2022-08-23T16:01:25-05:00 2021-09-30 346565596 ERNST & YOUNG US LLP 2005 MARKET ST STE 700 PHILADELPHIA PA 19103 990 2020-10-01 141338586 VASSAR BROTHERS MEDICAL CENTER VASS 8454759500 45 READE PLACE POUGHKEEPSIE NY 12601 STEVEN H ROSENBERG TREASURER/CFO 8454759500 2022-08-22 1 STEVEN ROSENBERG 999009999 LAUREN E BENNETT P01787029 2154485000 2022-08-22 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z PETER A KELLY 45 READE PLACE POUGHKEEPSIE NY 12601 744802042 0 X WWW.NUVANCEHEALTH.ORG X 1882 NY BECOME THE PARTNER-IN-HEALTH FOR THE PEOPLE THROUGHOUT THE CORE REGIONS OF WESTERN CONNECTICUT AND THE HUDSON VALLEY OF NEW YORK THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. 18 15 2549 84 0 0 515041 6764746 670483513 720468117 21280778 8624832 7922725 8742539 700202057 744600234 0 0 0 0 261837516 342664869 0 0 0 418497580 392067073 680335096 734731942 19866961 9868292 1209559949 1245233477 790037326 764478421 419522623 480755056 X BECOME THE PARTNER-IN-HEALTH FOR THE PEOPLE THROUGHOUT THE CORE REGIONS OF WESTERN CONNECTICUT AND THE HUDSON VALLEY OF NEW YORK THROUGH THE EFFICIENT DELIVERY OF EXCELLENT, INNOVATIVE AND COMPASSIONATE CARE. 0 0 662904169 0 717726627 INPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 21,407; NUMBER OF PATIENT DAYS 101,006; THE HOSPITAL PROVIDED APPROXIMATELY $3,343,935 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION.OUTPATIENT SERVICES: EMERGENCY VISITS 37,023; OTHER OUTPATIENT VISITS/PROCEDURES 390,176; THE HOSPITAL PROVIDED APPROXIMATELY $3,927,087 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION. 2418764 0 2618797 AFFILIATE RENTAL INCOME:RENTAL INCOME FROM RELATED ORGANIZATIONS FOR SPACE OCCUPIED TO PROVIDE MEDICAL SERVICES. 113321 0 122693 RESEARCH REVENUE: FOR FY 2021, VASSAR BROTHERS MEDICAL CENTER PARTICIPATED IN 12 RESEARCH STUDIES. NINE OF THESE WERE IN CARDIOLOGY AND THREE WERE IN INFECTIOUS DISEASE. THE MAIN GOAL OF VASSAR BROTHERS MEDICAL CENTER RESEARCH IS TO PROVIDE A SYSTEMATIC INVESTIGATION, INCLUDING RESEARCH DEVELOPMENT, TESTING, AND EVALUATION, DESIGNED TO DEVELOP OR CONTRIBUTE TO GENERALIZABLE KNOWLEDGE. ADDITIONALLY, WE STRIVE TO PARTICIPATE IN SCIENTIFICALLY SIGNIFICANT STUDIES WHICH CAN PROVIDE NOVEL THERAPIES IN ADDITION TO STANDARD CARE. IN INFECTIOUS DISEASE, WE ACCOMPLISHED THIS BY OFFERING 2 NOVEL THERAPIES FOR COVID 19 -ONE OF WHICH RESULTED IN AT LEAST 2 PUBLISHED PAPERS IN MAJOR MEDICAL JOURNALS AND CHANGED THERAPY FOR EARLY COVID 19 TREATMENT. IN CARDIOLOGY, TWO OF OUR INPATIENT STUDIES OFFER THERAPY FOR THOSE PATIENTS WITHOUT OTHER TREATMENT OPTIONS. LONGER TERM GOALS INCLUDE OFFERING CLINICAL TRIALS IN ADDITIONAL THERAPEUTIC AREAS SUCH AS NEUROLOGY. 6108551 0 6613731 21 READ PLACE DISTRIBUTION:EXPENSES: 3,374,089 REVENUE: 3,653,127 REFUNDS AND REBATES:EXPENSES: 967,035REVENUE: 1,047,010UROC MANAGEMENT FEE:EXPENSES: 785,478REVENUE: 850,438QUALITY INCENTIVE PROGRAMS:EXPENSES: 387,566 REVENUE: 419,618MED RECORDS, MISC, PURCHASE DISCOUNT:EXPENSES: 594,383REVENUE: 643,538 6108551 0 6613731 671544805 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 2549 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 1 1 1 NY X KAREN DARCY 2037394593 100 RESERVE ROAD DANBURY CT 06810 X SIMON GORWARA MD DIRECTOR/HVCP PHYSICIAN 2.00 40.00 X 0 909010 54461 KIMBERLY HELLER MD DIRECTOR/HQMP PHYSICIAN 2.00 40.00 X 0 571257 29481 PETER A KELLY PRESIDENT 40.00 3.00 X X 0 630524 18605 BARRY ROTHFELD DIRECTOR 2.00 0.00 X 0 0 0 FRANCOISE DUNEFSKY DIRECTOR 2.00 0.00 X 0 0 0 JOHN REID DIRECTOR 2.00 0.00 X 0 0 0 TIMOTHY DEAN CHAIRMAN 3.00 0.00 X X 0 0 0 CHARLES O'MARA DIRECTOR 2.00 0.00 X 0 0 0 CHERYL BOWERS DIRECTOR 2.00 0.00 X 0 0 0 KEVIN CLEARY DIRECTOR 2.00 0.00 X 0 0 0 SHAY HUMPHREY ESQ VICE CHAIRMAN 3.00 0.00 X X 0 0 0 THOMAS ROBINSON MD DIRECTOR 2.00 0.00 X 0 0 0 DEBRA DOMBER DIRECTOR 2.00 0.00 X 0 0 0 STEVEN TINKELMAN DIRECTOR 2.00 0.00 X 0 0 0 KATHLEEN MERGET PHD DIRECTOR 2.00 0.00 X 0 0 0 RONALD TATELBAUM MD DIRECTOR 2.00 0.00 X 0 0 0 JAMES WALKER DIRECTOR 2.00 0.00 X 0 0 0 ELIZABETH BRADLEY PHD DIRECTOR 2.00 0.00 X 0 0 0 STEVEN H ROSENBERG TREASURER/CFO 3.00 40.00 X 0 1701396 642496 CAROLYN MCKENNA ASST. SEC (TO 12/31); SEC/CLO 3.00 40.00 X 0 646887 16365 KERRY EATON CHIEF OPERATING OFFICER 3.00 40.00 X 0 936200 96246 CATHERINE FRIERSON CHIEF HUMAN RESOURCE OFFICER 3.00 40.00 X 0 531701 18175 GRACE LINHARD CHIEF DEVELOPMENT OFFICER 3.00 40.00 X 0 445735 19595 WAYNE MCNULTY CHIEF COMPLIANCE OFFICER 3.00 40.00 X 0 380122 25736 JEAN AHN FROM 0201 CHIEF STRATEGY OFFICER 3.00 40.00 X 0 498991 17321 KEVIN BOLAND DIRECTOR CARDIO PERFUSION 40.00 0.00 X 342565 0 53896 ANN ARMATER SVP DEVELOPMENT 40.00 0.00 X 383758 0 41432 CINDY A CZAPLINSKI VP OPERATIONS 40.00 0.00 X 388867 0 23968 WILLIAM V BEGG VP MEDICAL AFFAIRS 37.00 3.00 X 485430 40460 38633 IMTIAZ A MALLICK MD CLINICAL PHYSICIAN 29.00 11.00 X 365626 133100 36981 ROBERT FRIEDBERG FORMER HQ PRESIDENT/CEO 0.00 0.00 X 0 1696163 11745 MICHAEL HOLZHUETER FORMER ASSISTANT SECRETARY 0.00 0.00 X 0 1060019 18913 KATHERINE BACHER FORMER ASSISTANT TREASURER 0.00 0.00 X 0 210144 12407 CHERYL BOOTH FORMER ASSISTANT SECRETARY 0.00 0.00 X 0 133541 9679 JOSEPH MULLANY FORMER PRESIDENT 0.00 0.00 X 0 777727 19175 1966246 11302977 1205310 854 1 1 0 0 6671961 92785 2995 6764746 NET PATIENT SRVC. REV. 621110 694088744 694088744 COVID-19 STIMULUS 900099 23637883 23637883 AFF. RENTAL INCOME 532000 2618797 2618797 RESEARCH REVENUE 541700 122693 122693 720468117 2358163 2358163 988686 0 988686 988686 988686 6250077 218400 0 201808 6250077 16592 6266669 6266669 21 READE PL DISTRIB. 900099 3653127 3653127 CAFETERIA SALES 722514 1140122 1140122 REFUNDS AND REBATES 900099 1047010 1047010 1913594 1913594 7753853 744600234 727081848 0 10753640 304200 281501 22699 246880423 228458413 18422010 44885000 41540789 3344211 37016427 34254292 2762135 13578819 12565579 1013240 877630 812142 65488 776329 711922 64407 31069 31069 628558 628558 1401278 1140581 260697 669225 619323 49902 38169525 32213770 5955755 11988664 11128197 860467 8854537 7160020 1694517 196949 176449 20500 411383 309066 102317 2698559 2105532 593027 47451646 37084170 10367476 6514803 5213775 1301028 MEDICAL SUPPLIES 108046760 108046760 PHYSICIAN FEES 99204791 99204791 PURCHASED SERVICES 34481637 23088906 11392731 COVID RELATED EXPENSES 9185468 9185468 20478262 16243359 4234903 734731942 671544805 63187137 0 18077490 5103511 4580734 0 64838522 75746746 10656807 10602147 2049544 2558861 1237117623 441739297 785770914 795378326 176179872 195805192 25915927 25915927 121490139 134122767 1209559949 1245233477 89563097 55750866 466856164 460695023 18619804 14798796 214998261 233233736 790037326 764478421 X 385299224 452710409 34223399 28044647 419522623 480755056 1209559949 1245233477 X 9868292 11588896 31791652 7983593 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 31069 0 0 31069 0 PART II-B, LINE 1: A PORTION OF THE NORMET MEMBERSHIP, GNYHA MEMBERSHIP AND HEALTHCARE EDUCATION PROJECT, PAID BY VASSAR BROTHERS MEDICAL CENTER, WAS USED FOR LOBBYING EXPENDITURES ON BEHALF OF THE HOSPITAL INDUSTRY. 2190951 2190951 2190951 2190951 2190951 2190951 2190951 2190951 2190951 2190951 0.00000 1.00000 0.00000 0 0 19326758 19326758 777875491 434862017 343013474 12830220 444597 12385623 407486437 47049 407439388 19598717 6385634 13213083 795378326 POOLED INVESTMENTS 195805192 F 195805192 DUE FROM RELATED PARTIES 37345817 DEFERRED COMPENSATION 512692 RIGHT OF USE ASSET 2958040 INSURANCE LIABILITY 24277512 DUE FROM THIRD PARTY PAYORS 1772402 INTEREST IN FOUNDATION 58410026 MISC RECEIVABLES 1277524 DSRF 2005 BOND 2041 DSRF 2010 BOND 388 DSRF 2012 BOND 614334 DSRF 2014 BOND 543114 DSRF 2016B BOND 4317367 DSRF 2019B BOND 2091510 134122767 DUE TO RELATED PARTIES 97617755 POST RETIREMENT BENEFITS 103252765 DEFERRED COMPENSATION 515464 CAPITAL LEASE LIABILITY 2408105 FIN47 LIABILITY 5099089 SECURITY DEPOSIT LIABILITY 63046 INSURANCE LIABILITY 24277512 233233736 X PART V, LINE 4: THE ORIGINAL CONTRIBUTION IS BEING HELD FOR THE BENEFIT OF THE HOSPITAL. PART X, LINE 2: AS OF SEPTEMBER 30, 2021, THERE ARE NO UNRECOGNIZED TAX BENEFITS RESULTING FROM UNCERTAIN TAX POSITIONS. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 8416332 485986 7930346 0.01080 97411906 54017788 43394118 0.05930 105828238 54503774 51324464 0.07010 12610 12610 0.00000 30333248 6421052 23912196 0.03270 5074638 3703447 1371191 0.00190 35420496 10124499 25295997 0.03460 141248734 64628273 76620461 0.10470 1 2823396 269172046 351311235 -82139189 X 1 1 1 1 VASSAR BROTHERS MEDICAL CENTER 45 READE PLACE POUGHKEEPSIE NY 12601 WWW.NUVANCEHEALTH.ORG 1302001H X X X X VASSAR BROTHERS MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, SECTION C X X 1 19 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X X X X 1 1 X 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 X 1 X 0 X X X X 1 X 0 0 VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 5: HEALTHECONNECTIONS, THE LHDS AND HOSPITALS PARTNERED IN A COLLABORATIVE TO CREATE A REGIONAL SURVEY TO CONTRIBUTE TO THE COMMUNITY HEALTH ASSESSMENT AND INFORM FUTURE HEALTH IMPROVEMENT EFFORTS IN THE REGION. THE COLLABORATIVE DESIGNED THE SURVEY QUESTIONS TO COLLECT INFORMATION AROUND SEVERAL INITIATIVES AND PRIORITIES PUT FORWARD BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THESE INCLUDED THE PREVENTION AGENDA, THE EIGHT DOMAINS OF LIVABILITY, AND INCORPORATING HEALTHY AGING INTO HEALTH ACROSS ALL POLICIES. TO FURTHER SUPPLEMENT THE DATA COLLECTED FROM THE COMMUNITY, COLLABORATIVE MEMBERS HELD 12 FOCUS GROUPS WITH SERVICE PROVIDERS TO FURTHER UNDERSTAND THE NEEDS OF SPECIFIC COMMUNITIES AND POPULATIONS, AND THE BARRIERS THEY FACE TO ACHIEVING OPTIMAL HEALTH. IN NOVEMBER OF 2017, HEALTHECONNECTIONS HOSTED A MEETING WITH THE HOSPITALS, HEALTH SYSTEMS, PERFORMING PROVIDER SYSTEMS, AND LOCAL HEALTH DEPARTMENTS (LHD) TO DISCUSS THE BENEFITS OF COLLABORATING ON A REGIONAL CHA. THE LHDS THEN CONTRACTED WITH SIENA COLLEGE RESEARCH INSTITUTE (SCRI) IN DECEMBER OF 2017 TO CONDUCT A RANDOM SAMPLE COMMUNITY HEALTH SURVEY OF THE MID HUDSON REGION IN 2018 TO ASSESS THE HEALTH STATUS AND CONCERNS OF ITS RESIDENTS. LHDS AND HOSPITALS CONTINUED TO COLLABORATE AND MEET REGULARLY THROUGHOUT 2018 AND 2019. THEY WORKED COLLABORATIVELY TO COMPLETE THE REGIONAL CHA, WHICH WAS USED IN PREPARATION FOR THEIR COMMUNITY SERVICE PLANS (CSPS). ADDITIONALLY, THESE MEETINGS PROVIDE A FORUM TO DISCUSS REGIONAL INTERVENTIONS TO TARGET PRIORITY AREAS AND IMPROVE POPULATION HEALTH. ALTHOUGH THE MID-HUDSON REGION COMMUNITY HEALTH SURVEY COLLECTED RESPONSES FROM A RANDOMIZED SAMPLE OF OVER 5,000 HUDSON VALLEY RESIDENTS, THERE ARE SOME POPULATIONS THAT MAY NOT BE FULLY ACCOUNTED FOR IN THIS SURVEY. SOME OF THESE UNDERREPRESENTED POPULATIONS INCLUDE THOSE WHO ARE LOW-INCOME, VETERANS, SENIORS, PEOPLE EXPERIENCING HOMELESSNESS, LGBTQ MEMBERS, AND PEOPLE WITH A MENTAL HEALTH DIAGNOSIS. IN ORDER TO ENSURE THAT THE NEEDS OF THESE POPULATIONS WERE MET, FOCUS GROUPS WERE CONDUCTED WITH PROVIDERS THAT SERVE THESE POPULATIONS IN EACH OF THE SEVEN COUNTIES. THE TERM "PROVIDERS" REFERS TO THOSE WHO OFFER SERVICES, SUCH AS MENTAL HEALTH SUPPORT, VOCATIONAL PROGRAMS, AND PROGRAMS FOR UNDERSERVED POPULATIONS. THE REASON FOR DOING FOCUS GROUPS WITH PROVIDERS, RATHER THAN DIRECTLY SURVEYING THE TARGET POPULATIONS THROUGH CONVENIENCE SAMPLING, WAS THAT A CONVENIENCE SAMPLE RISKS ONLY ACCOUNTING FOR THOSE WHO ARE ALREADY ACCESSING SERVICES AND CARE. THE HOPE IN SURVEYING PROVIDERS WAS THAT THEY WOULD HAVE AN IDEA OF WHAT OBSTACLES AND BARRIERS THESE POPULATIONS FACE WHEN ACCESSING SERVICES. BEFORE THE FOCUS GROUPS TOOK PLACE, A SURVEY WAS SENT OUT TO PROVIDERS WITHIN EACH COUNTY IN ORDER TO SUPPLY ADDITIONAL INSIGHT AROUND LOCAL FACTORS INFLUENCING COMMUNITY HEALTH. THIS SURVEY COVERED SEVERAL TOPICS, INCLUDING THE POPULATIONS THE PROVIDERS SERVE; THE ISSUES THAT AFFECT HEALTH IN THE COMMUNITIES THEY SERVE; BARRIERS TO PEOPLE ACHIEVING BETTER HEALTH; AND INTERVENTIONS THAT ARE USED TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. IN THE MID-HUDSON REGION, 12 FOCUS GROUPS WERE CONDUCTED WITH VARIOUS SERVICE PROVIDERS. THE PARTICIPATING PROVIDERS SERVE A VARIETY OF CLIENTS, INCLUDING CHILDREN, ADULTS WITH DISABILITIES, LOW-INCOME INDIVIDUALS, AND PEOPLE WITH SUBSTANCE USE DISORDERS. WHEN LOOKING AT DATA FROM THE MID-HUDSON REGION AS A WHOLE, THE TOP THREE ISSUES THAT PROVIDERS FELT AFFECTED HEALTH IN THEIR COMMUNITIES WERE ACCESS TO AFFORDABLE, DECENT, AND SAFE HOUSING; ACCESS TO MENTAL HEALTH PROVIDERS; AND ACCESS TO AFFORDABLE, RELIABLE TRANSPORTATION. THE TOP THREE BARRIERS PROVIDERS FELT PREVENTED PEOPLE FROM ACHIEVING BETTER HEALTH IN THEIR COMMUNITIES WERE KNOWLEDGE OF EXISTING RESOURCES, HEALTH LITERACY, AND DRUG AND/OR ALCOHOL USE. MENTAL HEALTH AND SUBSTANCE USE ISSUES, CHRONIC DISEASES, AND HEALTH DISPARITIES WERE THOUGHT TO HIGHLY IMPACT THESE SPECIFIC POPULATIONS IN THE MID-HUDSON REGION. THESE DATA POINTS REFLECT THE MAJORITY OF RESPONSES FROM EACH INDIVIDUAL FOCUS GROUP CONDUCTED IN EACH COUNTY. IN DUTCHESS COUNTY, 48 RESPONSES WERE COLLECTED FROM PROVIDERS THAT SERVE VARIOUS POPULATIONS [THIS INFORMATION CAN BE VIEWED ONLINE IN OUR 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT, APPENDIX C]. THE DUTCHESS COUNTY DEPARTMENT OF BEHAVIORAL & COMMUNITY HEALTH (DBCH), ALONG WITH HEALTHECONNECTIONS, CONDUCTED TWO FOCUS GROUPS. ONE TOOK PLACE THROUGH THE DUTCHESS B.A.T. (BRINGING AGENCIES TOGETHER) COALITION, AND THE OTHER TOOK PLACE THROUGH THE EASTERN DUTCHESS RURAL HEALTH NETWORK. SEVERAL AGENCIES WERE REPRESENTED IN BOTH MEETINGS, AND THE DISCUSSION WAS CENTERED AROUND THE SURVEY QUESTIONS THAT WERE DISTRIBUTED PRIOR TO THE FOCUS GROUP. IN PUTNAM COUNTY, TWO FOCUS GROUPS WERE HELD WHERE 13 RESPONSES WERECOLLECTED FROM PROVIDERS THAT SERVE VARIOUS POPULATIONS. THE FIRST FOCUSGROUP WAS HELD WITH NINE AGENCIES OF THE COMMUNITY RESOURCE GROUP. THISGROUP FOCUSES ON IDENTIFYING GAPS IN ACCESS TO CARE AND RESOURCES ISSUESFOR THE BREWSTER COMMUNITY, AS A WHOLE, WITH MORE ATTENTION ON THEIMMIGRANT POPULATION. THE SECOND FOCUS GROUP WAS HELD WITH 15 AGENCIES OFTHE MENTAL HEALTH PROVIDER GROUP. THIS GROUP IS A FORUM FOR BEHAVIORALHEALTH PARTNERS TO IDENTIFY GAPS IN SERVICES, DISCUSS ISSUES, AND IDENTIFY SOLUTIONS. SEVERAL AGENCIES WERE REPRESENTED IN THIS MEETING, AND THEDISCUSSION WAS CENTERED AROUND THE SURVEY QUESTIONS THAT WERE DISTRIBUTEDPRIOR TO THE FOCUS GROUP.THE CHNA, INCLUDING PRIORITY AREAS TO INFORM THE COMMUNITY SERVICE PLAN, WAS APPROVED BY THE VASSAR BROTHERS MEDICAL CENTER BOARD OF TRUSTEES ON DECEMBER 5, 2019. THE COMMUNITY SERVICE PLAN WAS ALSO APPROVED ON DECEMBER 5, 2019. A COPY OF THE SURVEY ADMINISTERED AND DETAILED FOCUS GROUP RESPONSES CAN BE FOUND IN THE 2019 CHNA FOUND HERE: HTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 6A: SEVEN LOCAL HEALTH DEPARTMENTS OF THE MID-HUDSON REGION, INCLUDING DUTCHESS, ORANGE, PUTNAM, ROCKLAND, SULLIVAN, ULSTER AND WESTCHESTER COUNTIES, AND HEALTHECONNECTIONS CREATED THE LOCAL HEALTH DEPARTMENT PREVENTION AGENDA COLLABORATIVE WITH THE GOAL OF CREATING THE FIRST REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT. SHORTLY AFTER, THE COLLABORATIVE GAINED THE SUPPORT OF 17 LOCAL HOSPITALS. THE HOSPITAL SYSTEMS OR FACILITIES INCLUDED: BON SECOURS CHARITY HEALTH SYSTEM, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; CATSKILL REGIONAL MEDICAL CENTER, A MEMBER OF THE GREATER HUDSON VALLEY HEALTH SYSTEM; HEALTHALLIANCE HOSPITAL, A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK; MONTEFIORE HUDSON VALLEY COLLABORATIVE; MONTEFIORE NYACK HOSPITAL; MONTEFIORE ST. LUKE'S CORNWALL; ORANGE REGIONAL MEDICAL CENTER, A MEMBER OF THE GREATER HUDSON VALLEY HEALTH SYSTEM; ST. JOSEPH'S MEDICAL CENTER; AND THE HOSPITALS OF NUVANCE HEALTH. VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 6B: SEVEN LOCAL HEALTH DEPARTMENTS OF THE MID-HUDSON REGION AND HEALTHECONNECTIONS CREATED THE LOCAL HEALTH DEPARTMENT PREVENTION AGENDA COLLABORATIVE WITH THE GOAL OF CREATING THE FIRST REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTH DEPARTMENTS INCLUDED: DUTCHESS COUNTY DEPARTMENT OF BEHAVIORAL & COMMUNITY HEALTH; ORANGE COUNTY DEPARTMENT OF HEALTH; PUTNAM COUNTY DEPARTMENT OF HEALTH; ROCKLAND COUNTY DEPARTMENT OF HEALTH; SULLIVAN COUNTY PUBLIC HEALTH SERVICES; ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH; AND WESTCHESTER COUNTY DEPARTMENT OF HEALTH. VASSAR BROTHERS MEDICAL CENTER:PART V, SECTION B, LINE 7AHTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 7D: THE CHNA WAS ALSO PRINTED AND DISTRIBUTED THROUGHOUT THE HOSPITAL, INCLUDING THE MAIN LOBBY, PATIENT WAITING AREAS AND HOSPITAL ADMINISTRATION OFFICES. IT IS ALSO AVAILABLE BY REQUEST IN THE HEALTH QUEST ADMINISTRATIVE OFFICES. VASSAR BROTHERS MEDICAL CENTER:PART V, SECTION B, LINE 10AHTTPS://WWW.NUVANCEHEALTH.ORG/ABOUT-US/COMMUNITY-AND-WELLNESS/COMMUNITY-BENEFIT VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 11: NUVANCE HEALTH USED THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT AS A REFERENCE FOR KEY HEALTH INFORMATION TO IDENTIFY AND PRIORITIZE THE HEALTH NEEDS OF ITS NEW YORK COMMUNITIES AND DEVELOP ITS 2019-2021 COMMUNITY SERVICE PLAN. VASSAR BROTHERS MEDICAL CENTER (VBMC), NORTHERN DUTCHESS HOSPITAL (NDH) AND PUTNAM HOSPITAL (PH) IDENTIFIED PREVENTION OF CHRONIC DISEASES AND PROMOTION OF WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AS THEIR PRIORITIES FOR 2019-2021. VASSAR BROTHERS MEDICAL CENTER'S IMPLEMENTATION PLAN INCLUDED: PILOTING A CHRONIC DISEASE FOOD CLINIC/FOOD PANTRY IN PARTNERSHIP WITH LOCAL FOOD BANKS, BUSINESS, LOCAL FARMERS AND COMMUNITY ORGANIZATIONS TO ADDRESS NUTRITION-RELATED ILLNESSES BY LINKING DOCTORS, NUTRITIONISTS AND PATIENTS TO SUPPLEMENTAL FOOD TO PROMOTOE HEALTH, PREVENT FUTURE ILLNESS AND FACILITATE RECOVER. THIS PROGRAM WAS PUT ON-HOLD IN FYE2021 DUE TO COVID-19. OFFERING MEDICATION ASSISTED TREATMENT (MAT) TRAINING TO PHYSICIANS. THIS TRAINING ALLOWS PROVIDERS TO APPLY TO THE DEA FOR WAIVERS TO PRESCRIBE BUPRENORPHINE, A MEDICATION APPROVED BY THE FDA FOR TREATMENT OF OPIOID DISORDER. ONLY ONE VIRTUAL SESSION WAS OFFERED IN 2020, WITH LOW ATTENDANCE DUE TO PHYSICIANS HAVING COMPETING PANDEMIC PRIORITIES. NARCAN TRAINING FOR THE COMMUNITY. THIS TRAINING EXPLAINS HOW NALOXONE WORKS TO REVERSE AN OVERDOSE, WHAT TO DO WHEN AN OVERDOSE IS SUSPECTED AND HOW AND WHEN TO ADMINISTER THE MEDICATION. THIS TRAINING WAS PUT ON HOLD AT THE HOSPITALS IN FYE2021 DUE TO COVID-19. DEVELOPMENT OF AN OPIOD STEWARDSHIP PROGRAM TO ENCOURAGE REDUCTION IN OPIOID USE AS THE FIRST LINE OF TREATMENT, TRAINING OF PROVIDERS AND ESTABLISHMENT OF A REFERRAL BASE. THROUGH DISCUSSIONS WITH COMMUNITY PARTNERS, ADDITIONAL PREVENTION AGENDA PRIORITIES WERE IDENTIFIED AS PRIORITIES FOR EACH COUNTY. WHILE SOME OF THESE NEEDS ARE BEING MET BY OTHER NUVANCE HEALTH PROGRAMS, OTHERS ARE BEING ADDRESSED BY THE MANY VALUABLE COMMUNITY ORGANIZATIONS AND HEALTH CARE PARTNERS IN THE COMMUNITY. DUTCHESS COUNTY FOCUS AREA NEEDS NOT BEING ADDRESSED: PHYSICAL ACTIVITY - INCREASE ACCESS TO SAFE PLACES FOR ACTIVITY. THIS WAS A SYSTEM-WIDE PRIORITY IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. A ROBUST PROGRAM WAS BUILT AROUND ITS GETFIT FITNESS CHALLENGE THAT CONTINUES TODAY. TOBACCO PREVENTION - PREVENT INITIATION OF TOBACCO USE, INCLUDING COMBUSTIBLE TOBACCO AND ELECTRONIC VAPING PRODUCTS (ELECTRONIC CIGARETTES AND SIMILAR DEVICES) BY YOUTH AND YOUNG ADULTS. VASSAR BROTHERS MEDICAL CENTER CURRENTLY ADDRESSES THIS WITH SMOKING CESSATION CLASSES, SCREENING QUESTIONS IN THE PATIENT ELECTRONIC MEDICAL RECORD, REFERRALS TO THE NYS QUITLINE, A LOW-COST LUNG SCREENING PROGRAM AND EDUCATIONAL PROGRAMS. ADDITIONALLY, DURING THE COVID-19 PANDEMIC, VASSAR BROTHERS MEDICAL CENTER PIVOTED ITS COMMUNITY PROGRAMS TO FOCUS ON COVID-19 EDUCATION. THEY PARTNERED WITH THE LOCAL HEALTH DEPARTMENT, LOCAL SCHOOLS AND COMMUNITY AGENCIES TO OFFER ZOOM TOWN HALLS AND COMMUNITY Q&A SESSIONS ON COVID-19, SAFE RETURN TO SCHOOL AND VACCINATIONS. VASSAR'S FOCUS IN FYE2021 WAS AROUND VACCINES AND VACCINE HESITANCY, ESPECIALLY FOR OUR MINORITY COMMUNITIES. THE HOSPITAL COMMUNITY HEALTH NEEDS COMMITTEES MEET ON A REGULAR BASIS TO VIEW PROGRESS TOWARD THE GOALS STATED THE COMMUNITY SERVICE PLAN AND DETERMINE IF ANY CHANGES TO OBJECTIVES ARE REQUIRED. ADDITIONALLY, NUVANCE HEALTH COMPILES DATA ON EACH IMPLEMENTATION AREA AND REPORTS IT TO THE NEW YORK STATE DEPARTMENT OF HEALTH ON AN ANNUAL BASIS. VASSAR BROTHERS MEDICAL CENTER PART V, SECTION B, LINE 13H: THE FAP INDICATES A 75% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN 301% AND 350% OF THE FPG AND A 57.46% DISCOUNT FOR PATIENTS WITH INCOME BETWEEN 351% AND 400% OF THE FPG. VASSAR BROTHERS MEDICAL CENTER PART V, LINE 16A, FAP WEBSITE:FINANCIAL ASSISTANCE POLICY ("FAP"), IS MADE AVAILABLE ON THE FOLLOWING LINK:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE VASSAR BROTHERS MEDICAL CENTER PART V, LINE 16B, FAP APPLICATION WEBSITE:FINANCIAL ASSISTANCE POLICY ("FAP") APPLICATION IS MADE AVAILABLE ON THE FOLLOWING LINK:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE VASSAR BROTHERS MEDICAL CENTER PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:FINANCIAL ASSISTANCE POLICY ("FAP") PLAIN LANGUAGE SUMMARY IS MADE AVAILABLE ON THE FOLLOWING LINK:HTTPS://WWW.NUVANCEHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/PATIENT-FINANCIAL-ASSISTANCE 8 1 - FISHKILL AMBULATORY SURGERY CENTER 200 WESTAGE BUSINESS CENTER FISHKILL NY 12524 OUTPATIENT SAME DAY SURGICAL AND PAIN MANAGEMENT SERVICES 2 - VBMC PHYSICAL THERAPY 200 BUSINESS CENTER DRIVE STE 311 FISHKILL NY 12524 OUTPATIENT PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY 3 - VBMC CARDIAC TESTING & REHABILITATION CENT 115 DELAFIELD STREET POUGHKEEPSIE NY 12601 OUTPATIENT CARDIAC TESTING AND REHAB SERVICES 4 - ULSTER RADIATION ONCOLOGY CENTER 111 MARYS AVENUE KINGSTON NY 12401 OUTPATIENT ONCOLOGY AND INFUSION SERVICES 5 - VBMC CARDIAC TESTING CTR - COLUMBIA ST 1 COLUMBIA STREET POUGHKEEPSIE NY 12601 OUTPATIENT CARDIAC TESTING AND REHAB SERVICES 6 - CARDIAC TESTING - NEW WINDSOR 939 LITTLE BRITAIN ROAD NEW WINDSOR NY 12553 OUTPATIENT CARDIAC TESTING AND REHAB SERVICES 7 - VASSAR BROTHERS HOSP WOUND CARE CTR 21 FOX STREET POUGHKEEPSIE NY 12691 OUTPATIENT WOUND CARE AND HYPERBARIC SERVICES 8 - CARDIAC TESTING - FISHKILL 60 MERRITT BOULEVARD FISHKILL NY 12524 OUTPATIENT CARDIAC TESTING AND REHAB SERVICES PART I, LINE 7: THE COST TO CHARGE RATIO PERCENTAGE, BASED ON THE MEDICARE COST REPORT, WAS USED AS THE COSTING METHODOLOGY IN DETERMINING THE AMOUNTS REPORTED. PART I, LINE 7G: THE AMOUNTS REPORTED AS SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE PHYSICIAN CLINIC COSTS. PART III, LINE 2: VBMC FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN ITS RECOGNITION OF BAD DEBT EXPENSE. PATIENT ACCOUNT BALANCES WERE ONLY CONSIDERED FOR BAD DEBT AFTER APPLYING ALL CONTRACTUAL DISCOUNTS AND PAYMENTS, AND SCREENING FOR CHARITY ELIGIBILITY. PART III, LINE 3: VBMC DOES RECOGNIZE THAT THERE WAS SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WERE ELIGIBLE UNDER THE ORGANIZATION'S CHARITY POLICY. WE DID NOT HAVE A REASONABLE BASIS FOR ESTIMATING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PATIENTS WHO WERE ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY WERE ACCOUNTED FOR UNDER CHARITY CARE RATHER THAN BAD DEBT. PART III, LINE 4: FOOTNOTE ON AUDITED FINANCIALS THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 21-26 OF NUVANCE HEALTH AND SUBSIDIARIES CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE IN EXCESS OF THE COMPANY'S COSTS FOR THE PATIENTS IN THE COMMUNITY. THE COSTING METHODOLOGY USED TO CALCULATE THE SHORTFALL WAS THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT. PART III, LINE 9B: IT IS THE POLICY OF VASSAR BROTHERS MEDICAL CENTER TO PROVIDE "FINANCIAL ASSISTANCE" (EITHER FREE CARE OR REDUCED PATIENT OBLIGATIONS) TO PERSONS OR FAMILIES WHERE: (I) THERE IS LIMITED OR NO HEALTH INSURANCE AVAILABLE; (II) THE PATIENT FAILS TO QUALIFY FOR GOVERNMENTAL ASSISTANCE (FOR EXAMPLE MEDICARE OR MEDICAID); (III) THE PATIENT COOPERATES WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION; (IV) THE PATIENT DEMONSTRATES FINANCIAL NEED; AND (V) VASSAR BROTHERS MEDICAL CENTER MAKES AN ADMINISTRATIVE DETERMINATION THAT FINANCIAL ASSISTANCE IS APPROPRIATE. AFTER THE HOSPITAL DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL DETERMINE THE AMOUNT OF FINANCIAL ASSISTANCE AVAILABLE TO THE PATIENT BY UTILIZING THE CHARITABLE ASSISTANCE GUIDELINES, WHICH ARE BASED UPON THE MOST RECENT FEDERAL POVERTY GUIDELINES. VASSAR BROTHERS MEDICAL CENTER SHALL REGULARLY REVIEW THIS FINANCIAL ASSISTANCE POLICY TO ENSURE THAT AT ALL TIMES IT: (I) REFLECTS THE PHILOSOPHY AND MISSION OF THE HOSPITAL; (II) EXPLAINS THE DECISION PROCESSES OF WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE AND IN WHAT AMOUNTS; AND (III) COMPLIES WITH ALL APPLICABLE STATE AND FEDERAL LAWS, RULES, AND REGULATIONS CONCERNING THE PROVISION OF FINANCIAL ASSISTANCE TO INDIGENT PATIENTS. CONSISTENT WITH THIS MISSION, VASSAR BROTHERS MEDICAL CENTER RECOGNIZES ITS OBLIGATION TO THE COMMUNITY IT SERVES TO PROVIDE FINANCIAL ASSISTANCE TO INDIGENT PERSONS WITHIN THE COMMUNITY. IN FURTHERANCE OF ITS CHARITABLE MISSION, VASSAR BROTHERS MEDICAL CENTER WILL PROVIDE BOTH (I) EMERGENCY TREATMENT TO ANY PERSON REQUIRING SUCH CARE; AND (II) ESSENTIAL, NON-EMERGENT CARE TO PATIENTS WHO ARE PERMANENT RESIDENTS OF ITS PRIMARY SERVICE AREA WHO MEET THE CONDITIONS AND CRITERIA SET FORTH IN THIS POLICY, WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SUCH CARE. ELECTIVE PROCEDURES GENERALLY WILL NOT BE CONSIDERED ESSENTIAL, NON-EMERGENT CARE AND USUALLY WILL NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. VASSAR BROTHERS MEDICAL CENTER WILL COLLECT FROM INDIVIDUALS ON FINANCIAL ASSISTANCE IF THEY RECEIVED A PARTIAL CHARITABLE DISCOUNT. ALL PATIENTS CAN APPLY FOR CHARITABLE CARE ON BALANCES THEY FEEL THAT THEY CANNOT AFFORD. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE CHNAS CONDUCTED EVERY THREE YEARS, THE HOSPITAL HAS A COMMUNITY HEALTH NEEDS COMMITTEE THAT MEETS REGULARLY TO ASSESS ANY ADDITIONAL HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMITTEE PROVIDES OVERSIGHT TO THE HOSPITAL'S COMMUNITY HEALTH PRIORITIES, INCLUDING NEEDS ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS AND OTHER POPULATION HEALTH INITIATIVES. THEY HELP GUIDE PRIORITY ISSUES FOR ACTION TO IMPROVE COMMUNITY HEALTH AND HELP INFORM, GUIDE AND SHARE SUCCESSFUL PROGRAMS AND STRATEGIES THAT ADDRESS HEALTH AND WELLNESS THROUGHOUT THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE HOSPITAL HAS MESSAGES ON ALL STATEMENTS PROVIDING INFORMATION REGARDING HOW THE PATIENT CAN GET ASSISTANCE WITH THEIR HOSPITAL BILL. ALSO, SIGNS ARE POSTED THROUGHOUT THE HOSPITAL AND COUNSELORS ARE AVAILABLE TO PROVIDE FURTHER ASSISTANCE. ALL UNINSURED INPATIENTS ARE INTERVIEWED BY FINANCIAL COUNSELORS AND ASSESSED FOR ELIGIBILITY FOR ASSISTANCE PROGRAMS. THE HOSPITAL PROVIDES INFORMATIONAL HANDOUTS TO ALL UNINSURED PATIENTS AT THE TIME OF REGISTRATION WHICH REFERS THEM TO FINANCIAL COUNSELING IF THEY WOULD LIKE ASSISTANCE WITH THEIR BILLS. FURTHER, THE HOSPITAL MAILS NOTICES TO ALL SELF-PAY ACCOUNTS REFERRING THEM TO FINANCIAL COUNSELING IF THEY NEED ASSISTANCE. THE COLLECTION DEPARTMENT WILL ALSO REFER PATIENTS TO FINANCIAL COUNSELING WHEN A PATIENT INDICATES THAT THEY CANNOT AFFORD THEIR BALANCES; AND FINALLY, SCHEDULERS REFER UNINSURED PATIENTS TO FINANCIAL COUNSELING PRIOR TO THEIR TEST OR PROCEDURE. THE POLICY AND APPLICATIONS FOR ASSISTANCE ARE ALSO AVAILABLE ONLINE, AS WELL AS UPON REQUEST AT THE HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION:VASSAR BROTHERS MEDICAL CENTER (VBMC) IS A 350-BED FACILITY THAT HAS SERVED NEW YORK'S MID-HUDSON VALLEY SINCE 1887. LOCATED IN POUGHKEEPSIE, IT IS ONE OF THREE HOSPITALS LOCATED IN DUTCHESS COUNTY. THE VBMC SERVICE AREA POPULATION OF 327,093 IS EXPECTED TO SEE NO GROWTH THROUGH 2026 WITH A GRADUAL DECLINE IN THE NUMBERS OF YOUNG FAMILIES AND CHILDREN. THE MOST SIGNIFICANT GROWTH (13%) IS EXPECTED IN THE NUMBER OF RESIDENTS AGED 65 AND OLDER.THE AVERAGE HOUSEHOLD INCOME IN THE VBMC SERVICE AREA IS $113,379. A HIGH SCHOOL DIPLOMA OR GED IS THE HIGHEST LEVEL OF EDUCATION COMPLETED BY 27% OF THE SERVICE AREA AGE 25 AND OLDER. (SOURCE: THE CLARITAS COMPANY, 2021). ACCORDING TO THE U.S. BUREAU OF LABOR STATISTICS, THE DUTCHESS COUNTY/ PUTNAM COUNTY REGION HAD AN UNEMPLOYMENT RATE OF 6.1% IN JANUARY OF 2021. APPROXIMATELY 8.3% OF THE POPULATION IN DUCHESS COUNTY ARE LIVING IN POVERTY (CENSUS.GOV 2020). APPROXIMATELY 6% OF VBMC'S MARKET ARE UNINSURED, WHILE MEDICAID (29%), MEDICARE (24%) AND PRIVATE DIRECT OR EXCHANGE MAKE UP THE REST OF THE MARKET (41%). (SOURCE: THE CLARITAS COMPANY, 2021). ACCORDING TO THE HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA.GOV), BOTH THE EASTERN PART OF DUTCHESS COUNTY AND POUGHKEEPSIE HAVE BEEN IDENTIFIED AS MEDICALLY UNDERSERVED POPULATIONS (MUP) FOR PRIMARY CARE FOR LOW INCOME POPULATIONS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:VBMC IS A 350-BED COMMUNITY HOSPITAL. VBMC HAS ESTABLISHED CENTERS OF EXCELLENCE IN CARDIAC SERVICES, CANCER CARE AND WOMEN AND CHILDREN'S HEALTH SERVICES. AS A REGIONAL MEDICAL CENTER, VBMC HOUSES THE AREA'S FIRST AND ONLY CARDIOTHORACIC SURGERY PROGRAM BETWEEN WESTCHESTER AND ALBANY, NEW YORK AND THE ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT (NICU) IN THE REGION FOR PREMATURE, UNDERWEIGHT AND CRITICALLY ILL INFANTS. INNOVATIVE PROCEDURES AND SERVICES HAVE BEEN BROUGHT TO THE VBMC CAMPUS, INCLUDING ROBOTIC ORTHOPEDIC SURGERY, LIVER SURGERY, INTERVENTIONAL NEURORADIOLOGY, THORACIC SURGICAL ONCOLOGY AND TRANS-CATHETER AORTIC VALVE REPLACEMENT (TAVR), NEGATING THE NEED TO TRAVEL FOR THIS CARE. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS WHO LIVE AND WORK IN THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF THE FACILITY. IT ALSO OWNS A MEDICAL OFFICE BUILDING ON ITS PREMISES, AS WELL AS AN ADDITIONAL MEDICAL OFFICE BUILDING OFF CAMPUS WITH SPACE FOR DOCTORS. ANY MEMBER OF ITS ACTIVE MEDICAL STAFF HAS THE PRIVILEGE OF LEASING AVAILABLE OFFICE SPACE. RENT IS DERIVED FROM A FAIR MARKET VALUE ANALYSIS PROVIDED BY AN INDEPENDENT PARTY. THE HOSPITAL OPERATES A 24-HOUR EMERGENCY ROOM WHERE NO ONE REQUIRING MEDICAL ATTENTION IS DENIED CARE. THE HOSPITAL OPENED A 696,000 SQUARE FOOT PATIENT PAVILION, IN JANUARY 2021, WITH 264 PRIVATE MEDICAL/SURGICAL PATIENT ROOMS AND 30 CRITICAL CARE ROOMS THAT SOLIDIFIES ITS PLACE AS THE DESTINATION OF CHOICE FOR PATIENTS IN THE REGION. VBMC IS A LEVEL II TRAUMA CENTER, FURTHER ADVANCING THE VISION TO PROVIDE THE COMMUNITY WITH LOCAL ACCESS TO STATE-OF-THE-ART MEDICAL CARE. THE DYSON CENTER FOR CANCER CARE, LOCATED ON THE VASSAR CAMPUS, IS DESIGNED TO ACCOMMODATE PATIENTS AND THEIR FAMILIES WHILE PROVIDING RADIATION THERAPY, STEREOTACTIC RADIOSURGERY AND A WIDE VARIETY OF SUPPORT GROUPS. ANY INCOME OVER EXPENSES IS REINVESTED INTO THE HOSPITAL, ITS STAFF AND THE COMMUNITY. VBMC REALIZES THIS IS NECESSARY TO ACHIEVE AND MAINTAIN HIGH QUALITY STANDARDS, KEEP UP WITH THE RAPID ADVANCEMENT IN TECHNOLOGY, PROVIDE START-UP CAPITAL FOR NEW PROGRAMS, AND EXPAND EXISTING FACILITIES AND PROGRAMS IN ORDER TO PROVIDE QUALITY CARE TO THE COMMUNITY. PART VI, LINE 6: NUVANCE HEALTH IS AN INTEGRATED HEALTH SYSTEM OFERING CONVENIENT, ACCESSIBLE AND AFFORDABLE CARE TO OUR COMMUNITY MEMBERS. OUR TALENTED TEAM OF MORE THAN 15,000 COMPASSIONATE CAREGIVERS PROVIDE HIGH-QUALITY CARE THROUGH: COMMUNITY HOSPITALS, PRIMARY CARE AND SPECIALTY PRACTICE LOCATIONS, OUTPATIENT SETTINGS, HOME CARE SERVICES, A SKILLED NURSING HOME AND REHABILITATION FACILITY AND TELEHEALTH VISITS. FOR FYE2021, THE NETWORK PROVIDED APPROXIMATELY $29,353,000 IN TOTAL CHARITY CARE. DANBURY HOSPITAL, ITS NEW MILFORD HOSPITAL CAMPUS AND NORWALK HOSPITAL PROVIDE MEDICAL SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. SERVICES INCLUDE ROUTINE INPATIENT ANCILLARY AND OUTPATIENT CARE IN SUPPORT OF THE NETWORK'S MISSION STATEMENT, AS NOTED ABOVE, FOR FYE2021, CHARITY CARE WAS PROVIDED IN THE FOLLOWING AMOUNTS: NORWALK HOSPITAL, $9,323,000, DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS, $7,099,000. ALL HOSPITALS NOTED ABOVE HAVE OPEN MEDICAL STAFFS. IF AN INDIVIDUAL MEETS THE EDUCATIONAL, EXPERIENTIAL AND LICENSOR REQUIREMENTS THEY CAN JOIN THE MEDICAL STAFF. NUVANCE HEALTH MEDICAL PRACTICE CT, INC. (NHMPCT): THE MISSION OF NHMPCT IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND SPECIALTY HEALTH CARE IN THE COMMUNITIES THEY SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO THEIR PATIENTS' NEEDS. THEY SUPPORT A COMMITMENT TO ADVANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THEIR COMMUNITY BY DELIVERING QUALITY CARE, PARTICIPATING IN MEDICAL RESEARCH AND MEDICAL RESIDENCY PROGRAMS AND THE PROVISION OF MEDICAL SERVICES TO PATIENTS. FOR FYE2021 THEY PROVIDED APPROXIMATELY $2,290,000 IN CHARITY CARE. DANBURY HOSPITAL & NEW MILFORD HOSPITAL FOUNDATION INC. (DH/NMHF): DH/NMHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO DANBURY HOSPITAL AND ITS NEW MILFORD HOSPITAL CAMPUS AND OTHER DANBURY NOT-FOR-PROFIT HEALTH CARE AFFILIATES. NORWALK HOSPITAL FOUNDATION (NHF): NHF'S MISSION IS TO RAISE FUNDS, REINVEST AND ADMINISTER THESE FUNDS AND MAKE DISTRIBUTIONS TO NORWALK HOSPITAL AND OTHER NOT-FOR-PROFIT NORWALK HOSPITAL AFFILIATES. WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC. (WCHNA): WCHNA'S PRINCIPAL PURPOSE IS TO PROVIDE OUTPATIENT HEALTH CARE SERVICES IN VARIOUS LOCATIONS AND ALSO PROVIDE AMBULANCE SERVICES TO DANBURY AND SURROUNDING TOWNS, WHILE SERVING THOSE THAT CANNOT AFFORD THE CARE. FOR FYE2021, WCHNA PROVIDED APPROXIMATELY $40,000 IN CHARITY CARE. WESTERN CONNECTICUT HOME CARE, INC. (WCHC): WCHC PROVIDES STATE OF THE ART CLINICAL SERVICES RANGING FROM PEDIATRIC PATIENTS TO THE ELDERLY UTILIZING BEST PRACTICE IN HOME CARE TO MEET THE NEEDS OF THEIR PATIENTS. EASTERN NEW YORK MEDICAL SERVICES, P.C. (ENYMS): THE MISSION AT ENYMS IS TO PROVIDE SAFE, INNOVATIVE, CONVENIENT AND COORDINATED PRIMARY AND GASTROENTEROLOGY HEALTH CARE IN THE COMMUNITIES WE SERVE AND STRIVE TO BE AWARE OF AND RESPOND TO OUR PATIENTS' NEEDS. VASSAR BROTHERS MEDICAL CENTER (VBMC) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIEND SERVICES FOR RESIDENTS OF MID-HUDSON VALLEY. FOR FYE2021 VBMC PROVIDED APPROXIMATELY $6,820,000 IN CHARITY CARE. THE FOUNDATION OF VBMC'S PRINCIPAL ACTIVITY IS THE SOLICITATION, RECEIPT, HOLDING, INVESTMENT AND ADMINISTRATION OF CONTRIBUTION ON BEHALF OF VBMC. PUTNAM HOSPITAL (PH) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. FOR FYE2021 PH PROVIDED APPROXIMATELY $1,475,000 IN CHARITY CARE. PUTNAM HOSPITAL CENTER FOUNDATION ACTIVELY SOLICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES. NORTHERN DUTCHESS HOSPITAL (NDH) PROVIDES GENERAL ACUTE CARE WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY. FOR THE YEAR ENDING 2021 NDH PROVIDED APPROXIMATELY $946,000 IN CHARITY CARE. NORTHERN DUTCHESS HOSPITAL FOUNDATION (NDH) FOUNDATION ACTIVELY SOLICITS CONTRIBUTIONS FROM THE PUBLIC THROUGH DIRECT MAILINGS, FUND-RAISING PROGRAMS AND OTHER ACTIVITIES.VASSAR HEALTH CT, INC DBA SHARON HOSPITAL (SH) PROVIDES GENERAL ACUTE CARE WITH A RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR RESIDENTS IN THE NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 SH PROVIDED APPROXIMATELY $905,000 IN CHARITY CARE. NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY OPERATES AND MAINTAINS A RESIDENTIAL HEALTHCARE FACILITY FOR THE CARE AND TREATMENT OF PERSONS WHO REQUIRE MEDICAL CARE AND RELATED SERVICES. FOR FYE2021 NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY PROVIDED APPROXIMATELY $133,000 IN CHARITY CARE. NUVANCE HEALTH MEDICAL PRACTICE, PC IS THE BENEFICIAL OWNER OF VARIOUS PHYSICIAN PRACTICES THAT PROVIDE A FULL RANGE OF HOSPITAL-BASED AND OUTPATIENT SERVICES FOR RESIDENTS OF THE MID-HUDSON VALLEY AND IN THE NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 NUVANCE HEALTH MEDICAL PRACTICE, PC PROVIDED APPROXIMATELY $155,000 IN CHARITY CARE. HUDSON VALLEY CARDIOVASCULAR PRACTICE (HVCP) PROVIDES INVASIVE AND NONINVASIVE CARDIOVASCULAR, DIAGOSTIC AND THERAPEUTIC SERVICES AND IS LOCATED THROUGHOUT THE MID-HUDSON VALLEY AND NORTHWEST CONNECTICUT COMMUNITY. FOR FYE2021 HUDSON VALLEY CARDIOVASCULAR PRACTICE PROVIDED APPROXIMATELY $72,000 IN CHARITY CARE. HEALTH QUEST HOME CARE, INC WAS FORMED TO OPERATE A HOME HEALTH CARE SERVICE BUSINESS SERVING RESIDENTS OF THE MID-HUDSON VALLEY. FOR FYE2021 HEALTH QUEST HOME CARE PROVIDED APPROXIMATELY $97,000 IN CHARITY CARE. WELLS MANOR HOUSING DEVELOP. FUND CORP. IS A PRIVATE FOUNDATION. WELLS MANOR OPERATES AN APARTMENT COMPLEX OF 75 UNITS UNDER SECTION 202 OF THE NATIONAL HOUSING ACT OF 1959 AND SECTION 8 OF THE NATIONAL HOUSING ACT OF 1937, REGULATED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. ALAMO AMBULANCE SERVICES, INC'S ASSETS WERE SOLD IN SEPTEMBER 2009; HOWEVER, IT HAS MAINTAINED ITS LICENSE TO PROVIDE TRANSPORT TO SICK, DISABLED, OR INJURED PERSONS, GENERALLY WITHIN DUTCHESS, ORANGE, ULSTER AND PUTNAM COUNTIES, NEW YORK. PART VI, LINE 7NEW YORK AND CONNECTICUT. 1 1 0 0 0 0 0 1 0 STEVEN H ROSENBERG TREASURER/CFO 0 725983 0 0 0 975413 0 601834 0 40662 0 2343892 0 866877 ROBERT FRIEDBERG FORMER HQ PRESIDENT/CEO 0 179463 0 0 0 1516700 0 5538 0 6207 0 1707908 0 0 MICHAEL HOLZHUETER FORMER ASSISTANT SECRETARY 0 92086 0 131172 0 836761 0 7023 0 11890 0 1078932 0 0 KERRY EATON CHIEF OPERATING OFFICER 0 756173 0 60000 0 120027 0 94667 0 1579 0 1032446 0 0 SIMON GORWARA MD DIRECTOR/HVCP PHYSICIAN 0 596121 0 293001 0 19888 0 17100 0 37361 0 963471 0 0 JOSEPH MULLANY FORMER PRESIDENT 0 455140 0 37500 0 285087 0 0 0 19175 0 796902 0 0 CAROLYN MCKENNA ASST. SEC (TO 12/31); SEC/CLO 0 584841 0 0 0 62046 0 14250 0 2115 0 663252 0 0 PETER A KELLY PRESIDENT 0 525953 0 25000 0 79571 0 17100 0 1505 0 649129 0 0 KIMBERLY HELLER MD DIRECTOR/HQMP PHYSICIAN 0 545961 0 0 0 25296 0 8550 0 20931 0 600738 0 0 WILLIAM V BEGG VP MEDICAL AFFAIRS 436930 40460 48500 0 0 0 15784 1316 20296 1237 521510 43013 0 0 CATHERINE FRIERSON CHIEF HUMAN RESOURCE OFFICER 0 481256 0 0 0 50445 0 14250 0 3925 0 549876 0 0 IMTIAZ A MALLICK MD CLINICAL PHYSICIAN 311712 133100 0 0 53914 0 10890 3964 18446 3681 394962 140745 0 0 JEAN AHN FROM 0201 CHIEF STRATEGY OFFICER 0 417628 0 0 0 81363 0 14250 0 3071 0 516312 0 0 GRACE LINHARD CHIEF DEVELOPMENT OFFICER 0 384162 0 0 0 61573 0 17100 0 2495 0 465330 0 0 ANN ARMATER SVP DEVELOPMENT 301034 0 36762 0 45962 0 16974 0 24458 0 425190 0 0 0 CINDY A CZAPLINSKI VP OPERATIONS 358235 0 24150 0 6482 0 0 0 23968 0 412835 0 0 0 WAYNE MCNULTY CHIEF COMPLIANCE OFFICER 0 346401 0 0 0 33721 0 14250 0 11486 0 405858 0 0 KEVIN BOLAND DIRECTOR CARDIO PERFUSION 321137 0 15000 0 6428 0 17100 0 36796 0 396461 0 0 0 KATHERINE BACHER FORMER ASSISTANT TREASURER 0 191893 0 0 0 18251 0 12144 0 263 0 222551 0 0 CHERYL BOOTH FORMER ASSISTANT SECRETARY 0 126698 0 1500 0 5343 0 7876 0 1803 0 143220 0 0 PART I, LINE 3: VASSAR BROTHERS MEDICAL CENTER RELIED ON NUVANCE HEALTH, A RELATED TAX EXEMPT ORGANIZATION, TO APPROVE AND DETERMINE COMPENSATION FOR THE CEO AND TOP MANAGEMENT, WHICH USED A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO GATHER COMPARABLE DATA ON OTHER KEY EMPLOYEES. PART I, LINE 4A: DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, MICHAEL HOLZHUETER RECEIVED $694,731 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF DECEMBER 11, 2019. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, ROBERT FRIEDBERG RECEIVED $1,246,154 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF DECEMBER 11, 2019. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, JOSEPH MULLANY RECEIVED $233,654 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF AUGUST 1, 2020. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. DURING THE CALENDAR YEAR ENDING DECEMBER 31, 2020, IMTIAZ A. MALLICK, MD RECEIVED $48,308 IN SEVERANCE PAYMENTS, SUBSEQUENT TO HIS TERMINATION DATE OF OCTOBER 9, 2020. PART VII OF THE CURRENT YEAR'S TAX RETURN REFLECTS THIS AMOUNT. PART I, LINE 4B: WESTERN CONNECTICUT HEALTH NETWORK (WCHN), A RELATED ORGANIZATION, PREVIOUSLY ESTABLISHED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO KEY MEMBERS OF THE EXECUTIVE GROUP. UNDER THE AGREEMENTS FOR THE SERP, AMOUNTS PROMISED TO ELIGIBLE EXECUTIVES ARE BASED ON TARGETED RETIREMENT BENEFITS AND THE PAYMENT OF BENEFITS IS SUBJECT TO VESTING. THE BENEFITS AT THE VESTED AGE ARE PROVIDED IN THE FORM OF AN ACTUARIAL EQUIVALENT LUMP SUM PLUS A TAX GROSS-UP AMOUNT TO THE PARTICIPANTS. WCHN MAINTAINS AN ACCRUAL ON ITS BOOKS FOR THE PARTICIPANTS OF THE SERP. THE ACCRUALS ARE MAINTAINED SOLELY FOR ACCOUNTING PURPOSES AND ARE UNFUNDED. STEVEN H. ROSENBERG PARTICIPATED IN THE SERP AND ACCRUED BENEFITS AS OF SEPTEMBER 30, 2021. FOR CALENDAR YEAR 2020, STEVEN H. ROSENBERG RECEIVED A PAYOUT OF $866,877, WHICH IS REFLECTED AS COMPENSATION ON SCHEDULE J, PART II ON THE FORM 990, FOR THE CURRENT YEAR. ROBERT FRIEDBERG, KERRY EATON, MICHAEL HOLZHEUTER AND KATHERINE BACHER PARTICIPATED IN A SERP PLAN WITH HEALTH QUEST SYSTEMS, INC. (HEALTH QUEST), A RELATED ORGANIZATION. HEALTH QUEST MADE THE FOLLOWING CONTRIBUTIONS TO THE PARTICIPANTS, WHICH ARE REPORTED ON SCHEDULE J, PART II. AS OF JANUARY 15, 2021, THE HEALTH QUEST SERP PLAN WAS TERMINATED. KERRY EATON - $77,567 EFFECTIVE OCTOBER 1, 2020, NUVANCE HEALTH ESTABLISHED AN EXECUTIVE RETIREMENT PLAN IN ORDER TO PROVIDE NONQUALIFIED DEFINED CONTRIBUTION RETIREMENT BENEFITS TO DESIGNATED KEY MEMBERS OF ITS EXECUTIVE MANAGEMENT TEAM, SELECTED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. ONLY EXECUTIVES OCCUPYING DESIGNATED TIER 1 OR TIER 2 EXECUTIVE POSITIONS ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN CALENDAR YEAR 2020, CONTRIBUTIONS RELATED TO THIS PLAN ARE INCLUDED IN EACH PARTICIPANT'S WAGES AND ARE REFLECTED IN THE AMOUNTS REPORTED ON SCHEDULE J, PART II, COLUMN (B)(III) - OTHER REPORTABLE COMPENSATION. PART I, LINE 7: NUVANCE HEALTH ANNUAL LEADERSHIP INCENTIVE PLAN (EXCERPTS FROM) THE PURPOSE OF THE NUVANCE HEALTH ANNUAL LEADERSHIP INCENTIVE PLAN ("PLAN") IS TO ENGAGE AND MOTIVATE THE ORGANIZATION'S LEADERS TO FURTHER THE CHARITABLE MISSION OF NUVANCE HEALTH AND ITS AFFILIATES AND SUBSIDIARIES, BY PROMOTING EFFECTIVE MANAGEMENT OF OPERATIONS, DELIVERY OF HIGH-QUALITY CARE AND SERVICE, AND RESPONSIBLE USE OF RESOURCES TO MEET COMMUNITY NEEDS. THIS PLAN IS INTENDED TO ASSIST NUVANCE HEALTH, AND ITS AFFILIATES AND SUBSIDIARIES TO ATTRACT AND RETAIN LEADERSHIP WITH THE TALENT AND EXPERIENCE NEEDED TO BE SUCCESSFUL BY PROVIDING MEANINGFUL INCENTIVES AND REWARDS FOR OUTSTANDING PERFORMANCE. INDIVIDUALS MUST BE AN ELIGIBLE EMPLOYEE TO BE CONSIDERED AS A PARTICIPANT IN THIS PLAN. AN ELIGIBLE EMPLOYEE IS AN INDIVIDUAL EMPLOYED BY NUVANCE HEALTH AND HOLDS A POSITION ASSIGNED TO ONE OF THE FOLLOWING TIERS, AS OF APRIL 30TH OF THE PLAN YEAR: -TIER I, PRESIDENT, CEO, SENIOR EXECUTIVE -TIER II, EXECUTIVE -TIER III, SENIOR LEADER (A) -TIER III, SENIOR LEADER (B) -TIER IV, LEADER (A) ORGANIZATIONAL GOALS ARE GENERALLY BASED ON THE FOLLOWING CATEGORIES AND ARE WEIGHTED THROUGH A SPLIT BETWEEN ORGANIZATIONAL AND INDIVIDUAL: -QUALITY AND SERVICE -PEOPLE AND CULTURE -PATIENT EXPERIENCE -FINANCIAL STRENGTH EACH PLAN YEAR, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD ("THE COMMITTEE"), IN ITS SOLE DISCRETION AND UNLESS OTHERWISE APPROPRIATELY DELEGATED, SELECTS PARTICIPANTS FROM A LIST OF ELIGIBLE EMPLOYEES NOMINATED BY THE CEO. THE CEO, EX OFFICIO, IS AN ELIGIBLE EMPLOYEE FOR PURPOSES OF SELECTION TO PARTICIPATE IN THE PLAN. EACH PLAN YEAR, THE COMMITTEE, BASED ON INPUT FROM THE CEO, MAY ESTABLISH A THRESHOLD AWARD, A TARGET AWARD AND/OR A MAXIMUM AWARD FOR EACH PARTICIPANT. AWARD OPPORTUNITIES ARE ESTABLISHED BASED ON COMPETITIVE MARKET PRACTICES AND ON NUVANCE HEALTH'S COMPENSATION PHILOSOPHY. AWARD OPPORTUNITIES MAY BE BASED ON ADDITIONAL FACTORS, INCLUDING NUVANCE HEALTH'S FINANCIAL AND OPERATIONAL PERFORMANCE, REFLECTING MARKET PAY PRACTICES AND BENCHMARKING FOR COMPARABLE POSITIONS, AND ANY OTHER FACTORS DEEMED RELEVANT BY THE COMMITTEE. EACH PLAN YEAR, THE COMMITTEE, AND UNLESS OTHERWISE APPROPRIATELY DELEGATED FOR ANY PLAN YEAR, SHALL ESTABLISH PERFORMANCE GOALS TO EVALUATE THE PERFORMANCE OF EACH PARTICIPANT. AFTER COMPLETION OF EACH PLAN YEAR, THE COMMITTEE MAY EVALUATE WHETHER THE PERFORMANCE OF NUVANCE HEALTH AND PARTICIPANT MEETS OR EXCEEDS THE PERFORMANCE GOALS ESTABLISHED FOR THE PLAN YEAR. IF PERFORMANCE WARRANTS, THE COMMITTEE MAY APPROVE A FINAL AWARD AMOUNT FOR EACH PARTICIPANT AND APPROVE ANY ADDITIONAL CONDITION ON PAYMENT OF THE AWARD. NUVANCE HEALTH EXECUTIVE LONG TERM INCENTIVE PLAN (EXCERPTS FROM) ONLY EXECUTIVES OCCUPYING DESIGNATED TIER 1 EXECUTIVE POSITIONS SHALL BE ELIGIBLE EMPLOYEES TO PARTICIPATE IN THE PLAN. UNDER THE PLAN, PARTICIPANTS WILL BE ELIGIBLE TO RECEIVE INCENTIVE AWARD PAYMENTS BASED UPON THE ACHIEVEMENT OF SELECTED AND STRATEGICALLY IMPORTANT PERFORMANCE GOALS IDENTIFIED FOR EACH PERFORMANCE PERIOD. THE AWARD OPPORTUNITIES FOR AN ELIGIBLE EMPLOYEE WITH RESPECT TO A PERFORMANCE PERIOD SHALL BE EXPRESSED AS A PERCENTAGE OF HIS OR HER AVERAGE BASE SALARY IN EFFECT DURING THE APPLICABLE PERFORMANCE PERIOD. PRIOR TO THE BEGINNING OF EACH PERFORMANCE PERIOD, THE COMMITTEE MAY ESTABLISH A MINIMUM PERFORMANCE REQUIREMENT FOR NUVANCE HEALTH. NO FINAL AWARDS MAY BE GRANTED TO ANY PARTICIPANT FOR A PERFORMANCE PERIOD IN WHICH MINIMUM PERFORMANCE REQUIREMENTS, IN ANY, WERE NOT MET. THE FINAL AWARD PAYABLE TO EACH PARTICIPANT WILL BE DETERMINED WITHIN 60 DAYS FOLLOWING THE END OF THE PERFORMANCE PERIOD. AWARDS FOR A GIVEN PERFORMANCE PERIOD WILL BE PAID IN A SINGLE LUMP-SUM ON THE PAYMENT DATE PROVIDED HOWEVER, THAT NO PAYMENT WILL BE MADE UNTIL THE RESULTS ARE VERIFIED AND AUDITED. A DUTCHESS COUNTY LOCAL DEV CORP 273106797 267045GX4 2016-07-07 406680960 CONSTRUCT, RENOVATE, EQUIP FACILITY 0 0 0 A 430000 416791845 48004473 3361803 365425569 2021 0 0 1 1 A 0 1 1 1 0 0.01550 0.01550 0 0 1 A 0 0 0 1 0 0 0 1 1 A 0 SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: DUTCHESS COUNTY LOCAL DEV CORP DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2021 NOTE REGARDING THE REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART I, LINE A, COLUMN E, - TOTAL ISSUE PRICE PER IRS FORM 8038 - $438,672,526, ALLOCATED BETWEEN 3 ORGANIZATIONS: VASSAR BROTHERS MEDICAL CENTER (FEIN: 14-1338586) PUTNAM HOSPITAL (FEIN: 14-6019179) NORTHERN DUTCHESS HOSPITAL (FEIN: 14-1338467) PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF VASSAR BROTHERS MEDICAL CENTER ("VBMC") IS HEALTH QUEST SYSTEMS, INC. NUVANCE HEALTH IS THE SOLE MEMBER OF HEALTH QUEST SYSTEMS, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER (HEALTH QUEST SYSTEMS, INC.) SHALL ELECT VASSAR BROTHERS MEDICAL CENTER'S (VBMC'S) OFFICERS. SUBJECT TO THE APPROVAL OF THE MEMBER, ANY VACANCY OR VACANCIES OCCURRING IN ANY OFFICE MAY BE FILLED UNTIL THE NEXT MEETING AT WHICH OFFICERS ARE ELECTED BY THE AFFIRMATIVE VOTE OF THE REMAINING DIRECTORS IN OFFICE AT ANY MEETING OF THE BOARD, THOUGH SUCH REMAINING DIRECTORS MAY CONSTITUTE LESS THAN A QUORUM. ANY OFFICER MAY BE REMOVED AT ANY TIME WITH OR WITHOUT CAUSE BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN FUNDAMENTAL DECISIONS TO BE UNDERTAKEN BY VBMC REQUIRE THE APPROVAL OF THE MEMBER, INCLUDING BUT NOT LIMITED TO THE FOLLOWING: (I) ELECTION OR REMOVAL OF A DIRECTOR OR AN OFFICER WHO IS NOT AN EMPLOYEE OR CONTRACTOR; (II) AMENDMENT OF VBMC'S ORGANIZATIONAL DOCUMENTS; (III) ADOPTION OF OR REVISIONS TO POLICIES RELATING TO THE CONTROL AND SUPERVISION OF THE INVESTMENT OF VBMC'S FUNDS; (IV) ADOPTION OF OR AMENDMENT TO ANY OF VBMC'S QUALIFIED OR NON-QUALIFIED BENEFIT PLANS; (V) ADOPTION OF OR REVISIONS TO ANY SYSTEM-WIDE QUALITY, PERFORMANCE AND CREDENTIALING STANDARDS AND PROCEDURES; (VI) APPROVAL OF ALL AUDITED FINANCIAL STATEMENTS WHICH INCLUDES REVIEW OF THE SYSTEM-WIDE ACCOUNTING POLICIES AND CONTROLS AND THE SELECTION OF THE INDEPENDENT AUDITORS; (VII) ADOPTION OF OR ANY MATERIAL REVISIONS TO THE CAPITAL BUDGET AND OPERATING BUDGET; (VIII) ADOPTION OF, REVISIONS TO AND OVERSIGHT OF ANY SYSTEM-WIDE POLICIES AND PRACTICES RELATING TO REGULATORY COMPLIANCE; (IX) ANY CESSATION OF ANY SERVICE LINE OWNED OR CONTROLLED DIRECTLY OR INDIRECTLY; (X) ANY CLOSURE, SALE OR TRANSFER OF A HOSPITAL; (XI) ANY ASSIGNMENT FOR THE BENEFIT OF CREDITORS, THE FILING OF ANY PETITION IN VOLUNTARY BANKRUPTCY, THE FILING OF ANY PETITION OR ANSWER SEEKING REORGANIZATION, OR AN ARRANGEMENT WITH CREDITORS UNDER THE FEDERAL BANKRUPTCY LAW; (XII) ANY CHANGE IN THE TAX STATUS OF OR REVISION OF, THE CHARITY CARE POLICIES; (XIII) ANY MERGER, CONSOLIDATION OR SIMILAR TRANSACTION; (XIV) ANY INCURRENCE, ASSUMPTION, OR GUARANTEE OF ANY DEBT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE ORGANIZATION AND A DRAFT FORM 990 IS REVIEWED BY INTERNAL MANAGEMENT. A COMPLETE DRAFT IS THEN POSTED TO AN INTRANET SITE FOR NUVANCE BOARD MEMBERS, THE ULTIMATE PARENT OF THE ORGANIZATION, TO REVIEW PRIOR TO FILING. THE FORM 990 IS THEN SIGNED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, TRUSTEES/DIRECTORS, KEY EMPLOYEES AND OTHER DISQUALIFIED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE, AUDIT & PRIVACY OFFICER. ALSO THEY ARE REQUIRED TO DISCLOSE ANY CONFLICT TO THE BOARD OR DIRECTLY TO THE CHAIRMAN PRIOR TO ANY MEETING. AFTER A POTENTIAL CONFLICT OF INTEREST IS DISCLOSED ALONG WITH ALL RELATED MATERIAL FACTS, THE BOARD PROCEEDS TO DISCUSS AND DETERMINE THROUGH A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER AN ACTUAL CONFLICT OR DUALITY OF INTEREST EXISTS. IF THE INTERESTED PERSON IS PRESENT AT THE START OF THE DISCUSSION, HE OR SHE MAY ANSWER QUESTIONS RELATED TO THE MATTER AND PROVIDE ADDITIONAL, RELEVANT FACTS BUT IS REQUIRED TO LEAVE THE MEETING DURING DELIBERATIONS REGARDING WHETHER AN ACTUAL CONFLICT OR DUALITY OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 14: THE ORGANIZATION FOLLOWS A RECORD RETENTION POLICY THAT HAS BEEN APPROVED ONLY BY THE AUDIT COMMITTEE, NOT THE FULL BOARD. FORM 990, PART VI, SECTION B, LINE 15B NUVANCE HEALTH'S EXECUTIVE TOTAL REWARDS PHILOSOPHY IS DESIGNED TO ALIGN WITH THE COMPANY'S STRATEGIC DIRECTION, AND TO REINFORCE ITS CORE MISSION, VISION AND VALUES. IN ORDER TO ACHIEVE ITS OVERALL PERFORMANCE OBJECTIVES, NUVANCE HEALTH PROVIDES TOTAL REWARDS PROGRAMS THAT RECOGNIZE EXECUTIVES FOR PERFORMING WORK WELL TO ENSURE THE ACHIEVEMENT OF COMPANY GOALS. THESE PROGRAMS SERVE TO PROMOTE THE ATTRACTION, ENGAGEMENT, AND RETENTION OF TALENTED EXECUTIVES THROUGHOUT THEIR CAREERS WITH NUVANCE HEALTH. THE TOTAL REWARDS PROGRAMS ARE DESIGNED TO BE MARKET COMPETITIVE, COMPLIANT WITH REGULATORY GUIDELINES REFLECTIVE OF BEST PRACTICES, AND DIFFERENTIATED TO CREATE STRONG COMPETITIVE ADVANTAGE. TOTAL REWARDS PROGRAMS ARE REVIEWED ON AN ONGOING BASIS TO ENSURE CONTINUED MARKET COMPETITIVENESS, RELEVANT VALUE TO EXECUTIVES, AND FISCAL RESPONSIBILITY. TOTAL REWARDS FOR NUVANCE HEALTH EXECUTIVES CONSISTS OF KEY COMPONENTS OF COMPENSATION AND BENEFITS. OVERALL EXECUTIVE REWARDS PROGRAM WILL EMPHASIZE PERFORMANCE-BASED ELEMENTS, WHEREBY TARGETED LEVELS OF COMPENSATION WILL ONLY BE ACHIEVED IF THE ORGANIZATION AND INDIVIDUAL ACHIEVE STRETCH GOALS AND OBJECTIVES. BASED ON THE LABOR MARKETS FOR TALENT FOR EXECUTIVE ROLES, NUVANCE HEALTH WILL UTILIZE A WEIGHTED BLEND OF BOTH NATIONAL COMPARABLY-SIZED HEALTH CARE PROVIDER MARKET DATA WITH A +30% GEOGRAPHIC DIFFERENTIAL APPLIED (DIFFERENTIAL TO BE VALIDATED ON A PERIODIC BASIS) AT TWO-THIRDS WEIGHT AND NATIONAL COMPARABLY-SIZED GENERAL INDUSTRY DATA, FOR IDENTIFIED ROLES WHERE SKILL SETS OVERLAP AT ONE-THIRD WEIGHT. GEOGRAPHIC DIFFERENTIAL REFLECTS THE OBSERVED AND REPORTED COMPENSATION DIFFERENTIAL BETWEEN NUVANCE HEALTH'S OPERATING REGION AND THE BROADER NATIONAL HEALTH CARE PROVIDER MARKET. NUVANCE HEALTH'S TOTAL REWARDS PHILOSOPHY AND PRACTICES ARE TARGETED AT THE 50TH PERCENTILE OF THE RELEVANT MARKET FOR BASE SALARY, AND 75TH PERCENTILE FOR TOTAL CASH AND TOTAL DIRECT (WHERE AVAILABLE) COMPENSATION ELEMENTS IF TARGET PERFORMANCE IS ACHIEVED UNDER VARIABLE COMPENSATION PROGRAMS. NUVANCE HEALTH'S COMMITTEE HAS DISCRETION TO POSITION INDIVIDUAL LEVELS ABOVE OR BELOW THIS TARGETED COMPETITIVE POSITIONING, BASED ON SUCH FACTORS AS POSITIONING TO MARKET, HIGH DEMAND SKILLSETS AND DIFFICULT TO FILL OR CRITICAL TO THE ORGANIZATION'S STRATEGY AND SUCCESS. NUVANCE HEALTH'S TOTAL REWARDS PHILOSOPHY AND PRACTICES ARE TARGETED AT THE 50TH PERCENTILE OF THE RELEVANT MARKET FOR BASE SALARY, AND 75TH PERCENTILE FOR TOTAL CASH AND TOTAL DIRECT (WHERE AVAILABLE) COMPENSATION ELEMENTS IF TARGET PERFORMANCE IS ACHIEVED UNDER VARIABLE COMPENSATION PROGRAMS. NUVANCE HEALTH'S COMMITTEE HAS DISCRETION TO POSITION INDIVIDUAL LEVELS ABOVE OR BELOW THIS TARGETED COMPETITIVE POSITIONING, BASED ON SUCH FACTORS AS POSITIONING TO MARKET, HIGH DEMAND SKILLSETS AND DIFFICULT TO FILL OR CRITICAL TO THE ORGANIZATION'S STRATEGY AND SUCCESS. OUR GOVERNANCE PROMOTES CONSISTENCY AND EQUITY; PROVIDES CLARITY AND GUIDANCE TO DECISION-MAKERS; ENSURES STANDARD PROCESSES AND PROCEDURES FOR ASSESSING, CALIBRATING, ADMINISTERING, AND DELIVERING EFFECTIVE TOTAL REWARDS THROUGHOUT THE NUVANCE HEALTH SYSTEM. OVERSIGHT AND GOVERNANCE OF THE EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAMS FOR ELIGIBLE EXECUTIVES/DISQUALIFIED INDIVIDUALS (CURRENTLY CEO, PRESIDENT AND TIERS 1 AND 2) WILL BE AT THE COMPENSATION COMMITTEE OF THE BOARD LEVEL, AND WILL FOLLOW A STRUCTURED AND RIGOROUS PROCESS TO ENSURE COMPLIANCE WITH INTERMEDIATE SANCTIONS UNDER IRS GUIDELINES. FORM 990, PART VI, SECTION C, LINE 19 POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILINGS SUCH AS THE 990 AND BOND HOLDER AGREEMENTS. FORM 990, PART VII (ADDITIONAL INFORMATION) FOR THOSE OFFICERS AND TOP 5 EMPLOYEES, FOR WHICH ONLY 40 HOURS IS NOTED TO REFLECT PAID HOURS, ACTUAL HOURS WORKED EXCEEDED THIS AMOUNT. NOTE: ALL AMOUNTS IN COLUMN F, OF PART VII,"ESTIMATED AMOUNT OF OTHER COMPENSATION", REPRESENT BENEFITS, AND DO NOT REFLECT ANY COMPENSATION FOR WHICH THE AVERAGE AMOUNT OF TIME WORKED CAN BE REFLECTED. FORM 990, PART XI, LINE 9: CHANGE IN PENSION OBLIGATION 11,453,021. CHANGE IN EQUITY INTEREST IN THE FOUNDATION -2,656,274. CUMULATIVE EFFECT ADJUSTMENT UPON ADOPTION OF ASC 842, LEASES -61,382. RECLASSIFICATION OF NET ASSET GL ACCOUNTS UPON GL SYSTEM CONVERSION -751,772. FORM 990, PART XI, LINE 8 $31,791,652 IS REPORTED ON FORM 990, PART XI, LINE 8 AS PRIOR PERIOD ADJUSTMENT. DURING THE TAX YEAR, NUVANCE HEALTH (THE ULTIMATE PARENT COMPANY, RECENTLY FORMED BY THE MERGER OF TWO HEALTH SYSTEMS) WAS FINALIZING THE ALIGNMENT OF ACCOUNTING POLICIES AND PROCEDURES ACROSS THE ENTITIES WITHIN THE HEALTH SYSTEM. AS A RESULT, IT WAS DETERMIEND THE HISTORICAL ACCOUNTING USED TO REPRESENT THE INTEREST VBMC HELD IN THE SUPPORTING FOUNDATION (VASSAR BROTHERS HOSPITAL FOUNDATION) NEEDED TO BE ADJUSTED. THIS HAD NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS OF NUVANCE HEALTH AS A WHOLE, AS VBMC'S INTEREST IN THE FOUNDATION IS ELIMINATED IN CONSOLIDATION. AS A RESULT, A ONE-TIME CORRECTING ENTRY WAS RECORDED TO TRUE UP THE INTEREST IN THE FOUNDATION RECORDED ON VBMC'S BALANCE SHEET. 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