICK MD 2.00 X X 0 0 0 DAVID NOLAN 2.00 X X 0 0 0 KIM COOK 2.00 X X 0 0 0 LYNN REESE 2.00 X X 0 0 0 W ROBERT HERMANN 2.00 X 0 0 0 MARY DAVIS 2.00 X 0 0 0 DR ANKUR DESAI 2.00 X 0 0 0 SALLY HINMAN 2.00 X 0 0 0 JULIE GROW-DENTON 2.00 X 0 0 0 MICHAEL KRAMER 2.00 X 0 0 0 BASIL ARIGLIO 55.00 X 252542 0 14017 WALEED ALBERT MD 55.00 X 279408 0 14061 RAYMOND CARNEVALE 55.00 X 185621 0 6781 NICHOLAS MAYHEW 55.00 X 234796 0 13988 MARK SNYDERMAN 55.00 X 141126 0 10645 SCOTT BURNS 55.00 X 133835 0 11697 DURINDA DURR 55.00 X 128658 0 10624 DAVID LEE 55.00 X 125734 0 10416 BRUCE PETERSON 55.00 X 147224 0 13847 DARLENE BURNS 55.00 X 225801 0 6768 1854745 0 112844 24 1 1 0 CENTREX LABS 28 CAMPION RD NEW HARTFORD NY 13413 LAB SERVICES 3401925 CHARTIS PO BOX 10472 NEWARK NJ 07193 WORKERS COMPENSATION 687102 HUEBER BREUER PO BOX 515 SYRACUSE NY 13205 ARCHITECT 438579 MCKESSON PO BOX 98347 CHICAGO IL 606938347 HEALTHCARE INFORMATION TECHNOLOGY 366635 ROME EMERGENCY SERVICES 484 TEMPLE HILL ROAD NEW WINDSOR NY 12553 ER SERVICES 302895 9 46500 625457 301911 671957 HOSPITAL 621990 87265361 87265361 87265361 52966 52966 108741 135540 -26799 -26799 -26799 1658899 5 1479830 62524 179069 -62519 116550 116550 CAFETERIA SALES 722210 281077 281077 ACCOUNTING & CONSULTIN 541200 180000 180000 GAIN CHANGE ANGEL FUND 900099 5872 0 0 5872 413264 68782 344482 880213 88960248 87265361 248782 774148 1001214 1001214 38906635 33002660 5903975 1691485 1447783 243702 6280009 6274068 5941 2912702 2470707 441995 101255 101255 74292 74292 35421 35421 495585 185725 309860 803322 147154 656168 841558 666336 175222 100638 60559 40079 80400 35705 44695 637305 627488 9817 4424071 3572779 851292 751762 91933 659829 PURCHASE SERVICES 7388065 6855487 532578 BAD DEBT EXPENSE 6519067 6519067 0 SUPPLIES 5948926 5909506 39420 PHARMACY 2995626 2995626 7350618 4551247 2799371 89339956 75413830 13926126 0 3031569 2912737 2274926 3721436 11374729 14528649 1388348 1685833 1959094 2152446 806060 959969 83104387 43589530 38959245 39514857 1640006 2734213 61433977 68210140 11529039 12560830 13736568 19697813 6575000 6215000 5196586 6069647 37037193 44543290 X 23772243 23078501 40494 2408 584051 585941 24396784 23666850 61433977 68210140 X -379708 -350226 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 28364 0 0 28364 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: $28,364 REPRESENTS THE PORTION OF THE 2011 MEMBERSHIP DUES OF HANYS, AHA, AND IROQUOIS HEALTHCARE ALLIANCE, THAT RMH IS A MEMBER OF, THAT HAS BEEN DEEMED TO BE RELATED TO LOBBYING EXPENSES. THESE EXPENDITURES ARE DEFINED AS DIRECT COMMUNICATIONS WITH CERTAIN MEMBERS OF FEDERAL, STATE, OR LOCAL GOVERNMENTS TO INFLUENCE LEGISLATION. 624541 1890 33673 16151 643953 591605 4471 28465 624541 338312 120609 132684 591605 33374 304938 338312 0.09000 0.91000 0 0 43031500 16468073 26563427 2204068 2117280 86788 34839102 23063996 11775107 3029717 1940181 1089535 39514857 LINE OF CREDIT 1500000 ASSET RETIREMENT 2940938 ADVANCE FROM THIRD PARTIES 570000 THIRD PARTY PAYABLES 1058709 6069647 88960248 89339956 -379708 -189769 -160457 -350226 -729934 99519872 189769 10405276 10595045 88924827 35421 35421 88960248 99981853 10677318 10677318 89304535 35421 35421 89339956 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INTENDED USE OF ENDOWMENT FUND IS THAT THE PRINCIPLE CAN BE INVESTED, WHILE KEPT IN TACT IN PERPETUITY; ONLY THE INCOME GENERATED CAN BE USED BY THE ORGANIZATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN THE HOSPITAL'S CONSOLIDATED FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2011 AND 2010, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2008 THROUGH 2011. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. PART XI, LINE 8 - OTHER ADJUSTMENTS: TOTAL CHANGE IN INTEREST IN FOUNDATION -160,457. PART XII, LINE 2D - REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER AFFILIATE INCOME - CONSOLIDATED FINANCIAL STATEMENTS $10,405,276 PART XII, LINE 4B - EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER INVESTMENT EXPENSES - CONSOLIDATED FINANCIAL STATEMENTS $35,421 PART XIII, LINE 2D - EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER AFFILIATE EXPENSES-CONSOLIDATED FINANCIAL STATEMENTS $10,677,318 PART XIII, LINE 4B - EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER INVESTMENT EXPENSES - CONSOLIDATED FINANCIAL STATEMENTS $35,421 1 1 1 X 1 X 0 0 1 1 947665 450713 496952 0.00600 20242657 19607917 634740 0.00770 621606 439259 182347 0.00220 21811928 20497889 1314039 0.01590 78110 11356 66754 0.00070 28638 25936 2702 0.00000 106748 37292 69456 0.00070 21918676 20535181 1383495 0.01660 2200 2200 0.00000 2127 440 1687 0.00000 5179 5179 0.00010 287033 287033 0.00320 296539 440 296099 0.00330 0 2213100 328899 21104225 27604175 -6499950 X 1 0 1 GRIFFIS EYE CENTER LLC SEE SCHEDULE R PART VII 0.30000 0.00000 0.70000 1 1 ROME MEMORIAL HOSPITAL

1500 NORTH JAMES STREET ROME NY 13440

X X X ROME MEMORIAL HOSPITAL 1 1 X X X X X X X X X 09 1 1 1 X X X X X X X X X X 0 1 1 100.000000000000 1 300.000000000000 1 X X 1 1 X 1 X X 1 X X X X X X 1 X 0 0 13 COMMUNITY RECOVERY CENTER

264 W DOMINICK STREET ROME NY 13440

SUBSTANCE ABUSE COUNSELING MOHAWK VALLEY RADIATION MEDICINE

107 E CHESTNUT STREET ROME NY 13440

RADIATION ONCOLOGY PHYSICAL THERAPY

107 E CHESTNUT STREET ROME NY 13440

OFFSITE PHYSICAL THERAPY SERVICES BOONVILLE FAMILY CARE

13407 STATE ROUTE 12 BOONVILLE NY 13309

PRIMARY CARE SERVICES LABORATORY COLLECTION SITE

1801 BLACK RIVER BLVD ROME NY 13440

OFFSITE LAB COLLECTION SITE LABORATORY COLLECTION SITE

1617 N JAMES STREET ROME NY 13440

OFFSITE LAB COLLECTION SITE LABORATORY COLLECTION SITE

13407 STATE ROUTE 12 BOONVILLE NY 13309

OFFSITE LAB COLLECTION SITE LABORATORY COLLECTION SITE

BEECHES OFFICE COMPLEX-TURIN RD ROME NY 13440

OFFSITE LAB COLLECTION SITE MEDICAL IMAGING

1617 N JAMES STREET ROME NY 13440

OFFSITE RADIOLOGY SERVICES MEDICAL IMAGING

1801 BLACK RIVER BLVD ROME NY 13440

OFFSITE RADIOLOGY SERVICES MEDICAL IMAGING

107 E CHESTNUT STREET ROME NY 13440

OFFSITE RADIOLOGY SERVICES MEDICAL IMAGING

1819 BLACK RIVER BLVD ROME NY 13440

OFFSITE RADIOLOGY SERVICES PRENATAL CARE CENTER

155 WEST DOMINICK STREET ROME NY 13440

OFFSITE PRENATAL CARE SERVICES PART I, LINE 6A: ROME MEMORIAL HOSPITAL'S SECOND UPDATE OF ITS 2009-2012 COMMUNITY SERVICE PLAN IS POSTED ON ITS WEBSITE AT: WWW.ROMEHOSPITAL.ORG. THE HOSPITAL'S COMMUNITY SERVICE PLAN IS DERIVED FROM ITS PARTICIPATION IN THE COMPREHENSIVE COUNTYWIDE COMMUNITY NEEDS ASSESSMENT. THE COUNTY 2010-2013 COMMUNITY HEALTH ASSESSMENT IS AVAILABLE ONLINE AT: HTTP://WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT. PART I, LINE 7: CHARITY CARE AT COST (7A) AND UNREIMBURSED COSTS - OTHER MEANS TESTED GOVERNMENT PROGRAMS (7C) WERE CALCULATED BY USING A COST TO CHARGE RATIO. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, SUPPLIED BY THE IRS.UNREIMBURSED MEDICAID (7B) WAS CALCULATED BY USING ACTUAL COSTS.OTHER BENEFITS (7E & 7F) WERE CLACULATED BY DETERMINING ACTUAL COSTS AND ACTUAL REVENUE PER EVENT.THE MAIN SOURCE OR GUIDE OF HOW CALCULATIONS WERE DETERMINED WAS BY UTILIZING THE WORKSHEETS PROVIDED BY THE IRS AND THEN ADJUSTING ACCORDING TO ROME HOSPITAL SPECIFICS (IE. USING ACTUAL COSTS VS. COST TO CHARGE RATIO AS MENTIONED ABOVE). PART I, L7 COL(F): PERCENT OF TOTAL EXPENSE IS CALCULATED BY USING THE DENOMINATOR OF THE TOTAL FUNCTIONAL EXPENSES LESS BAD DEBT EXPENSE OF $6,519,067 (PER AUDITED FINANCIAL STATEMENTS). PART II: PART I 7E,7F,7J: ROME MEMORIAL HOSPITAL HAS MAINTAINED A LONG-STANDING COMMITMENT TO WELLNESS AND PREVENTION THROUGH AN ACTIVE EDUCATION DEPARTMENT THAT PROVIDES ONGOING HEALTH EDUCATION LECTURES AND FREE SCREENINGS. IN ADDITION, THE HOSPITAL ASSURES ACCESS TO SERVICES BY CONTINUING TO PROVIDE CRITICAL SERVICES TO THE COMMUNITY, EVEN THOUGH THEY ARE OPERATED AT A LOSS TO THE HOSPITAL. THESE ARE SOME OF THE HOSPITAL'S PROGRAMS THAT SUPPORT THE STATE'S PREVENTION AGENDA AND PROMOTE HEALTH IN OUR COMMUNITY: HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN THE MATERNITY DEPARTMENT'S WEIGH STATION PROVIDES MOTHERS WHO ARE BREASTFEEDING ADDED SUPPORT AND ENSURE THAT BABIES ARE GAINING WEIGHT AT A HEALTHY LEVEL. BABYCARE BASICS AND BREASTFEEDING EDUCATION PROGRAMS FOR NEW PARENTS HELP THEM ACQUIRE THE NECESSARY SKILLS FOR TAKING CARE OF A NEWBORN.CHRONIC DISEASE EDUCATION HEALTH NIGHT, SENIOR LIVE & LEARN, SPEAKER'S BUREAU LECTURES, AND OUTREACH AT HEALTH FAIRS PROVIDE COMMUNITY MEMBERS WITH THE LATEST INFORMATION AVAILABLE TO HELP THEM MODIFY THEIR LIFESTYLES TO PREVENT THE ONSET OF CHRONIC DISEASE OR BETTER MANAGE THEIR CHRONIC CONDITIONS. SMOKING CESSATION CLASSES FOR THE COMMUNITY AND HOSPITAL EMPLOYEES, ALONG WITH SMOKING PREVENTION PROGRAMS FOR AREA SCHOOLS PROVIDES ESSENTIAL OUTREACH TO ERADICATE THE LEADING CAUSE OF PREMATURE DEATH. SPONSORSHIP SUPPORT OF THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION AND OTHER HEALTH-RELATED ORGANIZATIONS TO PROVIDE FINANCIAL RESOURCES FOR EDUCATION AND RESEARCH.ACCESS TO QUALITY HEALTHCARE FREE ROUTINE SCREENINGS, INCLUDING BLOOD PRESSURE, PSAS, COLORECTAL CANCER AND DIABETES SCREENING, ARE OFFERED TO THE COMMUNITY TO PROMOTE EARLY DETECTION OF DISEASE. FACILITATED ENROLLMENT EFFORTS HELP LINK THE UNINSURED TO AVAILABLE INSURANCE OPTIONS TO ENABLE THEM TO ESTABLISH A RELATIONSHIP WITH A PRIMARY CARE PROVIDER. IMMUNIZATION CLINICS ARE OFFERED IN THE COMMUNITY TO PROTECT RESIDENTS FROM THE FLU. EFFORTS TO RECRUIT ADDITIONIAL PHYSICIANS TO THE COMMUNITY ADDRESS THE FACT THAT THE MOHAWK VALLEY REGION HAS THE WORST PHYSICIAN TO POPULATION RATIO IN ALL OF NEW YORK STATE. THE NEWLY CONSTRUCTED DIAGNOSTIC CENTER INCLUDED INVESTMENTS IN THE LATEST TECHNOLOGY INCLUDING DIGITAL MAMMOGRAPHY AND A NEW MRI TO ENHANCE THE HOSPITAL'S DIAGNOSTIC CAPABILITIES. THE HOSPITAL ADDED A NURSE NAVIGATOR TO HELP COORDINATE CARE FOR PATIENTS WITH A POTENTIAL CANCER DIAGNOSIS.PHYSICAL FITNESS AND NUTRITION AN INDOOR WALKING PROGRAM HELPS AREA RESIDENTS INCORPORATE PHYSICAL FITNESS INTO THEIR LIVES TO PREVENT CHRONIC DISEASE AND ENHANCE THEIR MENTAL HEALTH.COMMUNITY SUPPORT AND COALITION BUILDING ROME MEMORIAL HOSPITAL'S LEADERS ALSO PARTICIPATE ON NUMEROUS COMMUNITY COMMITTEES INVOLVED IN ENHANCING HEALTH CARE OUTCOMES THROUGH PREVENTION, EARLY DETECTION AND INTERVENTION, AS WELL AS EMERGENCY PREPAREDNESS ACTIVITIES TO ENSURE A COORDINATED RESPONSE IN AN EVENT OF A DISASTER. PART III, LINE 4: "SIGNIFICANT ESTIMATES MADE BY THE HOSPITAL INCLUDE, BUT ARE NOT LIMITED TO, THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS, RESERVES FOR THIRD-PARTY CONTRACTUAL ADJUSTMENTS AND SETTLEMENTS AND INSURANCE RESERVES. THE CURRENT ECONOMIC ENVIRONMENT HAS INCREASED THE DEGREE OF UNCERTAINITY INHERENT IN THOSE ESTIMATES AND ASSUMPTIONS.""AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS."FROM THE AGED ACCOUNTS RECEIVABLE TRIAL BALANCE, THE PAYOR CLASSES ARE SUMMARIZED INTO FOUR CATEGORIES: COLLECTION, SELF PAY, TIME PLAN AND OTHERS (ALL OTHER INSURANCE BALANCES) BY AGING BUCKET. IN ADDITION:THE ACCOUNTS THAT ARE "COLLECTION" ARE ALL PATIENT ACCOUNTS THAT HAVE BEEN SENT TO A COLLECTION AGENCY. FOR ALL ACCOUNTS THAT ARE CONSIDERED COLLECTION THESE ACCOUNTS ARE RESERVED AT:UNBILLED 150 DAYS - 98.63% LESS THE SURCHARGE PORTION OF THE SELF PAY OF 9.63%.151+ DAYS - 99.73% LESS THE SURCHARGE PORTION OF THE SELF PAY OF 9.63%.ACCOUNTS IN COLLECTION ARE NOW 100% WRITTEN OFF OUR ACCOUNTS RECEIVABLE. WE DO CALCULATE AN APPROXIMATE COLLECTION OF REVENUE FROM ACCOUNTS IN COLLECTION.FOR SELF PAY ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 30%0-30 DAYS - 45%31-60 DAYS - 60%61-90 DAYS - 70%91-120 DAYS - 75%121-150 DAYS - 85%151+ DAYS - 90%FOR TIME PLAN ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 62.38%0-30 DAYS - 62.38%31-60 DAYS - 62.38%61-90 DAYS - 62.38%91-120 DAYS - 62.38%121-150 DAYS - 62.38%151+ DAYS - 62.38%FOR OTHER ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 5%0-30 DAYS - 5%31-60 DAYS - 0%61-90 DAYS - 0%91-120 DAYS - 0%121-150 DAYS - 0%151+ DAYS - 0%THE BAD DEBT RESERVE THAT IS CALCULATED MONTHLY USING THIS ANALYSIS IS COMPARED TO ACTUAL RESERVE AT MONTH END. IF NECESSARY AN ADJUSTMENT WILL BE RECORDED.COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 & 3:RATIO OF PATIENT CARE COST TO CHARGESPART III, LINE 6; COSTING METHODOLOGY AND SOURCE:2011 ICR EXHIBIT 46 AND TENTATIVE MEDICARE SETTLEMENT RATES PART III, LINE 8: FINANCIAL AID PROGRAM THE SHORTFALL IN QUESTION 7 SHOULD BE TREATED AS COMMUNITY BENEFIT AS MEDICARE REIMBURSEMENTS FAIL TO COVER THE COSTS OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DESPITE EFFORTS TO IMPROVE EFFICIENCY, EXPENSES FOR TECHNOLOGY, PHARMACEUTICAL, AND SALARY AND BENEFITS CONTINUE TO ESCALATE. THE HOSPITALS BAD DEBT EXPENSES IS IMPACTED BY THE TOUGH ECONOMIC TIMES BATTERING THE COUNTRY, MANY PEOPLE HAVE LOST THEIR HEALTH INSURANCE. MANY CANNOT AFFORD RISING PREMIUMS, WHILE OTHERS HAVE LOST THEIR JOBS COMPLETELY. SOME PEOPLE HAVE INSURANCE, BUT THEIR OUT-OF-POCKET COSTS ARE HIGH BECAUSE EMPLOYERS HAVE RAISED THEIR DEDUCTIBLES OR CO-PAYMENTS, OR REDUCED WHAT THEIR PLANS COVER. AS A RESULT, THE AMOUNT OF UNCOMPENSATED CARE PROVIDED BY RMH CONTINUES TO GROW.TO HELP THOSE WHO ARE UNINSURED LEARN MORE ABOUT POSSIBLE OPTIONS, THE HOSPITAL'S PATIENT REGISTRATION DEPARTMENT PROVIDES INFORMATION FROM INSURERS WHICH OFFER FREE OR LOW-COST HEALTH INSURANCE THROUGH NEW YORK STATE'S CHILD HEALTH PLUS AND FAMILY HEALTH PLUS, ALONG WITH SPACE FOR REPRESENTATIVES TO ANSWER QUESTIONS AND ENROLL ELIGIBLE RESIDENTS.IN ADDITION, THE HOSPITAL HAS PARTNERED WITH THE MOHAWK VALLEY PERINATAL NETWORK, WHOSE FACILITATED ENROLLER CAN ASSIST INDIVIDUALS IN APPLYING FOR COVERAGE FROM CHILD HEALTH PLUS, FAMILY HEALTH PLUS, AND MEDICAID. IN ADDITION TO HELPING PEOPLE OBTAIN INSURANCE COVERAGE, THE HOSPITAL ALSO PROVIDES A FINANCIAL ASSISTANCE PROGRAM AND WORKS WITH PATIENTS TO SET UP AFFORDABLE PAYMENT PLANS.FINANCIAL ASSISTANCE BROCHURES ARE LOCATED IN THE HOSPITAL'S WAITING AREAS AND APPLICATIONS ARE AVAILABLE ON THE WEBSITE. RMH DISCOUNTS PATIENT ACCOUNTS UP TO 100% DEPENDING UPON FAMILY INCOME IN COMPARISON TO THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE BASED UPON THE BLUE CROSS RATE. ROME MEMORIAL HOSPITAL OFFERS DISCOUNTS TO THE UNINSURED/UNDERINSURED WHOSE INCOME IS UP TO 300% OF THE FEDERAL POVERTY LEVEL.BECAUSE LACK OF AWARENESS IS ONE OF THE BIGGEST BARRIERS, RMH PROVIDES INFORMATION ABOUT AVAILABLE PROGRAMS AT HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES.CHANGES (ACTUAL OR POTENTIAL) IMPACTING COMMUNITY HEALTH, PROVISION OF CHARITY CARE, AND ACCESS TO SERVICES: REIMBURSEMENTS THAT FAIL TO KEEP PACE WITH RISING EXPENSES AND THE CONTINUED GROWTH IN UNCOMPENSATED CARE ARE SIGNIFICANT CHALLENGES THAT NEW YORK'S HOSPITALS FACE, INCLUDING RMH. OTHER CHALLENGES INCLUDE THE ESCALATION OF COSTS FOR DRUGS DUE TO INFLATION AND HAVING TO FIND ALTERNATE SUPPLIERS BECAUSE OF MANUFACTURER PRODUCTION SHORTAGES, SERVICES AND BAD DEBT, AND INVESTMENTS REQUIRED TO COMPLY WITH MANDATES. HERE ARE JUST A FEW EXAMPLES OF OUR CHALLENGES:UNCOMPENSATED CARE: THE COST OF FREE SERVICES PROVIDED TO OUR COMMUNITY CONTINUES TO RISE AS RESIDENTS LOSE THEIR JOBS OR THEIR ABILITY TO AFFORD THEIR INSURANCE PREMIUMS. IN 2011, ROME MEMORIAL HOSPITAL'S BAD DEBT AND CHARITY CARE TOTALED $8.7 MILLION, COMPARED TO $7.8 MILLION IN 2010. PHYSICIAN SHORTAGES: ROME MEMORIAL HOSPITAL HAS BEEN SUCCESSFUL IN RECRUITING SEVERAL NEW PHYSICIANS TO THE COMMUNITY, BUT AT A GREAT COST. TODAY'S PHYSICIAN WANTS TO BE EMPLOYED SO THEY DON'T HAVE TO BEAR THE RISK OF OPENING A NEW PRACTICE OR MANAGE THE ADMINISTRATIVE ASPECTS OF MEDICINE. ALTHOUGH THEY PROVIDE CRITICAL ACCESS TO CARE, THESE PRACTICES STRUGGLE TO BREAK EVEN. LACK OF PRIMARY CARE: PATIENTS WHO DON'T HAVE INSURANCE OR WHO ARE COVERED BY MEDICAID OFTEN DON'T HAVE A REGULAR PHYSICIAN FOR PREVENTATIVE CARE OR TO MANAGE CHRONIC CONDITIONS. AS A RESULT, THEY USE THE EMERGENCY DEPARTMENT AS THEIR PRIMARY CARE OR DELAY CARE UNTIL THEIR CONDITION IS MORE CRITICAL AND MORE EXPENSIVE TO TREAT. SINCE ROME MEMORIAL HOSPITAL'S NEW EMERGENCY DEPARTMENT OPENED, THE NUMBER OF PATIENT VISITS HAS STEADILY INCREASED BY 19,000 IN 2006 TO 25,918 IN 2011. MANY PHYSICIANS DON'T ACCEPT MEDICAID PATIENTS BECAUSE OF LOW REIMBURSEMENT RATES. IN ADDITION, SENIORS MAY SOON FACE THE SAME ACCESS PROBLEMS IF CUTS TO PHYSICIAN MEDICARE RATES ARE IMPLEMENTED. PHARMACEUTICALS: THE HOSPITAL CONTINUES TO SEE SIGNIFICANT INCREASE IN DRUG COSTS DUE TO INFLATION AND MANUFACTURER PRODUCTION SHORTAGES. IN MANY CASES, THESE SHORTAGES FORCE US TO TURN TO ALTERNATE SUPPLIERS, WHO CHARGE A PREMIUM PRICE. INTERPRETER SERVICES: AS OUR POPULATION BECOMES MORE DIVERSE WITH BURMESE AND BOSNIAN REFUGEES AND SPANISH SPEAKING RESIDENTS, THERE IS A GREATER DEMAND FOR INTERPRETER SERVICES. DDSO POPULATION - THE HIGH CONCENTRATION OF DDSO CLIENTS IN ONEIDA COUNTY AND ROME PLACES A UNIQUE BURDEN ON ROME MEMORIAL HOSPITAL. WHEN DDSO CLIENTS REQUIRE HOSPITALIZATION, THEIR CASES ARE OFTEN VERY COMPLEX AND THEIR LENGTH OF STAY IS NEARLY TWICE AS LONG AS THE AVERAGE PATIENT. AS A RESULT, THE HOSPITAL IS ONCE AGAIN FACED WITH ABSORBING THE FINANCIAL LOSS OF CARING FOR THESE PATIENTS. PROGRAM VIABILITY: AS A RESULT OF THESE SIGNIFICANT FINANCIAL CHALLANGES, RMH CONTINUALLY EVALUATES THE VIABILITY OF SOME OF ITS SERVICES. AS A PART OF THE EVALUATION, RMH ASSESSES THE NUMBER OF PEOPLE SERVED AND AVAILABILITY OF OTHER SERVICES TO ADDRESS THE COMMUNITY NEED, IN ADDITION TO THE FINANCIAL BURDEN ON THE HOSPITAL. ROME MEMORIAL HOSPITAL PART V, SECTION B, LINE 1J: THE HOSPITAL PARTICIPATES IN THE COMPREHENSIVE COUNTY WIDE COMMUNITY NEEDS ASSESSMENT. THE COUNTY 2010 - 2013 ASSESSMENT IS AVAILABLE ONLINE AT WWW.OCGOV.NET/HEALTH/COMMUNITY.HEALTH.ASSESSMENT. SEE PART VI, LINE 2, RESPONSE BELOW FOR REQUIRED DESCRIPTIONS FOR PART VI, LINE 1 SUB-SECTIONS. ROME MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: THE HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ONEIDA AND HERKIMER COUNTY HEALTH DEPARTMENTS IN COLLABORATION WITH RMH, FAXTON-ST LUKES HEALTHCARE, ST. ELIZABETH MEDICAL CENTER, AND MULTIPLE COMMUNITY AGENCIES. ROME MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: THE MAJOR BARRIERS TO ADDRESSING ALL OF THE COMMUNITY'S HEALTHCARE NEEDS INCLUDE:-LIMITED FINANCIAL RESOURCES-CHALLANGES WITH IMPACTING INDIVIDUAL LIFESTYLE BEHAVIORS-SHORTAGE OF PRIMARY AND SPECIALITY PROVIDERS ROME MEMORIAL HOSPITAL PART V, SECTION B, LINE 19D: INDIVIDUALS WILL RECEIVE 50% DISCOUNT WITHOUT INSURANCE. IF APPROVED AND FAP-ELIGIBLE THE DISCOUNT WILL BE BASED ON BLUE CROSS RATES. PART VI, LINE 2: #2 NEEDS ASSESSMENT:ROME MEMORIAL HOSPITAL PARTICIPATES IN THE ASSESSMENT PROCESS LED BY THE ONEIDA COUNTY HEALTH DEPARTMENT, WHICH USES THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) FRAMEWORK TO CONDUCT THE MAJORITY OF ITS COMMUNITY HEALTH ASSESSMENT (CHA) ACTIVITIES. A COMMUNITY HEALTH ASSESSMENT PLANNING TEAM OF APPROXIMATELY 25-30 INDIVIDUALS WAS CONVENED IN JANUARY 2008 THAT CONSISTED OF THE STEERING COMMITTEE MEMBERS OF AN EXISTING COMMUNITY HEALTH PARTNERSHIP, THE ONEIDA COUNTY HEALTH COALITION, AND ADDITIONAL KEY COMMUNITY STAKEHOLDERS. THIS GROUP IS THE MAPP ADVISORY TEAM (MAT). SEVERAL SUB-COMMITTEES WERE CREATED TO ACCOMPLISH THE ASSESSMENT.THE COLLABORATING AGENCIES CONDUCTED PUBLIC VISIONING SESSIONS, HEALTHY CONVERSATION FOCUS GROUPS, AND COMMUNITY SURVEYS TO COLLECT THE PERCEPTIONS OF THOSE WHO ARE UNABLE TO ATTEND ONE OF THE FACE TO FACE SESSIONS. EFFORTS WERE MADE TO INCLUDE INPUT FROM MULTIPLE CONSTINUENCIES, INCLUDING SENIORS, FAMILIES, THE UNDERSERVED, THE BUSINESS COMMUNITY, ETC. THE SURVEY INSTRUMENT AND FOCUS GROUPS WERE PUBLICLY ADVERTISED. THE FEEDBACK FROM SURVEYS AND PUBLIC OUTREACH SESSIONS PROVIDE THE QUALITATIVE INFORMATION TO ENRICH THE STATISTICAL FINDINGS OF THE NEEDS ASSESSMENT TO ADDRESS THE PRIORITY HEALTH NEEDS OF THE COMMUNITY.BASED UPON THIS PROCESS, THE FOLLOWING FIVE ITEMS FROM NEW YORK STATE'S PREVENTION AGENDA WERE IDENTIFIED AS PRIORITIES FOR THE COUNTY:HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDRENMENTAL HEALTH AND SUBSTANCE ABUSECHRONIC DISEASEACCESS TO QUALITY HEALTHCAREPHYSICAL ACTIVITY AND NUTRITIONTHE FULL 2010-2013 ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT, ALONG WITH ITS DETAILED DATA BOOK CAN BE FOUND ONLINE AT WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT.ROME MEMORIAL HOSPITAL ALSO PARTICIPATES AND COLLABORATES WITH NUMEROUS COMMUNITY AND PROFESSIONAL ORGANIZATIONS. WITHIN THIS FRAMEWORK, IT IS POSSIBLE TO GAIN A BETTER UNDERSTANDING OF DIFFERENT NEED PERSPECTIVES AND ALSO EVALUATE COMMUNITY RESOURCES. THE ONGOING ANALYSIS OF QUANTITATIVE AND QUALITATIVE DATA IS UTILIZED TO CREATE ROME MEMORIAL HOSPITAL'S STRATEGIC PLAN, WHICH SERVES AS A BLUEPRINT FOR ADAPTING OUR AVAILABLE RESOURCES TO RESPOND TO THE CHANGING NEEDS OF THE COMMUNITY. ALTHOUGH THE 2009 COMMUNITY SERVICE PLAN AND UPDATES THEREAFTER (9/15/2011) WERE DESIGNED TO SPECIFICALLY ADDRESS THE STATE'S PREVENTION AGENDA, IT IS IMPORTANT TO NOTE THAT RMH'S STRATEGIC PLAN INCLUDES MANY ADDITIONAL INITIATIVES TO ADDRESS OUR COMMUNITY'S NEEDS AND ENSURE THE HOSPITAL'S CONTINUED FINANCIAL VIABILITY.RMH'S STRATEGIC PLAN PROVIDES A FRAMEWORK THAT GUIDES OUR DECISIONS AND BRINGS US FOCUS. THE STRATEGIC PLAN FOR 2011-2013 HAS FOUR MAJOR OBJECTIVES THAT ARE STRAIGHT-FORWARD, YET THE TACTICS TO ACHIEVE THEM ARE MULTI-FACETED IN SCOPE.1. FOSTER A CULTURE OF PATIENT SERVICE AND PATIENT SAFETY - WITH A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT, PROVIDE THE NECESSARY LEADERSHIP AND RESOURCES TO DELIVER EVIDENCE-BASED, PATIENT-CENTERED HEALTHCARE SERVICES IN SUPPORT OF OUR MISSION. IN 2011, RMH BECAME A BREAST CENTER OF EXCELLANCE UNDER THE NATIONAL QUALITY MEASURES FOR BREAST CENTERS PROGRAM TO BETTER COORDINATE AND BENCHMARK EXISTING SERVICES AND EXPAND THE CONTINUUM OF BREAST CANCER CARE FOR THE COMMUNITY. RMH HAS BEEN VERY SUCCESSFUL IN CREATING A CULTURE OF SAFETY AND SERVICE FOR ITS PATIENTS. AN EXAMPLE OF THIS IS RMH'S STRATEGIES FOR REDUCING THE RISK OF HEALTH ACQUIRED INFECTIONS. BY ADOPTING EVIDENCE BASED PRACTICES, THE HOSPITAL HAS NOT HAD A CENTRAL LINE INFECTION IN ITS ICU SINCE DECEMBER 2006. THE HOSPITAL WAS ONE OF ONLY EIGHT HOSPITALS IN THE NATION TO BE RECOGNIZED BY THE U.S. DEPARTMENT OF HEATH AND HUMAN SERVICES WITH AN "OUTSTANDING LEADERSHIP AWARD" FOR PROTECTING PATIENTS FROM LIFE-THREATENING BLOODSTREAM INFECTIONS. THE HOSPITAL RECRUITED A NEW GROUP OF EMERGENCY DEPARTMENT PHYSICIANS WITH A REPUTATION FOR WORKING COLLABORATIVELY WITH HOSPITAL STAFF TO DELIVER COMPASSIONATE AND EFFICIENT CARE. IN JUST THE TWO MONTHS, TEAMHEALTH REDUCED THE "DOOR TO DOC" TIME BY ABOUT 25 MINUTES AND THE AVERAGE LENGTH OF STAY BY AN HOUR.THE HOSPITAL CONTINUED ITS COMMITTMENT TO PREVENT HEALTHCARE ACQUIRED INFECTIONS BY IMPLEMENTING NEW TECHNOLOGY THAT USES HYDROGEN PEROXIDE VAPOR TO KILL DRUG- RESISTANT BACTERIA, VIRUSES, AND FUNGI IN HARD-TO-REACH PLACES. THE BIOQUELL SYSTEM WAS PURCHASED THROUGH THE GENEROSITY OF DONORS WHO CONTRIBUTED TO THE ROME HOSPITAL FOUNDATION.2. RECRUITMENT & RETENTION - CONTINUE TO RECRUIT AND RETAIN OUR MOST VALUABLE RESOURCES, OUR PHYSICIANS AND EMPLOYEES, WHO CONSISTENTLY DEMONSTRATE OUR ORGANIZATIONAL MISSION AND VISION. DURING 2011 RMH WELCOMED 44 NEW DOCTORS AND ALLIED HEALTH PROFESSIONALS ON STAFF, INCLUDING A GENERAL SURGEON AND A NEUROLOGIST. DUE TO NATIONAL PHYSICIAN SHORTAGES, THE IMPLEMENTATION OF THE NEW HOSPITALIST PROGRAM WAS DELAYED UNTIL EARLY 2012.3. INFORMATION TECHNOLOGY - TO EXTEND THE SCOPE AND APPLICATION OF INFORMATION TECHNOLOGY (IT) ACROSS THE CONTINUUM OF CARE, TO ENHANCE PATIENT SAFETY, EFFICIENCY AND AVAILABILITY OF INFORMATION. AFTER 18 MONTHS OF ASSESSING, BUILDING, TESTING AND TRAINING, RMH WENT LIVE ON A NEW HEALTH INFORMATION SYSTEM (HIS) JULY 2011 TO BETTER FACILITATE THE PROCESSING AND EXCHANGE OF CLINICAL, STATISTICAL, AND FINANCIAL INFORMATION. THE NEW HIS REPLACES MORE THAN 30 SEPARATE FINANCIAL, CLINICAL, AND ADMINISTRATIVE SYSTEMS - EVERYTHING FROM PATIENT REGISTRATION, BILLING AND PAYROLL TO PATIENT SCHEDULING, NURSING DOCUMENTATION, AND MEDICATION ADMINISTRATION. THE PROJECT INCLUDES SEVERAL NEW APPLICATIONS THAT ADDRESS THE HOSPITAL'S GOALS OF 1)CONVERTING FROM A PAPER-BASED PATIENT MEDICAL RECORD TO A FULLY ELECTRONIC HEALTH RECORD AND 2) PROVIDING ONLINE CLINICAL DECISION SUPPORT TO STANFARDIZE CARE, ADVANCE PATIENT SAFETY, AND ACHIEVE BETTER OUTCOMES.4. OPTIMIZE FINANCIAL PERFORMANCE BY --ENGAGING IN PRUDENT, ETHICAL BUSINESS PRACTICES TO OPTIMIZE PROFITABILITY THAT ALLOW US TO MEET THE PRIORITY HEALTHCARE NEEDS OF OUR COMMUNITY. THE STRATEGIES THAT ROME MEMORIAL HOSPITAL IMPLEMENTED IN 2011 TO DELIVER COST EFFECTIVE QUALITY CARE GENERATED MONIES FOR THE HOSPITAL TO REINVEST IN TECHNOLOGY AND SERVICES.-INCREASING THE UTILIZATION OF OUR HEALTHCARE SERVICES BY MAXIMIZING OPPORTUNITIES THAT MEET THE NEEDS OF OUR CUSTOMERS. IN 2011, ROME MEMORIAL HOSPITAL JOINED ITS THREE OPHTALMOLOGISTS TO BREAK GROUND ON A NEW EYE CENTER THAT WILL OPEN IN 2012. THE PROJECT ALIGNS WITH THE HOSPITAL'S NEED TO PROVIDE MORE AVAILABLE OPERATING ROOM TIME FOR NEWLY RECRUITED SURGEONS.PROGRESS ON A FEW OF THE OTHER MAJOR INITIATIVES INCLUDE:IN SEPTEMBER 2011, AFTER EVALUATION, RMH SENIOR BEHAVIORIAL HEALTH UNIT BECAME STATE CERTIFIED TO SERVE PATIENTS 55 AND OVER, AS OPPOSED TO 65 AND OVER AS IN PAST YEARS. EYE CENTER; THE CONSTRUCTION OF A NEW EYE CENTER AT GRIFFISS BUSINESS & TECHNOLOGY PARK WAS NEARING COMPLETION. THE JOINT VEBNTURE BETWEEN THE HOSPITAL AND ITS THREE OPTHALMOLOGISTS WILL PROVIDE A NEW STATE OF THE ART FACILITY THAT SPECIALIZES IN CATERACT, GLAUCOMA, AND EYELID SURGERY PROCEDURES. THE CENTER IS EXPECTED TO OPEN THE SECOND QUARTER OF 2012. HOSPITALISTS; PREPARATIONS HAVE BEEN MADE SO THAT IN EARLY 2012 A NEW 24-HOUR HOSPITALIST PROGRAM WILL BE LAUNCHED. THIS PROGRAM WILL PROVIDE COVERAGE FOR PATIENTS WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN WHEN THEY ARE ADMITTED TO THE HOSPITAL. ALSO, THE PROGRAM WILL GIVE PHYSICIANS ON THE HOSPITAL'S STAFF THE OPTION OF UTILIZING THE HOSPITALISTS TO ATTEND TO THEIR PATIENTS, WHICH WOULD GIVE THEM THE OPPORTUNITY TO FOCUS ON THEIR OFFICE PRACTICE. PART VI, LINE 3: #3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:TO ENSURE THAT THE COMMUNITY IS AWARE OF THE HOSPITAL'S COMMITMENT TO PROVIDE HEALTHCARE SERVICES TO THOSE WHO ARE UNABLE TO PAY, THE HOSPITAL POSTS INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONFORMS WITH THE GUIDELINES ESTABLISHED BY THE HEALTHCARE ASSOCIATION OF NEW YORK STATE. THIS POLICY INCLUDES DETAILED INFORMATION REGARDING ELIGIBILITY, THE APPLICATION PROCESS, FINANCIAL GUIDELINES, TYPES OF FINANCIAL ASSISTANCE AVAILABLE, AND THE APPEAL PROCESS. RMH'S WEBSITE ALSO LISTS CONTACT INFORMATION IF YOU NEED HELP DETERMINING IF YOU QUALIFY FOR A DISCOUNT OR HAVE QUESTIONS REGARDING THE PROCESS. FREE, CONFIDENTIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE ROME MEMORIAL HOSPITAL BUSINESS OFFICE. IF YOU DO NOT SPEAK ENGLSH, SOMEONE WILL HELP IN YOUR OWN LANGUAGE. ALSO, ROME MEMORIAL HOSPITAL HOSTS ENROLLMENT REPRESENTATIVES WHO CAN HELP ENROLL IN FREE OR LOW-COST INSURANCE PROGRAMS, SUCH AS MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS. PART VI, LINE 4: #4 COMMUNITY INFORMATION:ROME MEMORIAL HOSPITAL SERVES THE RESIDENTS OF ROME, A CITY OF 33,725 PEOPLE, AS WELL AS THE SURROUNDING RURAL TOWNS AND VILLAGES IN ONEIDA COUNTY. THE POPULATION OF THE PRIMARY MARKET IS APPROXIMATELY 100,000 PEOPLE. FOR SELECTED SPECIALTIES, SUCH AS SENIOR BEHAVIORAL HEALTH CARE, RMH'S SERVICE AREA EXTENDS INTO THE SURROUNDING COUNTIES OF MADISON, HERKIMER, LEWIS AND ONONDAGA COUNTIES.ACCORDING TO THE MOST RECENT CENSUS ESTIMATES AVAILABLE, OVERALL POPULATION GROWTH HAS DECLINED APPROXIMATELY 3.5% IN THE CITY OF ROME AND ONEIDA COUNTY SINCE 2000. RESEARCH SHOWS THAT SOCIOECONOMIC CHARACTERISTICS HAVE AN IMPACT ON COMMUNITY HEALTH AND ARE AS IMPORTANT TO HEALTH STATUS AS OUR GENES, OUR BEHAVIORS AND EVEN ACCESS TO MEDICAL CARE. WHEN COMPARED AGAINST STATE FIGURES, THE POPULATION IN ROME AND ONEIDA COUNTY IS OLDER, LESS EDUCATED AND EARNS LESS THAN THE AVERAGE NEW YORKER, WHICH PUTS THEM AT HIGHER RISK FOR HEALTH PROBLEMS. IN ONEIDA COUNTY, OVER 15% OF ADULTS OF ALL INCOMES AGED 18-64 ARE UNINSURED; THIS RATE IS HIGHER THAN NEW YORK STATE (EXCLUDING NEW YORK CITY) AT 13.6%. APPROXIMATELY 6% OF CHILDREN AGED 18 AND YOUNGER LACK INSURANCE. IN ADDITION, ACCORDING TO THE MOST RECENT ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT 2010 - 2013, THE NUMBER OF MEDICAID ELIGIBLE CHILDREN AGED 12-17 INCREASED FROM 3,970 IN 2000 TO 5,954 IN 2005. CHILD HEALTH PLUS ENROLLMENT FOR ONEIDA COUNTY WAS 5,454 AS OF JULY 2009. THE NUMBER OF MEDICAID ELIGIBLE ADULTS IN ONEIDA COUNTY AGED 18 AND OLDER INCREASED 18% FROM 22,398 IN 2000 TO 26,346 IN 2005.THE CHALLENGE IS COMPOUNDED BY THE FACT THAT ONEIDA COUNTY IS A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. IN ADDITION, THE CITY OF ROME AND TOWNS OF AVA, BOONVILLE, FORESTPORT, FLOYD, LEE, VERONA, WESTERN, ANNSVILLE, CAMDEN, FLORENCE AND VIENNA ARE FEDERALLY-DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS, WITH AN INADEQUATE NUMBER OF PRIMARY MEDICAL CARE PROVIDERS TO SERVE THE COMMUNITY.THE FOLLOWING TABLE HIGHLIGHTS AVAILABLE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS OF OUR COMMUNITY.SOCIO-ECONOMIC PROFILE ONEIDA COUNTY NEW YORKPOPULATION, 2011 ESTIMATE 234,287 19,465,197POPULATION, % CHANGE, APRIL 2010 TO JULY 2011 -.3% .4%POPULATION, 2010 234,878 18,378,102PERSONS UNDER 5 YEARS OLD, PERCENT, 2011 5.6% 6.0%PERSONS UNDER 18 YEARS OLD, PERCENT, 2011 21.5% 22.0%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2011 16.5% 13.7%FEMALE PERSONS, PERCENT, 2011 50.2% 51.5% ONEIDA COUNTY NEW YORKWHITE PERSONS, PERCENT, 2011 (A) 88.2% 71.5%BLACK PERSONS, PERCENT, 2011 (A) 6.7% 17.5%AMERICAN INDIAN/ALASKA NATIVE PERSONS,%,2011(A) 0.3% 1.0%ASIAN PERSONS, %, 2011 (A) 2.9% 7.8%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, %,2011(A) .1% .1%PERSONS REPORTING TWO OR MORE RACES, %, 2011 1.8% 2.2%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2011(B) 4.8% 18.0%WHITE PERSONS NOT HISPANIC, PERCENT, 2011 84.6% 58.0% ONEIDA COUNTY NEW YORK FOREIGN BORN PERSONS, PERCENT, 2006-2010 6.6% 21.7%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+, 2006-2010 10.8% 29.2%HIGH SCHOOL GRADUATES, PERCENT OF PERSONS AGE 25+, 2006-2010 86.0% 84.4%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+, 2006-2010 21.5% 32.1%VETERNS, 2006-2010 21,171 1,025,496 ONEIDA COUNTY NEW YORK HOUSING UNITS, 210 104,180 8,108,103HOMEOWNERSHIP RATE, 2006-2010 67.9% 55.2%HOUSING UNITS IN MULTI-UNIT STRUCTURES, %,2006-2010 31.2% 50.6%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS, 2006-2010 $101,900 $303,900 ONEIDA COUNTY NEW YORKHOUSEHOLDS, 2006-2010 92,058 7,205,740PERSONS PER HOUSEHOLD, 2006-2010 2.39 2.59MEDIAN HOUSEHOLD INCOME, 2006-2010 $46,708 $55,603PER CAPITA MONEY INCOME, 2006-2010 $23,458 $30,948PERSONS BELOW POVERTY LEVEL, PERCENT, 2009 14.9% 14.2% ROME NEW YORKPOPULATION, 2010 ESTIMATE 33,725 19,378,102POPULATION, % CHANGE, 4/1/2000 TO 7/1/2006 -3.5% 2.1%POPULATION, 2000 34,950 18,976,457PERSONS UNDER 5 YEARS OLD, PERCENT, 2010 6.1% 6.0%PERSONS UNDER 18 YEARS OLD, PERCENT, 2010 22.1% 24.7%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2010 16.5% 13.5%FEMALE PERSONS, PERCENT, 2010 48.6% 51.6% ROME NEW YORKWHITE PERSONS, PERCENT, 2010 (A) 87.4% 65.7%BLACK PERSONS, PERCENT, 2010 (A) 7.1% 15.9%AMERICAN INDIAN & ALASKA NATIVE PERSONS, %, 2010 (A) 0.3% 0.6%ASIAN PERSONS, PERCENT, 2010 (A) 1.1% 7.3%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER,%, 2010 (A) Z 0.0%PERSONS REPORTING TWO OR MORE RACES, PERCENT, 2010 2.7% 3.0%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2010 (B) 5.3% 17.6% ROME NEW YORK LIVING IN SAME HOUSE 1 YEAR & OVER, 2006-2010 81.7% 88.3%FOREIGN BORN PERSONS, PERCENT, 2006-2010 4.4% 21.7%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+,2006-2010 7.9% 29.2%HIGH SCHOOL GRADUATES, % PERSONS AGE 25+,2006-2010 83.0% 84.4%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+,2006-2010 16.9% 32.1% ROME NEW YORKHOUSING UNITS, 2010 14,893 8,108,103HOMEOWNERSHIP RATE, 2006-2010 58.4% 55.2%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS, 2006-2010 $85,200 $303,900 ROME NEW YORK HOUSEHOLDS, 2006-2010 13,730 7,205,740PERSONS PER HOUSEHOLD, 2006-2010 2.25 2.59MEDIAN HOUSEHOLD INCOME, 2006-2010 $42,779 $55,603PER CAPITA MONEY INCOME, 2006-2010 $21,989 $30,948PERSONS BELOW POVERTY, PERCENT, 2006-2010 15.3% 14.2% SOURCE: US CENSUS BUREAU STATE & COUNTY QUICKFACTS PART VI, LINE 5: #5 PROMOTION OF COMMUNITY HEALTH:1.ROME MEMORIAL HOSPITAL PROVIDES EMERGENCY SERVICES TO EVERYONE REGARDLESS OF ABILITY TO PAY.2.THE HOSPITAL'S INDEPENDENT GOVERNING BODY IS COMPRISED OF INDIVIDUALS WHO RESIDE OR WORK IN THE PRIMARY SERVICE AREA TO REPRESENT THE INTERESTS OF THE COMMUNITY.3.THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY.4.THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE CARE, EXPAND FACILITIES, RECRUIT STAFF AND ADVANCE MEDICAL TRAINING AND COMMUNITY EDUCATION. PART VI, LINE 6: #6 AFFILIATED HEALTH CARE SYSTEM:ROME MEMORIAL HOSPITAL, INC. (THE "HOSPITAL") IS A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AND TAX EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"), AND IS PART OF THE FOLLOWING CORPORATE STRUCTURE: GREATER ROME AFFILIATES, INC. ("GRA"), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS THE SOLE CORPORATE MEMBER, AND THEREFORE, THE "PARENT" OF THE HOSPITAL, AS WELL AS ROME MEMORIAL PROPERTIES, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC. GRA IS ALSO THE SOLE SHAREHOLDER OF RMH SERVICES, INC., A NEW YORK STATE BUSINESS CORPORATION, WHICH WAS ESTABLISHED TO UNDERTAKE CERTAIN FOR-PROFIT BUSINESS ACTIVITIES AND WHICH HAS AN EQUITY OWNERSHIP INTEREST IN, AND IS A MEMBER OF, THREE NEW YORK STATE LIMITED LIABILITY COMPANIES: 1819 BLACK RIVER ASSOCIATES, LLC; CHESTNUT COMMONS, LLC; AND RMH RETAIL PHARMACY, LLC. MEMBERS OF THE HOSPITAL'S BOARD OF TRUSTEES AND ADMINISTRATIVE STAFF HAVE OVERLAPPING RESPONSIBILITIES ON THE BOARDS OF THE AFFILIATED CORPORATIONS TO ENSURE THAT THE HOSPITAL'S BEST INTERESTS ARE BEING SERVED. ROME MEMORIAL HOSPITAL FOUNDATION, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS A SEPARATE CORPORATION ESTABLISHED FOR THE SOLE PURPOSE OF CONDUCTING FUND RAISING ACTIVITIES ON BEHALF OF THE HOSPITAL, INCLUDING THE RECEIPT OF GIFTS AND BEQUESTS ON BEHALF OF THE HOSPITAL, INVESTING SUCH ASSETS, AND TRANSFERRING THEM TO THE HOSPITAL IN SUPPORT OF ITS MISSION. IT IS GOVERNED BY A SEPARATE BOARD OF DIRECTORS, WHICH HAS AMONG ITS MEMBERS HOSPITAL TRUSTEES AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF.THE SYSTEM ALSO INCLUDES TWO CAPTIVE PROFESSIONAL CORPORATIONS, INCLUDING ROME MEDICAL GROUP, P.C., A MULTI-PHYSICIAN PRIMARY CARE PRACTICE, AND ROME MEDICAL PRACTICE, P.C., A MULTI-PHYSICIAN, SPECIALTY GROUP. THE PCS ARE THE VEHICLES THROUGH WHICH PHYSICIANS ARE EMPLOYED TO SERVE THE COMMUNITY. IN TODAY'S ENVIRONMENT, MANY PHYSICIANS PREFER TO BE EMPLOYED VS. GOING OUT IN PRIVATE PRACTICE. REPORTS FILED WITH STATES PART VI, LINE 7 NY X 1 1 X X X X 0 0 0 0 0 0 0 0 0 BASIL ARIGLIO 231466 0 21076 0 0 0 0 0 14017 0 266559 0 0 0 WALEED ALBERT MD 253426 0 25982 0 0 0 0 0 14061 0 293469 0 0 0 RAYMOND CARNEVALE 159602 0 16009 0 10010 0 0 0 6781 0 192402 0 0 0 NICHOLAS MAYHEW 183921 0 18351 0 32524 0 0 0 13988 0 248784 0 0 0 MARK SNYDERMAN 118908 0 3680 0 18538 0 0 0 10645 0 151771 0 0 0 BRUCE PETERSON 142850 0 1544 0 2830 0 0 0 13847 0 161071 0 0 0 DARLENE BURNS 133687 0 44114 0 48000 0 0 0 6768 0 232569 0 0 0 PART I, LINE 1A TYPE OF BENEFIT: PAYMENT OF 2011 INITIATION FEE, MEMBERSHIP DUES, AND GENERAL MAINTENANCE FEE FOR SOCIAL CLUB, AS AGREED UPON IN EMPLOYMENT CONTRACT. PERSON WHO RECEIVED BENEFIT: CEO THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION IN 2011 FOR PERSON LISTED ABOVE. ONEIDA COUNTY INDUSTRIAL DEVELOPMENT AGENCY 166158201 6824621LE 2005-06-16 11900000 FINANCE CONSTRUCTION 0 1 0 ONEIDA COUNTY LOCAL DEVELOPMENT CORPORATION 273190422 2010-12-30 6900000 FINANCE MRI CONSTRUCTION 0 1 0 DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 2011-10-27 7500000 FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT 0 1 0 DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 2007-09-21 1858108 FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT- CAT SCANN 0 1 0 11900000 509090 2006 0 0 1 1 6900000 222845 2009 0 0 1 1 7500000 1961 1439667 58826 5999546 2011 0 0 0 1 1858108 2007 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1 0 0 1 1 0 1 0 0 1 1 0 1 0 1 1 MANUFACTURERS AND TRUST 5.000000000000 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE K SUPPLENTAL INFORMATION THE CAPITAL LEASE AGREEMENTS ARE ALL TELP (TAX EXEMPT LEASE - PURCHASE (FINANCING)) LEASES THROUGH THE COUNTY OR STATE. DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 2009-12-01 1935034 FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT - MRI EQUIPMENT 0 1 0 1935034 15338 2009 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 MARY ANN JONES SISTER OF KEY EMPLOYEE 27704 COMPENSATION 0 DARLENE BURNS FORMER OFFICER 48000 CONTRACT FOR CONSULTING SERVICES 0 SCOTT BURNS SON OF FORMER OFFICER 138103 COMPENSATION 0 X MEDICAL EQUIPMENT 9 100072 ACTUAL INVOICE COST X 2 NORTH RENOVATIONS 1 92747 ACTUAL INVOICE COST X MRI/EMERGENCY ROOM PROJECT 52244 ACTUAL INVOICE COST X BIOQUELL SYSTEM 44850 ACTUAL INVOICE COST X IT SYSTEM 1 11998 ACTUAL INVOICE COST 0 1 0 CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 DURING SEPTEMBER 2011 RMH SENIOR BEHAVIORAL HEALTH UNIT OBTAINED STATE CERTIFICATION TO LOWER THE ELIGIBLE AGE FOR PATIENTS SERVED FROM 65 TO 55. FORM 990, PART VI, SECTION A, LINE 6 GREATER ROME AFFILIATES IS THE SOLE MEMBER OF ROME MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A PER THE HOSPITAL BY-LAWS "THE SOLE CORPORATE MEMBER OF THE CORPORATION SHALL BE GREATER ROME AFFILIATES, INC. WHICH SHALL ACT HEREUNDER AS SUCH MEMBER BY DULY AUTHORIZED RESOLUTION OF ITS BOARD OF DIRECTORS AND WHICH SHALL COMMUNICATE ITS ACTIONS TO THIS BOARD THROUGH ITS PRESIDENT OR OTHER DULY AUTHORIZED OFFICER." GREATER ROME AFFILIATES APPOINTS THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED 2011 990 WAS PRESENTED TO THE BOARD BY THE CFO OF THE HOSPITAL AT ITS OCTOBER 2012 BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CONSISTENT WITH ROME HOSPITAL'S GIFTS, GRATUITIES AND CONFLICT OF INTEREST POLICY, THE COMPLIANCE OFFICER OF RMH HAS A CONFLICT OF INTEREST DISCLOSURE FORM COMPLETED ON AN ANNUAL BASIS BY ALL OFFICERS, DIRECTORS AND MANAGEMENT PERSONNEL. THE COMPLIANCE OFFICER COLLECTS AND REVIEWS THE BOARD OF TRUSTEES/FOUNDATION BOARD INTEREST DISCLOSURE FORMS ON AN ANNUAL BASIS. THE INFORMATION GATHERED ON THE DISCLOSURE IS REVIEWED AND ANY CONFLICTS ARE COMMUNICATED TO THE PRESIDENT/CEO, COMPLIANCE BOARD, AND BOARD OF TRUSTEES TO ENSURE ALL HOSPITAL TRANSACTION/BUSINESS ACTIVITIES ARE CONDUCTED IN A MANNER THAT IS FREE FROM UNLAWFUL OR OTHERWISE INAPPROPRIATE OFFERS OR SOLICITATIONS OF IMPROPER INDUCEMENTS IN EXCHANGE FOR INFLUENCE OR ASSISTANCE IN A TRANSACTION. POTENTIAL CONFLICTS THAT MAY ARISE THROUGHOUT THE YEAR ARE BROUGHT TO THE ATTENTION OF THE COMPLIANCE OFFICER AND PRESIDENT/CEO FOR REVIEW. ANY IDENTIFIED CONFLICTS ARE THEN REVIEWED AT THE CORPORATE COMPLIANCE COMMITTEE AND BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 USE OF IROQUOIS DATA, ASSOCIATION FOR HEALTHCARE PHILANTHROPY SALARY DATA, AND THE ROME HOSPITAL HUMAN RESOURCE DEPARTMENT ARE UTILIZED TO DETERMINE COMPENSATION FOR THE ORGANIZATION'S EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 18 FORMS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 FORMS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST OR THROUGH WWW.GUIDESTAR.ORG- A WEBSITE THAT PROVIDES NON-PROFIT INFORMATION TO THE PUBLIC. RMH MAKES ITS GOVERNING DOCUMENTS (BY - LAWS) AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC THROUGH RMH WEBSITE - WWW.ROMEHOSPITAL.ORG. ALSO, FINANCIAL FACTS AND FIGURES AND ECONOMIC IMPACT REPORTS CAN BE FOUND ON THIS WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -189,769. TOTAL CHANGE IN INTEREST IN FOUNDATION -160,457. TOTAL TO FORM 990, PART XI, LINE 5: -350,226. FORM 990, PART XI, LINE 2C THE FINANCE/AUDIT COMMITTEE CONSISTS OF NO LESS THAN 3 AND NOT MORE THAN 7 MEMBERS. THIS COMMITTEE IS RESPONSIBLE FOR GENERAL OVERSIGHT OF THE FINANCIAL AFFAIRS OF THE HOSPITAL. THE COMMITTEE REVIEWS,ADVISES,AND REPORTS TO THE BOARD OF TRUSTEES ON THE INVESTMENT AND MANAGEMENT OF THE FINANCIAL RESOURCES OF THE CORPORATION AND SHALL REVIEW THE ANNUAL BUDGET AND CAPITAL PLANS, FUND MANAGEMENT PROCEDURES, AND INTERNAL CONTROLS RELATING TO THE SAFEGUARD OF FINANCIAL ASSETS. THE COMMITTEE ACTS AS FINANCIAL ADVISOR, REVIEWS PROPOSED SCOPE OF ANNUAL AUDITS PERFORMED BY INDEPENDENT AUDITORS, REVIEWS INDEPENDENT AUDITORS MANAGEMENT LETTERS, REVIEWS THE ADEQUACY OF ACCOUNTING POLICIES AND INTERNAL CONTROL STRUCTURES, RECOMMENDS THE APPOINTMENT OF INDEPENDENT AUDITORS TO THE BOARD OF TRUSTEES, AND REVIEWS PERIODICALLY THE CONFLICTS OF INTEREST POLICIES, AS WELL AS OVERSEES COMPLIANCE THEREWITH. GREATER ROME AFFILIATES 1500 N JAMES STREET ROME NY 13440 161508597 PARENT CORPORATION NY 501C3 LINE 11A, I 0 ROME MEMORIAL PROPERTIES 1500 N JAMES STREET ROME NY 13440 161492003 SUPPORT HOSPITAL ACTIVITIES NY 501C3 3 GRA 0 GRIFFIS EYE CENTER LLC 105 DART CIRCLE ROME NY 13441 263738675 SEE SCHEDULE R, PART VII NY INVESTMENT -43821 44597 0 0 0.30000 RMH SERVICES INC 1500 N JAMES STREET ROME NY 13440 161490045 FOR PROFIT NY GREATER ROME AFFILIATES C 56078 2757762 1.00000 ROME MEDICAL GROUP 1801 BLACK RIVER BLVD ROME NY 13440 161464822 CAPTIVE P.C. NY ROME MEMORIAL HOSPITAL C ROME MEDICAL PRACTICE 1500 N JAMES STREET ROME NY 13440 203827393 CAPTIVE P.C. NY ROME MEMORIAL HOSPITAL C 0 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 0 1 SCHEDULE R, PART III, COLUMN (B) REGARDING GRIFFIS EYE CENTER, LLC. PRIMARY ACTIVITY: SINGLE SPECIALTY AMBULATORY SURGERY CENTER SPECIALIZING IN AND PROVIDING ONLY OPHTHALMOLOGY SERVICES.