2024-08-15T12:32:15-05:00 2023-09-30 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2022-10-01 150346515 ALICE HYDE MEDICAL CENTER ALIC 5184833000 133 PARK STREET MALONE NY 12953 MATEJ KOLLAR VP/CFO 5184833000 2024-08-14 1 1 THOMAS J GIUFRE P00841958 3154463600 2024-08-13 2022 2024-08-08 14:25:15Z MATEJ KOLLAR 133 PARK STREET MALONE NY 12953 95725280 0 X WWW.ALICEHYDE.COM X 1905 NY TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE. 10 8 867 16 0 0 492756 2138318 82121802 89624346 11156 -58579 10964101 2657116 93589815 94361201 0 0 0 0 68841621 70829693 0 0 0 36734898 34491678 105576519 105321371 -11986704 -10960170 67901457 59902936 53424532 56241267 14476925 3661669 ALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE. 0 0 84850242 91958645 ALICE HYDE MEDICAL CENTER PROVIDES PATIENT CARE AS A GENERAL MEDICAL/SURGICAL HOSPITAL AND SKILLED NURSING FACILITY. ALICE HYDE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 1,463 PATIENTS ADMITTED. PROVIDED 404,421 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 83,684 PHYSICIAN OFFICE VISITS, AND PROVIDED 45,829 DAYS OF SKILLED NURSING FACILITY CARE. 10,454 DAYS OF ASSISTED LIVING FACILITY CARE WAS ALSO PROVIDED DURING THE PERIOD. 84850242 1 1 0 0 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 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 71 0 1 867 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MATEJ KOLLAR CFO 5184833000 133 PARK STREET MALONE NY 12953 ROBERT G MAIN JR CHAIR 10.00 X X 0 0 0 KEVIN HART SECRETARY 10.00 X X 0 0 0 THOMAS FITZPATRICK VICE CHAIR 10.00 X X 0 0 0 CAROL MCKEE RN BOARD MEMBER 10.00 X 0 0 0 DONNA KISSANE BOARD MEMBER 10.00 X 0 0 0 JASON ELLIS TREASURER 10.00 X X 0 0 0 PAUL KOEHLER BOARD MEMBER 10.00 X 0 0 0 BRIAN MONETTE BOARD MEMBER 10.00 X 0 0 0 BARBARA MONTOUR CPA BOARD MEMBER 10.00 X 0 0 0 CRAIG RICHARDS DO BOARD MEMBER 10.00 X 0 0 0 MATT JONES COO 50.00 X 245211 0 15884 MICHELLE LEBEAU CEO 2.00 48.00 X 0 607301 51434 CHRISTOPHER HICKEY SVP/CFO 8.00 42.00 X 0 440560 33055 DR LISA MARK CHIEF MEDICAL OFFICER 8.00 40.00 X 0 467309 36154 MATEJ KOLLAR VP/CEO 8.00 42.00 X 0 212288 32115 SUSAN BIONDOLOLLO BOARD MEMBER 1.00 X 192986 0 5764 WENDY FRANK FNP 40.00 X 187168 0 14317 ROBERT STOUT CRNA 40.00 X 246902 0 7798 DUYEN NGUYEN AVP 40.00 X 226930 0 15830 DEBRA PIERCEY CRNA 10.00 X 250016 0 9088 EMILY CAMPBELL BOARD MEMBER 1.00 X 204716 0 6151 EMILE BERNARDOT MD FORMER DIRECTOR 0.00 X 107000 0 0 MARINA MEDVED FORMER DIRECTOR 0.00 X 0 341612 13441 1660929 2069070 241031 114 1 1 0 CROSS COUNTRY STAFFING INC 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 PHYSICIAN SERVICES 4468394 WEATHERBY LOCUMS INC 15300 WESTON PKWY CARY NC 27513 PHYSICIAN SERVICES 813468 SIGNATURE STAFF RESOURCES LLC 2231 RIDGE RD ROCKWALL TX 75087 PHYSICIAN SERVICES 468982 ANJNI BHAGAT 756 WEBSTER STREET MALONE NY 12953 PHYSICIAN SERVICES 364522 STAFF CARE INC 8840 CYPRESS WATERS BLVD STE 300 COPPELL TX 75019 PHYSICIAN SERVICES 341012 11 7210 1680325 450783 2138318 PATIENT CARE 622000 84817522 84817522 340B REVENUE 900099 4806824 4806824 89624346 104455 104455 822163 497999 324164 324164 324164 701699 864733 -163034 -163034 -163034 0 7210 1347 -1347 -1347 CAFETERIA REVENUE 900099 450895 450895 1883404 1883404 2334299 94361201 91958645 0 264238 261095 261095 180069 180069 58660101 47369323 11290778 1553566 1273635 279931 6360941 5154860 1206081 3813921 3077834 736087 163264 131966 31298 4730 3817 913 2393 2393 6867828 5547733 1320095 43270 34975 8295 107246 86687 20559 226701 183242 43459 1444660 1167719 276941 148318 148318 1116458 902433 214025 3688121 2981108 707013 MEDICAL SUPPLIES & PHAR 10645760 8591128 2054632 SHARED SERVICES 3888629 3143179 745450 REPAIRS AND MAINTENANCE 2215290 1790619 424671 MISCELLANEOUS EXPENSES 1751809 1415730 336079 2177201 1845936 331265 105321371 84850242 20471129 0 3048184 1363354 13255893 3869180 7587878 10853008 103102 93923 1227735 1170888 1470271 1599183 64189673 31341346 36194424 32848327 3373122 3605330 16283 16283 1624565 4483460 67901457 59902936 8852703 10886995 29140996 27628545 15430833 17725727 53424532 56241267 X 13019447 2484263 1457478 1177406 14476925 3661669 67901457 59902936 -10960170 144914 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 897940 97569 995509 1122767 -224827 897940 949748 173019 1122767 872503 77245 949748 829056 43447 872503 1.00000 0 0 2051000 2051000 43744832 19146354 24598478 15142294 10528343 4613951 3251547 1666649 1584898 32848327 OTHER ASSETS 786305 OPERATING LEASE RIGHT-OF-USE ASSETS, NET 140058 ESTIMATED 3RD PARTY RECEIVABLE 3557097 4483460 DUE TO RELATED PARTIES 11705248 OTHER LIABILITIES 5743300 OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS 140058 CONTRACT LIABILITY - MEDICARE ACCELERATED PAYMENTS 137121 17725727 X PART V, LINE 4: THE FUNDS, AND ALL NET EARNINGS IN ADDITION THERETO, ARE HELD TO BENEFIT CHARITY, EDUCATION, RESEARCH, AND CHILDREN'S PROGRAMS. PART X, LINE 2: ALICE HYDE MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK. PAGES 17 AND 18 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAIN A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED. 1 1 1 X 1 X 1 1 1 0 0 1523332 740351 782981 0.00750 26274594 10360590 15914004 0.15170 27797926 11100941 16696985 0.15920 153960 153960 0.00150 153960 153960 0.00150 27951886 11100941 16850945 0.16070 1 449162 111142 15341326 24623058 -9281732 X 1 1 1 1 ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE NY 12953 WWW.ALICEHYDE.COM 1624000H X X X ALICE HYDE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X 1 X 0 X X X 1 X 0 0 ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 5: TO HELP INFORM A COLLABORATIVE APPROACH TO IMPROVING COMMUNITY HEALTH, THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) SOUGHT TO IDENTIFY PRIORITIES, FACTORS AND RESOURCES THAT INFLUENCE THE HEALTH OF RESIDENTS OF THE ADIRONDACK REGION (CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN AND WASHINGTON COUNTIES). ARHN SURVEYED STAKEHOLDERS IN THE SEVEN-COUNTY SERVICE AREA, TO PROVIDE THE CHA COMMITTEE WITH INPUT ON REGIONAL HEALTH CARE NEEDS AND PRIORITIES. STAKEHOLDERS INCLUDED PROFESSIONALS FROM HEALTH CARE, SOCIAL SERVICES, EDUCATIONAL, AND GOVERNMENTAL INSTITUTIONS AS WELL AS COMMUNITY MEMBERS. ALICE HYDE MEDICAL CENTER ENGAGED ESSENTIAL CLINICAL STAFF AS PART OF AN INTERNAL PRIORITIZATION COMMITTEE TO ASSESS AND IDENTIFY THE KEY CRITICAL AREAS FOR TARGETED FOCUS AS DETERMINED BY THE 2022 COMMUNITY STAKEHOLDER SURVEY, AND IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION TO THE VARIETY OF COMMUNITY AND REGIONAL RESOURCES AVAILABLE, ALICE HYDE MEDICAL CENTER ASSESSED DATA AND PROGRAMS FROM ITS OUTPATIENT PRIMARY CARE PRACTICES, THE EMERGENCY DEPARTMENT AND OTHER KEY HOSPITAL ALICE HYDE MEDICAL CENTER 15-0346515 DEPARTMENTS TO FURTHER IDENTIFY AREAS OF FOCUS AND AVAILABLE ASSETS. LEAD STAFF FROM FRANKLIN COUNTY PUBLIC HEALTH, THE UNIVERSITY OF VERMONT HEALTH NETWORK ALICE HYDE MEDICAL CENTER AND ADIRONDACK HEALTH WORKED WITH PARTNERS TO COLLECT ACTIVITIES AND INTERVENTIONS IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. DETERMINATION OF SPECIFIC INTERVENTIONS RELATED TO EACH PRIORITY AREA WAS BASED ON ALIGNMENT WITH THE SPECIFIC GOALS AND OBJECTIVES EACH AGENCY IS COMMITTED TO; OTHER POPULATION HEALTH BASED INITIATIVES OCCURRING WITHIN THE ORGANIZATION; AND ORGANIZATIONAL ABILITY TO MAKE A SUSTAINED IMPACT WITH THE INTERVENTION. ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 6A: ADIRONDACK HEALTH - ADIRONDACK MEDICAL CENTER ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 6B: FRANKLIN COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH UNIT ALICE HYDE MEDICAL CENTER PART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLANINVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLANBUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTS. UTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE: PHYSICAL ACTIVITYACTION PLAN IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE: TOBACCO PREVENTIONACTION PLAN IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINEUTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT ACTION PLANWORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN PART V, LINE 7B, OTHER WEBSITES FOR CHNA REPORT: HTTPS://AHIHEALTH.ORG/ARHN/ HTTPS://COUNTYFRANKLIN.DIGITALTOWPATH.ORG:1007 PART V, LINE 10A, MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY'S WEBSITE: HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN PART V, LINE 16A, FAP WEBSITE HTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM PART V, SECTION B, LINE 20A: ALICE HYDE MEDICAL CENTER DOES NOT PURSUE LEGAL ACTION IN ORDER TO COLLECT A DEBT, INCLUDING NOT SELLING DEBT INFORMATION TO ANOTHER PARTY FOR COLLECTIONS, REPORTING TO INDIVIDUAL CREDIT AGENCIES REGARDING PAYMENT STATUS, NOR DOES ALICE HYDE MEDICAL CENTER REFUSE TREATMENT FOR PAST DEBT OBLIGATIONS. 9 1 - THE ALICE CENTER 45 SIXTH STREET MALONE NY 12953 SKILLED NURSING FACILITY 2 - REDDY CANCER TREATMENT CENTER 23 FOURTH STREET STE 1 2 MALONE NY 12953 ONCOLOGY TREATMENT 3 - HASTINGS HEMODIALYSIS UNIT 20 FOURTH STREET MALONE NY 12901 OUTPATIENT DIALYSIS 4 - BESSETT HEALTH CENTER 6087 STATE ROUTE 11 CHATEAUGAY NY 12920 PRIMARY CARE CLINIC 5 - DWYER HEALTH CENTER 969 STATE ROUTE 11 MORIA NY 12957 PRIMARY CARE CLINIC 6 - THE MARTIN J LEROUX HEALTH CENTER 577 COUNTY ROUTE 1 FORT COVINGTON NY 12937 PRIMARY CARE CLINIC 7 - TOWER HEALTH CENTER 76 NORTH MAIN STREET SAINT REGIS FALLS NY 12980 PRIMARY CARE CLINIC 8 - ALICE HYDE WALK-IN CLINIC 134 PARK STREET MALONE NY 12953 URGENT CARE 9 - DENTAL CARE CENTER 134 PARK STREET MALONE NY 12953 DENTAL CARE PART I, LINE 7: UTILIZED IS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 449,162. PART III, LINE 2: OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.0% OF NET REVENUE. PART III, LINE 3: WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. FY2023 MARKS THE FIRST FULL YEAR OF A NEW ELECTRONIC HEALTH RECORD THAT HELPED REFINE THE METHODOLOGY. PART III, LINE 4: SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED SEPTEMBER 30, 2023 AND 2022, WAS NOT SIGNIFICANT. THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 25 IN FOOTNOTE 4 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2023 MEDICARE COST REPORT. THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK. PART III, LINE 9B: THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. PART VI, LINE 3: THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED. THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE. PART VI, LINE 4: ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES. PART VI, LINE 5: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLANINVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLANESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES.COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON.PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSUTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHESPROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVEWORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS,INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE. ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X X 0 0 0 0 0 0 0 1 1 1 MICHELLE LEBEAU CEO 0 491886 0 89938 0 25477 0 32091 0 19343 0 658735 0 0 DR LISA MARK CHIEF MEDICAL OFFICER 0 417732 0 49577 0 0 0 14162 0 21992 0 503463 0 0 CHRISTOPHER HICKEY SVP/CFO 0 389094 0 51466 0 0 0 15250 0 17805 0 473615 0 0 MARINA MEDVED FORMER DIRECTOR 0 341612 0 0 0 0 0 12237 0 1204 0 355053 0 0 MATT JONES COO 218421 0 26790 0 0 0 6901 0 8983 0 261095 0 0 0 DEBRA PIERCEY CRNA 250016 0 0 0 0 0 0 0 9088 0 259104 0 0 0 ROBERT STOUT CRNA 246902 0 0 0 0 0 7371 0 427 0 254700 0 0 0 MATEJ KOLLAR VP/CEO 0 199031 0 13257 0 0 0 9996 0 22119 0 244403 0 0 DUYEN NGUYEN AVP 226930 0 0 0 0 0 6793 0 9037 0 242760 0 0 0 EMILY CAMPBELL BOARD MEMBER 192877 0 11839 0 0 0 5766 0 385 0 210867 0 0 0 WENDY FRANK FNP 187168 0 0 0 0 0 5615 0 8702 0 201485 0 0 0 SUSAN BIONDOLOLLO BOARD MEMBER 181891 0 11095 0 0 0 5403 0 361 0 198750 0 0 0 EMILE BERNARDOT MD FORMER DIRECTOR 107000 0 0 0 0 0 0 0 0 0 107000 0 0 0 PART I, LINE 3 IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 7 ALICE HYDE MEDICAL CENTER PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS. PART I, LINE 8 SALARIES AND OTHER FIXED AMOUNTS PAYABLE TO EXECUTIVES SUCH AS OFFICERS AND CERTAIN KEY EMPLOYEES ARE SET BY CONTRACTS THAT ARE NEGOTIATED AND ENTERED INTO PRIOR TO THE COMMENCEMENT OF EACH EXECUTIVES' EMPLOYMENT. THE TERMS OF SUCH CONTRACTS ARE APPROVED IN ADVANCE BY THE APPROPRIATE COMPENSATION COMMITTEE OR OTHER BOARD-AUTHORIZED BODY, WHICH OBTAINS AND RELIES ON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING SUCH OFFER, AND CONCURRENTLY DOCUMENTS ITS BASIS FOR DETERMINATION. SEAN CURTIN FORMER CEO PART V X 150865 93923 0 1 1 93923 KRISTIN ELLIS-WOOD SIBLING OF BOARD MEMBER 180069 KRISTIN ELLIS-WOOD, SISTER TO BOARD MEMBER JASON ELLIS, IS THE AVP OF SUPPORT & PROFESSIONAL SERVICES 0 PART II, LOANS TO AND FROM INTERESTED PERSONS: (C) PURPOSE OF LOAN:THE ORGANIZATION HAS AN AGREEMENT WITH AND HAS PROVIDED THE EXECUTIVE WITH A LOAN FOR EDUCATIONAL EXPENSES UP TO A MAXIMUM OF $185,000, FOR A 5 YEAR PERIOD WITH INTEREST ACCRUED AT A COMPETITIVE MARKET RATE. THE ANNUAL PAYMENT, INCLUDING INTEREST, WILL BE FORGIVEN IF THE EXECUTIVE REMAINS EMPLOYED WITH THE ORGANIZATION FOR FIVE YEARS. DURING FY2019, THE EXECUTIVE LEFT EMPLOYMENT. THE LOAN TERMS WERE RENEGOTIATED FOR A 15 YEAR REPAYMENT PERIOD AT A COMPETITIVE FAIR MARKET RATE OF INTEREST. FORM 990, PART VI, SECTION A, LINE 2 MICHELLE LEBEAU, DR. LISA MARK, CHRISTOPHER HICKEY, AND MATEJ KOLLAR WERE EMPLOYED BY CHAMPLAIN VALLEY PHYSICIAN'S HOSPITAL MEDICAL CENTER, A RELATED ORGANIZATION AT WHICH THESE INDIVIDUALS ALSO SERVED AS OFFICERS. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE OCTOBER 1, 2022, THE CERTIFICATE OF INCORPORATION AND THE BYLAWS OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, INC. (THE "NETWORK") WERE AMENDED AND RESTATED TO FACILITATE TIMELY DECISION MAKING AND TO CLARIFY ROLES AND RELATIONSHIPS BETWEEN THE NETWORK AND ITS HOSPITAL AND HOME HEALTH CARE SUBSIDIARIES (THE "AFFILIATES"), INCLUDING ALICE HYDE MEDICAL CENTER ("AHMC"). CORRESPONDING AMENDMENTS WERE MADE TO THE ORGANIZATIONAL DOCUMENTS OF THE AFFILIATES. AHMC'S DOCUMENTS CHANGED IN THE FOLLOWING SIGNIFICANT RESPECTS: FIRST, THE CERTIFICATE OF INCORPORATION AND BYLAWS WERE AMENDED TO CREATE RESERVED POWERS OF THE NETWORK BOARD. THESE RESERVED POWERS INCLUDE: THE NETWORK'S ELECTION OF TRUSTEES FOR AHMC FROM NOMINEES SUBMITTED BY AHMC; ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS; ADOPTION OF STRATEGIC PLANS; AND APPROVAL OF MAJOR FINANCIAL DECISIONS INCLUDING MERGERS, BANKRUPTCIES, COMMENCEMENT OF PROJECTS REQUIRING THE ISSUANCE OF A CERTIFICATE OF NEED, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AND THE DEVELOPMENT OR TERMINATION OF PROGRAMS OR SERVICES. ADDITIONALLY, THE COMPENSATION COMMITTEE OF THE NETWORK IS GRANTED RESPONSIBILITY FOR DETERMINING COMPENSATION AND BENEFITS FOR AHMC'S PRESIDENT AND ANY OTHER EXECUTIVE CLASSIFIED AS A "DISQUALIFIED PERSON" UNDER APPLICABLE LAW. SECOND, AMENDMENTS WERE MADE TO GRANT REPRESENTATION TO MEMBERS OF AHMC'S BOARD OF TRUSTEES ON STANDING COMMITTEES OF THE NETWORK BOARD. UP TO TWO VOTING MEMBERS OF EACH NETWORK STANDING COMMITTEE ARE APPOINTED BY AHMC. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATIONS DID HAVE MEMBERS, AND UVMHN, INC., IS ALICE HYDE MEDICAL CENTER'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A UVM HEALTH NETWORK HAS POWERS TO ELECT ALICE HYDE MEDICAL CENTER'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B UVM HEALTH NETWORK HAS THE POWER TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AMENDMENTS TO ALICE HYDE MEDICAL CENTER'S BYLAWS AND ARTICLES OF THE ORGANIZATION, AND APPROVAL OF MAJOR FINANCIAL DECISIONS INCLUDING MERGERS, BANKRUPTCIES, AND THE DEVELOPMENT OR TERMINATION OF PROGRAM SERVICES. UVM HEALTH NETWORK IS A NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE. FORM 990, PART VI, SECTION B, LINE 15 ALICE HYDE MEDICAL CENTER (AHMC) HAS A FORMAL PROCESS THAT IS USED TO DETERMINE THE COMPENSATION OF THE CEO ON AN ANNUAL BASIS. THIS PROCESS INCLUDES A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, ENGAGING AN INDEPENDENT CONSULTANT, PERFORMANCE OF A COMPENSATION SURVEY OR STUDY, REVIEW OF OTHER ORGANIZATION'S 990 FORMS, AND APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE. A WRITTEN EMPLOYMENT AGREEMENT IS ESTABLISHED SETTING FORTH THE COMPENSATION AND BENEFITS OF THE CEO. AHMC PAYS NON-FIXED EARNINGS BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE CEO. COMPENSATION FOR SENIOR LEADERS IS REVIEWED ANNUALLY, IN ACCORDANCE WITH NATIONAL BENCH MARKETING AND INTERNAL EQUITY WITHIN THE UVM HEALTH NETWORK. REVIEW IS CONDUCTED BY HUMAN RESOURCES, LOCALLY AND NETWORK-WIDE. NON-FIXED EARNINGS OF OTHER OFFICERS ARE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA AND COMPARATIVE MARKET DATA. IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN SCHEDULE J, PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION C, LINE 18 THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. UVM HEALTH NETWORK MEDICAL GROUP 111 COLCHESTER AVE BURLINGTON VT 05401 030225105 PHYSICIAN SERVICES VT 501(C)(3) LINE 12B, II UVMHN 1 UNIV OF VT MED CTR FOUNDATION INC 111 COLCHESTER AVE BURLINGTON VT 05401 263159849 FUNDRAISING VT 501(C)(3) LINE 12B, II UVMMC 1 UNIV OF VT MED CTR AUXILLIARY INC 111 COLCHESTER AVE BURLINGTON VT 05401 208022004 SERVICE VT 501(C)(3) LINE 12D, III-O N/A 0 UNIV OF VT HEALTH NETWORK 111 COLCHESTER AVE BURLINGTON VT 05401 452880726 HOLDING COMPANY VT 501(C)(3) LINE 12B, II N/A 0 CENTRAL VT MEDICAL CENTER 111 COLCHESTER AVE BURLINGTON VT 05401 222547186 HOSPITAL VT 501(C)(3) LINE 3 UVMHN 1 UNIVERSITY HEALTH CENTER 111 COLCHESTER AVE BURLINGTON VT 05401 030229931 HOSPITAL VT 501(C)(3) LINE 12D, III-O UVMHNMG 1 COMMUNITY PROVIDERS INC 75 BEEKMAN STREET PLATTSBURGH NY 12901 222544844 HLTH SVC COORD NY 501(C)(3) LINE 12B, II UVMHN 1 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH NY 12901 141338471 HOSPITAL NY 501(C)(3) LINE 3 UVMHN 1 ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN NY 12901 141364513 HOSPITAL NY 501(C)(3) LINE 3 UVMHN 1 EMERGENCY MEDICAL TRANSPORT OF CVPH INC 75 BEEKMAN STREET PLATTSBURGH NY 12901 061718419 AMBULANCE SVC NY 501(C)(3) LINE 12C, III-FI UVMHN 1 CVPH MEDICAL CENTER FOUNDATION 75 BEEKMAN STREET PLATTSBURGH NY 12901 141727048 HLTH SVC COORD NY 501(C)(3) LINE 12C, III-FI CVPH 1 LAKE CHAMPLAIN PHYSICIAN SERVICES PC 75 BEEKMAN STREET PLATTSBURGH NY 12901 273785445 PHYSICIAN SERVICES NY 501(C)(3) LINE 12B, II CVPH 1 UNIVERSITY MEDICAL EDUCATION ASSOCIATES 89 BEAUMONT AVENUE BURLINGTON VT 05401 237107832 EDUCATIONAL VT 501(C)(3) LINE 11 UVMHNMG 1 PORTER MEDICAL CENTER INC 115 PORTER DRIVE MIDDLEBURY VT 05753 030310862 SUPPORTING ORG VT 501(C)(3) LINE 12B, II UVMHN 1 HELEN PORTER NURSING HOME 37 PORTER DRIVE MIDDLEBURY VT 05753 030306549 NURSING HOME VT 501(C)(3) LINE 3 PMC 1 AUXILIARY OF PORTER MEDICAL CENTER 37 PORTER DRIVE MIDDLEBURY VT 05753 237363227 SUPPORTING ORG VT 501(C)(3) LINE 12B, II PMC 1 PORTER HOSPITAL INC 37 PORTER DRIVE MIDDLEBURY VT 05753 030181058 HOSPITAL VT 501(C)(3) LINE 3 PMC 1 VMC INDEMNITY COMPANY INC 95 ST PAUL ST BURLINGTON VT 05401 831102018 INSURANCE VT 501(C)(3) LINE 12B, II UVMHN 1 UVMHN HOME HEALTH AND HOSPICE 1110 PRIM ROAD COLCHESTER VT 05446 030179603 HOME HEALTHCARE VT 501(C)(3) LINE 11 UVMHN 1 UVM HEALTH VENTURES INC 111 COLCHESTER AVE BURLINGTON VT 05401 043380045 HOLDING COMPANY VT UVMHN C 0 UVMHN NETWORK CREDENTIALING & ENROLLMENT 111 COLCHESTER AVE BURLINGTON VT 05401 030333056 ADMIN SVC VT UVMHN VENTURES C 0 CHARITABLE REMAINDER TRUST (6) SUPPORT VT UVMMCCVMC T 0 PERPETUAL TRUST (10) SUPPORT VT UVMMC T 0 CHARITABLE IRREVOCABLE TRUST (8) SUPPORT VT UVMMCCVMC T 0 CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH NY 12901 161586102 ADMIN SVC NY N/A C 0 MEDIQUEST INC PO BOX 1656 PLATTSBURGH NY 12901 141663061 MED OFFICE LEASE NY N/A C 0 YANKEE MEDICAL INC 276 NORTH AVENUE BURLINGTON VT 05401 030225363 HOME MEDICAL EQUIPMENT VT UVMHN C 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 THE UNIVERSITY OF VERMONT MEDICAL CENTER INC P 18106958 FMV UVM HEALTH NETWORK P 2604185 FMV VMCIC INC M 448570 FMV CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER P 327115