2023-11-13T12:17:20-06:00 2022-12-31 990 2022-01-01 161523353 Mount St Mary's Hospital of Niagara Falls MOUN 7168282974 144 Genesee St Buffalo NY 14203 Russell Edwards VP Finance/Corp. Controller 7169232968 2023-11-13 Russell Edwards 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Mark Sullivan 144 Genesee Street Administration 6th Floor Buffalo NY 14203 107224283 0 X www.chsbuffalo.org X 1907 NY The Mission of Mount St. Mary's Hospital of Niagara Falls, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Mount St. Mary's Hospital of Niagara Falls continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2022 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community 12 8 925 15 0 0 3403221 1791498 100495482 103274474 76508 58532 15055202 2099779 119030413 107224283 0 0 0 0 62512637 74857003 0 0 0 57175848 53485440 119688485 128342443 -658072 -21118160 85822879 123818443 65462076 124725054 20360803 -906611 X The Mission of Mount St. Mary's Hospital of Niagara Falls, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Mount St. Mary's Hospital continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2022 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community 0 0 40779111 39689954 Inpatient Routine/Surgery Visits:Acute Care Patient Days = 16,397Newborn Patient Days = 745Inpatient Surgeries = 622 49449382 48128654 Outpatient Routine/Surgery Services:Emergency Visits (Net of Admits) = 15,557Referred Ambulatory Visits = 62,312Operating Room = 2,582G.I. Laboratory = 1,188Interventional Radiology = 253 20845654 20288894 Clinic/Primary Care Services:Clinic Visits = 37,107Primary Care Visits = 33,558 111074147 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 1 94 0 1 925 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X Russell Edwards VP FinanceCorp Controller CHS 7169232968 144 Genesee Street Buffalo NY 14203 Mark Sullivan President and CEO 0.00 55.00 X X 0 1314161 25888 Walter Ludwig Director 0.00 55.00 X 0 351681 49177 Russell Edwards VP Finance & Corporate Con 0.00 55.00 X 0 222888 469 Charles Urlaub President & CEO MSM 55.00 0.00 X X 459970 0 20170 Aaron Chang Director 0.00 55.00 X 0 322970 27367 Carol Heckman Esq Director - Chair 0.00 8.00 X 0 0 0 Sister Marcia Ann Fiutko Director 0.00 4.00 X 0 0 0 Nelson J Grimm PhD Director 0.00 4.00 X 0 0 0 Kevin Keenan Director 0.00 4.00 X 0 0 0 Monsignor Robert E Zapfel Director - Vice Chair 0.00 4.00 X 0 0 0 Ellen Grant Director 0.00 4.00 X 0 0 0 Alexis Agnello Director 0.00 4.00 X 0 0 0 Emily H Jerge MSRNCHSE Director 0.00 4.00 X 0 0 0 Toni Murphy DO Director 0.00 4.00 X 0 0 0 Joyce Markiewicz Chief Business Development 0.00 55.00 X 0 561183 52362 David Macholz Chief Financial Officer 0.00 55.00 X 0 624031 15718 Dr Michael Galang Senior VP, Chief Informati 0.00 55.00 X 0 481207 46473 Hans Cassagnol Executive VP, Chief Physic 0.00 55.00 X 0 623902 30245 William Pryor Executive VP, Chief Admin. 0.00 55.00 X 0 653255 48421 Bartholomew Rodrigues Chief Mission Officer 0.00 55.00 X 0 265426 53262 James M Garvey Executive VP, Chief Operat 0.00 55.00 X 0 725997 40539 Rebecca McCormick Boyle Chief Integration Officer 0.00 55.00 X 0 242893 19523 Leonardo Sette-Camara General Counsel - Secretar 0.00 55.00 X 0 328158 19941 Lisa Cilano Senior VP, RMC & Business 0.00 55.00 X 0 337403 -281621 Martin Boryszak Senior VP of Acute Care & President of MHB 0.00 55.00 X 0 540613 10178 Dr Parag Parikh Physician 55.00 0.00 X 498941 0 16061 Dr Gregory Sambuchi Physician 55.00 0.00 X 393994 0 47815 Dr Stephen Watkins Physician 55.00 0.00 X 583697 0 8451 Dr Kafai Lai Physician 55.00 0.00 X 376084 0 8123 Dr Joseph Andrzejewski Physician 55.00 0.00 X 396096 0 18559 Gary Tucker Director - Former 0.00 0.00 X 58332 0 -2852 Eddie Bratko Director - Former 0.00 55.00 X 0 335523 13771 2767114 7931291 288040 103 1 1 0 PIKE COMPANY INC THE 1 Circle Street Rochester NY 14607 Construction Services 13620313 CLARK PATTERSON LEE 26 Mississippi St 300 Buffalo NY 14203 Construction Services 1544335 TRIMEDX 5451 LAKEVIEW PKWY S DRIVE INDIANAPOLIS IN 46268 Health Care Services 1171719 EXIGENCE HOSPITALIST MEDICAL 5300 Military Rd Buffalo NY 14092 Health Care Services 789333 LOGAN'S HEALTHCARE APOLLO DR BATAVIA NY 14020 Laundry Services 450691 26 588575 1202923 1791498 Medicare/Medicaid 621990 65378354 65378354 All Other Payers 621990 37896120 37896120 103274474 58532 20149 38383 186901 0 186901 186901 186901 340B Pharmacy 621990 3229296 3229296 CHS Shared Services 621990 417471 417471 Misc Rev Prior Year Reversal 621990 -2900001 -2900001 1166112 1166112 1912878 107224283 108107502 0 -2674717 61543530 55782835 5760695 1706065 1546371 159694 8306762 7529219 777543 3300646 2991694 308952 65951 2535 63416 3519 3519 4779991 3988384 791607 31972 3370 28602 3443607 1780104 1663503 90150 19589 70561 1250029 937522 312507 3023 1427 1596 1727 1727 260629 73668 186961 4234977 2914038 1320939 1298917 1145479 153438 Dues and Shared Service 18413340 13628476 4784864 Medical Supplies 14995117 15143607 -148490 Purchased Services 3491321 2679368 811953 Other Supplies Non-Medi 1121170 904734 216436 128342443 111074147 17268296 0 4630 4679 15935491 42101103 15370326 13431442 2504193 2265528 130677 163148 109178540 61299299 32791798 47879241 4950 19085764 17968352 85822879 123818443 16507772 16852785 5966667 8800001 5322980 49647972 451739 1773221 37212918 47651075 65462076 124725054 X 18442845 -2824568 1917958 1917957 20360803 -906611 85822879 123818443 X -21118160 -149254 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 72124 72124 0 Part II-B, Line 1: Part II-B, Line 1, i. Lobbying Activities: Other lobbying activities: Lobbying expenses of $72,124 represent the total of dues paid to national and state associations that is specifically allocable to lobbying. Mount St. Mary's Hospital does not participate in or intervene in (including the publishing or distributing of statement) any political campaign on behalf of (or opposition to) any candidate. 2084435 2084435 34526759 24149802 10376957 10277387 1974342 8303045 44790721 35803785 8986936 17499238 -628630 18127868 47879241 Due From Affiliates 2165119 Interest in Net Assets of MSM Foundation 9773557 Insurance Recoveries 4450091 Other Receivables 822631 Operating Lease Right of Use Assets 547325 Obligated FEMA Revenues 209629 17968352 Due to Affiliates 27534278 L/T General Liab/Workers Comp IBNR 8962454 Long-Term Pension Obligations 2601198 Asset Retirement Obligation 4339606 Long-Term Portion of EIB Bank 91341 Contingent Performance Obligation 4898876 Operating Lease Liabilities 549331 LT Portion of Disposables 8420 Debt Issuance Costs -1334429 47651075 106767754 -253607 -253607 107021361 202922 202922 107224283 129556611 1214168 1214168 128342443 0 128342443 Part XI, Line 2d - Other Adjustments: Childcare Revenue - 580,992. Foundation Revenue - (net of eliminations) -834,599. Part XI, Line 4b - Other Adjustments: Contributions from Foundation 202,922. Part XII, Line 2d - Other Adjustments: Childcare Expenses 741,878. Foundation Expenses (net of eliminations) 472,290. 1 1 X 1 X 1 X 1 1 1 0 1 1 843968 33235 810733 0.00630 36575227 29044595 7530632 0.05810 37419195 29077830 8341365 0.06440 32278 0 32278 0.00020 0 0 0.00000 18459962 17617468 842494 0.00650 0 0 0.00000 6579 0 6579 0.00010 18498819 17617468 881351 0.00680 55918014 46695298 9222716 0.07120 11612 11612 0.00010 11612 11612 0.00010 0 13324774 15217397 -1892623 X 1 1 1 1 Mount St Mary's Hospital of Niagara Falls 5300 Military Rd Lewiston NY 14092 www.chsbuffalo.org 3121001H X X X Ambulatory Surgery - Multi Specialty Mount St Mary's Hospital of Niagara Fal 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Part V, line 7a page 8 X 1 22 1 See Part V, line 10a page 8 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X www.chsbuffalo.org/billing-insurance/financial-assistance X www.chsbuffalo.org/sites/default/files/files/billing/catholic-healt X www.chsbuffalo.org/sites/default/files/files/billing/catholic-healt X X X X X X X 1 X 0 X 1 X 0 0 Part V, Section A: Ambulatory Surgery - Multi Specialty Chemical Dependence - Rehabilitation Chemical Dependence - Withdrawal O/PClinic Part Time ServicesClinical Laboratory ServiceCoronary CareEmergency Department Intensive CareLevel I Perinatal Care Lithotripsy MaternityMedical Services - Other Medical Specialties Medical Services - Primary CareMedical Social Services Medical/Surgical Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Radiology - Diagnostic Renal Dialysis - AcuteStroke Center Therapy - Occupational O/P Therapy - Speech Language Pathology O/P Mount St. Mary's Hospital of Niagara Falls Part V, Section B, Line 5: - Niagara County Health Department Assessed resources and determined that they would extend the 2019-- 2021 Priorities for the 2022-2024 cycle due to the COVID-19 pandemic.- CHNA/CHIP Steering Committee Monthly meetings held starting in February 2022. Delayed start due to resource allocation as a result of global COVID-19 pandemic.- Three Surveys Conducted Consumer, Provider, and Community Based Organizations- Consumer survey late March 2022 through mid-June 2022 2,329 respondents, reviewed by zip code toensure equitable geographic input- Provider Survey Conducted in May 2022, 49 responses received- Niagara Falls Health Equity Task Force survey Conducted in May 2022, 10 respondents- Focus Groups April 2022 through June 2022, 5 groups for a total of 61 participants- Findings of surveys and focus groups were compiled and reviewed by the Steering Committee which iscomprised of the hospitals, county representatives, and other community organizations who each thendisseminate results with their networks, county contacts, and other organizations (i.e., Niagara Falls HealthEquity Task Force). The results continue to be shared with county and community leaders as the countyworks to support residents during this unprecedented time.- Catholic Health CHNA Summit June 13, 2022. Health system clinical and non-clinical leaders were invitedto review and approve priorities identified through above processes.- Catholic Health Board Strategic Planning Committee Meeting July 11, 2022. Health priorities were sharedwith the committee for review and comment.- Catholic Health Mission Integration Committee September 7, 2022. The 2022-2024 health priorities and initiatives were presented and the reporting dashboard was discussed.- Niagara County Community Health Stakeholder Meeting September 12, 2022. Priorities reviewed andpotential interventions and strategies to target focus areas identified.- Catholic Health Ministry Services Board Meeting November 17, 2022. The CHNA reports and CHIP for eachof the hospitals were presented and approved by the board members.- Catholic Health Board of Directors were informed of the Ministry Services Board's approval of the 2022-2024CHNA reports and CHIP during the December 1, 2022 Board of Directors meeting.- All reports have been published electronically on the Catholic Health website (chsbuffalo.org) with hardcopies available upon request from the Catholic Health Mission Integration office. Mount St. Mary's Hospital of Niagara Falls Part V, Section B, Line 6a: Bernadette Franjoine Catholic Health bfranjoine@chsbuffalo.orgLauri McCoy Catholic Health lmccoy1@chsbuffalo.orgCarolyn Moore Eastern Niagara Hospital cmoore@enhs.orgAnnette Andrews Kaleida Health aandrews@kaleidahealth.orgBrian Meade Kaleida Health bmeade@kaleidahealth.orgKathleen Tompkins Kaleida Health ktompkins@kaleidahealth.orgStacy Knott Niagara County Department of Health stacy.knott@niagaracounty.comRobert Mowery Niagara Falls Memorial Medical Center robert.mowery@nfmmc.orgAlessandra Duarte Population Health Collaborative of WNY aduarte@phcwny.org Mount St. Mary's Hospital of Niagara Falls Part V, Section B, Line 6b: Heather Cruz NCDMH (contracted) heather.cruz@niagaracounty.comAdrienne Kasbaum Niagara County Department of Health adrienne.kasbaum@niagaracounty.comCathy Hoy-Patterson Niagara County Department of Health cathy.hoy-patterson@niagaracounty.comDan Stapleton Niagara County Department of Health dan.stapleton@niagaracounty.comJacquelyn Langdon Niagara County Department of Health jacquelyn.langdon@niagaracounty.comTracy Fricano-Chalmers Niagara County Department of Health tracy.fricanochalmers@niagaracounty.comVictoria Pearson Niagara County Department of Health victoria.pearson@niagaracounty.comKaren Hall Population Health Collaborative of WNY khall@phcwny.org Mount St. Mary's Hospital of Niagara Falls Part V, Section B, Line 11: Catholic Health 2022-2024 Prevention Agenda Priorities and DisparityIn collaboration with the Niagara County Department of Health and other community partners, the following priorities, goals, focus areas and interventions were selected for the Catholic Health Community Health Improvement Plans. Priority Area #1 and Priority Area #2 were priorities identified by the Niagara County Department of Health and selected for our community collaboration. Catholic Health is required to align with at least two county Priority Areas as part of the CHNA process. Of note, the Erie County Department of Health identified the same priorities.Priority Area #1: Prevent Chronic DiseasesDisparity: SocioeconomicFocus Area 1: Healthy Eating and Food SecurityOverarching Goal: Reduce obesity and the risk of chronic diseaseGoal 1.13: Increase the percentage of adults with perceived food securityPriority Area #2: Promote Well-Being and Prevent Mental and Substance Use DisordersDisparity: SocioeconomicFocus Area 1: Promote Well-BeingGoal 1.2: Facilitate supportive environments that promote respect and dignity for people of all agesGoal 2.2: Prevent opioid and other substance misuse and deathsFocus Area 2: Prevent Mental and Substance Use DisordersGoal 2.2: Prevent opioid and other substance misuse and deathsPriority Area #3: Promote Healthy Women, Infants, and ChildrenDisparity: EthnicityFocus Area 1: Maternal and Women's HealthGoal 1.2: Reduce maternal mortality and morbidityFocus Area 2: Perinatal and Infant HealthGoal 2.2: Increase breastfeedingA comprehensive review of outcome data from a variety of state and national resources were reviewed as part of the CHNA process. Primary resources utilized included the New York Prevention Agenda Dashboard, data from the United States census reporting, the University of Wisconsin's Population Health Institute's County Health Rankings and Roadmaps, as well as others. Due to the proximity and nature of the interrelationships between Erie and Niagara counties, as well as the reach of the Catholic Health service area and goal for high level of inclusivity for community health, data from both counties is represented in the following report. This provides a more comprehensive view of the overall service area while still allowing county specific needs to be identified.The overall assessment process is a collaborative effort between Catholic Health, Niagara County Department of Health, and other local organizations and hospitals. More than 15 organizations directly participated in planning meetings and feedback sessions and over 1,300 residents responded to the CHNA survey. Input was also solicited from a broad range of other community organizations, individuals, and groups. This input helped validate and bring focus to areas of specific need and disparity, as well as helped prioritize interventions to address the needs of those we serve. The completed assessment and analysis of the data provided a framework for the health system's overall implementation plan to support priority needs that were identified for the community over the next three years.chs.buffalo.org | 9The progress and overall improvement related to the Prevention Agenda priorities in the Catholic Health improvement plan will be monitored by the internal leaders who are coordinating the interventions identified by the teams to support the priorities identified and as outlined on the CHIP template provided by the New York State Department of Health. Catholic Health will submit updates on progress towards each intervention annually, or as requested. The county's steering committee representatives will also continue to meet at least annually and review progress as well as explore new opportunities to collaborate on to support the priority areas. The Prevention Agenda Dashboard will continue to serve as the primary resource to track latest available trending details and monitor outcome data.While Catholic Health is committed to serving the community through the CHNA priorities in this report, thereare a number of needs that were not incorporated into Catholic Health's individual 2022-2024 CommunityHealth Improvement Plan at this time for one or more of the following reasons: Requires resources that Catholic Health does not currently have available without compromising otherimportant initiatives. Is being targeted or addressed by other entities within the community. Was deemed not as impactful on the overall health of the community as compared to other identified needs.Should community circumstances change or additional resources become available, Catholic Health willconsider incorporating other initiatives into its plan. The Community Health Needs Assessment and Community Health Improvement Plan processes are linked directly to requirements specified by the Federal Internal Revenue Service and the New York State Department of Health. Under the Patient Protection and Affordable Care Act of 2010, the Internal Revenue Service requires all state-licensed, tax-exempt hospitals to develop a Community Health Needs Assessment and Community Health Improvement Plan to maintain their Internal Revenue Code Section 501(c)(3) tax-exempt status. Similarly, New York State requires hospitals and local health departments to collaborate within their community to identify local health priorities and to plan and implement a strategy for local health.Part V, line 7A Page 8: https://www.chsbuffalo.org/mission/social-responsibility-community-benefit Part V, line 10a Page 8: https://www.chsbuffalo.org/mission/social-responsibility-community-benefit Mount St. Mary's Hospital of Niagara Falls Part V, Section B, Line 16j: Includes information in both English and Spanish on all signage and brochures for financial assistance. 9 1 - Mount St Mary's Hospital Rehab Services 1 Columba Drive Niagara Falls NY 14305 Medical Services - Primary Care Therapy - Occupational O/P Therapy - Physica 2 - Mount St Mary's Diagnostic Imaging Serv 7300 Porter Road Niagara Falls NY 14304 Medical Services- Primary Care 3 - Mount St Mary's Ear Nose and Throat Se 6941 Elaine Drive Niagara Falls NY 14304 Medical Services- Primary Care 4 - Mount St Mary's Orthopedic Services 5320 Military Road Lewiston NY 14092 Medical Services- Primary Care 5 - Mount St Mary's Primary Care Extension 1302 Main Street Niagara Falls NY 14301 Medical Social Services O/P Primary Medical Care O/P Radiology - Diagnostic 6 - Mount St Mary's Neighborhood Health Cent 3101 Ninth Street Niagara Falls NY 14305 Medical Social Services O/P Nutritional O/P Prenatal O/P Primary Medical Car 7 - Mount St Mary's Health Center Lockport 6000 Brockton Drive Lockport NY 14094 Medical Services - Other Medical Specialties Medical Services - Primary Care 8 - Mount St Mary's Neurology Center 4600 Military Road Niagara Falls NY 14305 Medical Services - Other Medical Specialties- 9 - Mount St Mary's Campus Medical Arts Bui 5290 Military Road Suite 8 Niagara Falls NY 14092 Medical Services- Primary Care Part I, Line 6a: Mount St. Mary's Community Benefit Report is contained in the annual report prepared by the Catholic Health System. Part I, Line 7: Costing is a full step down methodology of cost from non-revenue producing departments to revenue producing departments', with assignment of cost to individual charge items based on volume and charge amount. All patient accounts are cost with the same methodology regardless of patient type (inpatient, outpatient, emergency room, etc.) or insurance coverage (Medicare, Medicaid, private insurance, uninsured, etc.). Part II, Community Building Activities: Community Building Activities for Mount St. Mary's Hospital included Community Support of $11,612. Part III, Line 2: The Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue. Part III, Line 3: The Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue. Part III, Line 4: The hospital does not have a footnote that describes bad debt in the financial statements. Part III, Line 8: Mount St. Mary's Hospital does not treat Medicare shortfall as a community benefit, as serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations. The existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories. Part III, Line 9b: The hospital's collection policies contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance. The hospital has implemented billing and collection practices for patient payment obligations that are fair, consistent, and compliant with state and federal regulations and no extraordinary collection practices are followed. Part VI, Line 2: As part of Catholic Health, Mount St. Mary's Hospital benefits from information received from a key stakeholders engaged in the facilities health ministry. This includes the voice of associate through requests and information received from Catholic Health associates via formal and informal conversations in their departments and requests for assistance through the Helping Hands fund. In addition evaluations administered by the Catholic Health Community Education Department after each class, workshop, or program it sponsors; from input from the physician community during doctor to doctor education programs; from physician and leadership participation in community boards, coalitions and forums to define the health needs of patient populations and seek community solutions; from participation in regional planning initiatives that look at the needs of the broader community; and input from the Catholic Health Board including Board Committee (e.g. Mission Integration Committee). Examples of other sources of input include engagement from a number of countywide, city/town, and regional organizations. Those organizations include the Niagara Falls Health Equity Task Force, Niagara and Lockport School Districts, Niagara Falls' Heart, Love and Soul Food Pantry, Pinnacle Community Services, Niagara County Department of Health, Niagara County Department of Mental Health and Substance Abuse and many others. In each of these organizations, representatives from Mount St. Mary's as well as Catholic Health are actively engaged and in many cases serve on boards or key committee with consistent dialogue about our services. The facility is an active partner in a number of county initiatives as well as the state required Community Health Needs Assessment process. This results in comprehensive geographic reaches and significant collaborative work specifically with the Niagara County Department of Health. Part VI, Line 3: Catholic Health's Mount St. Mary's Hospital inform and educate patients and persons who may be billed for medical services about their eligibility for assistance under federal, state, or local government programs or our own Healthcare Assistance Program (HAP) in a variety of ways. For example, Mount St. Mary's Hospital, like our other Catholic Health facilities, has posters and brochures available, which include eligibility and contact information for the Patient Financial Services Team. This information is available in admissions areas, emergency rooms, primary care and outpatient rehabilitation centers, the Administrative and Regional Training Center (ARTC) and other areas throughout Catholic Health where eligible patients and family members are likely to be present. This information is also on the website https://www.chsbuffalo.org/billing-insurance/financial-assistanceand includes general information, our policy and application and is translated in Spanish and Arabic. In addition, information on financial assistance is included on our website. Mount St. Mary's Hospital also provides information about financial assistance and Healthcare Assistance program (HAP) contact information to patients as part of the intake process and during or within 90 days of their discharge from the hospital via patient statements or outreach. To further assist patients, all patient bills include the following language: "If you need financial assistance: Catholic Health offers a healthcare assistance program to help those in need. For more details please visit www.chsbuffalo.org/financial assistance, or call our Patient Financial Services Team at (716) 601-3600". For free, confidential assistance in applying for financial assistance, patients can also call our Patient Financial Services team at 716-601-3600. A counselor will work with them to see if they qualify for free or low-cost insurance or other financial assistance. For patients who do not have insurance and need care at a Catholic Health hospital, a registration clerk can put the patient in touch with one of our Certified Application Counselors. Interpreting services are also available for patients who do not speak English. We offer case management services, and our Certified Application Counselors who discuss with patients the availability of various government benefits, such as Medicaid or other state and federal programs, and assist patients and families with eligibility and applications when necessary. Part VI, Line 4: Catholic Health is a not-for-profit integrated healthcare delivery system that operates four acute careoperations in Erie County and one in neighboring Niagara County. The Niagara County facility, Mount St.Mary's, provides services for residents from the county's cities, towns and the many rural areas in thecounty. In addition, Catholic Health has Home and Community Based Care, Primary Care Centers, as well as Diagnostic and Testing Centers that serve Niagara County residents. The health system is in the process of building a new neighborhood hospital that will be a campus of Mount St. Mary's to address needs in the eastern part of the county. The present hospital operating in the city of Lockport is in bankruptcy and likely closing in mid-2023. The local and state officials have been engaged and partnering with Catholic Health to ensure the 85,000 residents in that part of the county do not lose access to health care. This has resulted in the development of a new hospital concept for that part of Niagara County. The target populations include our general community population including those who may be at risk or disadvantaged. Niagara County is one of the 62 counties that comprise the State of New York. Niagara County has a total area of 522 square miles. It consists of 3 cities (Niagara Falls, North Tonawanda and Lockport) and 12 towns (Cambria, Hartland, Lewiston, Lockport, Newfane, Niagara, Pendleton, Porter, Royalton, Somerset, Wheatfield and Wilson.) It is also the most western part of New York State and is bordered by Lake Ontario on its northern border and the Niagara River (Canada) on its western border.Mount St. Mary's Primary Service Area includes the City of Niagara Falls (Zip Codes 14301, 14302, 14303, 14304 and 14305), a city of about 49,000 where 60% of the population is on some form of public assistance. The towns of Lewiston (14092, 14107, 14109, and 14132), Niagara (portions of 14304 and 14305), Wheatfield (portions of 14305 and 14120), Grand Island {14072) and Porter (14174) are more suburban and rural areas with slightly higher income levels. Secondary Service Area includes the towns of Wilson (14172) a small agricultural community and Lockport (14094) a nearby city with similar characteristics to Niagara Falls. In general, the primary service area is described as Western Niagara County.The population of Niagara County, New York in 2020 was 208,396, a loss of 3.7% from the 216,474 who lived there in 2010. For comparison, the US population grew 6.5% and New York's population shrank by 0.3% during that period. The largest ethnic groups in Niagara County are White (Non-Hispanic) 85.4% and Black or African American (Non-Hispanic) 6.89%. White (Hispanic) accounts for 1.78% and Asian (Non-Hispanic) accounts for 1.1%. Part VI, Line 5: One of the fundamental reasons for the creation of Catholic Health was to ensure the continued viability of faith-based health care to meet the needs of residents in Erie County and the surrounding communities. The Mission statement of Mount St. Mary's Hospital, as part of Catholic Health - We are called to reveal the healing love of Jesus to those in need further articulates why we exist. Integral to this effort is caring for the needs of those who are poor and disadvantaged. The services provided by Mount St. Mary's Hospital are in response to identified community needs and reflect the Hospitals' emphasis on caring for the underserved. The Hospital collaborates with other charitable organizations and social service agencies (i.e. Catholic Charities, Spectrum Human Services, Evergreen Health Services, Erie County Department of Health, etc.), to maximize its ability to provide needed services to the residents of our region.The governing Board of Directors of Mount St. Mary's Hospital is comprised of community representatives from universities, legal communities, and business leaders. Religious orders are represented, as well as active and retired medical staff members. The Mount St. Mary's Hospital medical staff is considered an "open" medical staff, as any physician can apply for privileges. Each application is reviewed by a vigorous credentialing verification process. The hospitals have robust health professional education programs. Mercy Hospital and Sisters Hospital are also physician teaching facilities. All Catholic Health sites participate in teaching programs for other allied health professionals. Our six emergency departments are open to all people regardless of their ability to pay. Our primary care centers are strategically located in areas deemed economically disadvantaged or where other medical services are lacking in both Erie and Niagara County. Each year, Mount St. Mary's Hospital, as part of Catholic Health touches thousands of area residents through its community health education programs, health screenings, clinical and support services, and community service activities. Most of these program are free to encourage participation by people from all walks of life. Programs offered also include those that are in alignment with state prevention priorities. Catholic Health continues to meet community needs by making charity care a priority and available to the uninsured and underinsured, traditional Medicaid services, and community benefit programs, including collaborative community health improvement initiatives, health professional education programs, volunteering and community service activities, and cash and in-kind contributions to community organizations that serve the poor and disadvantaged. In 2022, the Catholic Health System provided more than $210 million in charity care and community benefit activities to help make our community a healthier place, especially for the poor and underserved. Additional initiatives that Catholic Health and Mount St. Mary's Hospital associates in Erie and Niagara County participate in as part of CHS provide benefit to the community including:- 11 Day Power Play- Altus Management / CRS Radiopharmaceutical- American Red Cross- Amherst Chamber of Commerce- Antioch Missionary Baptist Church "- Bar Association of Erie County, Volunteer LawyersProject- BSA (Troop 229G & Pack 816)- Buffalo Prenatal Perinatal Network INC.- Canopy of Neighbors- Catholic Charities- Catholic Daughters of the Americas- Cheektowaga Senior Services- Department of Family Services - Niagara Falls- Diamonds in the Ruff Animal Rescue- Diocese of Buffalo- D'Youville College Governance Committee- East Aurora Boys Volley Ball Boosters- Ed Tech of WNY- Empower- Feed More WNY- Fourteen Holy Helpers- Franciscan Sisters of Saint Joseph- Gerard Place- Harvest House- Health Association of NYS- Healthcare Association of Western/Central NY- Heart, Love and Soul Dining, Food Pantry, andDaybreak- Holy Cross Church- InTandem- Juvenile Diabetes Research Foundation-JDRF- Kappa Alpha Psi- Lions Club of Hamburg- Literacy Buffalo Niagara- Little Portion Friary- Make-A-Wish of WNY- Masjid Al-Eiman and Islamic Cultural Association of WNY- Nativity Miguel- Near East and West Side (NEWS) Task Force- Niagara Organizing Alliance for Hope- Niagara River Region Chamber of Commerce- Operation Home Front for Military Families- Parish Nurse Ministries of NY, Inc- Paws for Love, Erie County SPCA- Pendleton Athletic Boosters Association- People Inc- Pinnacle Community Services- Save the Michaels- Sigma Pi Phi (Boule)- Squeaky Wheel Film & Media Arts Center- Stella Niagara Education Park- St. Leo the Great Roman Catholic Church- St. Peter Roman Catholic Church- The Buffalo Zoo- The Fellowship of God's Word- Trinidad Neighborhood Association- Urban Christian Ministries- Value Network Advisory Board- Western New York Invention Convention- WNY Church Unleashed/St. Paul's Lutheran Church- WNY Professional Nurses Association- WNYNYON-NY Organization of Nursing Leaders- Worldwide Community First Responders (WCFR)Note: The above list reflects names of organizations associates reported involvement with as part of a 2022 survey coordinated by the Catholic Health Diversity, Equity and Inclusion Committee as well as organizations identified by associates and providers through the Catholic Health Community Benefit Occurrence Tracker system. Part VI, Line 6: N/A Part VI, Line 7, Reports Filed With States NY X X X X X X 1 0 0 0 0 0 0 0 0 Mark Sullivan President and CEO 0 983779 0 62939 0 267443 0 9215 0 16673 0 1340049 0 0 James M Garvey Executive VP, Chief Operat 0 682362 0 0 0 43635 0 24133 0 16406 0 766536 0 0 William Pryor Executive VP, Chief Admin. 0 612232 0 25 0 40998 0 25808 0 22613 0 701676 0 0 Hans Cassagnol Executive VP, Chief Physic 0 586116 0 0 0 37786 0 7654 0 22591 0 654147 0 0 David Macholz Chief Financial Officer 0 606188 0 0 0 17843 0 -5919 0 21637 0 639749 0 0 Joyce Markiewicz Chief Business Development 0 541076 0 0 0 20107 0 36124 0 16238 0 613545 0 0 Dr Stephen Watkins Physician 583315 0 0 0 382 0 193 0 8258 0 592148 0 0 0 Martin Boryszak Senior VP of Acute Care & President 0 498780 0 25000 0 16833 0 -12319 0 22497 0 550791 0 0 Dr Michael Galang Senior VP, Chief Informati 0 464914 0 0 0 16293 0 38161 0 8312 0 527680 0 0 Dr Parag Parikh Physician 498399 0 0 0 542 0 693 0 15368 0 515002 0 0 0 Charles Urlaub President & CEO MSM 417240 0 0 0 42730 0 11880 0 8290 0 480140 0 0 0 Dr Gregory Sambuchi Physician 392188 0 0 0 1806 0 25412 0 22403 0 441809 0 0 0 Dr Joseph Andrzejewski Physician 395864 0 0 0 232 0 -3716 0 22275 0 414655 0 0 0 Walter Ludwig Director 0 333184 0 0 0 18497 0 33122 0 16055 0 400858 0 0 Dr Kafai Lai Physician 375704 0 0 0 380 0 -107 0 8230 0 384207 0 0 0 Aaron Chang Director 0 306394 0 0 0 16576 0 5047 0 22320 0 350337 0 0 Eddie Bratko Director - Former 0 299357 0 25 0 36141 0 -8560 0 22331 0 349294 0 0 Leonardo Sette-Camara General Counsel - Secretar 0 327603 0 25 0 530 0 -2400 0 22341 0 348099 0 0 Bartholomew Rodrigues Chief Mission Officer 0 226968 0 25 0 38433 0 30997 0 22265 0 318688 0 0 Rebecca McCormick Boyle Chief Integration Officer 0 232874 0 0 0 10019 0 19291 0 232 0 262416 0 0 Russell Edwards VP Finance & Corporate Con 0 202179 0 0 0 20709 0 -7619 0 8088 0 223357 0 0 Lisa Cilano Senior VP, RMC & Business 0 319655 0 25 0 17723 0 -295310 0 13689 0 55782 0 0 Gary Tucker Director - Former 28820 0 0 0 29512 0 -3392 0 540 0 55480 0 0 0 Part I, Line 3 Certain portions of the incentive compensation paid in 2022 are a result of the targets that were achieved in previous years. Deferred compensation reported in 2022 includes both qualified deferred pension compensation, as well as deferred compensation and employer contribution for 403b for certain associates for the amounts that are able to be estimated in 2022. Actual W-2 compensation paid to the executive is as per Schedule J Part II B. Part I, Line 4a Severance Payments/Change of Control Payments were made to: Gary Tucker: $11,551.97 Part II Column C: The change in present value shown for each participant represents the change in the actuarial value of the accrued benefit, whether or not funded, vested or subject to substantial risk of forfeiture. Note that the change in present value is partly due to changes in the discount rate and, for those accruing under the cash balance formula, the assumptions for future cash balance interest crediting rates and factors applicable to annuity conversions. A Dormitory Authority of the State of New York - Series A 146000293 SeePartVI 2019-04-25 3834625 See Part VI 0 0 0 B Dormitory Authority of the State of New York - Series B 146000293 64990GMH2 2019-04-25 1216395 See Part VI 0 0 0 C Niagara Area Development Corporation 900764545 SeePartVI 2022-03-22 44370499 See Part VI 0 0 0 A 4170597 47036 4120147 3413 2020 1 0 0 1 B 1216395 12941 1201101 2354 2020 1 0 0 1 C 44370499 4286984 2662301 999182 18107793 18314240 2023 0 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 (c) Issuer Name: Niagara Area Development Corporation Part I A (c) CUSIP #: The 2019 Bond Series A were issued under numerous CUSIP #s with varying maturity dates. The associated CUSIP #s are as follows: 64990GLN0, 64990GLP5, 64990GLQ3, 64990GLR1, 64990GLS9, 64990GLT7, 64990GLU4, 64990GLV2, 64990GLW0, 64990GLX8, 64990GLY6, 64990GLZ3, 64990GMA7, 64990GMB5, 64990GMC3, 64990GMD1, 64990GME9 Part I A (f) Purpose Series A Proceeds of bonds used to (i) finance portions of certain improvements, equipment and strategic investments, including but not limited to a new electronic medical records system, maternity services renovations and new sterile processing department. Part I B (f) Purpose - Series B Proceeds of bonds used to (i) finance portions of certain improvements, equipment and strategic investments, including but not limited to a new electronic medical records system, maternity services renovations and new sterile processing department. Part I C (c) CUSIP #: The 2022 Bond were issued under numerous CUSIP #s with varying maturity dates. The associated CUSIP #s are as follows: 653541BK7, 653541BJ0 Part I C (f) Purpose - Proceeds of bonds used to finance portions of certain improvements, equipment and strategic investments, including but not limited to, construction of Lockport Memorial Hospital. Susan Urlaub Wife of MSM CEO, C.J. Urlaub Clinical Documentation Specialist, SCH/SJC 0 Rachel Markiewicz Daughter in Law of Chief Business Development Officer, Joyce Markiewicz Social Worker, MSW 0 Carrie Sette-Camara Wife of Key Employee, Leonardo Sette-Camara Public Relations Manager, Sisters 0 David A Macholz Nephew of Chief Finance Officer, David Macholz Network Technical Analyst, CHS 0 Form 990, Part VI, Section A, line 6 CHS has two members: The Franciscan Sisters of St. Joseph of Hamburg, NY, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and have the power to approve any plan of dissolution of the corporation and the distribution of the assets upon dissolution, according to the CHS Bylaws. Form 990, Part VI, Section A, line 7a According to the CHS Bylaws, each member is equally allowed to appoint one representative and one alternative representative to serve on the Corporate Member Council and to serve as a voting director on the Catholic Health System Board of Directors. Form 990, Part VI, Section A, line 7b Yes, the corporate members do have reserve powers. Form 990, Part VI, Section B, line 11b Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities that file a 990. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6. Schedule J: Compensation Information 7. Schedule L: Transactions with Interested Persons 8. Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information Form 990, Part VI, Section B, line 16b: The Catholic Health System has a process to evaluate its participation in joint venture arrangements under applicable federal tax law, and has taken steps to safeguard the organization's exempt status with respect to such arrangements, and has developed a formal policy to formalize the process. Form 990, Part VI, Section B, line 12c All officers, directors, and key employees complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner. Form 990, Part VI, Section B, line 15 CHS, in determining the compensation for the CEO, utilizes a process of review and approval, governed by the Board of Directors that includes an outside nationally recognized independent compensation consultant experienced in compensation and benefit matters for non-profit healthcare organizations, and comparability data. In 2022, the Catholic Health System utilized a Compensation Committee of the corporation Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives Form 990, Part VI, Section C, line 19 We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws. Form 990, Part XI, line 9: Change in Pension Obligation, other than Net Periodic Cost 881,429. Change in Unrestricted Interest in Mount St. Mary's Foundation -1,444,731. Change in Restricted Interest in Mount St. Mary's Foundation 414,048. Catholic Health System Inc 144 Genesee Street Buffalo NY 14203 222565278 Health Care Delivery System NY 501 c 3 Schedule A Line 10 0 Mercy Hospital of Buffalo 565 Abbott Road Buffalo NY 14220 160756336 Acute Care Hospital NY 501 c 3 Schedule A Line 3 Catholic Health System Inc 0 Sisters of Charity Hospital 2157 Main Street Buffalo NY 14214 160743187 Acute Care Hospital NY 501 c 3 Schedule A Line 3 Catholic Health System Inc 0 Kenmore Mercy Hospital 2950 Elmwood Avenue Kenmore NY 14217 160762843 Acute Care Hospital NY 501 c 3 Schedule A Line 3 Catholic Health System Inc 0 Nazareth Home of the Franciscan Sisters 291 North Street Buffalo NY 14201 160813142 Skilled Nursing Facility NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 St Elizabeth Home for the Aged 5539 Broadway Lancaster NY 14086 160743154 Skilled Nursing Facility NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 St Francis Home of Williamsville 147 Reist St Williamsville NY 14221 160743153 Skilled Nursing Facility NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 St Francis of Buffalo Inc 34 Benwood Ave Buffalo NY 14214 161523535 Skilled Nursing Facility NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 St Vincent Manor 319 Washington Avenue Dunkirk NY 14048 160743167 Adult Home NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 WNY Catholic Long Term Care Inc 6400 Powers Rd Orchard Park NY 14127 161434368 Skilled Nursing Facility NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 Niagara Homemaker Services (Mercy Home Care) 144 Genesee Street Buffalo NY 14203 161317960 Home Care Provider NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 McAuley Seton Home Care 144 Genesee Street Buffalo NY 14203 161310062 Home Care Provider NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 Catholic Health System Infusion Pharmacy Inc 6350 Transit Road Depew NY 14043 200198518 Home Care Infusion Services NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 OLV Renaissance Corporation 144 Genesee Street Buffalo NY 14203 200167745 Real Estate Holding Company NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 CHS Program of All-Inclusive Care for the Elderly Inc 55 Melroy Avenue Lackawanna NY 14218 261252884 All-inclusive Care for the Elderly NY 501 c 3 Schedule A Line 3 Catholic Health System Inc 0 Trinity Medical WNY PC 2625 Harlem Rd Cheektowaga NY 14225 272576645 Primary Care Provider NY 501 c 3 Schedule A Line 12 Catholic Health System Inc 0 KMH Homes Inc 144 Genesee Street Buffalo NY 14203 161387890 Real Estate Holding Company NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 Mount St Mary's Hospital Foundation Inc 5300 Military Road Lewiston NY 14092 161360884 Foundation NY 501 c 3 Schedule A Line 7 Mount St Mary's Hospital of Niagara Falls 0 Mount St Mary's Hospital Child Care Center 5310 Military Road Lewiston NY 14092 161523352 Child Care NY 501 c 3 Schedule A Line 10 Catholic Health System Inc 0 Board of Associates of Mount St Mary's Hospital Inc 5300 Military Road Lewiston NY 14092 161582926 Fund Raising NY 501 c 3 Schedule A Line 12a Mount St Mary's Hospital of Niagara Falls 0 The St Francis Guild of Mount St Mary's Hospital of Niagara Falls Inc 5300 Military Road Lewiston NY 14092 510217790 Fund Raising NY 501 c 3 Schedule A Line 12a Mount St Mary's Hospital of Niagara Falls 0 CATHOLIC HEALTH ORTHOPEDIC MANAGEMENT COMPANY LLC 144 Genesee Street Buffalo NY 14203 843844132 General Purpose NY Related -47080 7359 0 0 0.20000 0 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 CATHOLIC HEALTH ORTHOPEDIC MANAGEMENT COMPANY LLC P 169701 Cash