2022-05-13T09:08:46-05:00 2021-06-30 990 2020-07-01 141338544 SAMARITAN HOSPITAL SAMA 5182713300 2215 BURDETT AVENUE TROY NY 12180 LORI SANTOS VP, ACUTE CARE FINANCE 5185251550 2022-05-05 LORI SANTOS XXX-XX-XXXX 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SEE SCHEDULE O MICHAEL FINEGAN 2215 BURDETT AVENUE TROY NY 12180 399996801 0 X WWW.SPHP.COM X 1898 NY TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 15 12 3400 38 1543529 277884 15288298 10893377 328543575 377754340 907343 5373717 3649129 2931531 348388345 396952965 738 0 0 0 164203273 176202834 0 0 0 178198109 207995365 342402120 384198199 5986225 12754766 303020238 318800961 191826565 204761618 111193673 114039343 X WE, ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. FOUNDED IN COMMUNITY-BASED LEGACIES OF COMPASSIONATE HEALING, WE PROVIDE THE HIGHEST QUALITY COMPREHENSIVE CONTINUUM OF INTEGRATED HEALTH CARE, SUPPORTIVE HOUSING AND COMMUNITY SERVICES, ESPECIALLY FOR THE NEEDY AND VULNERABLE. SAMARITAN HOSPITAL IS A MEMBER OF ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH. 0 0 364728288 0 380669670 SAMARITAN HOSPITAL, WHICH OPENED ITS DOORS IN 1898, IS A COMMUNITY HOSPITAL IN TROY, NY WITH A 457-BED CAPACITY AMONGST ALL ITS CAMPUSES. SAMARITAN HOSPITAL PROVIDES INPATIENT SERVICES, DIAGNOSTIC TREATMENT AND ANCILLARY SERVICES, OUTPATIENT AND COMMUNITY OUTREACH SERVICES, AND SURGICAL SERVICES. THE HOSPITAL OFFERS A VAST RANGE OF SERVICES, INCLUDING CRITICAL CARE, AMBULATORY SURGERY, CANCER CARE, WOMEN'S HEALTH, BEHAVIORAL HEALTH SERVICES, PHYSICAL REHABILITATION, MEDICAL IMAGING, AND MUCH MORE. BURDETT CARE CENTER, AN AFFILIATED TAX-EXEMPT ORGANIZATION, MERGED INTO SAMARITAN HOSPITAL ON OCTOBER 1, 2020. IT NOW OPERATES AS BURDETT BIRTH CENTER AND OFFERS MATERNITY SERVICES WITHIN THE MAIN SAMARITAN HOSPITAL CAMPUS. PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS:WWW.SPHP.COM/LOCATION/SAMARITAN-HOSPITAL 364728288 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 251 0 1 3400 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X LORI SANTOS 5185255537 315 S MANNING BLVD ALBANY NY 12208 BENJAMIN CARTER DIRECTOR AS OF 1/21; TH EVP & COO 1.00 54.00 X 0 1555234 83280 JAMES REED MD DIRECTOR; PRESIDENT & CEO 1.00 54.00 X X 0 916975 105627 PHILIP CLEMENTS MD PHYSICIAN 50.00 0.00 X 738485 0 42674 MICHAEL FINEGAN PRESIDENT, ACUTE CARE 22.00 33.00 X 0 581709 50866 EMILY BROWER DIR THR 12/20;TH SVP CLIN INT/PHY SV 1.00 49.00 X 0 454700 128414 AXEL HERRMANNSDOERFER MD PHYSICIAN 50.00 0.00 X 542045 0 37328 THOMAS ROBERT SPHP VP, CFO & TREASURER 1.00 49.00 X 0 460637 113339 DINA GOTTESMAN DO PHYSICIAN 50.00 0.00 X 507622 0 41692 ANDREW GUNTHER MD PHYSICIAN 50.00 0.00 X 513427 0 21873 NAMRATA PATEL MD PHYSICIAN 50.00 0.00 X 499451 0 24743 ALAN SANDERS MD CHIEF MEDICAL OFFICER, ACUTE CARE 20.00 30.00 X 0 404777 35664 LORI SANTOS VICE PRESIDENT, ACUTE CARE FINANCE 20.00 30.00 X 0 356673 29717 DANIEL KOCHIE FORMER OFFICER;REG DIRECTOR THR 1/20 24.00 26.00 X 0 211183 10350 ROBERT SWIDLER ESQ SECRETARY; VP LEGAL SERVICES 1.00 49.00 X 0 193863 0 GARY DAKE DIRECTOR; CHAIR THROUGH 12/20 1.00 6.00 X X 0 0 0 ROBERT MCCORMICK DIRECTOR; CHAIR AS OF 1/21 1.00 6.00 X X 0 0 0 RONALD GUZIOR DIR;TREAS THR 12/20;V CHR AS OF 1/21 1.00 6.00 X X 0 0 0 BEVERLY KARPIAK DIRECTOR & VICE CHAIR THROUGH 12/20 1.00 6.00 X X 0 0 0 KATHLEEN JIMINO DIRECTOR; TREASURER AS OF 1/21 1.00 6.00 X X 0 0 0 GUHA BALA DIRECTOR 1.00 6.00 X 0 0 0 ROBERT BYLANCIK DIRECTOR THROUGH 12/20 1.00 6.00 X 0 0 0 BARBARA COTTRELL DIRECTOR 1.00 6.00 X 0 0 0 ANN DISARRO DIRECTOR THROUGH 12/20 1.00 6.00 X 0 0 0 HAROLD GORDON ESQ DIRECTOR 1.00 6.00 X 0 0 0 GEORGE HEARST III DIRECTOR 1.00 6.00 X 0 0 0 ROBERT JOHNSON III ESQ DIRECTOR 1.00 6.00 X 0 0 0 MICHAEL KEEGAN DIRECTOR 1.00 6.00 X 0 0 0 MARY ANN LOGIUDICE RSM DIRECTOR 1.00 6.00 X 0 0 0 KATHLEEN NATWIN DC DIRECTOR THROUGH 12/20 1.00 6.00 X 0 0 0 CURTIS POWELL DIRECTOR 1.00 6.00 X 0 0 0 MICHAEL WOLFF MD DIRECTOR AS OF 9/20 1.00 6.00 X 0 0 0 2801030 5135751 725567 241 1 1 0 REHABILITATION SUPPORT SERVICES 5172 WESTERN TURNPIKE ALTAMONT NY 12009 HEALTH CARE SERVICES 3254219 QUEST DIAGNOSTICS PO BOX 829864 PHILADELPHIA PA 19182 HEALTH CARE SERVICES 1782479 SANO RUBIN CONSTRUCTION PO BOX 9078 ALBANY NY 12209 CONSTRUCTION SERVICES 1724306 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD MANAGEMENT SERVICES 1538135 CPESN USA LLC 1000 CENTREGREEN WAY STE 300 CARY NC 27513 HEALTH CARE SERVICES 1465166 55 3302634 7589743 1000 10893377 NET PATIENT SERVICE REVENUE 622110 376210811 376210811 LAB SERVICES 621500 1543529 1543529 377754340 1116738 1116738 683332 3043836 -2360504 -2360504 -2360504 4110029 146950 0 0 4110029 146950 4256979 4256979 PROVIDER INCENTIVE REVENUE 622110 2142568 2142568 SCHOOL OF NURSING 611310 1378523 1378523 CAFETERIA REVENUE 722514 814510 814510 956434 937768 18666 5292035 396952965 380669670 1543529 3846389 407586 407586 221533 221533 149972206 147541532 2430674 5174156 5082674 91482 10852915 10664943 187972 9574438 9343054 231384 318 318 1273 1273 173554 173554 23858326 20216568 3641758 131440 45722 85718 3326127 2406548 919579 381308 381308 8255230 7616747 638483 24391 23469 922 347839 347651 188 2053599 2053599 13056559 6497879 6558680 3543554 3543554 MEDICAL SUPPLIES 67087904 67087904 I/C PURCHASED SERVICES 56384220 53787337 2596883 BAD DEBT 20813153 20813153 UBI TAXES 95838 95838 8460732 7274328 1186404 384198199 364728288 19469911 0 81924 2821901 806560 880648 2823973 2702921 24107881 30076196 1036524 993787 7651248 8398052 934672 1240496 337034376 188551522 151448755 148482854 57028832 64601831 19096330 29158183 38003539 29444092 303020238 318800961 36538659 35485433 4822607 2757276 150465299 166518909 191826565 204761618 X 99528065 100923248 11665608 13116095 111193673 114039343 303020238 318800961 X 12754766 10248102 -20157198 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 17550 0 0 0 17550 0 PART II-B, LINE 1: SAMARITAN HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED SAMARITAN HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 3262648 40715 3303363 2624682 650323 -12357 3262648 2091504 525213 7965 2624682 2042513 40000 8991 2091504 2039365 3148 2042513 0.00000 1.00000 0.00000 0 0 3436801 3436801 192757286 79786647 112970639 66300 64834 1466 138991261 108700041 30291220 1782728 1782728 148482854 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 9164000 F HEDGE FUNDS 4998546 F EQUITY METHOD INVESTMENTS 14995637 C 29158183 MISCELLANEOUS RECEIVABLES 789283 OTHER LONG-TERM ASSETS 10044856 INTERCOMPANY ACCOUNTS RECEIVABLE 10725770 OPERATING LEASE RIGHT-OF-USE ASSETS 7884183 29444092 INTERCOMPANY ACCOUNTS PAYABLE 21138146 OTHER CURRENT LIABILITIES 4938883 ASSET RETIREMENT OBLIGATION 5290906 DEFERRED COMPENSATION LIABILITY 9376409 INTERCOMPANY NOTES PAYABLE 46576676 OVERDRAFT IN POOLED INVESTMENT 50234802 OPERATING LEASE LIABILITIES 8399466 MEDICARE CASH ADVANCES 20563621 166518909 PART V, LINE 4: THE ENDOWMENT FUNDS ARE INVESTED AND THE INVESTMENT REALIZED GAINS ARE USED FOR THE ONGOING OPERATIONS OF THE HOSPITAL OR THE SPECIFIC PURPOSE IDENTIFIED BY THE DONOR. 1 1 X 1 X 250.000000000000 1 X 1 0 1 1 1622415 390151 1232264 0.00340 75781007 53878618 21902389 0.06030 77403422 54268769 23134653 0.06370 14 20603 1897509 39710 1857799 0.00510 3 6 10002 10002 0.00000 5 59807 6114686 2571009 3543677 0.00980 2 176720 176720 0.00050 24 80416 8198917 2610719 5588198 0.01540 24 80416 85602339 56879488 28722851 0.07910 0 20813153 4519549 50109480 63459711 -13350231 X 1 1 1 1 SAMARITAN HOSPITAL 2215 BURDETT AVENUE TROY NY 12180 SPHP.COM/LOCATION/SAMARITAN-HOSPITAL 4102002H X X X SAMARITAN HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 18 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 250.000000000000 400.000000000000 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 SAMARITAN HOSPITAL PART V, SECTION B, LINE 3J: N/ALINE 3E: SAMARITAN HOSPITAL INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS:I. PREVENT CHRONIC DISEASE A. REDUCE OBESITY AND PREVENT DIABETES B. PREVENT/CONTROL ASTHMA AND PREVENT TOBACCO USE II. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS A. PREVENT MENTAL DISORDERS. SAMARITAN HOSPITAL PART V, SECTION B, LINE 5: THE SAMARITAN HOSPITAL COMMUNITY BENEFITS PROGRAM IS BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY THE HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI). HCDI IS A CONSORTIUM OF ORGANIZATIONS JOINED TOGETHER TO PRIORITIZE AND ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. SAMARITAN HOSPITAL HAS BEEN A MEMBER OF HCDI SINCE 1997. THE CHNA BENEFITED FROM THE REVIEW AND INPUT OF THE MEMBERS OF THE PREVENTION AGENDA WORKGROUP OF THE HCDI. BEGINNING IN JANUARY 2019, THESE INDIVIDUALS ARE SUBJECT MATTER EXPERTS FROM THE COUNTY PUBLIC HEALTH DEPARTMENTS OF ALBANY, RENSSELAER, AND SCHENECTADY; AND OF EACH OF THE CAPITAL REGION HOSPITALS: ST. PETER'S HOSPITAL, ALBANY MEDICAL CENTER, SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, SAMARITAN HOSPITAL, AND ELLIS HOSPITAL. DURING FEBRUARY AND MARCH, THIS GROUP WAS JOINED BY REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, BUSINESSES, CONSUMERS, SCHOOLS, ACADEMICS, AND THOSE WHO HAVE CONTACT WITH AND CARE FOR PEOPLE WITH CERTAIN CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA, COPD, AND CANCER. A TOTAL OF 28 DIFFERENT ORGANIZATIONS IN OUR CAPITAL REGION PARTICIPATED, SUCH AS CATHOLIC CHARITIES, WHITNEY M. YOUNG, JR. FEDERALLY QUALIFIED HEALTH CENTER (FQHC), CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, FIDELIS CARE HEALTH PLAN, UPPER HUDSON PLANNED PARENTHOOD, HUDSON VALLEY COMMUNITY COLLEGE, CAPITAL ROOTS, FOOD PANTRIES FOR THE CAPITAL DISTRICT, PROMESA/CAMINO NUEVO AND SENIOR HOUSING ORGANIZATIONS. ALMOST ALL OF THESE ORGANIZATIONS SERVE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS, AND MANY OFFER SPECIFIC PROGRAMS TARGETED TOWARDS THESE GROUPS. REPRESENTATIVES OF THE HCDI DETERMINED THE PROCESS FOR COMPLETING THE NEEDS ASSESSMENT AND REVIEWED THE COLLECTED DATA. THE CHNA IS THE RESULT OF OVER A YEAR OF MEETINGS WITH MEMBER ORGANIZATIONS AND COMMUNITY INPUT. IN ADDITION TO THE HEALTH DATA, THE 2018 COMMUNITY HEALTH SURVEY WAS CONDUCTED IN DECEMBER 2018 BY THE SIENA RESEARCH INSTITUTE. THE SURVEY WAS A REPRESENTATIVE SAMPLE OF ADULT (18+ YEARS) RESIDENTS OF THE CAPITAL REGION. THE SURVEY INCLUDED 1,204 (MOE +/- 3.4%) TOTAL INTERVIEWS WHICH WERE MADE UP OF A PHONE SAMPLE, OVERSAMPLE OF LOW-INCOME RESIDENTS AND A SMALL ONLINE SAMPLE. THIS CONSUMER SURVEY WAS CONDUCTED TO LEARN ABOUT THE HEALTH NEEDS, BARRIERS AND CONCERNS OF THE RESIDENTS OF THE CAPITAL REGION. FROM APRIL TO MAY 2019, DRAFTS OF THE SECTIONS WERE SENT TO LOCAL SUBJECT MATTER EXPERTS FOR REVIEW IN THE HEALTH DEPARTMENTS OF ALBANY, RENSSELAER, AND SCHENECTADY COUNTIES AND IN ST. PETER'S HEALTH PARTNERS (ST. PETER'S HOSPITAL, SAMARITAN HOSPITAL AND SUNNYVIEW REHABILITATION HOSPITAL), ALBANY MEDICAL CENTER, ELLIS HOSPITAL, BURDETT BIRTH CENTER AND COMMUNITY BASED ORGANIZATIONS. COMMENTS WERE ADDRESSED AND CHANGES WERE INCORPORATED INTO THE FINAL DOCUMENT. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED AND APPROVED IN JUNE 2019. SAMARITAN HOSPITAL PART V, SECTION B, LINE 6A: SAMARITAN HOSPITAL CONDUCTED ITS CHNA IN COLLABORATION WITH THE FOLLOWING HOSPITAL FACILITIES: ALBANY MEDICAL CENTER, ELLIS HOSPITAL, SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, ST. PETER'S HOSPITAL AND BURDETT CARE CENTER. SAMARITAN HOSPITAL PART V, SECTION B, LINE 6B: IN THE CHNA PROCESS, SAMARITAN HOSPITAL WAS JOINED BY REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, BUSINESSES, CONSUMERS, SCHOOLS, ACADEMICS, AND THOSE WHO HAVE CONTACT WITH AND CARE FOR PEOPLE WITH CERTAIN CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA AND BEHAVIORAL HEALTH ISSUES INCLUDING MENTAL HEALTH AND SUBSTANCE USE DISORDERS. A TOTAL OF 28 DIFFERENT ORGANIZATIONS IN OUR CAPITAL REGION PARTICIPATED, SUCH AS CATHOLIC CHARITIES, WHITNEY M. YOUNG, JR. FQHC, CENTRO CIVICO, CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, FIDELIS CARE HEALTH PLAN, HUDSON VALLEY COMMUNITY COLLEGE, PROMESA/CAMINO NUEVA, THE FOOD PANTRIES FOR THE CAPITAL DISTRICT, CAPITAL ROOTS, AND SEVERAL SENIOR HOUSING ORGANIZATIONS. SAMARITAN HOSPITAL PART V, SECTION B, LINE 11: SAMARITAN HOSPITAL TOOK THE LEAD ON SEVERAL OF THE HEALTH PRIORITIES FROM THE CHNA AND DURING FY21, THE FOLLOWING NEEDS FROM THE CURRENT CHNA WERE ADDRESSED:REDUCE OBESITY & PREVENT DIABETESON AN OUTPATIENT BASIS, DIABETES EDUCATORS FROM ST. PETER'S HEALTH PARTNERS (SPHP) DIABETES AND ENDOCRINE CARE PROVIDE DIABETES PREVENTION PROGRAMS (DPP) AND OTHER APPROPRIATE DIABETES EDUCATION AS NEEDED. IN FY21, 2,432 PATIENTS RECEIVED OUTPATIENT DIABETES EDUCATION. DURING FY21, SPHP ALSO FACILITATED EIGHT DPP SESSIONS, WITH A TOTAL OF 227 PARTICIPANTS ENROLLED, WHICH WERE HELD IN ALBANY AND RENSSELAER COUNTIES. THIS PROGRAM IS GRANT FUNDED AND WAS PROVIDED AT NO CHARGE TO PARTICIPANTS. ALSO, IN FY21, MONTHLY SUPPORT GROUPS WERE OFFERED, FREE OF CHARGE, FOCUSING ON A VARIETY OF TOPICS RELATED TO DIABETES.IN ORDER TO ADDRESS CHILDHOOD OBESITY IN FY21, SAMARITAN HOSPITAL PARTNERED WITH OTHER HOSPITALS WITHIN SPHP, THE U.S. SOCCER FOUNDATION, AND THE TROY BOYS AND GIRLS CLUB, TO SUPPORT THE SOCCER FOR SUCCESS PROGRAM FOR CHILDREN WITHIN THE CITIES OF TROY, ALBANY, AND SCHENECTADY. SOCCER FOR SUCCESS IS AN AFTERSCHOOL PROGRAM THAT IS PROVEN TO HELP CHILDREN ESTABLISH HEALTHY HABITS AND DEVELOP CRITICAL LIFE SKILLS THROUGH CARING COACH/MENTORS AND FAMILY ENGAGEMENT. THE PROGRAM IS OFFERED FREE OF CHARGE TO CHILDREN. PARTICIPANTS LEARN SOCCER SKILLS AND ABOUT EATING RIGHT AND OTHER WAYS TO STAY HEALTHY, WHILE GAINING IMPORTANT DECISION MAKING AND RELATIONSHIP SKILLS FROM THEIR INTERACTIONS WITH COACH/MENTORS AND PEERS. DURING FY21, 730 CHILDREN PARTICIPATED IN SOCCER FOR SUCCESS AT NINE BOYS AND GIRLS CLUB SITES THROUGHOUT ALBANY AND RENSSELAER COUNTIES. OUT OF THESE PARTICIPANTS, 74% MAINTAINED OR DECREASED THEIR BMI.SPHP AND SAMARITAN HOSPITAL (FUNDED BY A GRANT THROUGH THE MOTHER CABRINI FOUNDATION) PARTNERED WITH THE REGIONAL FOOD BANK OF NORTHEASTERN NEW YORK AND SPHP DIABETES AND ENDOCRINE CARE TO PROVIDE A ST. PETER'S HEALTHY OPTIONS PROGRAM (SHOP) TO DIABETIC PATIENTS WHO IDENTIFY AS FOOD INSECURE. THE FREE PROGRAM PROVIDES FOOD-INSECURE PATIENTS, WHO ALSO HAVE A CHRONIC DISEASE, WITH SUPPLIES OF HEALTHY FOOD. THE GOAL IS TO TEACH THESE PATIENTS TO MAKE HEALTHY CHOICES, EDUCATE THEM ON THE BENEFITS OF EATING NUTRITIOUS FOOD AND PROVIDE THEM WITH THE TOOLS TO HELP MANAGE THEIR CHRONIC CONDITIONS THROUGH HEALTHY EATING. AT THE COMPLETION OF THE FIRST COHORT, THE PARTICIPANTS' A1CS DROPPED AN AVERAGE OF 2.1% PER PARTICIPANT. ASTHMA AND TOBACCO CESSATIONIN FY21, 930 SPHP PATIENTS, IDENTIFYING AS TOBACCO USERS, WERE REFERRED TO THE NYS SMOKERS QUIT LINE, "OPT TO QUIT" PROGRAM. THIS PROGRAM IS A SYSTEM-WIDE SOLUTION FOR ENSURING THAT CESSATION SUPPORT IS OFFERED AND ACCESSIBLE TO ALL INPATIENTS SO THAT ONCE THEY LEAVE THE HEALTH CARE SETTING, THEY WILL HAVE A NICOTINE REPLACEMENT THERAPY AT HOME TO UTILIZE IF THEY OPT TO QUIT. DURING FY21, 215 PEOPLE ATTENDED THE BUTT STOPS HERE PROGRAMS (AN AWARD-WINNING COMMUNITY SMOKING-CESSATION PROGRAM DEVELOPED BY ST. PETER'S HEALTH PARTNERS IN 2001) OFFERED VIRTUALLY. PROMOTE WELLNESS AND PREVENT MENTAL HEALTH DISORDERSIN THE AREA OF MENTAL HEALTH, SPHP AND SAMARITAN HOSPITAL FOCUSED ON THE PROMOTION OF WELL-BEING WITH OUR HEALTHY FAMILIES PROGRAM, WHICH IS A COMBINATION OF HOME-BASED AND VIRTUAL (DUE TO THE PANDEMIC) VISITATION PROGRAM THAT PROVIDES INFORMATION, EDUCATION, AND SUPPORT TO EXPECTING AND NEW PARENTS OF RENSSELAER COUNTY. FUNDING IS PROVIDED BY THE NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES. DURING FY21, LEADERSHIP STAFF FROM SAMARITAN HOSPITAL WERE MEMBERS OF A WORKGROUP TO DEVELOP GOALS, OBJECTIVES AND INTERVENTIONS AROUND THE PREVENTION AGENDA FOCUS AREA OF PROMOTION OF WELL-BEING CONCEPT, SPECIFICALLY WITH LOCAL HEALTH DEPARTMENTS AND HOSPITALS. STAFF AT SPHP, INCLUDING SAMARITAN HOSPITAL, WERE OFFERED TRAINING IN MENTAL HEALTH FIRST AID AND CRISIS DE-ESCALATION.PREVENT SUBSTANCE ABUSE (FOCUS ON OPIOID ABUSE)DURING FY21, SUBSTANCE ABUSE NEEDS WERE ADDRESSED. ACTION PLANS WERE DEVELOPED TO INCREASE EDUCATION AND PRACTICE STRATEGIES TO REDUCE OPIOID OVERDOSE AND NON-MEDICAL USE OF OPIATES. PROVIDER EDUCATION WAS OFFERED TO ALL PRESCRIBERS AT SAMARITAN HOSPITAL, AS WELL AS SPHP, REGARDING ADDICTION AND PAIN MANAGEMENT (INCLUDING GUIDELINES, COMMUNITY RESOURCES AND INFORMATION TO PROVIDE TO PATIENTS REGARDING RISK AND HARM/MISUSE) USING THE FEDERAL GUIDELINES. HOSPITAL STAFF PROMOTED SAFE STORAGE AND PROPER DISPOSAL OF UNUSED PRESCRIPTION MEDICATIONS. SAMARITAN HOSPITAL HAS TAKEN THE LEAD ON THE MENTAL HEALTH GOALS AS IT HAS THE SPECIALIZED STAFF, A PSYCHIATRIC ER SERVICE SECTION, THE HEALTH HOMES, AND IN-HOSPITAL BEDS FOR PATIENTS WITH MENTAL HEALTH ISSUES. MANY HOSPITAL STAFF MEMBERS ARE TRAINED IN MOTIVATIONAL INTERVIEWING AND UTILIZE THE SKILLS FROM THE SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) TECHNIQUES. THE HOSPITAL WAS ACTIVE IN FY21 WITH PROVIDING MONTHLY TRAININGS FOR THE STAFF OF CAPITAL REGION HEALTH CONNECTIONS (HEALTH HOMES PROGRAM), INCLUDING MOTIVATIONAL INTERVIEWING, SBIRT TECHNIQUES, AND THE NY STATE OPIOID OVERDOSE PREVENTION TRAINING THROUGH ONE OF OUR COLLABORATIVE PARTNERS. SAMARITAN HOSPITAL ACKNOWLEDGES THE WIDE RANGE OF HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. THUS, SECONDARY PRIORITIES SUCH AS MATERNAL AND INFANT HEALTH, SEXUALLY TRANSMITTED INFECTIONS AND LYME DISEASE WERE NOT DIRECTLY ADDRESSED BY SAMARITAN HOSPITAL. SAMARITAN HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER. SAMARITAN HOSPITAL PART V, SECTION B, LINE 15E: ALTHOUGH NOT IN THE POLICY, OUR PROCESS DOES PROVIDE THE CONTACT INFORMATION OF NONPROFIT ORGANIZATIONS OR GOVERNMENT AGENCIES THAT MAY BE SOURCES OF ASSISTANCE WITH FAP APPLICATIONS. SAMARITAN HOSPITAL - PART V, SECTION B, LINE 7A: WWW.SPHP.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-REPORTS SAMARITAN HOSPITAL - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. SAMARITAN HOSPITAL - PART V, SECTION B, LINE 10A: WWW.SPHP.COM/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-REPORTS SAMARITAN HOSPITAL - PART V, SECTION B, LINE 16A: WWW.SPHP.COM/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE SAMARITAN HOSPITAL - PART V, SECTION B, LINE 16B: WWW.SPHP.COM/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE SAMARITAN HOSPITAL - PART V, SECTION B, LINE 16C: WWW.SPHP.COM/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE 1 1 - CONTINUING TREATMENT SERVICES 1801 SIXTH AVENUE TROY NY 12180 OUTPATIENT CONTINUING TREATMENT SVC/MICA PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: SAMARITAN HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF NEW YORK. IN ADDITION, SAMARITAN HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.SAMARITAN HOSPITAL ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $20,813,153, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART I, LINE 5A: DURING FY21, DUE TO THE COVID-19 PANDEMIC, THE HOSPITAL SUSPENDED ITS TRADITIONAL ANNUAL BUDGET PROCESS AND USED A QUARTERLY PROCESS TO PLAN FOR FREE AND DISCOUNTED CARE UNDER ITS FINANCIAL ASSISTANCE POLICY. THIS CHANGE IN PROCESS DID NOT ALLOW THE HOSPITAL TO BUDGET FOR FINANCIAL ASSISTANCE EXPENSES ON AN ANNUAL BASIS. THE HOSPITAL IMPLEMENTED A NEW ROLLING FORECAST METHOD FOR FINANCIAL PLANNING IN FY22. THE ROLLING FORECAST WILL FACILITATE CONTINUOUS PLANNING, PERFORMANCE ASSESSMENT AND ACCOUNTABILITY. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: A PERCENTAGE OF THE HOSPITAL'S BAD DEBT EXPENSE IS REPORTED ON LINE 3. THIS PERCENTAGE IS BASED ON THE SELF-PAY ACCOUNTS WITH NO PAYMENTS THAT WERE TRANSFERRED TO BAD DEBT AS COMPARED TO ALL OTHER PAYORS. THE RATIONALE IS THAT THESE SELF-PAY PATIENTS WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THEY APPLIED. PART III, LINE 4: SAMARITAN HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED." PART III, LINE 8: SAMARITAN HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT 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 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - SAMARITAN HOSPITAL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAMARITAN HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. SAMARITAN HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. SAMARITAN HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAMARITAN HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - SAMARITAN HOSPITAL IS LOCATED IN TROY, NY AND IN RENSSELAER COUNTY. TROY IS LOCATED ON THE WESTERN EDGE OF RENSSELAER COUNTY AND ON THE EASTERN BANK OF THE HUDSON RIVER. TROY HAS CLOSE TIES TO THE NEARBY CITIES OF ALBANY AND SCHENECTADY, FORMING A REGION POPULARLY CALLED THE CAPITAL DISTRICT. AT THE 2010 CENSUS, THE POPULATION OF TROY WAS 50,129. FOR PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, SAMARITAN HOSPITAL DEFINES ITS PRIMARY SERVICE AREA AS ALBANY AND RENSSELAER COUNTIES, WHICH REPRESENT THE HOME ZIP CODE OF 77% OF ITS PATIENTS. THE COMMUNITY SERVED BY SAMARITAN HOSPITAL INCLUDES THE COUNTIES OF ALBANY, RENSSELAER, AND SCHENECTADY, FORMING A REGION POPULARLY CALLED THE CAPITAL DISTRICT. THE THREE COUNTIES PROVIDE A RANGE OF GEOGRAPHY THAT INCLUDES URBAN, SUBURBAN AND RURAL SETTINGS. THE COMBINED POPULATION IN ALBANY, RENSSELAER, AND SCHENECTADY COUNTIES WAS 79.9% NON-HISPANIC WHITE, 10.3% BLACK OR AFRICAN AMERICAN, 5.66% HISPANIC AND 4.14% OTHER RACES/ETHNICITIES IN 2017. OVER TIME, THE CAPITAL DISTRICT POPULATION HAS GROWN MORE ETHNICALLY DIVERSE, WITH FEWER INDIVIDUALS IDENTIFIED AS WHITE NON-HISPANIC.IN GENERAL, PERSONS IN THE COMMUNITY SERVED BY SAMARITAN HOSPITAL TEND TO BE BETTER EDUCATED AND HAVE A HIGHER INCOME THAN THOSE IN THE U.S. AS A WHOLE AND THE STATE OF NEW YORK. THERE IS A LOWER RATE OF UNEMPLOYMENT AND FEWER PERSONS WITHOUT HEALTH INSURANCE THAN THE STATE OR NATIONAL COMPARISONS. THE POPULATION FOR THE THREE-COUNTY SERVICE AREA IS 623,619. THERE ARE 276,563 HOUSING UNITS IN THE SERVICE AREA WITH AN AVERAGE OF 64% OWNER OCCUPIED. ON AVERAGE, 12.4% OF PERSONS LIVE BELOW THE POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME IS $83,990.HEALTH CARE ACCESS INDICATORS SHOW THE CAPITAL DISTRICT HAVING FEWER BARRIERS TO CARE THAN THE REST OF THE STATE. CAPITAL DISTRICT RESIDENTS, BOTH CHILDREN AND ADULTS, HAD HIGHER HEALTH INSURANCE COVERAGE RATES COMPARED TO THE REST OF THE STATE. WHILE THE CAPITAL DISTRICT HAD GOOD HEALTH INSURANCE COVERAGE, 4.95% OF RESIDENTS WERE NOT COVERED BY ANY FORM OF HEALTH INSURANCE. PART VI, LINE 5: OTHER INFORMATION - SAMARITAN HOSPITAL PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE IN THE COMMUNITY IT SERVES. THESE SERVICES INCLUDE A 24-HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL IN NEED REGARDLESS OF ABILITY TO PAY, A CANCER CENTER, CARDIAC CARE, BEHAVIORAL HEALTH SERVICES, HEALTH CENTERS FOR UNINSURED MEMBERS OF OUR COMMUNITY, AND AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. SAMARITAN CONDUCTS ITS ACTIVITIES AND ITS HEALTH CARE PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, SEXUAL ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN.ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN UPSTATE NEW YORK, SAMARITAN HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY, NOT ONLY AS A CARING COMMUNITY MEMBER, BUT ALSO AS A CATALYST FOR CHANGE. AS SUCH, WE PARTICIPATE IN MANY COMMUNITY PARTNERSHIPS AIMED AT ASSESSING THE CURRENT HEALTH STATUS OF OUR COMMUNITY AND IDENTIFYING OPPORTUNITIES TO MAKE A DIFFERENCE IN THE HEALTH OF OUR CITIZENS, WITH PARTICULAR ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. AS WE HAVE DONE FOR MANY YEARS, WE CONTINUE TO PLAY A MAJOR ROLE IN THE HEALTHY CAPITAL DISTRICT INITIATIVE, AN ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF THE RESIDENTS OF ALBANY, RENSSELAER AND SCHENECTADY COUNTIES. OUR PARTNERS IN THIS ENDEAVOR ARE THE LOCAL COUNTY HEALTH DEPARTMENTS, OTHER HEALTH CARE PROVIDERS, INSURERS AND COMMUNITY MEMBERS. SAMARITAN SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, CHURCHES, AND OTHER HEALTH CARE ORGANIZATIONS TO PROVIDE COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES AND PROACTIVE HEALTH CARE PROGRAMS. THIS INCLUDES SITTING ON COMMUNITY BOARDS, COMMITTEES AND ADVISORY GROUPS.SAMARITAN HOSPITAL ALSO PROVIDES SERVICES FOR THE BROADER COMMUNITY AS A PART OF ITS OVERALL COMMUNITY BENEFIT. ONE CATEGORY OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS; HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NONPROFIT HEALTH CARE. THIS EDUCATION INCLUDES STUDENT INTERNSHIPS, CLINIC EXPERIENCE AND OTHER EDUCATION FOR NURSES, PHYSICAL THERAPISTS AND OTHER HEALTH CARE STUDENTS. AS A NONPROFIT ORGANIZATION THAT IS PART OF ST. PETER'S HEALTH PARTNERS, SAMARITAN HOSPITAL IS GUIDED BY A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE. SAMARITAN HOSPITAL HAS AN OPEN MEDICAL STAFF COMPOSED OF QUALIFIED PHYSICIANS WHO WORK TO PROVIDE CARE TO OUR COMMUNITIES. ALL MEDICAL STAFF MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. NO PART OF THE INCOME OF SAMARITAN HOSPITAL BENEFITS ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED. ALL SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, OR PROGRAMS OF THE HOSPITAL TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OUR FACILITIES, AND ADVANCE OUR MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS.IN FY21, SAMARITAN HOSPITAL REMAINED A "TOBACCO FREE" FACILITY, BANNING USE OF TRADITIONAL TOBACCO PRODUCTS, AS WELL AS ELECTRONIC VAPING DEVICES ON OUR PROPERTY. SIGNAGE IS VISIBLE ON THE GROUNDS OF SPHP FACILITIES, INCLUDING SAMARITAN, TO REFLECT CHANGES MADE IN FY16 TO THE SPHP SMOKE FREE ENVIRONMENT POLICY. IN ADDITION, OUR CENTER FOR HEALTH PROGRAMS AND THE CAPITAL DISTRICT TOBACCO FREE COMMUNITIES WORKED TO ADVOCATE FOR COUNTY LEVEL AND STATEWIDE LEGISLATION THAT WOULD END THE SALE OF FLAVORED TOBACCO PRODUCTS, INCLUDING MENTHOL AND VAPE PRODUCTS.SAMARITAN HOSPITAL, ALONG WITH ITS SPHP SISTER HOSPITALS, COLLABORATED WITH OTHER LOCAL HEALTH SYSTEMS, COUNTY HEALTH DEPARTMENTS AND COMMUNITY-BASED AGENCIES TO FORM WORKGROUPS TO FOCUS ON THE PRIORITIES OF THE CURRENT CHNA. DURING FY21, HOSPITAL STAFF WERE MEMBERS OF THE FOLLOWING WORKGROUPS RELATING TO THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP): OBESITY/DIABETES TASKFORCE AND BEHAVIORAL HEALTH/SUBSTANCE ABUSE TASKFORCE AND THE ASTHMA/TOBACCO COALITION. EACH GROUP MET ON A REGULAR BASIS THROUGHOUT FY21 TO STRATEGIZE, IMPLEMENT AND REPORT ON ACTIVITY RELATIVE TO THE GOALS SET FORTH IN THE CURRENT CHNA/CHIP. THESE GROUPS WERE LED BY HCDI. HCDI IS AN INCORPORATED NOT-FOR-PROFIT WHICH WORKS WITH OTHERS IN THE COMMUNITY TO DETERMINE WAYS IN WHICH THE CAPITAL REGION COULD BE MORE EFFECTIVE IN IDENTIFYING AND ADDRESSING PUBLIC HEALTH ISSUES.DURING FY21, SPHP, INCLUDING SAMARITAN HOSPITAL, INITIATED SCREENING FOR SOCIAL INFLUENCERS (DETERMINANTS) OF HEALTH IN OUR EMERGENCY DEPARTMENTS AND AMBULATORY SITES. PATIENT NAVIGATORS AND SOCIAL CARE HUB STAFF COMPLETED A 10-QUESTION SCREENING TOOL WITH PATIENTS. THE QUESTIONS ADDRESSED A VARIETY OF ISSUES SUCH AS HOUSING, TRANSPORTATION, FOOD INSECURITY, HEALTH LITERACY AND ACCESS TO CARE. PATIENTS IN NEED OF ASSISTANCE WITH THESE ISSUES WERE GIVEN REFERRALS TO APPROPRIATE RESOURCES/SERVICES. ALSO, DURING FY21, SPHP, INCLUDING SAMARITAN HOSPITAL, ADDRESSED THE ISSUE OF HOUSING BY COLLABORATING WITH THE INTERFAITH PARTNERSHIP FOR THE HOMELESS TO PROVIDE GOODS AND MONETARY DONATIONS TO THE SR. MAVIS JEWELL MEDICAL RESPITE PROGRAM FOR THE HOMELESS, JOSEPH'S HOUSE, HATAS AND EQUINOX. FOR EXAMPLE, SPHP PROVIDED PORTABLE HANDWASHING STATIONS AND COVID CARE KITS (BAGS CONTAINING ITEMS TO HELP KEEP VULNERABLE POPULATIONS SAFE AND PROVIDE VACCINE INFORMATION) TO SOME OF THESE ORGANIZATIONS.DURING FY21, SPHP, INCLUDING SAMARITAN HOSPITAL, PARTICIPATED IN COVID-19 EMERGENCY PREPAREDNESS EFFORTS IN A VARIETY OF ASPECTS. OUR SENIOR LEADERSHIP TEAM SERVED ON COMMAND CENTERS AND TASK FORCES (DAILY) TO MANAGE THIS HEALTH CRISIS, PARTNERING WITH EXTERNAL HOSPITAL SYSTEMS AND LOCAL AND STATE DEPARTMENTS OF HEALTH, IN ORDER TO PROVIDE A COORDINATED EFFORT TO ADDRESS THE NEEDS OF OUR COMMUNITY WITH RESPECT TO THIS PANDEMIC. STAFF WERE ALSO RE-DEPLOYED TO CENTRALIZED COMMUNITY DRIVE-UP TESTING SITES TO ADMINISTER COVID-19 TESTING AND ASSIST WITH PATIENT REGISTRATION. IN ADDITION, SPHP, INCLUDING SAMARITAN, CONDUCTED WELLNESS AND SOCIAL NEEDS ASSESSMENTS FOR COVID-19 PRESUMPTIVE OR POSITIVE PATIENTS WHO WERE UNDER SELF-QUARANTINE ORDERS. OUR SOCIAL CARE HUB CONTINUED TO SCREEN AND ADDRESS THE SOCIAL NEEDS OF OUR PATIENTS DURING THIS DIFFICULT TIME. PATIENTS NEEDING ASSISTANCE WITH FOOD, TRANSPORTATION, HOUSING, ACCESS TO CARE, CHILDCARE, ETC. WERE PROVIDED REFERRALS TO INTERNAL AND COMMUNITY ASSISTANCE PROGRAMS.DURING FY21, SPHP, INCLUDING SAMARITAN HOSPITAL, WORKED ON COVID-19 VACCINATION OUTREACH AND EDUCATION. SPHP COMMUNITY HEALTH & WELL-BEING (CHWB), IN CONJUNCTION WITH CORPORATE COMMUNICATIONS, AND TRINITY HEALTH LAUNCHED A CAMPAIGN, TITLED "IT STARTS HERE". IT FOCUSED ON POPULATIONS THAT HAVE BEEN DISPROPORTIONATELY AFFECTED BY COVID-19 INFECTIONS AND DEATH, MAINLY COMMUNITIES OF COLOR, AND PEOPLE WHO ARE POOR AND UNDERSERVED. "IT STARTS HERE" SUPPORTED LOCAL COMMUNITIES IN ACCELERATING EFFORTS BY RAISING AWARENESS, EDUCATING THE PUBLIC AND OFFERING THE VACCINE IN COMMUNITY ACCESSIBLE LOCATIONS, PARTICULARLY FOR COMMUNITIES OF COLOR AND THOSE WHO ARE VULNERABLE. CHWB COLLABORATED WITH AND SUPPORTED LOCAL COMMUNITY-BASED ORGANIZATIONS THROUGH GRANT FUNDS AWARDED BY TRINITY HEALTH; THESE FUNDS ASSISTED IN BUILDING COMMUNITY CAPACITY TO VACCINATE, PROMOTE AWARENESS OF AND AVAILABILITY TO RECEIVE THE COVID-19 VACCINE. PART VI, LINE 6: SAMARITAN HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR THOSE WHO ARE POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE BY CONNECTING SOCIAL AND CLINICAL CARE, ADDRESSING SOCIAL NEEDS, DISMANTLING SYSTEMIC RACISM, AND REDUCING HEALTH INEQUITIES. WE DO THIS BY: 1. INVESTING IN OUR COMMUNITIES 2. ADVANCING SOCIAL CARE3. IMPACTING SOCIAL INFLUENCERS OF HEALTHINVESTING IN OUR COMMUNITIES:TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2021, TRINITY HEALTH INVESTED $1.2 BILLION IN COMMUNITY BENEFIT, SUCH AS INITIATIVES SUPPORTING THOSE WHO ARE POOR AND VULNERABLE, HELPING TO MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, AND MOVING FORWARD POLICY, SYSTEM, AND ENVIRONMENTAL CHANGE. IN RESPONSE TO COVID-19, TRINITY HEALTH MEMBER HOSPITALS REDIRECTED SOME RESOURCES TO ADDRESS THE MOST URGENT SOCIAL AND MEDICAL NEEDS IN OUR COMMUNITIES, INCLUDING FOOD SUPPORT, EDUCATION SUPPORT, AND OUTREACH TO THOSE EXPERIENCING HOMELESSNESS.ADDITIONALLY, THROUGH TRINITY HEALTH'S COMMUNITY HEALTH INSTITUTE, $1.6 MILLION WAS INVESTED IN THE "IT STARTS HERE" COVID-19 VACCINE CAMPAIGN, COUPLING COMMUNITY ENGAGEMENT STRATEGIES AND SOCIAL MEDIA INFLUENCERS. THIS EFFORT DISTRIBUTED $1.1 MILLION IN CHWB GRANTS TO MEMBER HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF COMMUNITY ENGAGEMENT STRATEGIES FOCUSED IN COMMUNITIES OF COLOR. OVER 80% OF DOLLARS AWARDED SUPPORTED PRIORITIZED COMMUNITIES, DEFINED AS 40% OF THE COMMUNITY BEING BLACK/LATINX AND/OR NATIVE AMERICAN. IT STARTS HERE LAUNCHED IN FEBRUARY, AND IN JUST UNDER FIVE MONTHS, MEMBER HOSPITALS AND THEIR COMMUNITY PARTNERS REACHED NEARLY 615,000 PEOPLE THROUGH OUTREACH AND EDUCATION, ENGAGED OVER 1,150 COMMUNITY CHAMPIONS, AND HELD OVER 700 VACCINE CLINICS THAT PROVIDED OVER 152,000 VACCINATIONS. IN ADDITION TO COMMUNITY EFFORTS, IT STARTS HERE FUNDED SOCIAL MEDIA CAMPAIGNS TO IMPROVE ACCESS TO COVID-19 VACCINATION INFORMATION BY ENGAGING LOCAL SOCIAL MEDIA INFLUENCERS WHO REPRESENT THE CULTURE AND ETHNICITY OF OUR LOCAL COMMUNITIES.BEYOND COVID-19 EFFORTS, TRINITY HEALTH COMMITTED MORE THAN $46 MILLION IN LOANS TO 31 NOT-FOR-PROFIT ORGANIZATIONS FOCUSING ON IMPROVING COMMUNITY CONDITIONS AROUND HOUSING, FACILITIES, EDUCATION, AND ECONOMIC DEVELOPMENT THROUGH OUR COMMUNITY INVESTING PROGRAM. THE PROGRAM MAKES LOW-INTEREST RATE LOANS TO SELECT COMMUNITY PARTNERS AND INTERMEDIARIES TO POSITIVELY IMPACT SOCIAL INFLUENCERS THAT DRIVE HEALTHY OUTCOMES FOR FAMILIES AND RESIDENTS LIVING IN THE COMMUNITIES WE SERVE. ADVANCING SOCIAL CARE:TRINITY HEALTH'S SOCIAL CARE PROGRAM WAS DEVELOPED TO PROMOTE HEALTHY BEHAVIORS WHILE HELPING PATIENTS, COLLEAGUES AND MEMBERS ACCESS ESSENTIAL NEEDS, SUCH AS TRANSPORTATION, CHILDCARE, OR AFFORDABLE MEDICATIONS. COMMUNITY HEALTH WORKERS ARE A KEY COMPONENT OF SOCIAL CARE AND SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES AND THE COMMUNITY TO ADDRESS PATIENTS' SOCIAL NEEDS AND MITIGATE BARRIERS. TRINITY HEALTH'S COMMUNITY HEALTH WORKER HUB DRIVES INTEGRATION AND ASSIGNMENT OF COMMUNITY HEALTH WORKERS THROUGHOUT THE HEALTH SYSTEM. IT INCLUDES A NETWORK OF COMMUNITY HEALTH WORKERS AND COMMUNITY-BASED ORGANIZATIONS THAT TOGETHER, HELP SUPPORT INDIVIDUALS AND FAMILIES IN NEED. BECAUSE OF THEIR LIVED EXPERIENCES, COMMUNITY HEALTH WORKERS ARE TRUSTED MEMBERS OF THE COMMUNITY AND WORK CLOSELY WITH A PATIENT BY ASSESSING THEIR SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECT THE INDIVIDUAL TO SERVICES WITHIN THE COMMUNITY. IN FISCAL YEAR 2021, TRINITY HEALTH GREW ITS NETWORK OF COMMUNITY HEALTH WORKERS BY 15%, OVER 90 COMMUNITY HEALTH WORKERS, SPANNING NEARLY EVERY MEMBER HOSPITAL.ADDITIONALLY, WE CREATED THE TRINITY HEALTH COMMUNITY RESOURCE DIRECTORY, WHICH IS AN ONLINE PORTAL CONNECTING THOSE IN NEED TO FREE OR REDUCED-COST HEALTH AND SOCIAL SERVICE RESOURCES WITHIN THE COMMUNITY AND ACROSS ALL TRINITY HEALTH LOCATIONS. IN FISCAL YEAR 2021, THE COMMUNITY RESOURCE DIRECTORY YIELDED NEARLY 50,000 SEARCHES, OVER 1,000 REFERRALS, OVER 70 KEY ORGANIZATIONS CLAIMED THEIR PROGRAMS, AND OVER 900 SOCIAL NEEDS ASSESSMENTS WERE COMPLETED.TRINITY HEALTH CONTINUES TO EXPAND THE NATIONAL DIABETES PREVENTION PROGRAM THROUGH THE SUPPORT OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. EPIC, TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, IDENTIFIED THE DIABETES PREVENTION PROGRAM AS A BEST PRACTICE FOR IDENTIFICATION OF AT-RISK PATIENTS, REFERRAL, AND BI-DIRECTIONAL COMMUNICATION. ADDITIONALLY, THE AMERICAN MEDICAL ASSOCIATION PRESENTED TRINITY HEALTH'S DIABETES PREVENTION PROGRAM APPROACH TO THEIR BOARD OF DIRECTORS AS A BEST PRACTICE FOR A POPULATION HEALTH, DATA-DRIVEN STRATEGY TO PREVENT DIABETES.IMPACTING SOCIAL INFLUENCERS OF HEALTH:IN PARTNERSHIP WITH THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY, THE INVESTOR ENVIRONMENTAL HEALTH NETWORK AND INVESTORS FOR OPIOID AND PHARMACEUTICAL ACCOUNTABILITY, TRINITY HEALTH USES ITS OWNERSHIP OF SHARES OF STOCK IN CORPORATIONS TO INFLUENCE CORPORATIONS' POLICIES AND PRACTICES THAT AFFECT SOCIAL INFLUENCERS OF HEALTH, THE LIVING CONDITIONS THAT CAN AFFECT THE HEALTH OF A COMMUNITY, SUCH AS HOUSING, FOOD, EDUCATION, HEALTH CARE, AND ECONOMICS. TRINITY HEALTH TAKES ACTION BY WRITING LETTERS TO COMPANIES, MEETING WITH CORPORATE MANAGEMENT, AND SUBMITTING AND SUPPORTING SHAREHOLDER RESOLUTIONS AS AGENDA ITEMS FOR COMPANIES' ANNUAL MEETINGS OF SHAREHOLDERS.FISCAL YEAR 2021 YIELDED MANY POSITIVE OUTCOMES IN ITS 180 COMPANY ENGAGEMENTS, INCLUDING 50 COMPANY DIALOGUES AND 16 FILED RESOLUTIONS LEADING TO CHANGES IN POLICIES AND PRACTICES AT 18 CORPORATIONS. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 1 0 0 0 0 0 0 0 BENJAMIN CARTER DIRECTOR AS OF 1/21; TH EVP & COO 0 1254721 0 0 0 300513 0 12825 0 70455 0 1638514 0 0 JAMES REED MD DIRECTOR; PRESIDENT & CEO 0 683646 0 0 0 233329 0 21375 0 84252 0 1022602 0 0 PHILIP CLEMENTS MD PHYSICIAN 734862 0 0 0 3623 0 12825 0 29849 0 781159 0 0 0 MICHAEL FINEGAN PRESIDENT, ACUTE CARE 0 447448 0 0 0 134261 0 12825 0 38041 0 632575 0 0 EMILY BROWER DIR THR 12/20;TH SVP CLIN INT/PHY SV 0 436906 0 0 0 17794 0 91538 0 36876 0 583114 0 0 AXEL HERRMANNSDOERFER MD PHYSICIAN 532596 0 0 0 9449 0 21375 0 15953 0 579373 0 0 0 THOMAS ROBERT SPHP VP, CFO & TREASURER 0 448775 0 0 0 11862 0 78203 0 35136 0 573976 0 0 DINA GOTTESMAN DO PHYSICIAN 507120 0 0 0 502 0 12825 0 28867 0 549314 0 0 0 ANDREW GUNTHER MD PHYSICIAN 506456 0 0 0 6971 0 12825 0 9048 0 535300 0 0 0 NAMRATA PATEL MD PHYSICIAN 498791 0 0 0 660 0 12825 0 11918 0 524194 0 0 0 ALAN SANDERS MD CHIEF MEDICAL OFFICER, ACUTE CARE 0 401949 0 0 0 2828 0 12825 0 22839 0 440441 0 0 LORI SANTOS VICE PRESIDENT, ACUTE CARE FINANCE 0 347656 0 0 0 9017 0 17100 0 12617 0 386390 0 0 DANIEL KOCHIE FORMER OFFICER;REG DIRECTOR THR 1/20 0 28950 0 0 0 182233 0 488 0 9862 0 221533 0 0 ROBERT SWIDLER ESQ SECRETARY; VP LEGAL SERVICES 0 155800 0 0 0 38063 0 0 0 0 0 193863 0 0 PART I, LINE 3 SAMARITAN HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. SAMARITAN HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF SAMARITAN HOSPITAL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2020. THIS AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DANIEL KOCHIE - $176,442 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2020. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2020, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2020. THE FOLLOWING PAYOUTS FOR 2020 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BENJAMIN CARTER - $260,058 MICHAEL FINEGAN - $116,319 JAMES REED - $175,838 ROBERT SWIDLER - $38,063 THE FOLLOWING ACCRUALS FOR 2020 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: EMILY BROWER - $78,713 THOMAS ROBERT - $56,828 THE FOLLOWING IS A PARTICIPANT IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($285,000 FOR 2020). THE FOLLOWING PAYOUT FOR 2020 FOR THIS PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: LORI SANTOS - $3,825 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAMARITAN HOSPITAL IS ST. PETER'S HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A ST. PETER'S HEALTH PARTNERS IS THE SOLE MEMBER OF SAMARITAN HOSPITAL. ST. PETER'S HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF SAMARITAN HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, ST. PETER'S HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. ST. PETER'S HEALTH PARTNERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. AS THE PARENT OF THE NATIONAL TRINITY HEALTH SYSTEM, CERTAIN POWERS ARE RESERVED TO TRINITY HEALTH CORPORATION. THESE INCLUDE THE AUTHORITY TO ADOPT OR MODIFY THE ORGANIZATION'S GOVERNING DOCUMENTS, TO APPROVE MAJOR CHANGES SUCH AS A MERGER OR DISSOLUTION, AND TO APPROVE SIGNIFICANT FINANCE MATTERS IN EXCESS OF CERTAIN LIMITS ESTABLISHED BY TRINITY HEALTH CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR SAMARITAN HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS AFTER THE RETURN IS FILED. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SAMARITAN HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF SAMARITAN HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF SAMARITAN HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF SAMARITAN HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAMARITAN HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF SAMARITAN HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF SAMARITAN HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING COMPENSATION FOR THE CEO, CFO AND CERTAIN OTHER OFFICERS, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THESE INDIVIDUALS ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 SAMARITAN HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, SAMARITAN HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. SAMARITAN HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES -25,078,018. OTHER TRANSACTIONS 5,454,704. ASSET IMPAIRMENT -533,884. FORM 990, PART XII, LINE 2: SAMARITAN HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY21 CONSOLIDATED FINANCIAL STATEMENTS OF ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH, WHICH WERE BOTH AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES SAMARITAN HOSPITAL - ST. MARY'S CAMPUS, SAMARITAN HOSPITAL - ALBANY MEMORIAL CAMPUS, CAPITAL REGION FAMILY HEALTH CARE, LATHAM PRIMARY CARE ASSOCIATES, STILLWATER FAMILY HEALTH CENTER, SAMARITAN OB/GYN, CLIFTON PARK FAMILY PRACTICE, TROY PEDIATRIC HEALTH CENTER, CLIFTON PARK PHYSICAL REHABILITATION, CAPITAL REGION HEALTH CONNECTIONS, RIVERSIDE FAMILY MEDICAL GROUP, PREMIER HEALTH FOR BUSINESS, COHOES FAMILY CARE, DIABETES MANAGEMENT SYSTEMS, SKINCARE MANAGEMENT SYSTEMS, HEALTHFIRST ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI MI 48197 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EAST NORRITON PHYSICIANS SERVICES INC ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232515999 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 THE MERCY HOSPITAL INC 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL INC 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 12D, III-O N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HEART CENTER OF GREATER WATERBURY INC 114 WOODLAND STREET HARTFORD CT 06105 830416893 MANAGEMENT CT 501(C)(3) LINE 12A, I N/A 0 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 520738041 HEALTH CARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791028 HEALTH CARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 465421068 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 812531495 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOLY CROSS SENIOR SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 832256461 HEALTH CARE SERVICES FL 501(C)(3) LINE 10 HOLY CROSS HOSPITAL INC 1 HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY NY 12180 141514867 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 50401 421173708 HOSPICE SERVICES IA 501(C)(3) LINE 10 MERCY HEALTH SERVICES-IOWA CORP 1 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51104 383320710 HOSPICE SERVICES IA 501(C)(3) LINE 12A, I N/A 0 IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR MI 48106 383316559 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 JOHNSON MEMORIAL HOSPITAL INC 114 WOODLAND STREET HARTFORD CT 06105 475676956 HEALTH CARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232519529 HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232571699 HEALTH CARE SERVICES PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN NJ 08109 261854750 PACE PROGRAM NJ 501(C)(3) LINE 3 TRINITY HEALTH PACE 1 LIFE AT ST FRANCIS HEALTHCARE INC 7TH AND CLAYTON STREETS WILMINGTON DE 19805 452569214 PACE PROGRAM DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL INC 1 LIFE ST FRANCIS CORPORATION 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 ST FRANCIS MEDICAL CENTER TRENTON NJ 1 LIFE ST JOSEPH OF THE PINES INC 4900 RAEFORD ROAD FAYETTEVILLE NC 28304 272159847 PACE PROGRAM NC 501(C)(3) LINE 3 TRINITY HEALTH PACE 1 LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 262976184 PACE PROGRAM PA 501(C)(3) LINE 10 ST MARY MEDICAL CENTER 1 LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK IL 60160 474147171 TRANSPORTATION SERVICES IL 501(C)(3) LINE 10 LOYOLA UNIVERSITY MEDICAL CENTER 1 LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 363342448 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 12B, II TRINITY HEALTH CORPORATION 1 LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 364015560 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 LTC (EDDY) INC 2212 BURDETT AVE TROY NY 12180 222564710 MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 12B, II ST PETER'S HEALTH PARTNERS 1 MAXIS HEALTH SYSTEM 20555 VICTOR PARKWAY LIVONIA MI 48152 911940902 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT PA 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD CT 06117 061058086 SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 10 MERCY COMMUNITY HEALTH INC 1 MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH PA 15213 943436142 GRANT MAKING PA 501(C)(3) LINE 12B, II PITTSBURGH MERCY HEALTH SYSTEM INC 1 MERCY CARE CENTER 20555 VICTOR PARKWAY LIVONIA MI 48152 853904921 HEALTH CARE AND HOSPITAL SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 MERCY CARE FOUNDATION INC 424 DECATUR STREET ATLANTA GA 30312 581448522 FOUNDATION GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 231352191 HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 TRINITY HEALTH OF THE MID-ATLANTIC REGION 1 MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD CT 06117 061492707 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 12B, II TRINITY CONTINUING CARE SERVICES 1 MERCY FAMILY SUPPORT 1001 BALTIMORE PIKE SUITE 310 SPRINGFIELD PA 19064 232325059 HOME HEALTH SERVICES PA 501(C)(3) LINE 10 MERCY HOME HEALTH SERVICES 1 MERCY FOUNDATION INC 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