KALEIDA HEALTH: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: KALEIDA HEALTH (EIN 16-1533232)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-14
IRS object ID: 202223189349303882
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-14T09:40:12-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135565207	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	515 BROADWAY 4TH FL	AddressLine1Txt
City	ALBANY	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	122072974	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	161533232	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KALEIDA HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	KALE	BusinessNameControlTxt
Phone	7168598836	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	726 EXCHANGE STREET 200	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14210	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	STEPHEN HARDY	PersonNm
Person Title	VP FINANCE	PersonTitleTxt
Phone	5856107000	PhoneNum
Signature	2022-11-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	STEPHEN	PersonFirstNm
Person Last	HARDY	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	STEPHANIE LONCZAK	PreparerPersonNm
PTIN	P01880207	PTIN
Phone	5184274600	PhoneNum
Preparation	2022-11-08	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DONALD BOYD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HIGH STREET	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14203	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,425,829,441	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.KALEIDAHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	KALEIDA HEALTH PROVIDES HEALTHCARE SERVICES FOR THE EIGHT COUNTIES OF WNY AT FOUR ACUTE CARE, TWO LT CARE, AND OTHER OUTPATIENT NAD PRIMARY CARE SITES.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	7959	TotalEmployeeCnt
Total Volunteers	1175	TotalVolunteersCnt
Total Gross UBI	$6,080,321	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$92,997,486	PYContributionsGrantsAmt
CY Contributions Grants	$13,902,955	CYContributionsGrantsAmt
PY Program Service Revenue	$1,209,418,242	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,376,606,865	CYProgramServiceRevenueAmt
PY Investment Income	$1,605,023	PYInvestmentIncomeAmt
CY Investment Income	$4,049,446	CYInvestmentIncomeAmt
PY Other Revenue	$26,045,136	PYOtherRevenueAmt
CY Other Revenue	$27,897,019	CYOtherRevenueAmt
PY Total Revenue	$1,330,065,887	PYTotalRevenueAmt
CY Total Revenue	$1,422,456,285	CYTotalRevenueAmt
PY Grants And Similar Paid	$537,250	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$599,550	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$724,664,804	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$719,279,567	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$665,677,999	PYOtherExpensesAmt
CY Other Expenses	$694,657,051	CYOtherExpensesAmt
PY Total Expenses	$1,390,880,053	PYTotalExpensesAmt
CY Total Expenses	$1,414,536,168	CYTotalExpensesAmt
PY Revenues Less Expenses	-$60,814,166	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,920,117	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,227,951,462	TotalAssetsBOYAmt
Total Assets EOY	$1,193,308,740	TotalAssetsEOYAmt
Total Liabilities BOY	$1,324,141,945	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,131,944,176	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$96,190,483	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$61,364,564	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	KALEIDA HEALTH IS THE LARGEST HEALTHCARE PROVIDER IN WNY, SERVING THE AREA'S EIGHT COUNTIES WITH COMPREHENSIVE SERVICES & PROGRAMS PROVIDED AT FOUR ACUTE CARE, TWO LONG TERM CARE, AS WELL AS OUTPATIENT & PRIMARY CARE SITES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$1,212,201,037	ExpenseAmt
Grant	$599,550	GrantAmt
Revenue	$1,378,664,919	RevenueAmt
Desc	SEE SCHEDULE OKALEIDA HEALTH IS A VOLUNTARY, NOT-FOR-PROFIT; NEW YORK STATE DEPARTMENT OF HEALTH ARTICLE 28 LICENSED HOSPITAL-BASED HEALTHCARE DELIVERY SYSTEM SERVICING THE COMMUNITIES OF WESTERN NEW YORK STATE AT VARIOUS LEVELS AND WITH FACILITIES IN MULTIPLE LOCATIONS THROUGHOUT THE REGION. KALEIDA HEALTH INCLUDES THE BUFFALO GENERAL MEDICAL CENTER (BUFFALO GENERAL), MILLARD FILLMORE SUBURBAN HOSPITAL (MILLARD SUBURBAN), JOHN R. OISHEI CHILDREN'S HOSPITAL (OISHEI CHILDREN'S HOSPITAL, FORMERLY THE WOMEN & CHILDREN'S HOSPITAL OF BUFFALO), AND DEGRAFF MEMORIAL HOSPITAL (DEGRAFF). IN ADDITION TO THE FOUR KALEIDA HEALTH (KALEIDA) HOSPITALS, KALEIDA OPERATES TWO SKILLED NURSING FACILITIES, AND NUMEROUS OUTPATIENT CLINICS. THE ABOVE FACILITIES OPERATE UNDER ONE TAX IDENTIFICATION NUMBER.OUR FAMILY OF HEALTH CARE ORGANIZATIONS IS BLENDED TOGETHER INTO ONE FRAMEWORK FOR LEADERSHIP, GOVERNANCE, SHARED SERVICES, FINANCIAL INFRASTRUCTURE AND INFORMATION TECHNOLOGY PLATFORMS. COLLECTIVELY, KALEIDA HEALTH'S MARKET SHARE IS 32.9% IN WESTERN NEW YORK, 41.39% IN ERIE COUNTY AND 34.37% IN NIAGARA COUNTY. ANNUALLY $1.2 MILLION COMBINED INPATIENT, EMERGENCY DEPARTMENT AND OUTPATIENT VISITS OCCUR AT THE HEALTH CARE FACILITIES IN THE KALEIDA HEALTH SYSTEM, WHICH EMPLOYS APPROXIMATELY 8,700 STAFF AND HAVE APPROXIMATELY 2,450 MEDICAL STAFF MEMBERS. DURING 2021, THERE WERE 53,006 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED, 48% MEDICARE AND MEDICARE MANAGED CARE AND 0.4% WERE UNINSURED, AND 25% WERE OTHER. KALEIDA HEALTH'S MISSION IS TO ADVANCE THE HEALTH OF OUR COMMUNITY. OUR VISION IS TO PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE. OUR VALUES CLEARLY STATE WHO WE ARE AND HOW WE PERFORM OUR WORK:CENTERED: REMAIN CENTERED AROUND THE PATIENT AND FAMILY.ACCOUNTABLE: BE ACCOUNTABLE TO PATIENTS AND EACH OTHER.RESPECT: SHOW RESPECT AND INTEGRITY.EXCELLENCE: PROVIDE EXCELLENCE IN ALL WE DO.KALEIDA HEALTH'S PROGRAMS AND AFFILIATES ARE LICENSED BY THE STATE OF NEW YORK DEPARTMENT OF HEALTH AND ACCREDITED BY DNV. KALEIDA IS CERTIFIED BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PARTICIPATION IN MEDICARE AND MEDICAID. THE ACCREDITATION COUNSEL FOR GRADUATE MEDICAL EDUCATION APPROVES ALL RESIDENCY PROGRAMS FOR PHYSICIANS, AND THE AMERICAN DENTAL ASSOCIATION APPROVES ITS DENTAL AND ORAL SURGERY PROGRAMS. KALEIDA IS ALSO A MEMBER OF THE COUNCIL OF TEACHING HOSPITALS, THE AMERICAN DENTAL ASSOCATION, THE AMERICAN MEDICAL ASSOCATION AND THE GREATER NEW YORK HOSPITAL ASSOCATION.OPERATION OF EMERGENCY ROOMS:KALEIDA HEALTH OPERATES FOUR EMERGENCY ROOMS, ONE IN EACH OF THE ACUTE CARE HOSPITALS, GENERATING A TOTAL OF 157,353 PATIENT VISITS DURING 2021. THE EMERGENCY DEPARTMENTS, WHICH OPERATE 24 HOURS A DAY, SEVEN DAYS EACH WEEK, ARE OPEN TO ANYONE, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES.BOARD OF DIRECTORS AND COMMUNITY GUIDANCE:KALEIDA HEALTH MAINTAINS COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF KALEIDA HEALTH. THE MAJORITY OF THE DIRECTORS RESIDE IN WESTERN NEW YORK AND EACH DIRECTOR SERVES A THREE-YEAR TERM. OPEN MEDICAL STAFF:AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATON, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING OUR MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.USE OF SURPLUS FUNDS:SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY.COMMUNITY BENEFIT PROGRAMS AND SERVICES:KALEIDA HEALTH OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS AND SERVICES IN RESPONSE TO THE COMMUNITY'S NEEDS, BY IMPROVING ACCESS TO CARE, IMPROVE PUBLIC HEALTH, ADVANCE KNOWLEDGE AND RELIEVE GOVERNMENT PROGRAMS. THESE PROGRAMS ARE CONDUCTED IN COMMUNITY-BASED SETTINGS SUCH AS SCHOOLS, CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS AND PROGRAMS ARE ALSO OFFERED AT KALEIDA'S HOSPITAL CAMPUSES AND FACILITIES. COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE HEALTH FAIRS, HEALTH SCREENINGS, HEALTH EDUCATION LECTURES AND WORKSHOPS FOR COMMUNITY GROUPS AND THE GENERAL PUBLIC, SCHOOL HEALTH EDUCATION PROGRAMS, AND CONSUMER HEALTH INFORMATION IN THE KALEIDA HEALTH LIBRARIES. KALEIDA ALSO OFFERS A NUMBER OF SUBSIDIZED HEALTH SERVICES SUCH AS OUTPATIENT CLINICS, LONG-TERM CARE SERVICES, WOMEN'S HEALTH CENTERS, DIALYSIS SERVICES, BEHAVIORAL HEALTH SERVICES, SCHOOL-BASED HEALTH CENTERS, EARLY CHILDHOOD PROGRAM, EARLY INTERVENTION SERVICES, FAMILY PLANNING SERVICES, WESTERN NEW YORK CLINICAL INFORMATION EXCHANGE AND HEALTH-E-LINK AND DIAGNOSTIC, THERAPEUTIC AND REHABILITATION SERVICES FOR CHILDREN WITH SPECIAL NEEDS. KALEIDA'S HOSPITALS SERVE AS A MAJOR TEACHING AFFILIATE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND DENTAL MEDICINE, WITH TRAINING TO 400 MEDICAL AND DENTAL RESIDENTS EACH YEAR. KALEIDA IS INVOLVED IN AND SPONSORS RESEARCH PROJECTS, AND WE PROVIDE LOAN FORGIVENESS FOR PHYSICIANS TO ESTABLISH OR JOIN EXISTING PRACTICES THAT SERVE THE UNDERSERVED COMMUNITIES OF BUFFALO AND WESTERN NEW YORK. KALEIDA OFFERS CLINICAL TRAINING FACILITIES AND SUPPORT FOR NURSING AND A NUMBER OF ALLIED HEALTH PROFESSIONAL TRAINING PROGRAMS AT LOCAL COLLEGES AND UNIVERSITIES, AND OTHER PROFESSIONAL DEVELOPMENT/CONTINUING EDUCATION TRAINING PROGRAMS FOR COLLEAGUES FROM HEALTH CARE ORGANIZATIONS ACROSS THE REGION.	Desc
Total Program Service Expenses	$1,212,201,037	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	1027	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	7959	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (1)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MATTHEW DRAKE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7168598836	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HIGH STREET FLOOR 11	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14203	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROBERT NESSELBUSH
CHIEF EXECUTIVE OFFICER	40.00	Yes (X)	Yes (X)	$1,358,043	$0	$35,301
NICHOLAS J AQUINO MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
LORRIE A CLEMO PHD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GARY M CROSBY
CHAIRMAN	1.00	Yes (X)		$0	$0	$0
FRANK CURCI
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ABEER EDDIB MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
WILLIAM J HOCHUL JR
DIRECTOR (THRU AUG 21)	1.00	Yes (X)		$0	$0	$0
MUHAMMED JAVED MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
WILLIAM J MAGGIO JR
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GEORGE E MATTHEWS MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
TIMOTHY G MCEVOY ESQ
DIRECTOR	1.00	Yes (X)		$0	$0	$0
PAUL O'LEARY
DIRECTOR	1.00	Yes (X)		$0	$0	$0
CHRISTOPHER ROSS
DIRECTOR	1.00	Yes (X)		$0	$0	$0
MARY LOU RUSIN RD EDD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DONALD BOYD
PRESIDENT, COO	40.00		Yes (X)	$1,093,754	$0	$17,437	1.00
DAVID HUGHES MD
EVP, CMO	40.00		Yes (X)	$782,381	$0	$32,457	1.00
PAUL BELTER
EVP, CHIEF FINANCIAL OFFICER	40.00		Yes (X)	$643,787	$0	$18,813
CHERYL KLASS
EVP, CHIEF NURSE EXECUTIVE	40.00		Yes (X)	$601,194	$0	$18,530
ALYSON SPAULDING
GENERAL COUNSEL	40.00		Yes (X)	$578,706	$0	$28,723
CHRISTOPHER LANE
PRESIDENT BGMC AND GVI	40.00			$630,469	$0	$21,195		Yes (X)
ALLEGRA JAROS
PRESIDENT WCHOB	40.00			$521,104	$0	$19,625	1.00	Yes (X)
MICHAEL HUGHES
CHIEF ADMINISTRATIVE OFFICER	40.00			$527,071	$0	$7,773		Yes (X)
JUDY BAUMGARTNER
PRESIDENT DEGRAFF	40.00			$490,102	$0	$5,716		Yes (X)
STEPHEN HARDY
VP FINANCE	40.00			$306,234	$0	$16,423		Yes (X)
CHRISTOPHER MALLAVARAPU MD
EMPLOYED PHYSICIAN	40.00			$834,650	$0	$33,868			Yes (X)
KAVEH VALI MD
EMPLOYED PHYSICIAN	40.00			$768,747	$0	$11,711			Yes (X)
CARROLL HARMON MD
EMPLOYED PHYSICIAN	40.00			$684,300	$0	$12,855			Yes (X)
LUCY CAMPBELL MD
EMPLOYED PHYSCIAN	40.00			$596,107	$0	$35,558			Yes (X)
KATHRYN BASS MD
EMPLOYED PHYSICIAN	40.00			$402,965	$0	$18,225			Yes (X)
JODY LOMEO
FMR PRES/CEO EX-OFFICIO W/VOTE	0.00			$2,735,515	$0	$12,721				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$13,555,129	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$346,931	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1019	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CERNER CORPORATION
PO BOX 959156	ST LOUIS	MO	63195	TECH CONSULTANT	$8,265,519
WNY RADIOLOGY LLC
PO BOX 4029	BUFFALO	NY	14240	RADIOLOGY SERVICES	$7,503,886
PROLINK HEALTHCARE
4700 ROCKSIDE RD 640	INDEPENDENCE	OH	44131	STAFFING SERVICES	$3,505,734
METZ CULINARY MANAGEMENT
TWO WOODLAND DRIVE	DALLAS	PA	18612	DINING SERVICES	$3,092,116
ABBOTT DIAGNOSTICS
100 ABBOTT PARK ROAD	ABBOTT PARK	IL	00064	TECH CONSULTANT	$2,738,057

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	100	CntrctRcvdGreaterThan100KCnt
Related Organizations	$4,932,210	RelatedOrganizationsAmt
Government Grants	$5,872,829	GovernmentGrantsAmt
All Other Contributions	$3,097,916	AllOtherContributionsAmt
Noncash Contributions	$4,359,054	NoncashContributionsAmt
Total Contributions	$13,902,955	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	623990	$1,369,468,084	$1,369,468,084
LAB SERVICES	621500	$7,028,781		$7,028,781
MANAGEMENT FEES	561000	$110,000		$110,000

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,376,606,865	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,713,349	TotalRevenueColumnAmt
Unrelated Business Revenue	-$1,267,124	UnrelatedBusinessRevenueAmt
Exclusion	$5,980,473	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,341,853	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$573,156	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,768,697	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,768,697	TotalRevenueColumnAmt
Exclusion	$1,768,697	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,136,097	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$2,800,000	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$663,903	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$663,903	TotalRevenueColumnAmt
Exclusion	-$663,903	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS INCOME	561000	$14,186,903	$5,334	$14,181,569
REBATE REVENUE	900099	$8,662,647		$8,662,647
MANAGEMENT & CONSULTING FEES	541610	$1,349,519			$1,349,519

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,929,253	TotalRevenueColumnAmt
Related Or Exempt Func Income	$708,535	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$203,330	UnrelatedBusinessRevenueAmt
Exclusion	$1,017,388	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$26,128,322	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,422,456,285	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,371,526,138	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$6,080,321	UnrelatedBusinessRevenueAmt
Exclusion	$30,946,871	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$599,550	TotalAmt
Program Services	$599,550	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,532,844	TotalAmt
Management And General	$7,532,844	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$528,108,609	TotalAmt
Program Services	$493,098,304	ProgramServicesAmt
Management And General	$35,010,305	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$39,549,993	TotalAmt
Program Services	$742	ProgramServicesAmt
Management And General	$39,549,251	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$105,948,899	TotalAmt
Program Services	$72,270,813	ProgramServicesAmt
Management And General	$33,678,086	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$38,139,222	TotalAmt
Program Services	$36,084,112	ProgramServicesAmt
Management And General	$2,055,110	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,330,060	TotalAmt
Program Services	$1,084,489	ProgramServicesAmt
Management And General	$1,245,571	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$574,395	TotalAmt
Program Services	$34,092	ProgramServicesAmt
Management And General	$540,303	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$347,857	TotalAmt
Management And General	$347,857	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$155,939,397	TotalAmt
Program Services	$146,158,353	ProgramServicesAmt
Management And General	$9,781,044	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,914,705	TotalAmt
Program Services	$2,572,081	ProgramServicesAmt
Management And General	$342,624	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,495,252	TotalAmt
Program Services	$1,179,142	ProgramServicesAmt
Management And General	$316,110	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$21,716,507	TotalAmt
Program Services	$6,231,493	ProgramServicesAmt
Management And General	$15,485,014	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$807,752	TotalAmt
Program Services	$762,821	ProgramServicesAmt
Management And General	$44,931	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$16,922,135	TotalAmt
Program Services	$13,537,705	ProgramServicesAmt
Management And General	$3,384,430	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$72,451,337	TotalAmt
Program Services	$50,697,076	ProgramServicesAmt
Management And General	$21,754,261	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$23,443,065	TotalAmt
Program Services	$17,850,169	ProgramServicesAmt
Management And General	$5,592,896	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
HEALTH CARE SUPPLIES	$298,318,126	$298,248,718	$69,408
EQUIPMENT RENTAL & MAIN	$36,194,132	$14,886,116	$21,308,016
OTHER	$26,821,528	$30,682,895	-$3,861,367
SERVICE CONTRACTS	$19,597,271	$14,080,932	$5,516,339

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$14,783,532	TotalAmt
Program Services	$12,141,434	ProgramServicesAmt
Management And General	$2,642,098	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,414,536,168	TotalAmt
Program Services	$1,212,201,037	ProgramServicesAmt
Management And General	$202,335,131	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$45,429,798	BOYAmt
EOY	$13,128,710	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$6,374,720	BOYAmt
EOY	$9,566,264	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,804,000	BOYAmt
EOY	$925,000	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$149,584,235	BOYAmt
EOY	$122,508,432	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$46,496,356	BOYAmt
EOY	$44,619,757	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$13,534,168	BOYAmt
EOY	$14,273,658	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,084,609,042	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,462,619,478	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$649,314,177	BOYAmt
EOY	$621,989,564	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$26,201,767	BOYAmt
EOY	$89,191,534	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$96,628,673	BOYAmt
EOY	$42,044,127	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$192,583,568	BOYAmt
EOY	$235,061,694	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,227,951,462	BOYAmt
EOY	$1,193,308,740	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$221,523,065	BOYAmt
EOY	$208,178,968	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,740,920	BOYAmt
EOY	$4,038,878	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$300,241,359	BOYAmt
EOY	$282,668,611	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$796,636,601	BOYAmt
EOY	$637,057,719	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,324,141,945	BOYAmt
EOY	$1,131,944,176	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$124,794,839	BOYAmt
EOY	$30,996,000	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$28,604,356	BOYAmt
EOY	$30,368,564	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$96,190,483	BOYAmt
EOY	$61,364,564	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,227,951,462	BOYAmt
EOY	$1,193,308,740	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,920,117	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,312,000	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$148,322,930	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	0	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	Yes (1)	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$347,857	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$347,857	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	GRANTS TO OTHER ORGANIZATIONS THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1F REPRESENTS PAYMENTS MADE TO ORGANIZATIONS IN AN EFFORT TO ADVOCATE ON THE ORGANIZATION'S BEHALF AT THE NEW YORK STATE AND FEDERAL LEVELS AS IT SPECIFICALLY RELATES TO HEALTH CARE LEGISLATION AND REGULATORY ISSUES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$23,437,656	BeginningYearBalanceAmt
Contributions	$2,424,618	ContributionsAmt
Investment Earnings Or Losses	-$879,004	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,493,555	OtherExpendituresAmt
End Year Balance	$22,489,715	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$24,333,765	BeginningYearBalanceAmt
Contributions	$2,424,618	ContributionsAmt
Investment Earnings Or Losses	-$827,172	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,493,555	OtherExpendituresAmt
End Year Balance	$23,437,656	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$26,993,388	BeginningYearBalanceAmt
Contributions	$2,231,957	ContributionsAmt
Investment Earnings Or Losses	-$2,293,720	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,597,860	OtherExpendituresAmt
End Year Balance	$24,333,765	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$27,593,062	BeginningYearBalanceAmt
Contributions	$2,596,681	ContributionsAmt
Investment Earnings Or Losses	-$995,040	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,201,315	OtherExpendituresAmt
End Year Balance	$26,993,388	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,527,409	BeginningYearBalanceAmt
Contributions	$1,623,254	ContributionsAmt
Investment Earnings Or Losses	$2,762,723	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,320,324	OtherExpendituresAmt
End Year Balance	$27,593,062	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.50530	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.49470	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,713,867	OtherCostOrOtherBasisAmt
Book Value	$6,713,867	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$849,425,418	OtherCostOrOtherBasisAmt
Depreciation	$497,782,345	DepreciationAmt
Book Value	$351,643,073	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,211,982,793	OtherCostOrOtherBasisAmt
Depreciation	$952,936,894	DepreciationAmt
Book Value	$259,045,899	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,486,964	OtherCostOrOtherBasisAmt
Depreciation	$11,900,239	DepreciationAmt
Book Value	$4,586,725	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$621,989,564	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
OTHER RECEIVABLES	$91,280,722
OTHER ASSETS	$126,638,851
ESTIMATED 3RD PARTY PAYOR REC	$17,142,121

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$235,061,694	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DUE TO THIRD PARTY PAYORS	$16,541,270
SELF INSURANCE LIABILITY	$185,294,213
OTHER LIABILITIES	$115,329,838
PENSION LIABILITY	$217,541,815
ASSET RETIREMENT OBLIGATIONS	$9,093,802
CAPITAL LEASE OBLIGATIONS	$93,256,781

Field	Value	IRS element (for citing)
Total Liability	$637,057,719	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

INTENDED USE OF ENDOWMENTS: THE FOLLOWING ARE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS: 1) CAPITAL EXPANSION AND IMPROVEMENT 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES 3) SUPPORT PEDIATRIC HEALTH CARE SERVICES

PART X, LINE 2:

KALEIDA AND SUBSTANTIALLY ALL OF ITS AFFILIATES HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KALEIDA RECOGNIZES INCOME TAX POSITIONS ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (3 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
CENTRAL AMERICA AND THE CARIBBEAN	INVESTMENTS	$394,421,856
EUROPE (INCLUDING ICELAND AND GREENLAND)	INVESTMENTS	$56,583,024
SUB-SAHARAN AFRICA	INVESTMENTS	$1,819,677

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$452,824,557	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$452,824,557	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (1)	PassiveForeignInvestmestCoInd
Foreign Partnership	Yes (1)	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3:	INVESTMENT AMOUNTS REPORTED ARE DERIVED FROM KALEIDA'S BOOKS AND RECORDS WHICH ARE MAINTAINED ON AN ACCRUAL BASIS.
PART III ACCOUNTING METHOD:

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,821,527	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,724,389	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,097,138	NetCommunityBenefitExpnsAmt
Total Expense	0.00500	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$429,417,297	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$265,639,984	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$163,777,313	NetCommunityBenefitExpnsAmt
Total Expense	0.11580	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$442,238,824	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$271,364,373	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$170,874,451	NetCommunityBenefitExpnsAmt
Total Expense	0.12080	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,391,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,391,873	NetCommunityBenefitExpnsAmt
Total Expense	0.00450	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,662,839	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,766,730	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,896,109	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$40,864,438	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,001,007	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,863,431	NetCommunityBenefitExpnsAmt
Total Expense	0.01690	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$76,919,150	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,767,737	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$34,151,413	NetCommunityBenefitExpnsAmt
Total Expense	0.02420	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$519,157,974	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$314,132,110	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$205,025,864	NetCommunityBenefitExpnsAmt
Total Expense	0.14500	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	83	ActivitiesOrProgramsCnt
Persons Served	12439	PersonsServedCnt
Total Community Benefit Expns	$127,957	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$127,957	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	83	ActivitiesOrProgramsCnt
Persons Served	12439	PersonsServedCnt
Total Community Benefit Expns	$127,957	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$127,957	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Reimbursed By Medicare	$192,831,098	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$179,873,085	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$12,958,013	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (6 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HARLEM ROAD LEASING
MRI EQUIPMENT LEASING	0.50000	0.50000
2 AMTON IMAGING LLC
HEALTH CARE SERVICES	0.50000	0.50000
3 SITE E LLC
REAL ESTATE LEASING CO	0.50140	0.49860
4 SOUTHTOWNS IMAGING
IMAGING EQUIPMENT LEASING	0.70000	0.30000
5 GL MEDICAL BILLING
MEDICAL BILLING	0.50000	0.50000
6 SOUTHTOWNS SURG CTR
PHYSICIAN SERVICES	0.63950	0.36040

Field	Value	IRS element (for citing)
Hospital Facilities	4	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd	Childrens HospitalChildrensHospitalInd
BUFFALO GENERAL MEDICAL CENTER
1	100 HIGH STREET	BUFFALO	NY	14203	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
OISHEI CHILDREN'S HOSPITAL
2	818 ELLICOTT STREET	BUFFALO	NY	14203	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A	Yes (X)
MILLARD FILLMORE SUBURBAN HOSPITAL
3	1540 MAPLE ROAD	WILLIAMSVILLE	NY	14221	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
DEGRAFF MEMORIAL HOSPITAL
4	445 TREMONT STREET	NORTH TONAWANDA	NY	14120	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GROUP A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.KALEIDAHEALTH.ORG/COMMUNITY	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.KALEIDAHEALTH.ORG/COMMUNITY	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.KALEIDAHEALTH.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.KALEIDAHEALTH.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.KALEIDAHEALTH.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	0	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 5	IN CONDUCTING ITS 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP), KALEIDA HEALTH TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITALS LOCATED IN ERIE AND NIAGARA COUNTIES, THE PRIMARY SERVICE AREA. FOR EACH COUNTY, KALEIDA HEALTH PARTICIPATED IN COLLABORATIVE WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH AND COMPRISED OF REPRESENTATIVES FROM OTHER HOSPITALS, ORGANIZATIONS, AGENCIES, AND SCHOOLS; AND INCLUDED INPUT FROM THE COMMUNITY INCLUDING THE MEDICALLY UNDERSERVED.THE ERIE COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON MAY 17, 2018 AND HELD REGULAR MEETINGS THROUGHOUT 2018-2019. COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2019 INCLUDING A CONSUMER SURVEY WITH 1,725 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. INPUT WAS RECEIVED FROM THE UNDERSERVED WITH 16% OF RESPONDENTS HAVING INCOMES OF LESS THAN $25,000 AND 22% HAVING INCOMES OF $25,000-$50,000. THERE WERE SEVERAL DISTRIBUTION SITES TARGETING THE LOW INCOME AND UNDERSERVED. KALEIDA HEALTH POSTED THE SURVEY ON THE KALEIDA HEALTH PUBLIC WEBSITE, KALEIDA HEALTH EMPLOYEE WEBSITE, AND ON FACEBOOK AND TWITTER. THROUGHOUT MARCH TO MAY 2019, SIX FOCUS GROUP SESSIONS WERE CONDUCTED TO CAPTURE COMMUNITY INPUT ON THE STATUS OF HEALTH AND HEALTHCARE NEEDS. SESSION LOCATIONS TARGETED A GEOGRAPHIC CROSS-SECTION OF SITES, AGES, AND INCOME LEVELS. IN FEBRUARY AND MARCH 2019, KALEIDA HEALTH COLLABORATED WITH CATHOLIC HEALTH SYSTEM AND THE POPULATION HEALTH COLLABORATIVE TO HOST THREE COMMUNITY STAKEHOLDER SESSIONS WITH PROFESSIONALS FROM HEALTH, MENTAL HEALTH AND SOCIAL SERVICES ORGANIZATIONS AND OBTAINED INPUT ON THE COMMUNITY'S CURRENT HEALTH STATUS, NEEDS AND ISSUES. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES; AND ARE INCLUDED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP AND ALIGNED WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN.THE NIAGARA COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON SEPTEMBER 17, 2018 AND HELD REGULAR MEETINGS THROUGHOUT 2018-2019. COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2019 INCLUDING A CONSUMER SURVEY WITH 1,492 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. INPUT WAS RECEIVED FROM THE UNDERSERVED WITH 11.11% OF RESPONDENTS HAVING INCOMES OF $10,000-$15,000, 9.01% HAVING INCOMES OF $25,000-$35,000, AND 15.77% HAVING INCOMES OF $35,000-$50,000. SURVEY LINKS WERE PROVIDED ON THE NIAGARA COUNTY DEPARTMENT OF HEALTH'S WEBSITE AND FACEBOOK PAGE AND SHARED WITH THE PARTNERING HOSPITALS FOR ADDITIONAL ELECTRONIC AND PRINT DISSEMINATION. IN-PERSON SURVEY DISTRIBUTION WAS ALSO CONDUCTED BY VARIOUS NIAGARA COUNTY PUBLIC AGENCIES AND ORGANIZATIONS. KALEIDA HEALTH AND DEGRAFF MEDICAL PARK POSTED THE SURVEYS ON THE KALEIDA HEALTH PUBLIC WEBSITE, KALEIDA HEALTH EMPLOYEE WEBSITE, AND ON FACEBOOK AND TWITTER. DEGRAFF ALSO DISTRIBUTED PAPER COPIES THROUGHOUT ITS FACILITIES AND AT VARIOUS COMMUNITY LOCATIONS. SIX FOCUS GROUP SESSIONS WERE CONDUCTED IN FEBRUARY- MARCH 2019 AT FIVE NIAGARA COUNTY LOCATIONS INCLUDING HOSPITALS, SUBSIDIZED HOUSING FACILITIES AND COMMUNITY/SENIOR CENTERS. THE FOCUS GROUPS WERE FACILITATED BY EASTERN NIAGARA HOSPITAL, DEGRAFF MEDICAL PARK, MOUNT ST. MARY'S HOSPITAL AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH. ADDITIONALLY, A COUNTYWIDE KEY STAKEHOLDER MEETING WAS CONVENED ON AUGUST 6, 2019 WITH REPRESENTATION FROM AREA HEALTH, MENTAL HEALTH, AND HUMAN SERVICE AGENCIES. INFORMATION AND DATA WAS SHARED FROM THE CONSUMER HEALTH SURVEYS AND COMMUNITY FOCUS GROUP SESSIONS AND EACH ORGANIZATION HAD AN OPPORTUNITY TO SHARE THEIR EXPERIENCES AND PROVIDE INPUT ON COUNTY-WIDE HEALTH PRIORITIES. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES INCLUDED IN KALEIDA HEALTH'S CHNA-CSP AND ALIGNED WITH THE NIAGARA COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN.THE KALEIDA HEALTH 2019-2021 CHNA-CSP WAS APPROVED BY THE KALEIDA HEALTH BOARD OF DIRECTORS ON DECEMBER 2, 2019. IT IS AVAILABLE TO THE PUBLIC IN THE COMMUNITY HEALTH SECTION OF THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. A PAPER VERSION IS AVAILABLE UPON REQUEST AT NO CHARGE AT THE HOSPITALS. WRITTEN COMMENTS ON THE CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN" LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. THIS INFORMATION IS DOCUMENTED IN THE CHNA-CSP IN THE DISSEMINATION TO THE PUBLIC SECTION. NO COMMENTS ON THE 2019-2021 CHNA-CSP WERE RECEIVED FROM THE PUBLIC IN 2021.
PART V, SECTION B, LINE 6A	KALEIDA HEALTH'S FOUR HOSPITALS ARE INCLUDED IN ITS 2019-2021 CHNA-CSP: BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL, ALL LOCATED IN ERIE COUNTY AND DEGRAFF MEDICAL PARK LOCATED IN NIAGARA COUNTY. IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND INCLUDED UNRELATED HOSPITAL FACILITIES OF CATHOLIC HEALTH SYSTEM AND BERTRAND CHAFFEE HOSPITAL. IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE NIAGARA COUNTY DEPARTMENT OF HEALTH, AND INCLUDED THE FOLLOWING UNRELATED HOSPITAL FACILITIES: NIAGARA FALLS MEMORIAL MEDICAL CENTER, MOUNT ST. MARY HOSPITAL, AND EASTERN NIAGARA HOSPITAL SYSTEM.
PART V, SECTION B, LINE 6B	IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2019-2021 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: ERIE COUNTY DEPARTMENT OF HEALTH, UNITED WAY OF BUFFALO & ERIE COUNTY, BUFFALO STATE COLLEGE, D'YOUVILLE COLLEGE, STATE UNIVERSITY OF NEW YORK AT BUFFALO, AMERICAN HEART ASSOCIATION, AND THE POPULATION HEALTH COLLABORATIVE.IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2019-2021 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: NIAGARA COUNTY DEPARTMENT OF HEALTH, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH, AND THE POPULATION HEALTH COLLABORATIVE.
PART V, SECTION B, LINE 11	WITH HOSPITALS IN BOTH ERIE AND NIAGARA COUNTIES, KALEIDA HEALTH WORKED COLLABORATIVELY WITH WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH TO REVIEW HEALTH CARE DATA, DISSEMINATE CONSUMER SURVEYS AND CONDUCT FOCUS GROUP SESSIONS TO PRIORITIZE SIGNIFICANT HEALTH NEEDS AND IMPLEMENTATION STRATEGIES FOR EACH COUNTY. THE STRATEGIES FURTHER ALIGN WITH THE PRIORITY AREAS OF THE NEW YORK STATE PREVENTION AGENDA. KALEIDA HEALTH INCLUDED THESE COLLABORATIVE PRIORITY AREAS ITS 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICES PLAN (CHNA-CSP).THROUGHOUT 2021, KALEIDA HEALTH MADE PROGRESS IMPLEMENTING THE INTERVENTIONS OUTLINED IN ITS CHNA-CSP AND AS ALIGNED WITH THE NYS PREVENTION AGENDA, AND ADDRESSING THE NEEDS OF THE UNDERSERVED. HOWEVER, THE COVID 19 PANDEMIC PRESENTED SOME IMPLEMENTATION CHALLENGES. DURING 2020 AND THROUGHOUT 2021, KALEIDA HEALTH HOSPITALS EXPERIENCED AN INFLUX OF PATIENTS AFFECTED BY THE CORONAVIRUS IN BOTH INPATIENT AND OUTPATIENT CARE. IT WAS CRITICAL FOR EMPLOYEES TO HAVE APPROPRIATE PPE AND BE PROVIDED THE MOST UP TO DATE INFORMATION RELATED TO THE CARE AND TREATMENT OF THE DISEASE. ALL EMPLOYEE AND CORPORATE EFFORTS TO EDUCATE, SCREEN AND TEST EMPLOYEES, PATIENTS AND THE COMMUNITY WAS A TOP PRIORITY AND CONTINUES IN 2022. OUTPATIENT CARE AND ELECTIVE SURGERIES AT KALEIDA HEALTH HOSPITALS WERE CUT BACK IN 2020 AND 2021 DUE TO NYS MANDATES AND KALEIDA HEALTH OUTPATIENT CLINICS ENLISTED TELEHEALTH PROGRAMS TO HELP MEET PATIENT CARE NEEDS. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH CONTINUED TO IMPLEMENT THE COMMUNITY INTERVENTIONS THAT WERE NOT HAMPERED BY PANDEMIC RESTRICTIONS; AND CONTINUES TO WORK TO RE-ASSESS THE IMPACT OF COVID 19 ON OTHER INTERVENTIONS AND IN THE ADVANCEMENT OF ITS NYS PREVENTION AGENDA PRIORITY AREAS. COMMUNITY NEED AND INTERVENTION PROGRESS IN 2022 AND ANY RESULTING IMPACTS DUE TO COVID 19 ARE OUTLINED BELOW. HEALTH CARE NEEDS ADDRESSED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSPCHRONIC DISEASEHEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES ACCOUNTING FOR 183.2 PER 100,000 POPULATION OF ALL DEATHS IN ERIE COUNTY AND 232.4 PER 100,000 IN NIAGARA COUNTY (2019 COUNTY HEALTH RANKINGS), AND THERE IS A HIGH INCIDENCE OF RISK FACTORS AMONG RESIDENTS INCLUDING HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING. HEART DISEASE FURTHER AFFECTS MINORITY AND UNDERSERVED POPULATIONS DISPROPORTIONALLY. THE MORTALITY RATE FOR DISEASES OF THE HEART PER 100,000 POPULATION (AGE-ADJUSTED) FOR ERIE COUNTY IS 217.5 FOR NON-HISPANIC, AFRICAN AMERICANS, 174.5 FOR WHITES, AND 135.2 FOR HISPANICS; AND IN NIAGARA COUNTY, THE MORTALITY RATES ARE 293.4 FOR NON-HISPANIC, AFRICAN AMERICANS, 220.9 FOR WHITES, AND 197.7 FOR HISPANICS (2014-2016, ERIE COUNTY AND NIAGARA COUNTY HEALTH INDICATORS BY RACE/ETHNICITY, NYS DEPARTMENT OF HEALTH). IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH WORK GROUPS, KALEIDA HEALTH SELECTED "PREVENT CHRONIC DISEASE" AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES. KALEIDA HEALTH HOSPITALS IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS CHRONIC DISEASE IN ITS 2019-2021 CHNA-CSP: ERIE COUNTY - HEALTHY EATING AND FOOD SECURITY - COMMUNITY DIABETES AND PRE-DIABETES NUTRITION EDUCATION AND MOBILE FOOD MARKET (DISPARITY - LOW INCOME POPULATION), WORKSITE NUTRITION AND PHYSICAL ACTIVITY PROGRAMS- PREVENTIVE CARE AND MANAGEMENT - CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IN OB-GYN CENTERS (DISPARITY - FEMALE, MEDICAID POPULATION), CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITY, HEALTH LITERACY TASK FORCE (COLLABORATIVE COUNTY PROJECT)NIAGARA COUNTY - HEALTHY EATING AND FOOD SECURITY - HEALTH EDUCATION FOR CHILDREN, LITTLE FREE PANTRY (DISPARITY - FOOD INSECURE POPULATION), NUTRITION AND HEALTHY COOKING EDUCATION- PREVENTIVE CARE AND MANAGEMENT - CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITYIN 2021, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING CHRONIC DISEASE INTERVENTIONS:- BUFFALO GENERAL MEDICAL CENTER HOSTED ALEX WRIGHT'S AFRICAN HERITAGE MOBILE FOOD CO-OP, AN OUTDOOR MARKET OF HEALTHY FRUITS AND VEGETABLES AND NUTRITIONAL EDUCATION SERVING THE CAMPUS AND ADJACENT LOW-INCOME FRUIT BELT NEIGHBORHOOD. THE MARKET WAS HELD EVERY OTHER WEEK FROM MAY THROUGH OCTOBER 2021. TO BETTER SERVE LOW-INCOME INDIVIDUALS, EVERY THIRD THURSDAY DURING COVID WAS DESIGNATED AS "PAY AS YOU CAN". -IN 2021, THE PARTNERSHIP BETWEEN KALEIDA HEALTH AND ITS FOOD VENDOR METZ CULINARY MANAGEMENT AND THE BUFFALO NIAGARA MEDICAL CAMPUS CONTINUED TO HELP BRING MORE LOCALLY GROWN AND SOURCED PRODUCE, MEATS AND OTHER MENU ITEMS TO THE CAFETERIAS AT BUFFALO GENERAL MEDICAL CENTER, JOHN R. OISHEI CHILDREN'S HOSPITAL, AND HIGHPOINTE ON MICHIGAN. KALEIDA HEALTH EMPLOYEES, PATIENTS AND VISITORS WERE PROVIDED INFORMATION ON HEALTHY EATING AND NUTRITION, AND WERE INTRODUCED TO THE FARMERS BEHIND THE PRODUCTS. THE METZ CHEFS AND GENERAL MANAGERS VISITED LOCAL FARMS TO LEARN NEW AGRICULTURAL METHODS AND SUSTAINABLE PRACTICES. THROUGH THE METZ FARM TO HOSPITAL PARTNERSHIP, KALEIDA HEALTH PROVIDES EMAILS VIA CAMPUS E-NEWS TO EMPLOYEES OF PARTICIPATING FACILITIES, PROMOTING FACTS ON THE BENEFITS OF LOCAL FRUIT AND VEGETABLES, AS THEY ARE FRESHER AND SAFER THAN MANY STORE-BOUGHT OPTIONS.-NUTRITION TUNE-UP DAYS FOR EMPLOYEES WERE NOT HELD IN 2020 AND 2021 DUE TO COVID-19 RESTRICTIONS. IN THE ABSENCE OF THE NUTRITION TUNE-UP DAYS, IN 2021, APPROXIMATELY 10 EMPLOYEES PER MONTH VISITED A KALEIDA HEALTH DIETICIAN AT VARIOUS TIMES AT BUFFALO GENERAL MEDICAL CENTER FOR NUTRITION/WELLNESS CONCERNS AND RECEIVED NUTRITION EDUCATION AND PRINT MATERIALS. UNFORTUNATELY NUTRITION EDUCATION SESSIONS IN THE COMMUNITY CONTINUED TO BE POSTPONED THROUGHOUT 2021 DUE TO COVID-19 RESTRICTIONS.-IN 2021, WELLNESS ACTIVITIES FOR EMPLOYEES OF BUFFALO GENERAL MEDICAL CENTER AND JOHN R. OISHEI CHILDREN'S HOSPITAL IN COLLABORATION WITH THE BUFFALO NIAGARA MEDICAL CAMPUS (BNMC) WERE PRIMARILY ON HOLD DUE TO COVID-19 RESTRICTIONS. HOWEVER, THE WALKS ON WEDNESDAY PROGRAM DID SUCCESSFULLY RESUME IN 2021. -CARDIOVASCULAR EDUCATION AND SCREENING TARGETING LOW-INCOME PATIENTS WAS PROVIDED AT KALEIDA HEALTH'S OB-GYN CENTERS WHERE AN ESTIMATED 81.5% (2018) OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID. IN 2021, 244 CLINIC PATIENTS WERE SCREENED FOR CARDIOVASCULAR DISEASE AND PROVIDED COUNSELING AND EDUCATION. -DUE TO COVID 19 RESTRICTIONS AND THE NEED FOR COMMUNITY SAFETY FROM THE VIRUS, IN-PERSON CHRONIC DISEASE RISK FACTOR EDUCATION AND SCREENING EVENTS THROUGH KALEIDA HEALTH HOSPITALS IN ERIE AND NIAGARA COUNTIES WERE REPLACED WITH VIRTUAL PROGRAMS. - IN 2021, 17,756 INDIVIDUALS PARTICIPATED IN VIRTUAL HEALTHY U PROGRAMS VIA FACEBOOK LIVE AND 309 INDIVIDUALS ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION. - IN 2021, 52 WEEKLY MEDICAL MINUTE VIDEOS REACHING 83,178 INDIVIDUALS WERE PRESENTED ON WIVB-TV, CH. 4 AND KALEIDA HEALTH SOCIAL MEDIA ON HEALTH RELATED TOPICS. - IN 2021, THE MEDICALLY SPEAKING INTERVIEW SERIES PROVIDED 21 COMMUNITY HEALTH EDUCATION VIDEOS ON VARIOUS HEALTH TOPICS INCLUDING THE COVID-19 PANDEMIC TO 48,053 VIEWERS ON KALEIDA HEALTH FACEBOOK AND AT WWW.KALEIDAHEALTH.ORG/MEDICALLY-SPEAKING.1,077 INDIVIDUALS FURTHER ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION.- IN 2021, THE LITTLE FREE PANTRY AT DEGRAFF MEDICAL PARK CONTINUED TO PROVIDE COMMUNITY ACCESS TO A FREE SOURCE OF FOOD AT AN ON-SITE, SELF-CONTAINED OUTDOOR PANTRY TO PROMOTE FOOD SECURITY AMONG UNDERSERVED POPULATIONS. DEGRAFF PROVIDES HEALTH EDUCATION LITERATURE AND EMPLOYEES AND COMMUNITY MEMBERS WORK TO KEEP THE PANTRY STOCKED WITH HEALTHY, NUTRITIONAL ITEMS. THE TEDDY BEAR CLINICS PROVIDING HEALTH EDUCATION AT LOCAL SCHOOLS THROUGH DEGRAFF MEDICAL PARK WERE CANCELLED IN 2020 AND 2021 DUE TO COVID-19 RESTRICTIONS. MENTAL AND SUBSTANCE USE DISORDERSKALEIDA HEALTH, IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH IDENTIFIED THE RISING OPIOID ADDICTION PROBLEM AS A DIRE AREA OF CONCERN FOR THEIR COMMUNITIES. THE PROBLEM HAS BEEN ON THE RISE NATIONALLY AND BOTH COUNTIES HAVE BEEN SIGNIFICANTLY AFFECTED. IN 2015 AND 2016, OPIOID USE INCREASED DRAMATICALLY IN NEW YORK STATE (NYS) AND THE COUNTIES OF ERIE AND NIAGARA WERE LARGELY IMPACTED. IN 2016, THE OPIOID BURDEN (CRUDE RATE PER 100,000 POPULATION) WAS 352.2 IN ERIE COUNTY AND 416.5 IN NIAGARA COUNTY, SOME OF THE HIGHEST RATES IN NYS. IN ADDITION TO STATISTICAL DATA ON OPIOID USE, RESULTS FROM ERIE COUNTY AND NIAGARA COUNTY CONSUMER SURVEYS AND FOCUS GROUP SESSIONS INDICATED THE NEED TO ADDRESS THE PROBLEM.
PART V, SECTION B, LINE 11, CONTINUED	KALEIDA HEALTH IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES IN ITS 2019-2021 CHNA-CSP TO ADDRESS THE OPIOID ADDICTION PROBLEM:ERIE COUNTY AND NIAGARA COUNTY -BUFFALO MATTERS BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM-AVAILABILITY AND ACCESS AND LINKAGE TO OPIOID OVERDOSE REVERSAL MEDICATIONS-MEDICATION AND SYRINGE DROP BOXES IN HOSPITAL EMERGENCY DEPARTMENTS -DRUG TAKE-BACK DAYSIN 2021, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING SUBSTANCE USE DISORDER INTERVENTIONS:-IN 2021, KALEIDA HEALTH HOSPITALS PARTICIPATED IN NEW YORK MATTERS, A HOSPITAL-INITIATED BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM. THIS ONLINE, REAL-TIME REFERRAL PROGRAM CONNECTS PATIENTS PRESENTING IN THE EMERGENCY ROOM WITH OPIATE USE DISORDERS TO A NETWORK OF 20 WESTERN NEW YORK TREATMENT AGENCIES. IN 2020, 18 REFERRALS WERE MADE TO NEW YORK MATTERS AT KALEIDA HEALTH EMERGENCY DEPARTMENTS-KALEIDA HEALTH EMERGENCY DEPARTMENTS AT BUFFALO GENERAL MEDICAL CENTER AND MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK PROVIDE PATIENT ACCESS TO OVERDOSE REVERSAL MEDICATION INCLUDE NALOXONE THROUGH THE KALEIDA HEALTH PHARMACY. IN 2021, 27 NALOXONE KITS, AN OVERDOSE REVERSAL MEDICATIONS, WERE PROVIDED TO PATIENTS/FAMILIES IN KALEIDA HEALTH EMERGENCY DEPARTMENTS. ADDITIONALLY, IN 2021, FENTANYL TEST STRIPS WERE ADDED TO THE NARCAN KITS TO HELP TO DECREASE ACCIDENTAL OVERDOSE DUE TO FENTANYL-LACED PRODUCTS. -IN PARTNERSHIP WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, MEDICATION AND SYRINGE DROP BOXES ARE PROVIDED AT THE EMERGENCY DEPARTMENTS OF KALEIDA HEALTH HOSPITALS. NIAGARA COUNTY SHERIFF'S OFFICES PICK UP AND TRANSPORT CONTENTS OF DROP BOXES ON A REGULAR BASIS FOR INCINERATION.-PRESCRIPTION DRUG TAKE BACK DAYS WERE HELD ON APRIL 24, 2021 AND OCTOBER 23, 2021 AT MILLARD FILLMORE SUBURBAN HOSPITAL IN ERIE COUNTY AND AT DEGRAFF MEDICAL PARK IN NIAGARA COUNTY.MATERNAL, INFANT, AND CHILD HEALTHTHE HEALTH OF WOMEN, INFANTS, CHILDREN AND THEIR FAMILIES IS FUNDAMENTAL TO POPULATION HEALTH AND IS A PRIORITY AREA FOR THE 2019-2024 NYS PREVENTION AGENDA. ERIE COUNTY AND NIAGARA COUNTY BOTH HAVE HIGH RATES OF INFANT AND MATERNAL MORTALITY, PREMATURE BIRTH, LOW BIRTHWEIGHT BABIES, AND TEEN PREGNANCY RATES. THESE RATES ARE AFFECTED BY MULTIPLE DISPARITIES INCLUDING RACE, POVERTY, AND LACK OF ACCESS TO QUALITY PRENATAL CARE, AS WELL AS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS OBESITY, SMOKING, SUBSTANCE USE, AND MENTAL HEALTH DISORDERS. ERIE COUNTY AND NIAGARA COUNTY INFANT MORTALITY RATES ARE SIGNIFICANTLY HIGHER THAN NYS RATES PER 2014-2016 NYS VITAL STATISTICS DATA:-THE INFANT MORTALITY RATE PER 1,000 LIVE BIRTHS (<1 YEAR) FOR ERIE COUNTY IS 7.3, AND THE RATE FOR NIAGARA COUNTY IS 6.8 WHILE THE NYS RATE IS 4.5. -THE PERCENTAGE OF LOW BIRTHWEIGHT BIRTHS (<2.5 KG) IS 8.6% IN ERIE COUNTY, 7.5% IN NIAGARA COUNTY VERSUS THE NYS RATE OF 7.8%. DISPARITIES EXIST AMONG MINORITY POPULATIONS GIVEN THAT THE PERCENTAGE OF LOW BIRTHWEIGHT BABIES IN ERIE COUNTY IS 7.0% AMONG THE WHITE POPULATION AND 13.7% AMONG THE AFRICAN AMERICAN/BLACK POPULATION.-WHILE THE HEALTH BENEFITS OF BREASTFEEDING ARE WELL DOCUMENTED AND PROMOTED AMONG NEW MOTHERS, THERE IS MORE WORK TO BE DONE TO INCREASE RATES THROUGHOUT ERIE AND NIAGARA COUNTIES. THE PERCENTAGE OF INFANTS FED ANY BREAST MILK IN A DELIVERY HOSPITAL IS 75.2% IN ERIE COUNTY, 69.3% IN NIAGARA COUNTY, MUCH LOWER THAN THE NYS RATE OF 87.3%.KALEIDA HEALTH'S DELIVERY HOSPITALS OF OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) ARE LOCATED IN ERIE COUNTY. THEREFORE, KALEIDA HEALTH SELECTED MATERNAL, INFANT, AND CHILD HEALTH AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES FOR ERIE COUNTY AND IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS IN ITS 2019-2021 CHNA-CSP:ERIE COUNTY-MATERNAL AND WOMEN'S HEALTH CENTERING PREGNANCY PROGRAM (DISPARITY- MEDICAID POPULATION)-PERINATAL AND INFANT HEALTH - SAFE SLEEP INITIATIVE, YOMINGO ONLINE PARENT EDUCATION - BREASTFEEDING PROMOTION AND EDUCATION PROGRAMIN 2021, KALEIDA HEALTH PROVIDED THE FOLLOWING MATERNAL, INFANT, CHILD HEALTH INTERVENTIONS: -THROUGH THE SAFE SLEEP INITIATIVE, IN 2021, OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) PROVIDED SAFE SLEEP EDUCATION AND THE HALO SLEEP SACK FOR ALL NEWBORNS; AND AT OCH FOR ADMITTED PEDIATRIC PATIENTS UP TO ONE YEAR OF AGE AS PROVIDED BY CORPORATE PARTNERS: PEGULA SPORTS + ENTERTAINMENT, THE BUFFALO BILLS AND THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION. IN 2021, AT OCH, 3,626 NEWBORN CAREGIVERS AT OCH AND 2,146 NEWBORN CAREGIVERS AT MFS WERE PROVIDED SAFE SLEEP EDUCATION; AND SAFE SLEEP SWADDLES WERE ALSO DISTRIBUTED. -MILLARD FILLMORE SUBURBAN HOSPITAL OFFERED CHILDBIRTH EDUCATION TO PREGNANT WOMEN AND PARENTS WITH INFORMATION ON PRENATAL, PERINATAL, INFANT AND CHILD CARE THROUGH THE USE OF THE YOMINGO APP (WWW.MYYOMINGO.COM) TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES. IN 2021, MILLARD FILLMORE SUBURBAN HOSPITAL RECORDED 492 ACTIVE USERS ON YOMINGO AND THE PROGRAM WAS PROMOTED THROUGH YOMINGO FLYERS DELIVERED TO 250 PHYSICIANS/PROVIDERS THROUGHOUT THE COMMUNITY.-THROUGHOUT 2021, JOHN R. OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) CONTINUED THEIR BREASTFEEDING PROMOTION AND EDUCATION ACTIVITIES TO INCREASE INITIATION AND EXCLUSIVE BREASTFEEDING RATES. AT OCH, A HOSPITAL WITH 65% OF PATIENTS WITH MEDICAID, THE AVERAGE BREASTFEEDING RATES IN 2021 WERE 71.3% INITIATION AND 36.2% EXCLUSIVE (3,626 BIRTHS). AT MFS, THE AVERAGE RATES IN 2021 WERE 80.0% INITIATION AND 46.0% EXCLUSIVE (2,874 BIRTHS).THE CENTERING PREGNANCY PROGRAM WAS NOT PROVIDED AT KALEIDA HEALTH OB-GYN CLINICS IN 2021 DUE TO COVID-19 RESTRICTIONS. PLANNING IS UNDERWAY TO CONTINUE THE PROGRAM POST-COVID.HEALTH CARE NEEDS NOT ADDRESSED IN KALEIDA HEALTH 2019-2021 CHNA-CSPCANCERWHILE CANCER IS THE NUMBER TWO CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES, THE COUNTY WORK GROUPS AGREED TO INSTEAD PRIORITIZE CARDIOVASCULAR DISEASE, THE NUMBER ONE CAUSE OF DEATH, IN THEIR 2019-2021 PLANS. THE IMPACT OF CANCER ON THE HEALTH OF RESIDENTS IS WELL RECOGNIZED AND ADDRESSED WITH SEVERAL ONGOING CANCER PREVENTION, EDUCATION, SCREENING AND TREATMENT INITIATIVES IN PLACE IN THE REGION. ROSWELL PARK COMPREHENSIVE CANCER CENTER, LOCATED IN BUFFALO, HOLDS THE NATIONAL CANCER INSTITUTE DESIGNATION AS A COMPREHENSIVE CANCER CENTER AND HAS A PROVEN MULTIDISCIPLINARY APPROACH. OISHEI CHILDREN'S HOSPITAL PARTNERS WITH ROSWELL ON THE ROSWELL PARK OISHEI CHILDREN'S CANCER AND BLOOD DISORDERS PROGRAM PROVIDING BOTH INPATIENT AND OUTPATIENT CARE AND A MULTIDISCIPLINARY APPROACH FOR CHILDREN AND ADOLESCENTS WITH CANCER AND HEMATOLOGIC DISORDERS. KALEIDA HEALTH'S MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK OFFER CANCER REHABILITATION AND RECOVERY THROUGH THE SURVIVOR STEPS PROGRAM. KALEIDA HEALTH PARTICIPATES IN THE GREAT LAKES CANCER CARE COLLABORATIVE, IN PARTNERSHIP WITH CANCER CARE OF WESTERN NEW YORK, ECMC, GASTROENTEROLOGY ASSOCIATES, LLP, GENERAL PHYSICIAN, PC, GREAT LAKES MEDICAL IMAGING, UBMD PHYSICIANS' GROUP, WESTERN NEW YORK UROLOGY ASSOCIATES, WINDSONG, AND THE VISITING NURSING ASSOCIATION OF WESTERN NEW YORK- WITH THE GOAL TO HARNESS THE REGION'S TOP TALENT AND MOST ADVANCED TECHNOLOGY IN A UNIQUE COLLABORATION TO DIAGNOSE, TREAT AND ELIMINATE CANCER. TOBACCOTOBACCO CESSATION PROGRAMS ARE PROVIDED THROUGHOUT ERIE AND NIAGARA COUNTIES, AND KALEIDA HEALTH'S INPATIENT AND OUTPATIENT PROGRAMS CONTINUE TO PROVIDE PATIENT EDUCATION ON THE HEALTH BENEFITS OF NOT SMOKING AND WILL CONTINUE TO REFER PATIENTS TO THESE PROGRAMS. ENVIRONMENTAIR AND WATER QUALITY, FOOD SAFETY, BUILT ENVIRONMENTS TO PROMOTE PHYSICAL HEALTH, SUSTAINABILITY, HEALTHY HOME AND SCHOOL ENVIRONMENTS ARE ADDRESSED THROUGH FEDERAL, STATE AND LOCAL GOVERNMENTS AND NEIGHBORHOOD AND COMMUNITY-BASED ORGANIZATIONS. KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PARTNERS WITH THE WNY ASTHMA COALITION TO IMPROVE AIR QUALITY IN THE HOME TO IMPROVE ADULT AND CHILDHOOD ASTHMA RATES. THE HOSPITAL FURTHER ADDRESSES HOME SAFETY THROUGH ITS LEAD POISONING PREVENTION PROGRAM.MENTAL HEALTHKALEIDA HEALTH PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES FOR CHILDREN THROUGH THE CHILDREN'S PSYCHIATRY CENTER OF OISHEI CHILDREN'S HOSPITAL. THE CENTER ALSO PARTNERS WITH OTHER COMMUNITY-BASED PROVIDERS TO ASSURE IMPROVED ACCESS TO THE MOST APPROPRIATE CARE FOR CHILDREN WITH MENTAL HEALTH CONDITIONS. KALEIDA HEALTH IS A PARTNER WITH ERIE COUNTY MEDICAL CENTER, HOME OF THE REGIONAL CENTER OF EXCELLENCE FOR BEHAVIORAL HEALTH OFFERING MENTAL HEALTH AND PSYCHIATRY SERVICES, AS WELL AS ALCOHOL AND DRUG ADDICTION DETOXIFICATION AND REHAB.
PART V, SECTION B, LINE 11, CONTINUED	COMMUNICABLE DISEASE BOTH ERIE COUNTY AND NIAGARA COUNTY PROVIDE PUBLIC AWARENESS AND EDUCATION ON COMMUNICABLE DISEASES INCLUDING COVID-19, HIV, SEXUALLY TRANSMITTED DISEASES, HEPATITIS C VIRUS AS WELL AS THE IMPORTANCE OF VACCINES, AND THE IMPROVEMENT OF INFECTION CONTROL IN HEALTHCARE FACILITIES. ALL OF THESE AREAS ARE PRIORITIES FOR KALEIDA HEALTH AND ITS HOSPITALS AND CLINICS; AND ADHERE TO ALL NEW YORK STATE REQUIREMENTS FOR COMMUNICABLE DISEASES INCLUDING INFECTION CONTROL, AND VACCINES INCLUDING PEDIATRIC IMMUNIZATION, COVID-19, AND FLU VACCINES FOR PATIENTS AND EMPLOYEES. KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PROVIDES THE FOLLOWING:-YOUTH LINK AND BE PREPARED PROGRAM - SUPPORTIVE SERVICES TO YOUTH AND YOUNG ADULTS, AGES 13-24, WHO IDENTIFY AS LGBTQ+, ARE LIVING WITH OR ARE AT RISK FOR HIV AND STIS, ARE EXPERIENCING HOMELESSNESS, SEXUAL ABUSE, SUBSTANCE USE AND/OR MENTAL HEALTH RELATED ISSUES.-THE FAMILY PLANNING CLINIC AND THE WOMEN'S HEALTH CENTERS ADDRESS STIS, HIV AND HCV.ALL KALEIDA HEALTH HOSPITALS ASSURE AND ALSO PROVIDE COVID-19 TESTING AND VACCINES FOR ITS EMPLOYEES AND PATIENTS.
PART V, SECTION B, LINE 16J	INFORMATION THAT EXPLAINS HOW QUALIFIED PATIENTS CAN ACCESS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL IS INCLUDED ON BILLS AND STATEMENTS TO PATIENTS.APPLICATION MATERIALS INCLUDE A NOTICE TO PATIENTS THAT ONCE THEY SUBMIT A COMPLETED APPLICATION AND DOCUMENTATION, THEY MAY DISREGARD ANY BILLS UNTIL THE HOSPITAL HAS RENDERED A WRITTEN DECISION ON THE APPLICATION. THE HOSPITAL MAY NOT FORWARD ACCOUNTS TO COLLECTION WHILE AND APPLICATION IS PENDING.

Field	Value	IRS element (for citing)
Facility	20	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (20 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - HIGHPOINTE ON MICHIGAN
1031 MICHIGAN AVE	BUFFALO	NY	14203	INPATIENT SKILLED NURSING FACILITY
2 - CENTER FOR LABORATORY MEDICINE
115 FLINT ROAD	AMHERST	NY	14226	HOSPITAL BASED LAB SERVICES
3 - DEGRAFF SKILLED NURSING FACILITY
445 TREMONT STREET	NORTH TONAWANDA	NY	14120	INPATIENT SKILLED NURSING FACILITY
4 - MILLARD FILLMORE SURGERY CENTER
215 KLEIN ROAD	WILLIAMSVILLE	NY	14221	AMBULATORY SURGERY CENTER
5 - MAPLE WEST MEDICAL COMPLEX
705 MAPLE ROAD	AMHERST	NY	14221	MEDICAL SERVICES - OTHER MEDICAL SPECIALTIES
6 - NORTH BUFFALO MEDICAL PARK
900 HERTEL AVE	BUFFALO	NY	14207	MEDICAL SERVICES - PRIMARY CARE, RADIOLOGY OUTPATIENT, OUTPATIENT THERAPY
7 - KALEIDA HEALTH FAMILY PLANNING CENTER
1313 MAIN STREET	BUFFALO	NY	14209	OUTPATIENT FAMILY PLANNING
8 - TOWNE GARDEN PEDIATRICS
461 WILLIAM STREET	BUFFALO	NY	14204	MEDICAL SERVICES - PRIMARY CARE
9 - SOUTHTOWNS SURGERY CENTER
5959 BIG TREE ROAD SUITE 100	ORCHARD PARK	NY	14217	AMBULATORY SURGERY CENTER
10 - WCHOB WOMEN'S OBGYN HEALTH CENTER
462 GRIDER STREET	BUFFALO	NY	14215	MEDICAL SERVICES - PRIMARY CARE
11 - WCHOB MCKINLEY OBGYN
3860 MCKINLEY PARKWAY	HAMBURG	NY	14219	MEDICAL SERVICES - PRIMARY CARE
12 - WCHOB CHILD PROTECTION CENTER
556 FRANKLIN STREET	BUFFALO	NY	14202	MEDICAL SERVICES - PRIMARY CARE
13 - STANLEY MAKOWSKI SBHC
1095 JEFFERSON AVE	BUFFALO	NY	14214	SCHOOL BASED PRIMARY CARE SERVICES
14 - HILLERY PARK #27 SBHC
72 PAWNEE PARKWAY	BUFFALO	NY	14210	SCHOOL BASED PRIMARY CARE SERVICES
15 - WESTMINSTER #86 SBHC
24 WESTMINSTER AVE	BUFFALO	NY	14215	SCHOOL BASED PRIMARY CARE SERVICES
16 - DR LYDIA WRIGHT #89 SBHC
106 APPENHEIMER STREET	BUFFALO	NY	14214	SCHOOL BASED PRIMARY CARE SERVICES
17 - BUILD ACADEMY #91 SBHC
340 FOUGERON STREET	BUFFALO	NY	14211	SCHOOL BASED PRIMARY CARE SERVICES
18 - BUFFALO SCHOOL OF TECHNOLOGY SBHC
414 SOUTH DIVISION STREET	BUFFALO	NY	14204	SCHOOL BASED PRIMARY CARE SERVICES
19 - HERMAN BADILLO #76 SBHC
315 CAROLINE STREET	BUFFALO	NY	14201	SCHOOL BASED PRIMARY CARE SERVICES
20 - SOUTHTOWNS CLINIC
4535 SOUTHWESTERN BLVD	HAMBURG	NY	14075	MEDICAL SERVICES PRIMARY CARE

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	KALEIDA HEALTH HAS IMPLEMENTED AND COMMUNICATES ITS FINANCIAL ASSISTANCE (CHARITY CARE) POLICY, WHICH ASSISTS LOW INCOME, UNINSURED OR UNDERINSURED INDIVIDUALS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR MEDICAL SERVICES RENDERED. LEVELS OF DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION AND IN ACCORDANCE WITH THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. INDIVIDUALS ARE PROVIDED FINANCIAL ASSISTANCE CONTACT INFORMATION DURING INTAKE AND REGISTRATION. THE APPLICANT FOR FREE OR REDUCED PRICE CARE WORKS DIRECTLY WITH A MEMBER OF THE FINANCIAL COUNSELING OR CHARITY CARE TEAM FOR FINANCIAL SCREENING AND ENROLLMENT IN A GOVERNMENT-FUNDED PROGRAM, IF ELIGIBLE.AFTER REVIEW OF INCOME AND ASSETS, AN INDIVIDUAL MAY BE APPROVED FOR FREE CARE (100% DISCOUNT) OR A DISCOUNT LEVEL OF 50, 60, 75, OR 90%, FOR MEDICALLY NECESSARY SERVICES RENDERED AT A KALEIDA HEALTH FACILITY, AS FOLLOWS: LESS THAN 200% OF FEDERAL POVERTY GUIDELINE IS AWARDED 100% DISCOUNT200% - 249% OF FEDERAL POVERTY GUIDELINE IS AWARDED 90% DISCOUNT250% - 299% OF FEDERAL POVERTY GUIDELINE IS AWARDED 75% DISCOUNT300% - 349% OF FEDERAL POVERTY GUIDELINE IS AWARDED 60% DISCOUNT350% - 400% OF FEDERAL POVERTY GUIDELINE IS AWARDED 50% DISCOUNT
PART I, LINE 7:	THE AMOUNTS REPORTED IN THE TABLE UNDER PART 1, LINE 7 WERE DETERMINED USING THE HEALTH SYSTEM'S DECISION SUPPORT SOFTWARE PROGRAM AND REVENUE AND EXPENSES FROM THE GENERAL LEDGER. THE OVERALL REVENUE AND EXPENSES INCLUDED IN THE DECISION SUPPORT SOFTWARE PROGRAM WERE RECONCILED TO THE GENERAL LEDGER WHICH RECONCILES TO THE AUDITED FINANCIAL STATEMENTS. THE DECISION SUPPORT SOFTWARE PROGRAM ALLOCATES DIRECT COSTS TO EACH PATIENT ACCOUNT BASED ON THE RESOURCES USED BY THAT PATIENT WITHIN THE SPECIFIC COST CENTER. INDIRECT COSTS ARE ALLOCATED USING SIMILAR STEPDOWN METHODOLOGY USED BY CMS IN THE INSTITUTIONAL COST REPORT.
PART II, LINE 7	KALEIDA HEALTH'S COMMUNITY HEALTH SERVICES SUPPORTS A COMPREHENSIVE PROGRAM OF COMMUNITY HEALTH IMPROVEMENT ADVOCACY. OUTREACH IS CONDUCTED IN MULTIPLE WESTERN NEW YORK COMMUNITIES TARGETING VARIED POPULATIONS OF ALL AGES AND ETHNICITIES, INCLUDING THE MEDICALLY UNDERSERVED. PROGRAMS AND EVENTS PROMOTE THE REDUCTION OF HEALTH DISPARITIES, ACCESS TO CARE, AND PROMOTE OVERALL COMMUNITY HEALTH AND WELLNESS; AND INCLUDE HEALTH EDUCATION AND SCREENING, SPEAKERS ON HEALTH-RELATED TOPICS, AND COMMUNITY REFERRALS. TOPICS RANGE FROM HEALTH INSURANCE ENROLLMENT TO DIABETES, STROKE, HEART DISEASE, MATERNAL AND CHILD HEALTH, AND HEALTH CAREER EXPLORATION.IN 2021, COVID-19 RESTRICTIONS CONTINUED AND LIMITED KALEIDA HEALTH'S ABILITY TO PROVIDE THE SAME COMPREHENSIVE PROGRAM OF COMMUNITY OUTREACH AND EDUCATION IT HAD IN PREVIOUS YEARS. HOWEVER, WORKING AROUND THE PANDEMIC SURGE, KALEIDA HEALTH PARTNERED WITH VARIOUS ORGANIZATIONS AND PARTICIPATED IN 83 IN-PERSON AND VIRTUAL EVENTS TO REACH 12,439 INDIVIDUALS WITH COMMUNITY SERVICE PROGRAMMING. ALL OF THE OUTREACH PROGRAMS ARE FREE AND REACH CROSS SECTION OF CULTURES, ETHNICITIES, ECONOMIC DEMOGRAPHICS, LANGUAGES, RELIGIONS AND ALL GENDERS INCLUDING LGBTQ+ COMMUNITY. MATERIALS PROVIDED TO THE COMMUNITY DURING OUTREACH EVENTS INCLUDED: INFORMATION ON FREE PSA SCREENINGS; BREAST, PROSTATE, COLON CANCER; STROKE PREVENTION; DIABETES PREVENTION; HEART DISEASE AND RISK FACTORS; CHILDREN'S HEALTH; BARIATRIC / OBESITY / BMI; FAMILY PLANNING; HPV/ STD/STI; CHILDREN'S MEDICAID HEALTH HOMES; NUTRITION; WOMEN'S HEALTH; MATERNITY INCLUDING BREASTFEEDING; KALEIDA HEALTH WELLNESS SERIES / "HEALTHY YOU".ADDITIONALLY, KALEIDA HEALTH EMAILED HEALTH AND WELLNESS INFORMATION ON A MONTHLY BASIS TO A LIST-SERVE OF 150 DIVERSE COMMUNITY MEMBERS. KALEIDA HEALTH COMMUNITY OUTREACH EXTENDED THROUGHOUT ITS SERVICE AREA AND PRIMARILY IN THE CITY OF BUFFALO, A CITY WITH A POVERTY RATE OF 28.3% AND A HIGH MINORITY POPULATION WITH 35.2% BLACK/AFRICAN AMERICAN AND 12.2% HISPANIC (US CENSUS 2020). BUFFALO HAS SEVERAL CENSUS TRACTS THAT ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS. IN-PERSON AND VIRTUAL OUTREACH IN BUFFALO INCLUDED THE FOLLOWING:-BUFFALO PUBLIC SCHOOLS, MATH SCIENCE TECHNOLOGY SCHOOL-VIRTUAL-NAACP BUFFALO BRANCH -VIRTUAL-EVERY PERSON INFLUENCES CHILDREN - VIRTUAL-NAACP BUFFALO BRANCH-VIRTUAL-HOLY CROSS HEAD START -WILLIAM EMSLIE YMCA - SENIOR LUNCHEON -BUFFALO NIAGARA MEDICAL CAMPUS -WESTMINSTER CHARTER SCHOOL - FARMERS MARKET -GREATER BUFFALO UNITED ACCOUNTABLE HEALTHCARE NETWORK (GBUAHN) -BPS INTERNATIONAL SCHOOL - SINGLE MOMS CLUB -HIGH POINTE ON MICHIGAN LONG TERM CARE FACILITY-BUFFALO PUBLIC SCHOOL 54 BACK TO SCHOOL/MEET THE TEACHER-UB EDUCATION OPPORTUNITY CENTER -HISPANIC HERITAGE COUNCIL -CITY OF BUFFALO CLEAN SWEEP PROGRAM-CENTENNIAL AME CHURCH -BLACK ACHIEVERS DINNER -SENECA ONE TOWER -RECOVERY IN CHRIST CHURCH -DOWNTOWN BUFFALO PUBLIC LIBRARY - BABY EXPO -KOMEN BREAST CANCER WALK -BUFFALO FEDERATION NEIGHBORHOOD CENTERS -BUFFALO BUSINESS FIRST- EMPLOYEE NETWORKING EVENT -BROADWAY MARKET - PASSPORT TO WELLNESS EVENT-SAY YES BUFFALO, BUFFALO PUBLIC SCHOOLS - COMMUNITY SCHOOL PROGRAM -NEAR EAST & WEST SIDE TASK FORCE - VIRTUAL KALEIDA HEALTH FURTHER ENGAGED IN CANCER SCREENING INITIATIVES THROUGH COLLABORATIONS WITH GREAT LAKES CANCER CARE AND WESTERN NEW YORK UROLOGY. PSA COLON CANCER SCREENINGS WERE HELD IN COMMUNITIES WHERE NYS DATA IDENTIFIED ZIP CODES WITH HIGH LEVELS OF CANCER AND HEALTH DISPARITIES AND INCLUDED THE FOLLOWING:-MOUNT MORIAH BAPTIST CHURCH, MEN'S PROGRAM & COMMUNITY WELLNESS FUN DAY - BUFFALO-MOUNT OLIVE BAPTIST CHURCH, EAST DELEVAN - BUFFALO -AMHERST SENIOR CENTER, NYS SENATOR RATH FAMILY HEALTH FAIR - AMHERST-MACEDONIA BAPTIST CHURCH BUFFALO-WUFO 1080 AM/POWER 96.5 FM - BUFFALOKALEIDA HEALTH COMMUNITY OUTREACH WAS ALSO PROVIDED TO THE AREA'S UNDERSERVED AND MINORITY POPULATIONS AS FOLLOWS:-THE GREAT LAKES HEALTH RADIO PROGRAM HOSTED BY KALEIDA HEALTH, AIRED TWO TIMES PER MONTH IN 2021 ON WUFO 1080 AM/POWER 96.5 FM AND FEATURED 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS INCLUDING PHYSICIANS, NURSES AND OTHER HEALTH PROFESSIONALS ON A VARIETY OF HEALTH AND WELLNESS TOPICS. A SENIOR MOMENT PROGRAM ALSO AIRED ON POWER 96.5 FM AND FEATURED 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS ON HEALTH AND WELLNESS TOPICS FOR AGES 60+. IN 2021, LISTENERSHIP WAS 81,600 FOR THE GREAT LAKES HEALTH PROGRAM AND 20,400 FOR THE SENIOR MOMENT PROGRAM. THESE PROGRAMS REACH A PREDOMINATELY URBAN POPULATION OF, ALL AGES, RACES, SEXUAL ORIENTATIONS, AND ETHNIC GROUPS IN WESTERN NEW YORK, AND MAY ALSO BE ACCESSED ACROSS THE COUNTRY THROUGH WWW.POWER965RADIO.COM OR GOOGLE WUFO 1080 AM, BUFFALO, NY OR GOOGLE POWER 96.5FM, BUFFALO, NY.-BUFFALO PUBLIC SCHOOL, MATH SCIENCE TECHNOLOGY (MST) HIGH SCHOOL SPEAKER SERIES WAS HELD VIRTUALLY AND IN-PERSON AS PERMITTED DURING COVID-19. KALEIDA HEALTH EMPLOYEES SHARED THEIR KNOWLEDGE AND EXPERIENCES ON THEIR CAREERS WITH HIGH SCHOOL STUDENTS PREPARING FOR COLLEGE AND CAREERS AS CERTIFIED NURSING ASSISTANTS (CNAS). MST IS LOCATED IN A PRIMARILY AFRICAN AMERICAN COMMUNITY IN ZIP CODE 14215, A NEIGHBORHOOD WITH HIGH RATES OF HEALTH DISPARITIES, UNEMPLOYMENT, AND UNDEREMPLOYMENT AND IS A FOOD DESERT. IN 2021, 10 KALEIDA HEALTH SPEAKER PRESENTATIONS, IN PERSON AND VIRTUAL WERE CONDUCTED FOR THE MST CNA PROGRAM. ADDITIONALLY, KALEIDA HEALTH'S COMMUNITY RELATIONS SPECIALIST ACTIVELY PARTICIPATES IN THE FOLLOWING COMMUNITY ORGANIZATIONS:-NEAR EAST AND WEST SIDE TASK FORCE - EXECUTIVE DIRECTOR-CRISIS SERVICES- OUTREACH, MEMBERSHIP-WNED - COMMUNITY ADVISORY COMMITTEE-UB MINI MEDICAL SCHOOL - COMMUNITY COMMITTEE MEMBER-NAACP - BOARD OF DIRECTORS 2ND VP, BUFFALO; CHAIR HEALTH COMMITTEE, BUFFALO AND NEW YORK STATE-LEADERSHIP BUFFALO -CLASS CHAIR-HISPANIC WOMEN'S LEAGUE- MEMBERSHIP CHAIR AND SPECIAL PROJECTS-ALBRIGHT-KNOX ART GALLERY - ADVANCEMENT COMMITTEE -EPIC - OUTREACH COMMITTEE -LIVE WELL ERIE -BOARD OF DIRECTORS AND OLDER ADULT AND FAMILY WORKING GROUPS-ST. JOHN BAPTIST CHURCH - CHAIR, HEALTH COMMITTEE AND OUTREACH-BUFFALO NIAGARA MEDICAL CAMPUS - NEIGHBORHOOD ENGAGEMENT & GOVERNMENT AFFAIRS COUNCIL-UB MEDICAL SCHOOL CURRICULUM REVISION COMMITTEE - COMMUNITY ADVISORY COMMITTEE -HEALTH SCIENCES CHARTER SCHOOL - BOARD OF DIRECTORSPART III, SECTION A, LINE 2BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING 2021 AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS.KALEIDA ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT'S CARE MAY BE CLASSIFIED AS CHARITY CARE IN ACCORDANCE WITH CERTAIN ESTABLISHED POLICIES OF KALEIDA. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED.TO ENHANCE AND ACCELERATE THE CHARITY CARE QUALIFICATION PROCESS, KALEIDA UTILIZES A PRESUMPTIVE CHARITY SCORING SYSTEM IN ORDER TO DETERMINE CHARITY CARE ELIGIBILITY. THE SYSTEM USES DEMOGRAPHIC AND PUBLIC FINANCIAL INFORMATION TO QUALIFY PATIENT ACCOUNTS FOR CHARITY CARE. IN ADDITION, KALEIDA MAKES AND RECEIVES PAYMENTS TO AND FROM A STATEWIDE POOL TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT NEW YORK. THESE NET PAYMENTS ARE REPORTED AS A COMPONENT OF PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8:	THERE ARE NO MEDICARE SHORTFALLS INCLUDED IN THE CALCULATION OF COMMUNITY BENEFIT.COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT, AS REFLECTED IN PART III, LINE 6: KALEIDA HEALTH USED THE FILED, BUT UNAUDITED 2021 CMS MEDICARE COST REPORT TO DETERMINE THE AMOUNTS REPORTED ON THESE LINES.
PART III, LINE 9B:	ONCE PATIENT LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE, THE PATIENT STATEMENT IS MAILED FOR PAYMENT RECOVERY. KALEIDA HEALTH HAS A PRE-COLLECTION PROCESS FOR ACCOUNTS WITH A POSITIVE PATIENT BALANCE GREATER THAN $4.99 AND A FIRST BILL DATE OLDER THAN 60 DAYS, BUT NOT PREVIOUSLY PAID IN FULL BY THE PATIENT (EXCLUDING ACCOUNTS FOR PATIENTS THAT HAVE SUBMITTED A COMPLETED APPLICATION FOR CHARITY CARE, MEDICAID, OR CHILD HEALTH PLUS, AND AN ELIGIBILITY DETERMINATION IS PENDING).UPON A PATIENT EXPRESSING FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE (CHARITY CARE). ONCE THE PATIENT SUBMITS THE COMPLETED APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THEN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THEN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY.
PART VI, LINE 2:	KALEIDA HEALTH ASSESSES THE NEEDS OF THE COMMUNITY THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP) WITH ITS MOST RECENT PLAN COMPLETED IN 2019. THE 2019-2021 CHNA-CSP IS AVAILABLE TO THE PUBLIC ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/ AND A PRINTED COPY IS AVAILABLE UPON REQUEST AT NO CHARGE. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN", LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. IN ADDITION TO THE 2019-2021 CHNA-CSP (AS REPORTED IN PART V, SECTION B), KALEIDA HEALTH STAFF ENGAGE IN OTHER METHODS TO ASSESS THE NEEDS OF THE COMMUNITY. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH, AND LOCAL COMMUNITY HEALTH NEEDS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING SERVICES AND PROGRAMS. RESPONSIVE TO COMMUNITY PRIORITIES, PROGRAM DEVELOPMENT AND SERVICES FILL IDENTIFIED GAPS OR SUPPLEMENT EXISTING PROGRAMS.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE KALEIDA HEALTH INFORMS INDIVIDUALS OF FINANCIAL ASSISTANCE MADE AVAILABLE AT THE TIME OF REGISTRATION INTO THE INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, AND LONG-TERM CARE FACILITY. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE AVAILABLE THROUGHOUT THE KALEIDA LOCATIONS. BROCHURES AND PAMPHLETS INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AS WELL AS APPLICATION IS ALSO MADE AVAILABLE THROUGH KALEIDA HEALTH'S WEBSITE. KALEIDA HEALTH OFFERS ASSISTANCE TO INDIVIDUALS IN OUR COMMUNITY FOR ACCESSING AFFORDABLE HEALTH CARE, INCLUDING:- FACILITATED ENROLLMENT: ASSISTS ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, ESSENTIAL PLANS, STATE AID PROGRAM FOR CHILDREN WITH SPECIAL NEEDS AND ALL QUALIFIED HEALTH PLANS MADE AVAILABLE THROUGH THE NEW YORK STATE OF HEALTH, HEALTH PLAN MARKETPLACE. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN BROCHURES AT KALEIDA SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. - FINANCIAL ASSISTANCE PROGRAM: AS DESCRIBED ABOVE, THE KALEIDA FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE PROVIDES FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT KALEIDA HEALTH HOSPITALS OR LONG-TERM CARE FACILITIES. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. - PRESUMPTIVE ELIGIBILITY: KALEIDA HEALTH HAS SHOWN A WILLINGNESS TO EXTEND FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH OUTSTANDING BILLS WHO HAVE NOT COMPLETED THE CHARITY APPLICATION PROCESS. THIS IS ACHIEVED THROUGH AN AUTOMATED PARO SCORING PROCESS USING PUBLIC RECORDS, REGIONAL COST OF LIVING, ESTIMATED HOUSEHOLD INCOME THRESHOLDS, COMMUNITY DEMOGRAPHICS TO DERIVE AN ESTIMATED FINANCIAL POSITION FOR EACH PATIENT. THOSE PATIENTS SCREENED THROUGH THIS AUTOMATED PROCESS AND DEEMED ELIGIBLE ARE ADJUSTED OFF TO CHARITY CARE IN LIEU OF BAD DEBT.
PART VI, LINE 4:	KALEIDA HEALTH SERVES WESTERN NEW YORK'S EIGHT COUNTIES OF ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS, AND WYOMING. THE POPULATION FOR THE REGION IS APPROXIMATELY 1.5 MILLION WITH ERIE COUNTY AND NIAGARA COUNTY COMPRISING AN ESTIMATED 1.1 MILLION OF THIS TOTAL. THREE KALEIDA HEALTH HOSPITALS INCLUDING BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN ERIE COUNTY, THE HOSPITALS' PRIMARY SERVICE AREA. DEGRAFF MEDICAL PARK IS LOCATED IN NIAGARA COUNTY, ITS PRIMARY SERVICE AREA. DEGRAFF ALSO SERVES A NUMBER OF ERIE COUNTY RESIDENTS GIVEN ITS LOCATION LESS THAN ONE MILE FROM THE ERIE COUNTY BORDER. EACH FACILITY'S PRIMARY SERVICE AREA IS DEFINED AS THE COUNTY WITH THE HIGHEST PERCENTAGE OF ALL WNY COUNTIES FOR 2019 INPATIENT DISCHARGES, EMERGENCY DEPARTMENT VISITS, AND OUTPATIENT VISITS AS IDENTIFIED IN THE 2019-2021 CHNA-CSP.ERIE COUNTYERIE COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE BORDERING LAKE ERIE, AND ALSO LIES ON THE INTERNATIONAL BORDER BETWEEN THE UNITED STATES AND CANADA. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, JULY 1, 2018 AS INDICATED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 919,719 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. ERIE COUNTY'S MEDIAN HOUSEHOLD INCOME IS $54,006, ITS POVERTY RATE IS 14.5%, AND 17.5% OF ITS POPULATION IS 65 YEARS AND OVER. ITS LARGEST CITY AND COUNTY SEAT IS BUFFALO WITH A POPULATION OF 256,304. THE CITY HAS A 30.9% POVERTY RATE THE MEDIAN HOUSEHOLD INCOME IN BUFFALO IS $34,268 WHILE THE MEDIAN HOUSEHOLD INCOME IN ERIE COUNTY IS $54,006 AND IN NEW YORK STATE, $62,765. BUFFALO HAS THE FOURTH HIGHEST YOUTH POVERTY RATE IN THE COUNTRY. OF THE 58,618 BUFFALO RESIDENTS UNDER 18 YEARS OF AGE, 27,678 OR 47% OF THOSE CHILDREN LIVE BELOW THE FEDERAL POVERTY LEVEL. THE ERIE COUNTY YOUTH POVERTY RATE IS 19.8% AND THE NYS RATE IS 20.8%. ONLY DETROIT, ROCHESTER AND CLEVELAND HAVE WORSE YOUTH POVERTY RATES (BUFFALO BUSINESS FIRST, 1-15-19). BUFFALO ALSO HAS A HIGH MINORITY POPULATION WITH 35.7% OF ITS RESIDENTS BEING BLACK NON-HISPANIC AND 11.7% HISPANIC AS COMPARED TO 13% BLACK NON-HISPANIC AND 5.3% HISPANIC FOR ALL OF ERIE COUNTY. PERSONS UNDER 65 WITHOUT HEALTH INSURANCE COMPRISE 6.9% OF ERIE COUNTY'S POPULATION AND 10.7% OF BUFFALO'S POPULATION. BUFFALO GENERAL MEDICAL CENTER AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN THE CITY OF BUFFALO AND SERVE A HIGH PERCENTAGE OF BUFFALO'S POOR AND UNDERSERVED POPULATION. MOST CENSUS TRACTS IN BUFFALO ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE TOWN OF AMHERST IS ONE OF THE COUNTY'S LARGEST SUBURBS WITH A POPULATION OF 125,659 AND IS HOME TO MILLARD FILLMORE SUBURBAN HOSPITAL. IN CONTRAST TO BUFFALO, THE TOWN OF AMHERST HAS A POVERTY RATE OF 10.8% AND THE MEDIAN HOUSEHOLD INCOME (IN 2017 DOLLARS) 2013-2017 IS $72,459. AMHERST'S POPULATION IS 80.7% WHITE NON-HISPANIC. THE TOWN ALSO HAS 8.9% ASIAN POPULATION, COMPARABLE TO THE NYS RATE OF 9.1% WHILE THE ERIE COUNTY RATE IS 3.1%. THE TOWN HAS A SIGNIFICANT SENIOR POPULATION WITH 19.2% OF RESIDENTS 65 YEARS AND OVER, AND MILLARD FILLMORE SUBURBAN HOSPITAL SERVES A HIGH PERCENTAGE OF THE TOWN'S AGING POPULATION. NIAGARA COUNTYNIAGARA COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE, JUST NORTH OF BUFFALO (ERIE COUNTY) AND ADJACENT TO LAKE ONTARIO ON ITS NORTHERN BORDER AND THE NIAGARA RIVER AND CANADA ON ITS WESTERN BORDER. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, JULY 1, 2018 AS INDICATED IN KALEIDA HEALTH'S 2019-2021 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 210,433 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. NIAGARA COUNTY'S MEDIAN HOUSEHOLD INCOME (IN 2017 DOLLARS) 2013-2017 IS $51,656, ITS POVERTY RATE IS 12.4%, AND 18.5% OF ITS POPULATION IS 65 YEARS AND OVER. ITS CITIES INCLUDE NIAGARA FALLS, POPULATION 48,148; NORTH TONAWANDA, POPULATION 30,372; AND ITS COUNTY SEAT OF LOCKPORT, POPULATION 20,434. THESE CITIES INCLUDE A HIGH PROPORTION OF THE COUNTY'S LOW INCOME AND UNDERSERVED POPULATION. 22.3% OF NIAGARA FALLS RESIDENTS IS BLACK/AFRICAN AMERICAN AND THE CITY HAS A 27.5% POVERTY RATE. ADDITIONALLY, NIAGARA FALLS IS FEDERALLY DESIGNATED AS AN AREA WITH A MEDICALLY UNDERSERVED POPULATION. THE POVERTY RATE FOR NORTH TONAWANDA IS 8.8%, AND 15.4% FOR LOCKPORT. THE PERCENTAGE OF RESIDENTS UNDER 65 YEARS WITHOUT HEALTH INSURANCE RANGES FROM 6.4% IN NIAGARA FALLS AND 5.1% IN NORTH TONAWANDA AND LOCKPORT. NIAGARA COUNTY IS ALSO HOME TO THE TUSCARORA RESERVATION WITH A POPULATION OF 1,288, A POVERTY RATE OF 13% AND A MEDIAN INCOME OF $32,500, MUCH LOWER THAN THAT OF NIAGARA COUNTY. (WIKIPEDIA, US CENSUS 2000) NORTH TONAWANDA IS HOME TO DEGRAFF MEDICAL PARK, AND, A COMMUNITY HOSPITAL A WITH A RECENTLY EXPANDED, NEW STATE-OF-THE ART EMERGENCY ROOM TO BETTER SERVE THE GROWING EMERGENCY CARE NEEDS OF THE COMMUNITY.DURING 2021, THERE WERE 53,006 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED CARE, 48% MEDICARE AND MEDICARE MANAGED CARE, 0.4% WERE UNINSURED, AND 25% WERE OTHER.IN ADDITION TO KALEIDA HEALTH'S 3 HOSPITALS IN ERIE COUNTY AND 1 HOSPITAL IN NIAGARA COUNTY, THERE ARE 9 OTHER HOSPITALS IN ERIE COUNTY AND 3 OTHER HOSPITALS IN NIAGARA COUNTY SERVING WESTERN NEW YORK PER THE NEW YORK STATE DEPARTMENT OF HEALTH WEBSITE.MORE INFORMATION IS AVAILABLE IN THE KALEIDA HEALTH 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP). THE DOCUMENT WAS COMPLETED IN FALL 2019, AND CAN BE FOUND ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. PRINTED COPIES AVAILABLE UPON REQUEST AT NO CHARGE AT KALEIDA HEALTH HOSPITALS. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED AND A "COMMENT LINK" IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY
PART VI, LINE 5	PROMOTION OF COMMUNITY KALEIDA HEALTH'S MISSION IS TO "ADVANCE THE HEALTH OF ITS COMMUNITY AND ITS VISION IS TO "PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE." KALEIDA HEALTH BOARD OF DIRECTORS KALEIDA HEALTH MAINTAINS CONTROL OVER THE CORPORATION THROUGH ITS SELF-PERPETUATING,15 MEMBER GOVERNING BOARD OF DIRECTORS. A MAJORITY OF THE BOARD OF DIRECTORS RESIDES IN KALEIDA HEALTH'S PRIMARY SERVICE AREA OF ERIE AND NIAGARA COUNTIES AND IS NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF KALEIDA HEALTH, NOR FAMILY MEMBERS THEREOF. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY LEADERS FROM THE BUSINESS, INDUSTRY, AND HEALTHCARE SECTORS, INCLUDING PHYSICIANS WHO ARE ON THE MEDICAL STAFF. EACH DIRECTOR SIGNS A CONFLICT OF INTEREST STATEMENT AND SERVES A THREE-YEAR TERM. ROBERT NESSELBUSH, PRESIDENT AND CEO OF KALEIDA HEALTH SERVES AS AN EX-OFFICIO DIRECTOR WITH VOTING RIGHTS. USE OF SURPLUS FUNDS SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY. IN ADDITION TO THE COMMUNITY SERVICE PROGRAMS ADDRESSED IN THE SECTION VI, PART II COMMUNITY BUILDING SECTION, KALEIDA HEALTH PROVIDES A NUMBER OF ADDITIONAL PROGRAMS AND COLLABORATIONS. KALEIDA HEALTH IS COMMITTED TO EDUCATION AND RESEARCH AS IT SERVES AS A MAJOR CLINICAL TEACHING AFFILIATE OF THE UNIVERSITY AT BUFFALO, JACOBS SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES. THROUGH AFFILIATIONS WITH A NUMBER OF EDUCATIONAL INSTITUTIONS, KALEIDA HEALTH ALSO PROVIDES A CLINICAL EXPERIENCE FOR HEALTH CARE PROFESSIONALS IN TRAINING IN THE FIELDS OF PHARMACY, NURSING, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND REHABILITATION SERVICES. AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATION, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS, AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING KALEIDA HEALTH'S MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.KALEIDA HEALTH IS COMMITTED TO PROVIDING HEALTH CARE FOR THE UNINSURED AND UNDERINSURED, OFFERS PROGRAMS AND SERVICES IN COMMUNITY-BASED SETTINGS AND IN ITS CAMPUSES AND FACILITIES, AND WORKS WITH PARTNERING ORGANIZATIONS TO FURTHER MEET THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. PROGRAMS AND EVENTS TARGET ALL AGES AND BACKGROUNDS, INCLUDING THE MEDICALLY UNDERSERVED; AND FOCUS ON THE REDUCTION OF HEALTH DISPARITIES, IMPROVED ACCESS TO CARE, EFFECTIVE USE OF HEALTH SERVICES, AND THE PROMOTION OF OVERALL COMMUNITY HEALTH AND WELLNESS.IN 2019, THE MED-LAW PARTNERSHIP OF WESTERN NEW YORK OPENED AT BUFFALO GENERAL MEDICAL CENTER/GATES VASCULAR INSTITUTE OFFERING PATIENTS LEGAL EXPERTISE AND SERVICES AT NO CHARGE TO ADDRESS PATIENTS' HEALTH-RELATED SOCIAL NEEDS.IN 2021, KALEIDA HEALTH CONTINUED ITS PARTNERSHIPS WITH CHARTER SCHOOLS LOCATED IN UNDERSERVED COMMUNITIES IN THE CITY OF BUFFALO AS IT BECAME A MEMBER OF THE HEALTH SCIENCES CHARTER SCHOOL AND A KALEIDA HEALTH STAFF MEMBER SERVES ON THE SCHOOL'S BOARD OF DIRECTORS. DUE TO COVID 19 RESTRICTIONS IN 2020 AND 2021, AND THE SCHOOL DISTRICT'S CHANGE TO PRIMARILY VIRTUAL LEARNING, MANY OF KALEIDA HEALTH'S PLANNED ACTIVITIES WERE CANCELLED INCLUDING STUDENT INTERNSHIPS, VOLUNTEERS AND HOSPITAL TOURS. KALEIDA HEALTH WELLNESS ACTIVITIES WERE ALSO CURTAILED FOR ITS PARTNER, BUFFALO UNITED CHARTER SCHOOL.A NYS MEDICAID HEALTH HOME SERVING CHILDREN WAS ESTABLISHED IN 2016 THROUGH OISHEI CHILDREN'S HOSPITAL TO PROVIDE CARE MANAGEMENT TO WNY CHILDREN WITH MEDICAID WHO HAVE COMPLEX PHYSICAL AND/OR BEHAVIORAL HEALTH CONDITIONS. THE HOSPITAL ALSO OPERATES SEVEN SCHOOL BASED HEALTH CENTERS IN BUFFALO PUBLIC SCHOOLS, A SCHOOL DISTRICT WITH 82% OF STUDENTS ECONOMICALLY DISADVANTED (2019-2020 DATA.NYSED.GOV).OISHEI CHILDREN'S HOSPITAL IS KNOWN FOR ITS COMMUNITY COLLABORATIONS TO ADDRESS PUBLIC HEALTH CONCERNS AND ASSURE ACCESS TO CARE FOR WOMEN AND CHILDREN, MANY OF WHOM ARE MEDICALY UNDERSERVED. IN ADDITION TO ITS WIDE RANGE OF SPECIALIZED PEDIATRIC AND MATERNAL SERVICES, THE HOSPITAL SERVES THE REGION AS A NEW YORK STATE REGIONAL PERINATAL CENTER, NYS DESIGNATED EBOLA PREPARED CENTER, AND THE PEDIATRIC & ADOLESCENT AIDS DESIGNATED CETNER OF WNY. IT HAS A LEVEL IV NEONATAL INTENSIVE CARE UNIT, LEVEL I PEDIATRIC TRAUMA UNIT, AND PEDIATRIC INTENSIVE CARE UNIT AND IS HOME TO THE ROBERT WARNER CENTER FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS, CHILDREN'S GUILD FOUNDATION AUTISM SPECTRUM DISORDER CENTER, REGIONAL LEVEL IV EPILEPSY MONITORING CENTER OF WNY, SAFE BABIES NEW YORK PROGRAM, LEAD POISONING PREVENTION RESOURCE CENTER OF WESTERN NEW YORK, SICKLE CELL & HEMOGLOBINOPATHY CENTER OF WESTERN NEW YORK, ROSWELL PARK AND OISHEI CHILDREN'S CANDER AND BLOOD DISORDER CENTER AND CYSTIC FIBROSIS CENTER OF WNY, AMONG OTHERS.INCREASING BREASTFEEDING RATES IS A PUBLIC HEALTH PRIORITY OF THE NEW YORK STATE PREVENTION AGENDA. AS DELIVERY HOSPITALS, BOTH OISHEI CHILDREN'S HOSPITAL AND MILLARD FILLMORE SUBURBAN HOSPITAL ARE ENGAGED IN SEVERAL EDUCATIONAL AND CLINICAL INITIATIVES TO IMPROVE EXCLUSIVE BREASTFEEDING RATES THROUGH NEW YORK STATE DEPARTMENT OF HEALTH GUIDELINES. IN 2019, ADDITIONALLY, KALEIDA HEALTH'S OB-GYN CENTERS HAVE ALL ACHIEVED NEW YORK STATE BABY-FRIENDLY PRACTICE DESIGNATION. IN 2018, OISHEI CHILDREN'S OPENED A BABY CAFE TO PROVIDE FREE BREASTFEEDING SUPPORT AND GUIDANCE TO PREGNANT AND BREASTFEEDING MOMS.CARDIOVASCULAR DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN BOTH ERIE AND NIAGARA COUNTIES AND KALEIDA HEALTH SUPPORTS SEVERAL CARDIOVASCULAR INITIATIVES. CARDIAC AND STROKE CARE IS A MAJOR SERVICE LINE FOR KALEIDA HEALTH AND THE GATES VASCULAR INISTITUTE OF BUFFALO GENERAL MEDICAL CENTER SERVES AS A REGIONAL SPECIALTY CARE AND RESEARCH FACILITY FOCUSING ON THE HEART, NEUROLOGICAL, AND RELATED VASCULAR SYSTEM. IN 2021, DUE TO COVID-19 RESTRICTIONS CHRONIC DISEASE RISK FACTOR EDUCATION AND SCREENING EVENTS WENT VIRUTAL WITH 17,756 INDIVIDUALS PARTIPATING IN HEALTHY U PROGRAMS VIA FACEBOOK. ADDITIONALLY, MEDICAL MINUTE VIDEOS ON HEALTH TOPICS AIRED ON WIVB-TV AND KALEIDA SOCIAL MEDIA REACHING 83,178 AND THE MEDICALLY SPEAKING INTERVIEW SERIES REACHED 48,053 VIA FACEBOOK AND THE KALEIDA WEBSITE. A TARGETED CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IS PROVIDED TO MEDICALLY UNDERSERVED FEMALES AT THE OB-GYN CENTERS OF OISHEI CHILDREN'S HOSPITAL, WHERE A MAJORITY OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID.COLLABORATION AND ACCESS TO CARE ACROSS ALL OF WESTERN NEW YORK IS A PRIORTY FOR KALEIDA HEALTH. TO ADDRESS THE NEED FOR CARDIAC CATHETERIZATION SERVICES IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED WITH NIAGARA FALLS MEMORIAL MEDICAL CENTER (NFMMC), CATHOLIC HEALTH SYSTEM, AND ERIE COUNTY MEDICAL CENTER TO MAKE THIS LIFESAVING CARE READILY ACCESSIBLE TO RESIDENTS THROUGHOUT THE NIAGARA REGION. A NEW CARDIAC CATHETERIZATION LABORATORY OPENED IN 2017 AT THE HEART CENTER OF NIAGARA ON THE NFMMC'S DOWNTOWN NIAGARA FALLS CAMPUS.
PART VI, LINE 5 - CONTINUED	MILLARD FILLMORE SUBURBAN HOSPITAL SERVES THE WESTERN NEW YORK COMMUNITY WITH A COMPREHENSIVE CANCER REHAB PROGRAM. THE HOSPITAL FURTHER PROVIDES CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS AND PARTICIPATES IN COMMUNITY EVENTS INCLUDING NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS. KALEIDA HEALTH'S DEGRAFF MEDICAL PARK PARTICIPATES IN SEVERAL COMMUNITY EVENTS TO PROVIDE CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS, AND SERVES AS A SITE FOR NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS. DEGRAFF MEDICAL PARK PROVIDES CANCER REHABILITATION AND RECOVERY SERVICES, CARDIAC REHABILITATION SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY.KALEIDA HEALTH HOSPITALS ARE RESPONDING TO THE COMMUNITY'S OPIATE PROBLEM THROUGH THE BUFFALO MATTERS BUPRENORPHINE TREATMENT PROGRAM IN THE EMERGENCY DEPARTMENTS WITH IMMEDIATE BUPRENORHINE TREATMENT AND PATIENT REFERRAL TO COMMUNITY TREATMENT AGENCIES. ADDITIONALLY, MEDICATION AND SYRINGE DROP BOXES ARE ON-SITE AT EACH HOSPITAL. KALEIDA HEALTH'S HUMAN RESOURCES DEPARTMENT PARTNERS WITH THE BUFFALO AND ERIE COUNTY WORKFORCE DEVELOPMENT COUNCIL AND THE BUFFALO EDUCATION AND TRAINING CENTER ON DIFFERENT WORKFORCE DEVELOPMENT INITIATIVES AND EVENTS, INCLUDING THOSE TARGETING THE UNDERSERVED. ADDITIONALLY, KALEIDA HEALTH NURSE RECRUITERS PARTNER WITH LOCAL SCHOOLS AND COLLEGES TO ADVANCE RECRUITMENT EFFORTS.INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE PROGRAMS IS PROMOTED TO THE PUBLIC THROUGH MULTIPLE COMMUNITY OUTREACH ACTIVITIES AND EVENTS, ON THE KALEIDA HEALTH WEBSITE WWW.KALEIDAHEALTH.ORG, ON FACEBOOK AND TWITTER; AND AS INCLUDED IN THE 2019-2021 CHNA-CSP. THE CHNA-CSP IS AVAILABLE ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY OR IN PRINT FORMAT UPON REQUEST. WRITTEN COMMENTS ON THE 2019-2021 CHNA-CSP ARE INVITED AND A COMMENT LINK IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE.THE COVID-19 PANDEMIC - ITS IMPACT AND KALEIDA HEALTH'S RESPONSETHROUGHOUT 2020-2021, KALEIDA HEALTH MADE PROGRESS IMPLEMENTING THE INTERVENTIONS OUTLINED IN ITS COMMUNITY SERVICE PLAN AND AS ALIGNED WITH THE NYS PREVENTION AGENDA, WHILE ALSO ADDRESSING THE NEEDS OF THE UNDERSERVED. HOWEVER, THE COVID-19 PANDEMIC PRESENTED SOME IMPLEMENTATION CHALLENGES. DURING THE PANDEMIC, KALEIDA HEALTH HOSPITALS EXPERIENCED AN INFLUX OF PATIENTS AFFECTED BY THE CORONAVIRUS IN BOTH INPATIENT AND OUTPATIENT CARE. IT WAS CRITICAL FOR EMPLOYEES TO HAVE APPROPRIATE PPE AND BE PROVIDED THE MOST UP-TO-DATE INFORMATION RELATED TO THE CARE AND TREATMENT OF THE DISEASE. ALL EMPLOYEE AND CORPORATE EFFORTS TO EDUCATE, SCREEN AND TEST EMPLOYEES, PATIENTS AND THE COMMUNITY WAS A TOP PRIORITY AND CONTINUES TO BE SO IN 2022. OUTPATIENT CARE AND ELECTIVE SURGERIES AT KALEIDA HEALTH HOSPITALS WERE CUT BACK IN 2020-2021 DUE TO NYS MANDATES, AND KALEIDA HEALTH OUTPATIENT CLINICS ENLISTED TELEHEALTH PROGRAMS TO HELP MEET PATIENT CARE NEEDS. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH CONTINUED TO IMPLEMENT THE COMMUNITY INTERVENTIONS THAT WERE NOT HAMPERED BY PANDEMIC RESTRICTIONS; AND CONTINUES TO WORK TO RE-ASSESS THE IMPACT OF COVID-19 ON OTHER INTERVENTIONS AND IN THE ADVANCEMENT OF ITS NYS PREVENTION AGENDA PRIORITY AREAS. COVID-19 PRESENTED MANY UNPLANNED COMMUNITY NEEDS, AND KALEIDA HEALTH RESPONDED. THROUGHOUT THE PANDEMIC, KALEIDA HEALTH TRANSFORMED ITS OPERATIONS COMING TOGETHER WITH OTHERS IN THE COMMUNITY IN NOVEL WAYS TO MANAGE THE OVERWHELMING NUMBER OF PATIENTS TO BE TREATED. AS KALEIDA HEALTH PIVOTED TO RESPOND, IT WAS CRITICAL TO EFFECTIVELY COMMUNICATE INTERNALLY WITH OUR STAFF AND PROVIDERS AS WELL AS EXTERNALLY WITH THOSE IN OUR COMMUNITY WHO RELIED ON OUR MEDICAL EXPERTS FOR INFORMATION AND GUIDANCE. KALEIDA HEALTH TEAMS WERE INNOVATIVE AND DECISIVE ON HOW THEY HANDLED CLINICAL CARE, APPLYING A RISK-BASED APPROACH AND ALWAYS REMAINING FOCUSED ON THE WELLNESS AND RESILIENCY OF ITS HEROIC HEALTHCARE WORKERS.KALEIDA HEALTH'S ACCREDITATION PARTNER, DNV HEALTHCARE USA INC. AWARDED KALEIDA HEALTH ITS INAUGURAL 2021 PIVOT AWARD FOR THE COLLECTIVE DEDICATION, INNOVATION AND COLLABORATION OF THE ENTIRE KALEIDA HEALTH FAMILY IN RESPONDING TO COVID-19 CHALLENGES. THE PIVOT AWARD (PROGRESSIVE, INNOVATIVE, VALUABLE, OPPORTUNE, AND TRANSFORMATIVE) IS GIVEN TO A HOSPITAL OR HEALTHCARE SYSTEM THAT QUICKLY IMPLEMENTS NEW WAYS TO MEET PATIENT, COMMUNITY AND STAFF NEEDS. THE NEWLY-CREATED AWARD RECOGNIZES THE EXTRAORDINARY EFFORTS HOSPITALS PUT IN PLACE IN RESPONDING TO THE CHALLENGES CREATED BY THE COVID-19 PANDEMIC.DNV HIGHLIGHTED SEVERAL OF KALEIDA HEALTH'S NOTEWORTHY COLLABORATIVE COMMUNITY EFFORTS, INCLUDING:-TRANSFORMED THE FORMER SEARS AUTOMOTIVE BUILDING AT THE WALDEN GALLERIA INTO A DRIVE-THRU COVID-19 TESTING FACILITY, - CREATED A RELATIONSHIP WITH A LOCAL COMMUNITY 503B COMPOUNDING PHARMACY (PINE PHARMACY) TO PRODUCE SACCHARIN SOLUTION NEEDED FOR FIT TESTING PROCESS,-WORKED WITH THE UNIVERSITY AT BUFFALO (UB) TO DEVELOP PREDICTIVE ANALYTICS ON THE WESTERN NEW YORK COVID-19 POSITIVE TEST RATES TO PREPARE LEADERSHIP FOR COVID-19 INPATIENT SURGES, - WITH PARTNERS AT UB, 26 CLINICAL TRIALS WERE PERFORMED AT KALEIDA HEALTH, RESULTING IN 28 PUBLICATIONS. BECAUSE OF OUR CLINICAL TRIALS, WE HAD EARLY ACCESS TO POTENTIAL THERAPEUTIC TREATMENTS FOR PATIENTS WITHIN OUR REGION, -COLLABORATED WITH MANY COMMUNITY, GOVERNMENT AND FAITH-BASED PARTNER ORGANIZATIONS TO CREATE INNOVATIVE VIRTUAL COMMUNITY OUTREACH EVENTS, INCLUDING A VIRTUAL EDUCATION SERIES WITH THE BUFFALO NAACP, WHICH FEATURED KALEIDA HEALTH'S MEDICAL EXPERTS WHO SHARED INFORMATION ABOUT COVID-19 DISEASE, TRANSMISSION, PREVENTION, TREATMENT OPTIONS, TESTING OPPORTUNITIES AND VACCINE SAFETY AND AVAILABILITY, -LED NATIONAL GUIDELINE EFFORTS TO ESTABLISH TREATMENT GUIDELINES FOR EMERGENT ACUTE STROKE PATIENTS IN THE SETTING OF COVID, -LEAD TESTING EFFORTS IN THE COMMUNITY DURING THE FIRST WAVE, PROVIDING TESTING FOR FIRST RESPONDERS AND ESSENTIAL SERVICE PERSONNEL TO SUPPORT THE COMMUNITY; WITH INNOVATIONS INTERNALLY FROM THE KALEIDA HEALTH IT TEAM TO CREATE EFFICIENCIES AND EASE OF SCHEDULING, - VISITING NURSING ASSOCIATION OF WNY TRAINED OTHER HEALTH SYSTEMS AND NURSING HOME TEAMS TO DELIVER MONOCLONAL ANTIBODY TREATMENT FOR NURSING HOME PATIENTS, -SUPPORTED OTHER HEALTHCARE ORGANIZATIONS WITH MUCH-NEEDED PPE, PARTICULARLY FACE MASKS AT THE BEGINNING OF THE PANDEMIC,-DEVELOPED AN EMOTIONAL SUPPORT TASK FORCE WITH A TEAM OF SOCIAL WORKERS, PSYCHOLOGISTS, AND PSYCHIATRISTS TO SUPPORT MENTAL HEALTH NEEDS OF STAFF ACROSS GREAT LAKES HEALTH SYSTEM OF WNY.PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEMKALEIDA HEALTH IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHOSE MEMBERS INCLUDE: THE UPPER ALLEGHENY HEALTH SYSTEM, KALEIDA HEALTH FOUNDATION, VISITING NURSING ASSOCIATION OF WNY, INC., VNA HOMECARE SERVICE, INC., AND OISHEI CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
UNIVERSITY ORTHOPEDIC SERVICE
5500 MAIN STREET	BUFFALO	NY	14221	161406947	N/A	$150,000	$0	FMV	SPONSORSHIP
WNY CLINICAL INFO EXCHANGE
2475 GEORGE URBAN BLVD	BUFFALO	NY	14043	364594483	N/A	$93,750	$0	FMV	CONTRIBUTION
WNY HEALTHENET
2475 GEORGE URBAN BLVD	DEPEW	NY	14043	043726634	N/A	$127,000	$0	FMV	SPONSORSHIP
AMHERST CHAMBER OF COMMERCE
400 ESSJAY RD	WILLIAMSVILLE	NY	14221	160959485	N/A	$12,500	$0	FMV	SPONSORSHIP
TROCAIRE COLLEGE
360 CHOATE AVE	BUFFALO	NY	14220	160909446	501(C)(3)	$7,500	$0	FMV	CONTRIBUTION
JACOBS INSTITUTE INC
875 ELLICOTT ST	BUFFALO	NY	14203	263085485	501(C)(3)	$200,000	$0	FMV	CONTRIBUTION
LEADERSHIP BUFFALO INC
500 SENECA STREET	BUFFALO	NY	14204	161363536	501(C)(3)	$8,800	$0	FMV	SPONSORSHIP

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	4	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: KALEIDA HEALTH MAKES CONTRIBUTIONS TO ORGANIZATONS IN WESTERN NEW YORK THAT ALSO HAVE HEALTH CARE RELATED ACTIVITIES. ALL CONTRIBUTIONS MUST BE APPROVED BY THE GOVERNING BODY BEFORE MONEY IS DISTRIBUTED.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JODY LOMEO
FMR PRES/CEO EX-OFFICIO W/VOTE	$418,798	$0	$1,075,285	$0	$1,241,432	$0	$8,424	$0	$4,297	$0	$2,748,236	$0	$0	$0
ROBERT NESSELBUSH
CHIEF EXECUTIVE OFFICER	$1,276,901	$0	$0	$0	$81,142	$0	$15,319	$0	$19,982	$0	$1,393,344	$0	$0	$0
DONALD BOYD
PRESIDENT, COO	$893,850	$0	$0	$0	$199,904	$0	$31	$0	$17,406	$0	$1,111,191	$0	$0	$0
CHRISTOPHER MALLAVARAPU MD
EMPLOYED PHYSICIAN	$830,323	$0	$0	$0	$4,327	$0	$16,539	$0	$17,329	$0	$868,518	$0	$0	$0
DAVID HUGHES MD
EVP, CMO	$616,406	$0	$0	$0	$165,975	$0	$15,171	$0	$17,286	$0	$814,838	$0	$0	$0
KAVEH VALI MD
EMPLOYED PHYSICIAN	$768,190	$0	$0	$0	$557	$0	$10,660	$0	$1,051	$0	$780,458	$0	$0	$0
CARROLL HARMON MD
EMPLOYED PHYSICIAN	$679,475	$0	$0	$0	$4,825	$0	$11,606	$0	$1,249	$0	$697,155	$0	$0	$0
PAUL BELTER
EVP, CHIEF FINANCIAL OFFICER	$605,041	$0	$0	$0	$38,746	$0	$5,800	$0	$13,013	$0	$662,600	$0	$0	$0
CHRISTOPHER LANE
PRESIDENT BGMC AND GVI	$567,038	$0	$38,400	$0	$25,031	$0	$3,952	$0	$17,243	$0	$651,664	$0	$0	$0
LUCY CAMPBELL MD
EMPLOYED PHYSCIAN	$590,504	$0	$0	$0	$5,603	$0	$18,468	$0	$17,090	$0	$631,665	$0	$0	$0
CHERYL KLASS
EVP, CHIEF NURSE EXECUTIVE	$559,556	$0	$0	$0	$41,638	$0	$10,931	$0	$7,599	$0	$619,724	$0	$0	$0
ALYSON SPAULDING
GENERAL COUNSEL	$486,350	$0	$0	$0	$92,356	$0	$11,575	$0	$17,148	$0	$607,429	$0	$0	$0
ALLEGRA JAROS
PRESIDENT WCHOB	$463,850	$0	$32,250	$0	$25,004	$0	$2,500	$0	$17,125	$0	$540,729	$0	$0	$0
MICHAEL HUGHES
CHIEF ADMINISTRATIVE OFFICER	$463,822	$0	$0	$0	$63,249	$0	$6,942	$0	$831	$0	$534,844	$0	$0	$0
JUDY BAUMGARTNER
PRESIDENT DEGRAFF	$466,102	$0	$24,000	$0	$0	$0	$4,804	$0	$912	$0	$495,818	$0	$0	$0
KATHRYN BASS MD
EMPLOYED PHYSICIAN	$400,218	$0	$0	$0	$2,747	$0	$17,335	$0	$890	$0	$421,190	$0	$0	$0
STEPHEN HARDY
VP FINANCE	$302,480	$0	$0	$0	$3,754	$0	$9,513	$0	$6,910	$0	$322,657	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	HEALTH OR SOCIAL CLUB DUES AS PART OF THEIR COMPENSATION PACKAGE, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE ENTITLED TO CHOOSE AS AN EXECUTIVE PERK THE BENEFIT OF BUSINESS RELATED SOCIAL DUES OR INITIATION FEES.
PART I, LINE 4A	JODY LOMEO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $1,016,489. THIS AMOUNT IS INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III).
PART I, LINE 7	CERTAIN INDIVIDUALS QUALIFIED TO RECEIVE BONUS/INCENTIVE COMPENSATION PAYMENTS BASED ON CERTAIN PERFORMANCE METRICS BEING MET. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN(B)(II).

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
DORMITORY AUTHORITY - STATE OF NEW YORK
A	146000293	000000000	2016-09-30	$7,650,258	LEASE OF EQUIPMENT	0	0	0
DORMITORY AUTHORITY - STATE OF NEW YORK
B	146000293	000000000	2016-09-30	$7,349,742	LEASE OF EQUIPMENT	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$5,482,683	$7,650,424	$197,725	$104,266	$7,348,433	2017	0	0	Yes (1)	Yes (1)
B	$5,267,313	$7,350,549	$525,560		$6,748,676	2017	0	0	Yes (1)	Yes (1)	$76,312

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	Yes (1)	Yes (1)	0	0	0	0
B	0	0	Yes (1)	Yes (1)	0	0	0	0

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	0	0	Yes (1)	0	0	0	Yes (1)	Yes (1)
B	0	0	0	Yes (1)	0	0	0	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE K, PART II, LINE 3

THE TOTAL PROCEEDS TO DO AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS AND MARKET VALUE FLUCTUATIONS.

SCHEDULE K, PART IV, ARBITRAGE, LINE 2C

(A) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK. DATE OF REBATE COMPUTATION PERFORMED: 09/30/2020. (B) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK. DATE OF REBATE COMPUTATION PERFORMED: 05/31/2021. NOTE REGARDING THE REBATE COMPUTATIONS ON 9/30/20 & 5/31/21: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASES, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	MEDICAL EQUIPMENT	Desc
Contribution	2	ContributionCnt
Noncash Contributions Rpt F990	$4,359,054	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	REVIEW PROCESS FOR FORM 990 ORGANIZATION'S MANAGEMENT, IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, KPMG, REVIEW THE FORM 990. THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE FORM 990 IS FILED WITH THE IRS, THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE SAME TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE POTENTIAL, ACTUAL, OR EVEN APPEARANCE, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. THE COMPLETED CONFLICTS OF INTEREST AND DISCLOSURE FORMS FOR DIRECTORS ARE RETURNED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION APPROVAL PROCESS ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES FOR REVIEW AND APPROVAL. SUCH INFORMATION IS COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT AND INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS OFFICE AT 726 EXCHANGE STREET, SUITE 200, BUFFALO, NY 14210. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 80,562,814. MANAGEMENT AND GENERAL EXPENSES 2,728,355. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,291,169. INTERNS & RESIDENTS FEES: PROGRAM SERVICE EXPENSES 29,491,151. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,491,151. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 27,681,499. MANAGEMENT AND GENERAL EXPENSES 4,117,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,799,439. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 8,422,889. MANAGEMENT AND GENERAL EXPENSES 2,934,749. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,357,638.
FORM 990, PART XI, LINE 9:	MINORITY INTEREST IN SUBSIDIARY -4,419,000. NET ACTUARIAL GAIN ON PENSION PLAN 153,879,000. OTHER TRANSFERS, NET -1,137,070.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
KALEIDA MCO LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161570311	DORMANT	NY	$0	$0	KH
KALEIDA IPA LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161570380	DORMANT	NY	$0	$0	KH
KALEIDA WNYI LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	453189404	HEALTH CARE	NY	-$1,446,274	-$1,778,288	KH
KALEIDA SERVICES LLC
2100 WEHRLE DRIVE	WILLIAMSVILLE	NY	14221	472284036	ADULT DAYCARE	NY	-$110,724	$167,622	KH
MFSC LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	261582864	HEALTH CARE	NY	-$1,409,074	$3,747,118	KH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
MILLARD FILLMORE AMBULATORY SURGER CTR
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161307129	SUPPORT ORG	NY	501(C)(3)	12A	KH	Yes (1)
VNA HOME CARE SERVICES
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161491203	HOME HLTH CAR	NY	501(C)(3)	10	KH	Yes (1)
VNA OF WESTERN NEW YORK
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	160743214	HOME HLTH CAR	NY	501(C)(3)	10	KH	Yes (1)
VISK
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	222738425	SUPPORT ORG	NY	501(C)(3)	10	KH	Yes (1)
KALEIDA HEALTH FOUNDATION
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161579143	FUNDRAISING	NY	501(C)(3)	7	KH	Yes (1)
THE WOMEN & CHILDREN'S HOSP OF BFLO FDN
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161332044	FUNDRAISING	NY	501(C)(3)	7	KH	Yes (1)
CHILDREN'S HEALTH HOME OF WNY INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	814086046	PED HOME HLTH	NY	501(C)(3)	10	KH	Yes (1)
UPPER ALLEGHENY HEALTH SYSTEM INC
515 MAIN STREET	OLEAN	NY	14760	271255425	SUPPORT ORG	NY	501(C)(3)	12A	KH	Yes (1)
OLEAN GENERAL HOSPITAL
515 MAIN STREET	OLEAN	NY	14760	160743102	HOSPITAL	NY	501(C)(3)	3	BRMC	Yes (1)
BRADFORD REGIONAL MED SERVICES
116 INTERSTATE PARKWAY	BRADFORD	PA	16701	232875157	PHYS. GROUP	NY	501(C)(3)	3	BRMC	Yes (1)
HEALTH SYSTEM PHYSICIAN PC
130 SOUTH UNION STREET	OLEAN	NY	14760	464304317	PHYS. GROUP	NY	501(C)(3)	10	OGH	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
HARLEM ROAD LEASING LLC
3435 MAIN STREET	BUFFALO	NY	14214	205588135	EQUIPMENT LEASING	NY	KALEIDA HEALTH	UNRELATED	$14,492	$221,229	0	Yes (1)	0.50000
AMTON IMAGING LLC
199 PARK CLUB LANE SUITE 300	WILLIAMSVILLE	NY	14221	262925470	HEALTH CARE	NY	KALEIDA WNYI	RELATED	-$896,737	-$3,461,171	0	Yes (1)	0.50000
SITE E LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	272124795	REAL ESTATE MGMT	NY	KPI	EXCLUDED	$93,898	$1,705,923	0	0	0.50150
SOUTHTOWNS IMAGING LLC
5959 BIG TREE ROAD SUITE 105	ORCHARD PARK	NY	14127	471123230	EQUIPMENT LEASING	NY	KALEIDA WNYI	UNRELATED	-$438,764	$2,532,100	0	Yes (1)	0.70000
COLLABORATIVE CARE VENTURES LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	472365690	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	-$2,016	$2,467,097	0	0	0.60000
GREAT LAKES MEDICAL BILLING SVCS LLC
199 PARK CLUB LANE SUITE 300	WILLIAMSVILLE	NY	14221	461668448	MEDICAL BILLING	NY	KALEIDA WNYI	UNRELATED	-$110,773	$248,776	0	0	0.50000
ALTUS MANAGEMENT LLC
840 AERO DRIVE SUITE 150	CHEEKTOWAGA	NY	14225	900149133	GROUP PURCHASING	NY	KALEIDA HEALTH	EXCLUDED	$363,190	$2,959,132	0	0	0.59190
SOUTHTOWNS SURGERY CENTER LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	464742028	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	$785,618	$4,686,199	0	Yes (1)	0.65240

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
KALEIDA PROPERTIES INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	222738483	PROP MGMT SVCS	NY	KALEIDA HEALTH	C	-$4,074,765	$8,050,459	1.00000	Yes (1)
WESTLINK CORPORATION
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161354421	MED & DIAGN SVCS	NY	KALEIDA HEALTH	C	-$25		1.00000	Yes (1)
GREAT LAKES INTEGRATED NETWORK INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	823184375	HEALTH CARE	NY	KALEIDA HEALTH	C	$184,945	$8,533,482	0.50000	0
KHBC INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	823184375	HEALTH CARE	NY	KALEIDA HEALTH	C	-$3,547,744	$94,396	0.50000	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (1)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (37 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MILLARD FILLMORE AMBULATORY SURGERY CENTER
C	$539,156	ACTUAL COST
VNA HOME CARE SERVICES
O	$177,202	ACTUAL COST
VNA HOME CARE SERVICES
Q	$2,107,256	ACTUAL COST
VNA HOME CARE SERVICES
E	$160,622	ACTUAL COST
VNA OF WESTERN NEW YORK
O	$98,267	ACTUAL COST
VNA OF WESTERN NEW YORK
L	$358,004	ACTUAL COST
VNA OF WESTERN NEW YORK
Q	$16,880,558	ACTUAL COST
VNA OF WESTERN NEW YORK
D	$155,002	ACTUAL COST
KALEIDA PROPERTIES INC
Q	$1,189,862	ACTUAL COST
KALEIDA PROPERTIES INC
D	$327,753	ACTUAL COST
SITE E LLC
K	$108,454	ACTUAL COST
VISK
D	$300,450	ACTUAL COST
WOMEN AND CHILDREN'S HOSPITAL FOUNDATION
C	$350,163	ACTUAL COST
WOMEN AND CHILDREN'S HOSPITAL FOUNDATION
S	$12,842,325	ACTUAL COST
WOMEN AND CHILDREN'S HOSPITAL FOUNDATION
D	$17,706,631	ACTUAL COST
KALEIDA HEALTH FOUNDATION
C	$4,008,891	ACTUAL COST
KALEIDA HEALTH FOUNDATION
S	$6,330,023	ACTUAL COST
KALEIDA HEALTH FOUNDATION
D	$11,728,707	ACTUAL COST
SOUTHTOWNS IMAGING LLC
D	$3,187,095	ACTUAL COST
SOUTHTOWNS IMAGING LLC
J	$289,310	ACTUAL COST
SOUTHTOWNS IMAGING LLC
Q	$155,947	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
L	$431,451	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
J	$850,979	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
R	$138,278	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
D	$5,786,078	ACTUAL COST
COLLABORATIVE CARE VENTURES LLC
D	$1,000,000	ACTUAL COST
CHILDREN'S HOME HEALTH OF WNY INC
O	$57,946	ACTUAL COST
CHILDREN'S HOME HEALTH OF WNY INC
Q	$92,668	ACTUAL COST
CHILDREN'S HOME HEALTH OF WNY INC
E	$133,320	ACTUAL COST
UAHS
O	$2,476,256	ACTUAL COST
UAHS
Q	$6,910,742	ACTUAL COST
UAHS
D	$1,283,105	ACTUAL COST
HEALTH SYSTEM PHYSICIANS PC
O	$22,851	ACTUAL COST
HEALTH SYSTEM PHYSICIANS PC
Q	$3,583,703	ACTUAL COST
HEALTH SYSTEM PHYSICIANS PC
D	$3,606,015	ACTUAL COST
BRADFORD REGIONAL MEDICAL SERVICES PC
Q	$1,717,481	ACTUAL COST
BRADFORD REGIONAL MEDICAL SERVICES PC
D	$3,564,533	ACTUAL COST