2011-11-15T11:43:29-06:00 2010-12-31 990 2010-01-01 160743192 Soldiers and Sailors Memorial Hospital of Yates County SOLD 3157874085 418 North Main Street Penn Yan NY 14527 PATRICIA P THOMPSON 3157874031 2011-11-15 2010 2016-03-07 17:11:31Z Patricia P Thompson 196 North Street Geneva NY 14456 37588029 0 X www.flhealth.org X 1924 NY Provider of Healthcare Services. 18 14 553 66 0 0 573642 6040103 28757826 29140134 722373 525072 1107071 1023975 31160912 36729284 0 0 0 0 20533968 19902189 0 0 0 11495857 11296657 32029825 31198846 -868913 5530438 43570416 45826852 29626746 25506129 13943670 20320723 Soldiers & Sailors Memorial Hospital of Yates County is a community owned, not-for-profit hospital dedicated to maintaining and improving the health of all people in the Central Finger Lakes Region. 0 0 27722036 30329121 Patient Service Program - inpatient and outpatient general hospital care. In 2010, Soldiers & Sailors Memorial Hospital of Yates County had 56,212 patient days, 7,864 emergency room visits, 159,992 outpatient procedures and 15,606 outpatient clinic visits. In 2010 Soldiers & Sailors Memorial Hospital of Yates County had Charity Care totaling $410.094 with a Community Benefit valued at $608.928 27722036 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 553 1 0 0 0 0 0 0 0 0 X 18 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Patricia Thompson 3157874031 196 North Street Geneva NY 14456 Suzanna Sinclair 1.00 X X 0 0 0 Dominic Fonte 1.00 X X 0 0 0 Phil Beckley 1.00 X X 0 0 0 Paul Bleakley MD 1.00 X 0 0 0 David Bunnell 1.00 X 0 0 0 Menzo Case 1.00 X 0 0 0 Richard Catanise 1.00 X 0 0 0 Stephen DeRaddo 1.00 X 0 0 0 Jason Feinberg 1.00 X 0 288787 0 Donald Gentilcore Jr 1.00 X 0 0 0 John Hicks 1.00 X 0 0 0 Charles Lilly 1.00 X X 279727 0 0 James Long 1.00 X 0 0 0 Paul Marble 1.00 X 0 0 0 Carolanne Marquis 1.00 X 0 0 0 Kelly Mittiga 1.00 X 0 0 0 Ann Orman 1.00 X 0 0 0 Richard Sayers 1.00 X 0 0 0 Bruce Teague 1.00 X 0 0 0 Bryan VonHahmann 1.00 X 0 0 0 Donald Wertman 1.00 X 0 0 0 Joann Wisor 1.00 X 0 0 0 Jose Acevado MD MBA 40.00 X 0 396008 62125 Lawrence J Farnand 40.00 X 0 682349 7396 James Hiserodt 40.00 X 0 226482 12565 Errol Zimmerman 40.00 X 0 208104 11646 Reginald Ewing 40.00 X 237635 0 0 Jennifer Palamara 40.00 X 217381 0 0 Magda Daoud MD 40.00 X 192661 0 5285 Nancy-Jo Rembaum 40.00 X 167361 0 6607 James Dooley 40.00 X 0 382635 13891 1094765 2184365 119515 9 1 1 0 0 85360 5954743 6040103 Net Patient Revenue 621990 29140134 29140134 29140134 360060 360060 1023257 500 858745 164512 500 165012 165012 Other Revenue 900099 1023975 1023975 1023975 36729284 30329121 0 360060 15692038 13943311 1748727 266616 236904 29712 2840046 2523550 316496 1103489 980516 122973 161327 143349 17978 40733 36194 4539 2907452 2583444 324008 48538 43129 5409 350367 311322 39045 202929 180315 22614 484536 430539 53997 161139 143182 17957 645949 573964 71985 2212242 1965709 246533 332220 295197 37023 Supplies 1436106 1276066 160040 Bad Debt Expense 1245592 1106783 138809 NYS Assessment Tax 709531 630461 79070 Repairs & Maintenance 335044 297707 37337 Training 22952 20394 2558 31198846 27722036 3476810 0 25457 25403 1586628 1572750 2640412 3009346 399521 375714 205744 168651 290716 268050 56348456 35069947 21490843 21278509 16931095 19128429 43570416 45826852 2068476 3222679 10037512 9847788 10391563 9717124 7129195 2718538 29626746 25506129 X 13943670 20320723 13943670 20320723 43570416 45826852 X 5530438 846615 X 1 1 0 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 399264 399264 25454263 10955819 14498444 1794233 1331585 462648 28700696 22782543 5918153 0 21278509 Mortgage Sinking Funds 2492032 Plant Replacement Investment 11325406 Reserve for Replacement LTC 1319280 Escrow Reserve LTC 199805 Capital Lease 45314 Construction In Progress 76644 SSMH Plant Operating Fund 1967810 5 Star Money Market 273027 SSMH Ventures 491762 Due From Affiliates 937349 19128429 Additional Pension Liability 2347048 BCR Advance 371490 2718538 Description of Uncertain Tax Positions Under FIN 48: Part X: Soldiers & Sailors Memorial Hospital implemented FIN48 in 2008 and our current accounting policy for evaluating uncertain tax positions is in accordance with generally accepted accounting principles. SSMH has not recognized any benefits from uncertain tax postiions in 2010 and we believe that we have no uncertain tax positions for which it is reasonably possible that the total amounts of unrecognized tax benefits will significantly increase or decrease within 12 months of the balance sheet date. Schedule D, Pg 4, Part XI, Ln 8. Additional Pension Liability 1 1 1 X 1 X 1 1 0 1 1 419858 196261 223597 0.00720 10601802 10626250 -24448 0.00000 11021660 10822511 199149 0.00720 69273 69273 0.00220 59015 59015 0.00190 128288 128288 0.00410 11149948 10822511 327437 0.01130 465 465 0.00000 147775 147775 0.00470 55 55 0.00000 29111 29111 0.00090 256279 256279 0.00820 46955 46955 0.00150 480640 480640 0.01530 1 759972 354299 5187423 5573206 -385783 X 1 1 1 1 Soldiers & Sailors Memorial Hospital

418 North Main Street Penn Yan NY 14527

X X X X Soldiers and Sailors Memorial Hospital 1 1 1 400.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X X X 1 X X X 1 X 1 X 1 1 Part II: Part VI, Ln5: Soldiers & Sailors Memorial Hospital's Community Building activities promote the health of the communities it serves through:1. Economic Development: Soldiers & Sailors Memorial Hospital (SSMH) supports economic development in the community, via its membership in the Chamber of Commerce.2. Community Support: a. To be equipped for disaster situations, SSMH participates in emergency preparedness/disaster readiness activities, including disaster drills; stockpiling essential supplies for use during a disaster; training staff for disasters; and conducting POD events as training in the event of a disaster requiring mass immunizations.b. SSMH provides free meeting space, and in some instances facilitation, for various community organizations such as TOPS, Community Blood Drives, American Cancer Society, TB & Health Association, as well as providing free space for a Community Fitness Center.3. Environmental Improvements: SSMH accepts sharps from community households and provides proper disposal of same at no cost to the households.4. Coalition Building: a. Finger Lakes Health, which includes SSMH, Administrative Team members participate in multiple community organizations/partnerships for the betterment of the communities, including the United Way, Red Cross, Visiting Nurse Service, ARC, and Boys & Girls Club, among others.b. Likewise, employees of the organization participate in many community organizations on behalf of SSMH, that benefit the health of the community, including the United Way, Regional EMS Councils, Poison Control Council, county Health Planning Council, Cancer Services Partnership, Obesity Task Force, among others.c. SSMH sponsors community not-for-profit activities for organizations, such as, but not limited to, the American Cancer Society and the Lions Club Sight Program.5. Workforce Development:a. Physician Recruitment expenses associated with efforts to recruit physicians to meet an unmet community need in an underserved population including primary care physicians and specialists such as a pulmonologist, nephrologist, geriatrician, physiatrist, etc.b. Health Careers Programs/Workforce Investment expenses associated with programs, including summer camps and school-to-work experiences for the exploration of health careers by high school students; mentoring of high school and college-age students to provide training in various professions in our facilities; and partnerships with area colleges to provide education/mentoring for students in various health-related careers. Part III, Line 4: SSMH estimates the amount to be recognized in the combined financial statements for doubtful accounts by analyzing specific patient and resident accounts for collectibility and also by applying historically established percentages for self-pay and various third-party payers to the aging categories in the accounts receivable aging for each facility.Part III, Section A. Line 4: The organization estimates that 46% of patient accounts turned over to bad debt could have qualified as charity care. This percentage came from a national study conducted by Connance Inc and Paro Decision Support LLC which conducted a sample survey of hospitals and concluded the percentage for the nation's hosptials as a whole. This number was adjusted to reflect the difference in per capita income in Soldiers and Sailors Memorial Hospital Part III, Line 9b: After the Customer Service Representative's initial determination, or the determination rendered after an appeal review, the patient's hospital account is adjusted to reflect the amount of any financial aid deduction to be applied to it. The patient is billed for any remaining amount due, and is offered the telephone number of an individual within Patient Accounts who is available to assist the person in creating a self-payment plan that outlines patient re-payment steps over a specified period of time should the patient require such assistance. Soldiers and Sailors Memorial Hospital Part V, Section B, Line 19d: We generally bill gross charges (usual and customary). We do allow for a discount based on Excellus reimbursement for scheduled surgery. Soldiers and Sailors Memorial Hospital Part V, Section B, Line 20: Presently we apply a percentage discount to published charges for patients eligible for assistance under our financial assistance policy. Any individual patient's discounted amount may or may not be more than the amounts generally billed to individuals who had insurance covering such care. Soldiers and Sailors Memorial Hospital Part V, Section B, Line 21: We generally bill gross charges (usual and customary). We do allow for a discount based on Excellus reimbursement for scheduled surgery. Part VI, Line 2: Part VI, Line 2: SSMH uses health indicators and utilization data to determine healthcare programs and services to meet the needs of our population. Specific indicators include the New York State Community Health data set on disease incidence and mortality, the Behavior Risk Factor Surveillance System (BRFSS) data set from New York State Department of Health, and Statewide Planning and Research Cooperative System (SPARCS) database for data reported by NYS hospitals. This external data is supplemented by real-time information about our own current service area needs and utilization rates. Finger Lakes Health (FLH) mailed a survey to every household in our service area in the health systems biannual news magazine Family Focus. The Community Advisory Committee addressed many community needs, including access to care, transportation, diabetes, nutrition, childhood obesity, mental health services, cardiovascular risk, and lack of awareness regarding service availability. All the needs identified are addressed in the organization's strategic business plan, as well as our Community Service Plan. We engage an outside firm to conduct patient and resident satisfaction surveys for our inpatient and emergency services. We also conduct an annual Employee Opinion Survey. As the largest employer in our region, our employees are representative of our community at large and are in a unique position to help us identify needs and solutions. We participate in the needs assessment process conducted by multiple area health departments who participated in a wider rural health network to compare data between counties and develop common objectives using MAPP (Mobilizing for Action through Community Planning and Partnership) process to conduct a six county wide needs assessment. Finally, to know the needs of our community, our leadership team is actively engaged in the community through board participation on local and state-wide related organizations which regularly assess needs. Our strategic plan informs our priorities and guides us towards achieving our vision, and is informed by the needs of various stakeholders. This input is incorporated into departmental operations and multi-year plans and ultimately informs our Strategic Business Plan. Through this broad-based input, our health system has been able to evolve and grow to meet the changing needs of our community. Part VI, Line 3: Part VI, Line 3: Financial Aid under the organization's charity care policy is available to assist uninsured or underinsured members of our community who are willing but unable to pay in full for their care. The program allows a person to receive medically necessary and emergency services at no charge or reduced charges when they meet certain eligibility requirements. We have made public information about availability of financial assistance through signage and applications placed in the emergency departments, registration areas, and the patient accounts office. We have also published this information in a direct mail sent to area homes and promoted the program on local radio shows. Part VI, Line 4: Part VI, Line 4: SSMH provides a full range of acute care services to residents of the Finger Lakes region in Upstate New York. The hospital reviews demographic data from sources such as the US Census to identify trends. The hospital uses health indicators and utilization data from numerous sources and receives community input form public surveys. We participate in a Needs Assessment Process and participate as an active member of the community through board participation on numerous local and state-wide health related organizations. Part VI, Line 6: Schedule Part VI. Ln 6. SSMH through it's affiliation with Finger Lakes Health participated in the screening of nearly 500 young athletes from more than 16 area schools for Hypertropic Cardiomyopathy at the Geneva Community Center. Forty-five students were identified as having a heart abnormality requiring a follow-up visit with their doctor. The screening was made possible through the support of the Finger Lakes Health Foundation and was conducted in partnership with the Anthony Bates Foundation. It was the first screening of its type conducted in New York State and the largest screening of its type ever conducted in the US. Finger Lakes Health also sponsored Authentic Women: Authentic Health, which was a full day seminar that was attended by more than 125 women. This event was designed to promote a healthier lifestyle and heighten the womens' awareness of available services. FLH also hosted fifteen Dine & Discuss events presented by our physician and staff which were attended by 1,067 community members. Average rating was 9.3 out of 10 for these programs. Part VI, Line 7: Part VI, Line 7: Services are provided on three campuses located in Geneva, NY (Ontario County), Waterloo, NY (Seneca County) and Penn Yan, NY (Yates County). The health system offers a broad range of primary, specialty and sub-specialty services to residents of Finger Lakes. X X X X 0 0 0 0 0 0 0 0 0 Jason Feinberg 0 288787 0 0 0 0 0 0 0 0 0 288787 0 0 Charles Lilly 279727 0 0 0 0 0 0 0 0 0 279727 0 0 0 Jose Acevado MD MBA 0 394838 0 0 0 1170 0 50000 0 12125 0 458133 0 0 Lawrence J Farnand 0 680437 0 0 0 1912 0 0 0 7396 0 689745 0 0 James Hiserodt 0 225294 0 0 0 1188 0 0 0 12565 0 239047 0 0 Errol Zimmerman 0 205782 0 0 0 2322 0 0 0 11646 0 219750 0 0 Reginald Ewing 237635 0 0 0 0 0 0 0 0 0 237635 0 0 0 Jennifer Palamara 217381 0 0 0 0 0 0 0 0 0 217381 0 0 0 Magda Daoud MD 192510 0 0 0 151 0 0 0 5285 0 197946 0 0 0 Nancy-Jo Rembaum 166173 0 0 0 1188 0 0 0 6607 0 173968 0 0 0 James Dooley 0 376808 0 0 0 5827 0 0 0 13891 0 396526 0 0 Supplemental Information Part III James J. Dooley, Former President & CEO Geneva General Hospital: Average Hours per week: 23.62; Base Compensation:$225,983;Benefits: $8,205 James J. Dooley, Former President & CEO Living Center at Geneva South Inc: Average Hours per week: 2.64; Base Compensation: $25,250; Benefits $917 James J. Dooley, Former President & CEO Living Center at Geneva North Inc: Average Hours per week: 1.62; Base Compensation: $15,540; Benefits: $564 James J. Dooley, Former President & CEO Huntington Living Center Inc: Average Hours per week: 3.14; Base Compensation: $30,052; Benefits: $1,091 James J. Dooley, Former Assistant Secretary Finger Lakes Health Foundation Inc: Average Hours per week: .17; Base Compensation: $1,596; Benefits: $58 James J. Dooley, Former President & CEO Soldiers & Sailors Memorial Hospital: Average Hours per week: 8.8; Base Compensation: $84,212; Benefits: $3,057 James J. Dooley, Former President & CEO Finger Lakes Health: Total Average Hours per week: 40; Total Base Compensation: $382,635; Total Benefits: $13,891 Lawrence J. Farnand, Treasurer & CFO Geneva General Hospital: Average Hours per week: 23.62; Base Compensation: $402,993; Benefits: $4,367 Lawrence J. Farnand, Treasurer & CFO Living Center at Geneva South Inc: Average Hours per week: 2.64; Base Compensation: $45,029; Benefits: $488 Lawrence J. Farnand, Treasurer & CFO Living Center at Geneva North Inc: Average Hours per week: 1.62; Base Compensation: $27,713; Benefits: $300 Lawrence J. Farnand, Treasurer & CFO Huntington Living Center Inc: Average Hours per week: 3.14; Base Compensation: $53,592; Benefits: $581 Lawrence J. Farnand, Treasurer & CFO Finger Lakes Health Foundation: Average Hours per week: .17; Base Compensation: $2,847; Benefits: $31 Lawrence J. Farnand, Treasurer & CFO Soldiers & Sailors Memorial Hospital: Average Hours per week: 8.8; Base Compensation: $150,175; Benefits: $1,628 Lawrence J. Farnand, Treasurer Finger Lakes Health: Total Average Hours per week: 40; Total Base Compensation: $682,349; Total Benefits: $7,396 Jose Acevedo MD MBA, President & CEO Geneva General Hospital: Average Hours per week: 23.62; Base Compensation: $233,880; Benefits: $7,160; Deferred Compensation: $29,531 Jose Acevedo MD MBA, President & CEO Living Center at Geneva South Inc: Average Hours per week: 2.64; Base Compensation: $26,133; Benefits: $800; Deferred Compensation: $3,300 Jose Acevedo MD MBA, President & CEO Living Center at Geneva North Inc: Average Hours per week: 1.62; Base Compensation: $16,083; Benefits: $492; Deferred Compensation: $2,031 Jose Acevedo MD MBA, President & CEO Huntington Living Center Inc: Average Hours per week: 3.14; Base Compensation: $31,103; Benefits: $952; Deferred Compensation: $3,927 Jose Acevedo MD MBA, Assistant Secretary Finger Lakes Health Foundation: Average Hours per week: .17; Base Compensation: $1,652; Benefits: $51; Deferred Compensation: $209 Jose Acevedo MD MBA, President & CEO Soldiers & Sailors Memorial Hospital: Average Hours per week: 8.80; Base Compensation: $87,156; Benefits: $2,669; Deferred Compensation:$11,004 Jose Acevedo MD MBA, President & CEO Finger Lakes Health: Total Average Hours per week: 40; Total Base Compensation: $396,008; Total Benefits: $12,125; Total Deferred Compensation: $50,000 FL Visiting Nurse Service CFO serves on Board of Directors 0 Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the Administrative Committee prior to being filed to ensure compliance with 990 Internal Revenue Service Review Requirements. Form 990, Part VI, Section B, line 12c Soldiers & Sailors Memorial Hospital of Yates County maintains a conflict of interest policy which board members are required to sign prior to taking office. Statements are updated annually and reviewed by an Administrative Committee. The process for handling any conflicts of interest which may arise are detailed in the corporate by-laws. Form 990, Part VI, Section B, line 15 Compensation of officers or key employees includes a review as well as comparability data as part of the decision. Form 990, Part VI, Section C, line 19 Soldiers & Sailors Memorial Hospital of Yates County makes its governing documents, conflict of interest policy, and financial statements available to the public where required by law and upon request. The organization's Form 990 is provided to any individual who provides a request in person or who submits a written request. There is no charge other than a reasonable fee for copying and postage. Copies are available at the hospital Finance Office or at www.guidestar.org Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 419,122. Additional Pension Liability under FASB 158 427,493. Total to Form 990, Part XI, Line 5: 846,615. Geneva General Hospital 196 North Street Geneva NY 14456 160743032 Provider of Healthcare Services NY 501 (C) (3) 3 Finger Lakes Health 22-3193606 0 Finger Lakes Health Foundation 196 North Street Geneva NY 14456 150549310 Coordinator of Fundraising Activities NY 501 (C) (3) 11c Finger Lakes Health 22-3193606 0 Living Center at Geneva South 196 North Street Geneva NY 14456 160957268 Skilled Nursing Facility NY 501 (C) (3) 3 Finger Lakes Health 22-3193606 0 Huntington Living Center 369 E Main Street Waterloo NY 13165 510169552 Skilled Nursing Facility NY 501 (C) (3) 3 Finger Lakes Health 22-3193606 0 Geneva General Hospital Housing Development Co 196 North Street Geneva NY 14456 222816883 Operate Low Income Housing for elderly & handicapped NY 501 (C) (3) 9 Finger Lakes Health 22-3193606 0 Taylor Brown Memorial Housing Development Co 371 East Main Street Waterloo NY 13165 222807734 Operate Low Income Housing for elderly & handicapped NY 501 (C) (3) 9 Finger Lakes Health 22-3193606 0 Living Center at Geneva North Inc 196 North Street Geneva NY 14456 161449543 Skilled Nursing Facility NY 501 (C) (3) 3 Finger Lakes Health 22-3193606 0 FLH Senior Communities Inc 196 North Street Geneva NY 14456 205604917 Develop and Operate Senior Citizen Housing Complex NY 501 (C) (3) 9 Finger Lakes Health 22-3193606 0 Soldiers Ventures Inc 196 North Street Geneva NY 14456 161556419 Holding, Investing NY C 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 Finger Lakes Health Foundation C 85360 Finger Lakes Health Foundation R 514857 Geneva General Hospital R 435082