2023-11-07T12:51:52-07:00 2022-12-31 990 2022-01-01 150533564 SCHUYLER HOSPITAL INC SCHU 6075357121 220 Steuben Street Montour Falls NY 14865 Rebecca Gould President, CFO 6075358639 2023-11-07 1 1 11 1 AAL2 X 2022 2023-04-26 12:10:37Z Rebecca Gould CFO 220 Steuben Street Montour Falls NY 14865 37642781 0 X http://www.schuylerhospital.org X 1929 NY Schuyler Hospital is a 25 bed acute care facility with critical access hospital status and 24 hour emergency services. It provides a full complement of healthcare services to the public in support of the community need for healthcare close to home, which includes the residents of Schuyler County and its surrounding communities. Medical services in 2020 included 3,729 inpatient days, 41,110 Long Term Care days, 189,353 outpatient procedures and 23,092 physician visits. In 2020 Schuyler Hospital provided $116k in free and reduced cost care through its charity care policy and incurred over $938k in bad debt due to the remaining uninsured and increasing under-insured population in the community. 18 16 469 84 0 0 2344144 2539652 36361917 37123951 609678 -2626225 652284 605403 39968023 37642781 0 0 0 0 24998966 26217609 0 0 179935 14009944 17707722 39008910 43925331 959113 -6282550 54341361 51480604 15857556 19618398 38483805 31862206 Schuyler Hospital is a network of providers, programs and services that meets the healthcare needs of a population of over 32,000 residents, through a wide range of medical services, highly skilled medical staff, and our devotion to customer service. Our Mission: Together with valued partners, Cayuga Health will be the region's leading healthcare system, and most trusted driver of integrated health services. We will empower our people and employ our capabilities to equitably improve the communities we serve. Our Vision: To be an essential organization that inclusively and cooperatively drives superior health outcomes and demonstrable community benefit . Our Values Include: Integrity and Honesty - We keep our word and treat everyone with mutual trust; Quality and Accountability - We accept responsibility for the trust placed in us; Dignity and Respect - We treat everyone with honor and compassion; Teamwork - We align our energies and enhance patient/resident care by working together 0 0 38367415 0 37661856 Schuyler Hospital is a 25 bed acute care facility with critical access hospital status and 24 hour emergency services. It provides a full complement of healthcare services to the public in support of the community need for healthcare close to home, which includes the residents of Schuyler County and its surrounding communities. Medical services in 2022 included 3,823 inpatient days, 29,190 Long Term Care days, 198,830 outpatient procedures and 24,404 physician visits. In 2022 Schuyler Hospital provided $123k in free and reduced cost care through its charity care policy and incurred nearly $1.1M in bad debt due to the remaining uninsured and increasing under-insured population in the community. 0 0 0 38367415 1 1 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 118 0 0 469 1 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Rebecca Gould CFO 6075353801 220 Steuben Street Montour Falls NY 14865 Martin Stallone MD President/CEO Cayuga Medical Center 1 39 X 0 999371 54196 John Collett CFO/VP 1 39 X 0 522400 37400 Ashraf Sabahat Physician 40 0 X 411961 0 62344 Rebecca Gould CFO 38 2 X 375840 0 36994 Jagmohan Singh Physician 40 0 X 302933 0 55810 Ben Saks Physician 40 0 X 304945 0 49269 Patrick Ryan Executive Director/Administrator SNF 40 0 X 167399 0 43024 Mary Ann Mahajan Pharmacy Director 40 0 X 166680 0 42136 Eunice Nayo Board Member and Physician 40 0 X 33400 0 0 Thomas LiVigne Chair 4 0 X X 0 0 0 Paula Younger Vice-Chair 4 0 X X 0 0 0 Greg Hartz Treasurer 4.0 0 X X 0 0 0 Suzanne Blowers Secretary 4 0 X X 0 0 0 James Brown Board Member 3 0 X 0 0 0 La Jerne Cornish PHD Board Member 3 0 X 0 0 0 Rev Dr Kenneth Clarke Board Member 3 0 X 0 0 0 Cris Donovan Board Member 3 0 X 0 0 0 R Brooke Hollis Board Member 3 0 X 0 0 0 Joel Malina Board Member 3 0 X 0 0 0 Laurie Mante Board Member 3 0 X 0 0 0 John-Paul Mead MD Board Member 3 0 X 0 0 0 John Lambert MD Board Member 3 0 X 0 0 0 Jennifer Whittaker Board Member 3.00 0 X 0 0 0 Fred Wickham Board Member 3 0 X 0 0 0 Kathryn Shallenberger Schuyler Auxiliary President, ex-officio 2 0 X 0 0 0 Carl Sgrecci Board Member 3.00 0 X 0 0 0 1763158 1521771 381173 28 0 1 0 TRUSTED NURSE STAFFING LLC 591 Delware Ave Buffalo NY 14202 Nursing Contract Labor 838147 Medical Information Technology Inc PO Box 74569 Chicago IL 60696 Software and support services 696642 Streeter Associates Inc 101 East Woodlawn Ave Elmira NY 14901 Contractors 597705 Supplemental Health Care PO BOX 677896 Dallas TX 752677896 NURSING CONTRACT LABOR 419486 Medical Solutions LLC 666 Walnut St Suite 700 Des Moines IA 50309 NURSING CONTRACT LABOR 299857 15 0 0 0 264298 2271227 4127 0 2539652 Net Patient Service Revenues 622000 35899692 35899692 0 0 1224259 1224259 0 0 37123951 500142 0 0 500142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -3128124 1757 0 0 -3128124 1757 -3126367 0 0 -3126367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cafe Sales, Vending, Rebates & Other Misc Rev 622000 601136 533368 0 67768 Non Operating - Misc Revs 622000 4267 4267 0 0 0 0 0 0 605403 37642781 37661586 0 -2558457 0 0 0 0 0 0 0 0 446234 33400 412834 0 0 0 0 0 20093641 17758005 2256539 79097 411672 356721 53312 1639 3809701 3270831 524587 14283 1456361 1261963 188601 5797 0 0 0 0 115572 0 115572 0 73565 0 67556 6009 0 0 0 0 0 0 0 0 0 0 47974 0 47974 0 291459 330 267716 23413 3549752 3403134 135235 11383 0 0 0 0 0 0 0 0 754499 663533 83551 7415 13128 12903 224 1 0 0 0 0 18617 9984 7377 1256 77428 0 77428 0 0 0 0 0 1666586 1415022 251564 0 249553 178321 71232 0 Purchased Services 8203489 7845156 346265 12068 Provisions for Bad Debt 1093314 1093314 0 0 1552786 1064798 470414 17574 43925331 38367415 5377981 179935 331713 330531 7323117 898672 647773 638126 3152549 4339797 0 0 0 0 0 0 842634 790278 376099 254153 46642514 24167114 21719008 22475400 16081143 13375771 0 0 0 0 0 0 3867325 8377876 54341361 51480604 13428051 16256228 0 0 2294762 887170 0 0 122801 117033 0 0 11942 2318643 0 0 39324 15857556 19618398 X 34195905 28668462 4287900 3193744 38483805 31862206 54341361 51480604 X -6282550 -316395 0 0 0 -22654 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 17100 17100 43908228 43925328 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 25645 4158 7583 17100 54486 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 0 1 X 131599 0 131599 33111900 0 14245261 18866639 0 0 0 0 13399015 0 9921853 3477162 0 0 0 0 22475400 Due from Affiliates 5193741 Beneficial Interest in Schuyler Health Foundation 1859001 Assets whose use is limited 1168775 Other Assets 156359 8377876 0 Copier Lease 39324 39324 Schedule D, Part IV, Line 2b Schuyler Hospital serves as a custodian for residents in our Skilled Nursing Facility. Residents have access to their funds 24 hours a day, 7 days a week 1 1 1 X 0 1 1 0 1 1 1061015 72959 988056 0.0231 13369154 5980149 7389005 0.1725 0 0 14430169 6053108 8377061 0.1956 40305 30000 10305 0.0002 206509 0 206509 0.0048 7574179 4591608 2982570 0.0696 35148 0 35148 0.0008 0 0 7856141 4621608 3234532 0.0754 0 0 22286310 10674716 11611593 0.2710 6443 6443 0.00015 0 0 20950 2750 18200 0.00042 2500 2500 0.00006 0 0 29893 2750 27143 0.00063 1 1093314 327994 9231768 10105515 -873747 X 1 0 1 1 Schuyler Hospital 220 Steuben Street Montour Falls NY 14865 http://www.schuylerhospital.org X X X X Surgical Services,Lab,Imaging,Respiratory,Rehab,Skilled Nursing Facility,Employed Physicians Schuyler Hospital 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X https://cayugahealth.org/wp-content/uploads/2023/03/CommunityHealthAssessment-2022-Schuyler.pdf' X X 1 22 1 https://schuylerhospital.org/wp-content/uploads/CommunityHealthAssessment 2022-Schuyler.pdf 0 0 1 X 100 1000 X X X X X 1 1 X X X X 1 X https://schuylerhospital.org/wp-content/uploads/Financial-Assistance-Policy_CMC_2019_NEW-1.pdf X https://schuylerhospital.org/wp-content/uploads/Financial-Assistance-Policy_CMC_2019_NEW-1.pdf X https://schuylerhospital.org/wp-content/uploads/Financial-Assistance-Policy_CMC_2019_NEW-1.pdf X X X X X 1 X 0 X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Schuyler Hospital The Schuyler County CHA/CHIP team, a group of diverse partners who span all sectors of the community, participated in the prioritization process and disparity and intervention identification. While a complete list of partners is available within the Schuyler County Chapter under "Community Health Improvement Plan/Community Service Plan," agencies present represented academia, not-for-profits and community organizations, businesses, the general public, and local government. They included the Schuyler County Public Health Department, Schuyler Hospital, Cancer Services Program, Mental Health, MR Hess Home Works, and more. Partners' roles in the assessment were to help inform and select the 2022-2024 priority areas by sharing any pertinent data or concerns and actively participating in planning meetings. Community members were involved in the 2018 My Health Story survey, and inclusion of community was considered as part of the oversight committee. The 2022 My Health Story survey took place in the summer and fall of 2022, and this will help gain community insight on key health matters in the county and surrounding areas. Both primary and secondary data were reviewed including, but not limited to, the US Census Bureau American Community Survey, the enhanced Behavioral Risk Factor Surveillance System, Vital Statistics, communicable disease and dental reports, data collected from Pivital Public Health Partnership (formerly known as S2AY Rural Health Network) and Common Ground Health's My Health Story 2018 survey, 211 Lifeline, and the Statewide Planning and Research Cooperative System (SPARCS). Schedule H, Part V, Section B, Line 6b-Schuyler Hospital The hospital facility took into account input from persons who represent the community. The primary partners in the assessment process include Schuyler County Public Health, Schuyler Hospital and Primary Care, however, there are a wide variety of other community partners that serve on the Schuyler County Public Health Professional Advisory Committee (PAC) and other community based organization non for profits that participated at some point along this process and priority setting meetings. Schedule H, Part V, Section B, Line 7d-Schuyler Hospital Schuyler also filed Community Health Needs Assessment with NYS DOH, as the Annual Required Community Service Plan. Schedule H, Part V, Section B, Line 11-Schuyler Hospital Schuyler Hospital is working with Public Health and other County agencies to improve overall community Health. The CHNA is divided into two Priority Areas: Promote Well-Being and Prevent Mental and Substance Use Disorders and Prevent Chronic Diseases. Focus Area: Prevent mental and substance use disorders - The opioid overdose epidemic has been a significant public health concern for several decades now. The CDC stated that the number of drug overdose deaths has quadrupled since 1999,8 and provisional data from November 2021 showed an estimated 100,306 drug overdose deaths in the United States from April 2020-April 2021. This represented an approximately 29% increase from the previous year.9 One method of decreasing access and, therefore, possible addiction and adverse outcomes, is by prescribing less opioid analgesics and utilizing other options for pain management instead. Trended data for Schuyler County showed a rate of 688.3 opioid analgesic prescriptions per 1,000 population in 2012 compared to 422.1 per 1,000 population in 2020, decreasing by about 39%. In 2020, the opioid analgesic prescription rate in Schuyler County is nearly 1.2 times higher10 than in the Finger Lakes Region (349.5 per 1,000 population) and New York State, excluding New York City (342.6 per 1,000 population). The rate consistently decreased within Schuyler County between 2012-2020, which is a positive feat that community partners attribute to initiatives taken within the county. First, primary care clinic patients sign a drug contract before beginning any controlled medications, which helps to inform the patient about the medication as well as hold them accountable for its use. Most prescribers are also required to consult the Prescription Monitoring Program Registry when writing scripts for controlled substances as part of the I-STOP Program, which helps them to identify patient treatment history and any red flags for substance abuse.11 Secondly, providers are now recommending either physical therapy or alternative pain medications as first line of therapy as opposed to opioid analgesics. Additionally, insurance companies are limiting scripts for seven days, making it more difficult for patients to get access, and pharmacies have a policy in place that they cannot switch the prescription to another pharmacy but rather the prescriber would need to do so. Beginning in the spring of 2022, Schuyler Hospital began using an opioid risk assessment tool as well. Focus Area: Preventive Care and Management - Cancer screenings are an essential preventive care service that help to detect cancers earlier on when they are more treatable. Pre-pandemic, in 2018 in Schuyler County, about 81% of women aged 40 and older and about 85% of women aged 50-74 completed breast cancer screenings,14 as well as about 62% of adults aged 50-75 completed colorectal cancer screenings. During the same year, the Finger Lakes region as a whole reported about 71% of women aged 40 and older and about 80% of women aged 50-74, who had an annual household income of less than $25,000, participated in breast cancer screenings. More recent data from the Cancer Services Program shows that, between September 1, 2018 and July 20, 2022, the following screenings were conducted within Schuyler County: Schuyler Hospital Primary Care Center completed 29 clinical breast exams (CBEs) for 16 clients and 7 pap smears for 7 clients, Schuyler Hospital completed 35 mammograms for 21 clients, 4 diagnostics and 4 HPVs, and Schuyler Hospital Montour Falls Extension Clinic completed 2 CBEs and 1 pap smear. With the onset of the COVID-19 pandemic, the nation noticed a troublesome decline in cancer screenings. A paper published in March 2022 showed that cancer screening rates are generally still below pre-pandemic levels (at least through early 2021), especially with colorectal screenings. A study from JAMA Oncology in April 2021 estimated (through July 2020 alone) that disruptions from the pandemic caused more than 9 million breast, colorectal and prostate cancer screenings to be missed. Not only had the pandemic deterred individuals, but additional challenges to cancer screenings were identified by Schuyler County community partners. The Cancer Services Program (CSP) noted that patients are, often times, afraid of having the screenings completed because they lack an understanding of the procedure itself. Many have also reported that they cannot afford a screening nor treatment if the screening returned with a positive cancer diagnosis. While programs exist in the county to help with such matters, not all are aware of these services and benefits. Schedule H, Part V, Section B, Line 16j-Schuyler Hospital Schuyler Hospital includes on every patient statement reference to the Financial Assistance Policy as well as the hospital's internet address where the policy can be found. Schedule H, Part V, Section B, Line 20c-Schuyler Hospital Schuyler Hospital - the Hospital chooses not to utilize presumptive eligibility determinations within their financial assistance policies (FAPs) to proactively identify patients in need of assistance. Schedule H, Part V, Section B, Line 20d-Schuyler Hospital Schuyler Hospital - n/a - did not authorize/perform 1 Seneca View Long Term Skilled Nursing Facility 220 Steuben Street Montour Falls NY 14865 120 Bed Skilled Nursing Facility, attached to and operated under Schuyler Hospital (provider based). Schedule H, Part I, Line 3c The organization uses a sliding fee scale for persons over 100% of the poverty guideline. There is no family income limit (though had to put a % in box on line 3 of 1000%) sliding fee scale is based on number of persons in household, % above FPG and then % of gross charges is determined by % over FPG as follows: 90% of 101-125% FPG, 80% of 126-150% FPG, 70% of 151-175% FPG, 60% of 176-200% FPG, 50% of 201-250% and 40% of 251-300% above FPG. Schedule H, Part I, Line 6a The organization's community benefit/health Assessment report is contained in a report prepared by Schuyler County Chapter - Common Ground Health. Participating local health department - Schuyler County Health Department. Participating Hospital System - Schuyler Hospital. Schedule H, Part I, Line 7 Used ratio of cost to charge calculation for lines 7a, 7b and 7g and used actual costs on lines 7e, 7f and 7i. Schedule H, Part I, Line 7, Column f $1,093,314 is the amount of bad debt expense that was included in Form 990, Part IX, line 25, Column (A), but removed for this figure for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f). Schedule H, Part I, Line 7g No physician amounts were included. Schedule H, Part II Schuyler Hospital, the county's largest employer, with 469 employees working in various departments in an array of professional, technical and supports and promotes the community it operates in. The Hospital extends use of its facilities for health care related meetings of any type, along with other community meetings and events (due to Covid-19 Pandemic continuation, some in person meetings were Zoom meetings/conference calls). Annually sends employees to Leadership Schuyler, and is a disaster preparedness hub for the county. Its employees volunteered over 3,900 hours to support community events this year. Schuyler actively works with the County Department of Health and the Schuyler Health Foundation, Inc. to enrich the healthcare of the population it serves. Schedule H, Part III, Section A, Line 4 The Hospital estimates the amount to be recognized in the consolidated financial statements for doubtful accounts by analyzing patient and resident accounts for collectability and applying historically established percentages for self-pay and various third-party payers to the aging categories in the accounts receivable aging and reviewing specific outstanding balances. Accounts for which no payments have been received for a significant amount of time are considered delinquent and the account is written-off when customary collection efforts are exhausted. The Hospital's accounting policy with respect to the consolidated financial statements is to report the consolidated bad debt expense as an expense, see Exhibit VI, page 41 of the AFS. Schedule H, Part III, Section B, Line 8 SCH H - Part III, Section B Medicare - Line 8 - Describe in Part VI surplus/shortfall reported s/b treated as community benefit - There was a Medicare shortfall. The Medicare shortfall of uncompensated care should be included as a community benefit due to the rural demographic area in which the hospital is located, as it consists of a high Medicare/Medicaid (dual eligible) payer mix. Medicare is the Hospital's largest payer (followed by Commercial/other at 25% and Medicaid at 23%), consisting of 50% of our patients. Due to accessibility and transportation, (which is why we are a critical access hospital), it is easier for community member to come to the hospital for services that it is for them to travel 25 miles or more on rural roads to access care at other facilities. The costing methodology to determine Medicare allowable costs of care relating to payments on line 5 was the ratio of cost from the 2022 Medicare cost report from charges from our system on gross Medicare charges for dates of service 01/01/2022 to 12/31/2022. Schedule H, Part III, Section C, Line 9b The policy does not specifically contain a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance, however the hospital's financial counselors do not send an account to collection if they are aware that the patient qualifies for charity care or financial assistance, as they are also the persons responsible for the charity care or financial assistance processes. Schedule H, Part VI, Line 2 In all S2AY Network Counties, every three years, NYS request that local health departments and their local hospital systems work together to create a joint community health assessment and improvement plan using the Prevention Agenda guidelines. During each new cycle, public health and hospital systems turn to key partners and community informants to help determine what the course of action ought to be to improve the population's health. For this particular cycle, Eight local health departments and hospitals opted to leverage a local regional health planning agency (Common Ground Health) to conduct a community health assessment for the eight county region. Data collection and analysis effort focused on data related to the main priorities in the past years CHA for the region as well as some emerging issues that the hospitals and Public Health agreed should be analyzed based both on their knowledge of what they were seeing in their communities and what was revealed in the for Delivery System Reform Incentive Payment Program (DSRIP) needs assessment. After initial review of the priority areas, a multi-voting technique was used to select the priority areas. Participants were asked to consult with other members of their organization and complete an online survey which matrixed a combination of the magnitude of the problem, impact on other health outcomes, social determinant of health considerations, and capacity to address the issue for each priority and focus area discussed. Schuyler County had fifteen members from their committee participate in the survey. As a result, the following areas were selected for the 2022-2024 Community Health Improvement Plan: Promote Well-Being and Prevent Mental and Substance Use Disorders - Focus Area - Prevent mental and substance sue disorders. Prevent Chronic Diseases - Focus Area - Preventive care and management. On February 10, 2022, a diverse group of stakeholders, representing various aspects of the community as well as underserved and minority populations, were invited to attend a health priority setting meeting (a complete list of stakeholders can be found in the Community Health Improvement Plan/ Community Service Plan section). At this meeting, participants reviewed the overarching goals of the New York State Prevention Agenda and relevant qualitative, quantitative, primary and secondary data. A pre-read document containing detailed county specific analyses relating to the five Prevention Agenda priority areas was sent to all participants for review in advance. Primary and secondary data were collected from a variety of sources including, but not limited to, the American Community Survey, the enhanced Behavioral Risk Factor Surveillance System, Vital Statistics, communicable disease and dental reports, Pivital Public Health Partnership (previously S2AY Rural Health Network), Common Ground Health's My Health Story survey, and 211 Lifeline. My Health Story 2018 was a regional survey completed on behalf of nine counties in the Finger Lakes Region. Its primary purpose was to gather qualitative and quantitative data from Finger Lakes Region residents on health issues in each county. Health departments, hospitals and other local partners were instrumental in distributing the survey to community members including disparate populations. The survey was updated in the summer and fall of 2022 and will be used to help inform potential shifts in strategies to improve the priority areas selected by Schuyler County. Schedule H, Part VI, Line 3 Schuyler Hospital recognizes the needs in our community to provide financial counseling and assistance to those patients with limited income, no insurance, or high deductible insurance plans, who find it difficult to meet the expenses incurred in receiving health care services. The hospital has successfully been administering its financial aid policies and procedures for reducing charges otherwise applicable to low-income individuals without health insurance, or who have exhausted their health insurance benefits, and who can demonstrate an inability to pay full charges. Our Financial Assistance and Charity Program Policy defines the Financial Assistance Program and establishes the necessary criteria, guidelines and approval process for the provision of financial assistance and Sliding Fee Scale to eligible individuals to help ease the burden of the costs of health care services provided. Therefore, Schuyler Hospital updated its financial assistance program in 2007, 2010, 2014, and 2016. In 2010 we established a self-pay task force to review our policies and follow up on any issues that arose from such financial aid policies and procedures. Currently, the monthly Revenue Cycle meetings handle any issues that may arise. We have a prompt pay discount for any payments from an individual, which is good for all balances except co-pays. Also, Schuyler Hospital has been able to discount co-pays and deductible payments from those individuals who can demonstrate an inability to pay such amounts. All patients who are self-pay or have large self-pay balances are proactively given Information regarding our charity care program and our sliding scale program, which is administered using the federal poverty guidelines. The hospital employs two full time financial counselors, who are located by the Admissions Department in the Emergency Room of the Hospital from 7:30am to 4:30pm Monday through Friday, who make it their mission to reach out to those in need and help find a way to fund their health service's needs. Schuyler Hospital has also worked to provide monthly on-site facilitated enrollment for Medicaid and Child Health Plus and Family Health Plus programs. A large challenge Schuyler Hospital faces is actually getting people to apply for the program. It is a challenge to get the paperwork filled out and have patients who may be eligible under our financial aid policies and procedures to complete the application requirements and necessary documentation. The application process has been simplified in an attempt to make it easier for those in need to get the assistance they so desperately need. However, it continues to be a barrier to the success of the program. Also, it has been challenging ensuring that we have disseminated the information about the many policies we have that can be taken advantage of by patients. But the largest challenge has been the financial burden of such programs; reduced reimbursement for quality services provided additional overhead costs and additional time/resources. Schuyler Hospital provides emergency care and medically necessary Essential Health Services without regard to a patient's source of payment. In 2014, we created conspicuous signs that reside near every registration area indicating our FAP, and where it can be found. We also added the application to the Schuyler Hospital website for easy reference. Schedule H, Part VI, Line 4 Schuyler Hospital, Inc, located in Montour Falls, Schuyler County, is situated in rural upstate New York in the heart of the Finger Lakes, and is the only hospital in Schuyler County, a Federally Designated Medically Underserved Population and a Health Professional Shortage Area. Schuyler Hospital, established in 1920, is a 25-bed Critical Access Hospital that provides acute, ambulatory and long-term care services in Primary and Secondary Service areas with a population of 32,000. This rural population includes: Schuyler County residents and the rural residents of adjoining Chemung, Steuben, Tompkins, Seneca and Yates counties. Additionally, Schuyler Hospital is the resource for medical services to over 2 million tourists who visit Schuyler County and the surrounding area each year. Schuyler County itself is the second smallest county in NYS and a rural county with a declining population. The county's census data (ACS 2020 5-year unless noted) revealed a population to a total of 17,650 residents. Schuyler County is largely a "bedroom" community, with residents traveling a mean average of 25.6 minutes to/from their workplace. With that said, due to the county's rural nature, transportation to and from remote areas of the county is a challenge. In 2010, the county began operating its first public transit system, which reaches into the more populated villages of the county. Our service area also encompasses a large Amish and Mennonite population. Median household income is $56,437 (under the NYS median income of $67,000) and 13.6% of the county's population lives below the poverty level. The county's current rate of unemployment is 4.50%. 23% of Schuyler Hospital patients are on Medicaid and another 2% (Self-Pay) are under-insured (Source page 8 of the Consolidated AFS ). While Schuyler Hospital's main campus is located in Montour Falls, Schuyler has evolved over the years into a network of providers, programs, and services that reaches throughout Schuyler County and into southern Yates and Seneca Counties. For the purpose of the Community Service Plan, Schuyler Hospital and Schuyler County Public Health consider Schuyler County to be the Primary Service Area - encompassing the towns of Montour, Reading, Dix, Orange, Hector, Cayuta, Catherine and Tyrone; as well as the villages of Montour Falls, Burdett, Odessa and Watkins Glen. Schuyler County has a population of 17,650 within 328 square miles. This underserved rural population experiences significant social, economic and health issues. For nearly 100 years, Schuyler Hospital has provided basic and emergency care to the people of this community. As the county's largest employer, it is a large economic generator - $67 million last year - due to jobs, purchasing, and taxes. Schuyler Hospital is accredited by The Joint Commission (formerly JCAHO). The medical staff includes physicians, specializing in internal medicine, family practice, surgery, orthopedics and sports medicine, pathology, critical care, pain management, sleep disorders, colon-rectal and anesthesiology. The hospital offers a wide array of services - including 24 hour ER, ICU, and Imaging department (MRI, CT, Ultrasound, X-ray, Mammo, bone density testing). Extensive physical, occupational, respiratory and speech therapy programs, as well as pulmonary testing are offered. The primary care and family health centers in Montour Falls and Ovid provide pediatric, adolescent, and adult health and wellness care. Seneca View, our 120 bed skilled nursing facility, located in the hospital offering inpatient services that include physical, speech and occupational rehabilitation. Schedule H, Part VI, Line 5 Schuyler Hospital, Inc. is proud to provide care to our community. Our doors are open 24 hours a day, seven days a week, 365 days a year. Also, in 2018 Schuyler Hospital was awarded $10.3 MIL Transformation Grant to build a new Medical Surgical Building (completed in April 2020) and to renovate the old Medical Surgical space to Primary Care Center in the Hospital (Completed February 2021). Every year, we serve thousands of individuals and keep our community healthy, strong, and vibrant. This record of service is, and always will be, our most valuable contribution to the community. Additionally, Schuyler Hospital, being the largest employer in the county, is seeking to have a positive impact in the region, promote area development and hopefully also advance economic development, for which there is a documented need. The people of Appalachia must have adequate healthcare to promote socially and economically competitive communities, and Schuyler Hospital helps fulfill this need. It has been especially difficult to deliver services to remote rural regions due to the closing of independent community hospitals and/or some of the services they provide. Schuyler Hospital does not plan on being one of them and has continued to morph its vision and strategic plan to survive and continue to move forward, especially during difficult financial and economic times, to remain a pillar of strength in the community. In general, health-care and the delivery of medical services to patients, as well as the underlying operations to support patient services, have become increasingly dependent upon technology - especially communications and information technology. Schedule H, Part VI, Line 6 On September 29, 2014 Schuyler Hospital became a part of the Cayuga Health System. The mission of Cayuga Health System is to further the ability of its member healthcare organizations to honor their community based missions of providing the highest quality, patient centered care in a safe, compassionate and sustainable manner. The Vision of CHS is to "Further the ability for both organizations to meet their missions and realize their visions to improve the overall health care of our communities and generating loyalty and pride in the health care of our communities." Cayuga Health System will be recognized as an innovative, integrated regional health care leader committed to the health of our communities through the collaborative efforts of all members characterized by: * An ever improving quality of care provided within a culture of safety across the entire health system. * An unwavering focus on the health of the population served in our communities while empowering members of our communities to make healthy choices. * A steadfast drive to exceed the expectations of those we serve. * A sustainable business model with rigorous attention on achieving system efficiencies, regional growth, and sharing of expertise within an ever changing healthcare environment. * Local access to appropriate community based healthcare services enhanced by collaborations with regionally and nationally recognized healthcare resources. * An inclusive system that generates loyalty and pride from all of the communities we serve. Schedule H, Part VI, Line 7 New York X X X 0 0 0 0 0 0 0 0 0 Rebecca Gould CFO 310215 0 65625 0 0 0 0 0 36994 0 412834 0 0 0 Mary Ann Mahajan Pharmacy Director 162930 0 3750 0 0 0 0 0 42135 0 208815 0 0 0 Patrick Ryan Executive Director/Administrator SNF 159816 0 7583 0 0 0 0 0 43025 0 210424 0 0 0 Ashraf Sabahat Physician 411961 0 0 0 0 0 0 0 62343 0 474304 0 0 0 Ben Saks Physician 287445 0 17500 0 0 0 0 0 49270 0 354215 0 0 0 Jagmohan Singh Physician 296436 0 6497 0 0 0 0 0 55810 0 358743 0 0 0 Martin Stallone MD President/CEO Cayuga Medical Center 0 772870 0 205614 0 20888 0 0 0 54195 0 1053567 0 0 John Collett CFO/VP 0 432706 0 81350 0 8344 0 0 0 37400 0 559800 0 0 Schedule J, Part I, Line 3 The executive compensation policy involves an annual survey of wages for the CFO and CNO/COO, compared to the market using the regional and national Healthcare Wage Surveys. Due to constraints of the economy, the compensation of these positions may not be adjusted annually. Any change in CFO compensation is approved by the Executive Committee. In addition, the Medical Director's salary is compared to MGMA data at the contract renewal date. Form 990, Part VI, Section B, Line 11b The hospital Assistant Controller and Cost Accountant prepares the annual form 990 (with oversight from CFO) and CFO distributes to the Board of Directors and members of the Hospital Executive Team for review, comment and questions prior to filing with IRS. Form 990, Part VI, Section B, Line 12c The hospital has a written conflict of interest policy. Each member of the Board of Directors and senior management reviews annually and signs the corresponding conflict of interest statement. In addition, as new members are inducted, prior to induction they read the policy and sign the conflict of interest statement. Form 990, Part VI, Section B, Line 15 The executive compensation policy involves an annual survey of wages for the CFO and CNO/COO, compared to the market using the regional and national Healthcare Wage Surveys. Due to constraints of the economy, the compensation of these positions may not be adjusted annually. Any change in CFO compensation is approved by the Executive Committee. In addition, the Medical director's salary is compared to MGMA data at the contract renewal date. Form 990, Part VI, Section C, Line 19 Upon request, appropriate schedules of the annual financial statements, IRS Form 990 and conflict of interest forms can be released to the public. The forms are housed in the executive office of the CFO and are available at a minimum copying fee. Form 990, Part XI, Line 9 ($22,654) consists of the following: (386,619) change in beneficial interest in Schuyler Health Foundation; $363,957 Contributions and Grants Net, $8 Other Form 990, Part XII, Line 2c No changes to this process from the prior year Schuyler Health Foundation 220 Steuben Street Montour Falls NY 14965 222890619 To raise funds to support the mission of Schuyler Hospital and healthcare in Schuyler County. NY 501(c)(3) 7 N/A 0 Cayuga Medical Center 101 Dates Drive Ithaca NY 14850 222325405 Hospital NY 501(c)(3) 3-Hospital N/A 0 Cayuga Health System 101 Dates Drive Ithaca NY 14850 471899601 To bring together organizations to serve community healthcare needs. NY 501(c)3 12 N/A 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 Schuyler Health Foundation c 10957 Schuyler Health Foundation holds an annual capital fund raising campaign to benefit Schuyler Hospital. Each year those funds are released to Schuyler Hospital as the purpose of the funds is met. In 2022 Schuyler Health Foundation transferred $10,957 for SNF Aging in place and improvements. Schuyler Health Foundation e 1000000 Schuyler Hospital has a line of credit with Chemung Canal Trust Company which is secured by investments owned by Schuyler Health Foundation. Schuyler Health Foundation q 63943 Schuyler Health Foundation reimburses Schuyler Hospital for expenses paid on their behalf. These expenses include the associated costs of office space and a copier/scanner/fax. Expenses are reconciled and reimbursed on a monthly basis. For 2022 total reimbursements to Schuyler Hospital amounted to $63,943 Schuyler Health Foundation o 76555 Schuyler Hospital reports wages and remits taxes for the employees who carry out the Foundation responsibilities, including one Finance employee. Total 2022 wages for the Schuyler Health Foundation Executive Director and the Foundation Assistant Totaled $76,555 Cayuga Medical Center p 2060562 Schuyler Hospital reimburses Cayuga Medical Center for the following services: Anesthesia, Lab testing, Insights, KRONOS and Relay Health Software costs, AP mailings, Split Advertising, RL Solutions and iContracts, supplies, as well as shared insurance and legal fees. ($2,060,562) Cayuga Medical Center m 605954 Schuyler Hospital utilizes Cayuga Medical Center to perform the following services: Sleep, EKG Staff, Payroll, AP, Wound Clinic Staff, Remote Pharmacy, 340B services, Radiology Techs, Case Management, Oversight, and Bio-Engineering. Cayuga Medical Center l 124423 Schuyler Hospital provides staffing for nursing, pharmacy, lab, and nurse aid training positions as needed to CMC. In 2022, total services amounted to $124,423 We submitted an extension to ensure that information submitted was complete and accurate and to ensure Board of Directors have time to review. Extensions were filed timely and were granted by the IRS to extend filing date.