2022-11-08T09:37:48-07:00 2021-12-31 990 2021-01-01 160743024 THE FREDERICK FERRIS THOMPSON HOSPITAL FRED 5853966000 350 Parrish Street Canandaigua NY 14424 Mark Prunoske Sr VP Finance CFO 5853966280 2022-11-08 1 11 1 AAL2 2021 2022-09-23 18:48:47Z Michael F Stapleton Jr 350 Parrish Street Canandaigua NY 14424 189128219 0 X www.thompsonhealth.org X 1904 NY FF Thompson Hospital is dedicated to continuously improving the health of the residents and communities of the Finger Lakes and surrounding regions. 24 17 1857 17 1202922 0 7457113 5665463 143279452 169966618 35402 -91927 8906788 7486931 159678755 183027085 0 0 0 0 90902001 99471905 0 0 0 65150748 71387557 156052749 170859462 3626006 12167623 191262621 200303892 132813974 124581594 58448647 75722298 FF Thompson Hospital is a community hospital which exists to serve the health care needs of the people in partnership with regional health care providers. FF Thompson Hospital serves as the center of a health care network to provide a full range of health care services and to improve community health. 0 0 144150179 0 177453549 Inpatient care: 6,071 Inpatient discharges, 26,608 Inpatient Days. Outpatient: 594,311 Lab visits/tests, 29,276 ED visits, 89,491 Diagnostic Imaging visits, 31,794 Urgent Care visits, 131,935 Primary Care visits, 48,806 Rehabilitation visits, and 5,289 Surgical Services visits. Charity Care was provided in the amount of $922,374 (at cost). Community Benefit was $997,152. Uncompensated Care was $4,327,997. 0 0 0 144150179 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 X 83 0 1 1857 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 24 17 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X FF Thompson Hospital Roberta Spezzano 5853966000 350 Parrish Street Canandaigua NY 14424 X Steven Goldstein Board Member 0.50 71.00 X 0 3165449 215223 Mark Taubman MD Board Member 0.50 75.00 X 0 1570098 204474 Michael F Stapleton JR President/CEO 31 9 X X 0 845524 113568 Michael Apostolakos MD Board Member 0.5 64.00 X 0 678764 111083 A David Peter MD Board Member and Surgeon 40 1.5 X 596195 0 37962 Jeffrey Goldstein Gastroenterologist 40 0 X 545428 0 27985 David Baum MD SVP Medical Affairs & Emergency Physician 20 20 X 0 481271 88184 Joseph Talarico MD Physician 40.0 0 X 500309 0 16133 Matthew Osborne MD Medical Director Chief of Emergency Medicine 40.0 0 X 449139 0 43704 Mark Prunoske Senior VP & CFO 30.0 10.0 X 0 416451 73437 Robert L Smith Physician 40.0 0 X 440094 0 42644 Kurt Koczent EVP/COO 36.0 4 X 317297 79324 70564 Jennifer Wills Physician 37.00 0 X 444187 0 10292 Elizabeth Talia VP Legal & Regulatory Affairs and General Counsel 26.50 13.50 X 0 230915 39770 Jennifer DeVault VP Associate Services and Wellness 36.0 4.0 X 221078 0 45520 Robert Scott MD Board Member - President of Medical Staff 40.0 1.5 X 219411 0 41980 Hazel Robertshaw VP Patient Care Services/CNO 40 0 X 231492 0 23068 Cynthia Teerlinck MD Board Member and Physician 23 1.5 X 181743 0 20442 Daniel Fuller Board Chair 0.5 1.5 X X 0 0 0 Dale Hunt Board Vice Chair 0.5 2.0 X X 0 0 0 David G Case Board Treasurer 0.5 1.5 X X 0 0 0 Lauren Dixon Board Secretary 0.5 2.0 X X 0 0 0 Mark Blazey Board Member 0.5 1.5 X 0 0 0 Randall Farnsworth Board Member 0.5 1.5 X 0 0 0 Roger Friedlander Board Member 0.5 1.5 X 0 0 0 Paul Griswold Board Member 0.5 2.0 X 0 0 0 Frank Hamlin III Esq Board Member 0.5 1.5 X 0 0 0 Jennifer Jones Board Member 0.5 1.5 X 0 0 0 William R Kenyon Esq Board Member 0.5 1.5 X 0 0 0 Gigi Lamb Board Member 0.5 1.5 X 0 0 0 Deborah Price Board Member 0.5 1.5 X 0 0 0 Lauren Sands Esq Board Member 0.5 2.0 X 0 0 0 Margaret Somerset Esq Board Member 0.5 1.5 X 0 0 0 Lori Van Dusen Board Member 0.5 1.5 X 0 0 0 Maureen Wolfe Board Member 0.5 1.5 X 0 0 0 4146373 7467796 1226033 158 0 1 0 Locumtenens 2575 Northwinds Pkwy Alpharetta GA 30009 Temporary placement agency for Physicians 834568 The Pike Company 1 Circle Street Rochester NY 14607 Contractor 792780 Genesee Construction Company 7653 RT-63 Dansville NY 14437 Contractor 510869 Barton Associates 300 Jubilee Drive Peabody MA 01960 Healthcare staffing company 436604 Allscripts 24630 Network Place Chicago IL 606731246 Remote Hosting Services 264517 21 0 0 0 3658599 2006864 0 0 5665463 Patient Care Revenues, net 622110 168763696 168763696 0 0 Lab Revenue 621500 1202922 0 1202922 0 169966618 38938 0 0 38938 0 0 0 0 0 0 0 0 0 0 496876 5473393 411111 5690023 85765 -216630 -130865 0 0 -130865 0 Pharmacy Sales 446110 2854409 2854409 0 0 4632522 4632522 0 0 7486931 183027085 176250627 1202922 -91927 X 0 0 0 0 0 0 0 0 1547805 777938 769867 0 0 0 0 0 80769822 72243530 8526292 0 2778993 2465160 313833 0 8817299 7821558 995741 0 5557986 4930321 627665 0 230766 33040 197726 0 67675 0 67675 0 126744 0 126744 0 0 0 0 0 0 0 0 0 0 0 20043424 15179388 4864036 0 18308 0 18308 0 2384960 2062656 322304 0 2609866 1626556 983310 0 0 0 0 0 2851414 2648497 202917 0 36559 28045 8514 0 129516 119618 9898 0 2255563 1199061 1056502 0 10991484 7560568 3430916 0 1141994 960609 181385 0 Facility Services 828246 536538 291708 0 Medical Supplies 22875975 22817640 58335 0 Health System Assessment 3640566 25484 3615082 0 New York State Assessment 700084 700084 0 0 454413 413888 40525 0 170859462 144150179 26709283 0 36508084 46807358 8080637 10191552 11251173 13517104 2826552 3133283 6300858 2068878 214735760 120510473 98250554 94225287 389963 427503 27654800 29932927 191262621 200303892 26965259 26202080 0 0 33025000 31830000 0 0 4936786 4317871 0 67886929 62231643 132813974 124581594 X 54323023 71359062 4125624 4363236 58448647 75722298 191262621 200303892 X 12167623 -31299 0 0 0 5137327 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11445637 0 2564889 0 463031 0 13547495 10174748 402401 1387742 0 519254 0 11445637 8875689 460767 1269141 0 430849 0 10174748 9096199 0 104438 0 324948 0 8875689 8302363 0 1208679 0 414843 0 9096199 0.93 0.07 0 0 1 1 0 58076 58076 0 112078575 50785672 61292903 0 6864336 2353118 4511218 0 91087953 64327996 26759957 0 4646820 3043687 1603133 94225287 Other Assets 22176758 Due from Affiliates 2437447 Assets Limited as to Use 981266 Beneficial Interest in Charitable Remainder Trust 416272 Beneficial Interest in net assets in FFTH Foundation 3519460 Estimated third-party payor settlements 401724 29932927 0 Accrued Pension Liability 7998984 Charitable Gift Annuity Payment Liability 69579 Estimated third party payor settlements 10958227 Acc Ins Reserve 17500 MCIC Tail Liability, Net 2377990 Workers Comp 3865281 CARO 212511 Due to URMC 10132035 CMG Capital Lease 16630212 Operating Lease Liabilities ROU, net 7523050 Victor Rehab Lease 1063727 Deferred Financing costs, net -662277 Highland Hospital Loan 2044824 62231643 X 188133113 -31299 0 0 5137327 5106028 183027085 0 0 0 183027085 170859462 0 0 0 0 0 170859462 0 0 0 170859462 Schedule D, Part V, Line 4 The funds are held by the Foundation for the benefit of FF Thompson Health System, Hospital, Senior Communities, and Continuing Care Center. The Foundation continuously evaluates the needs of these organizations and attempts to meet those needs. Schedule D, Part X, Line 2 As of December 31, 2021 and 2020, the Hospital does not have a liability for unrecognized tax positions. Schedule D, Part XI, Line 2d Change in value of charitable gift annuities ($2,130), Net periodic pension cost ($841,074), Change in funded status of pension plan $5,420,418, Change in beneficial interest in charitable remainder trust ($30,998), Change in beneficial interest in the net assets of the FF Thompson Foundation ($158,890), Other non-operating activity $750,000, rounding - $1. 1 1 1 X 1 X 1 1 1 0 1 1 2930278 326082 2604196 0.0152 22449981 20567659 1882322 0.011 0 0 25380259 20893741 4486518 0.0262 207297 3801 203496 0.0012 2977074 2283783 693291 0.0041 38700 38700 0.0002 0 0 3223071 2287584 935487 0.0055 0 0 28603330 23181325 5422005 0.0317 61666 61666 0.0004 0 0 61666 0 61666 0.0004 1 4327997 86560 18860804 18098519 762285 X 1 1 1 1 The Frederick Ferris Thompson Hospital 350 Parrish Street Canandaigua NY 14424 www.thompsonhealth.org 3429000H X X X The Frederick Ferris Thompson Hospital 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X See Part V, Section C X See Part V, Section C X X 1 19 1 See Part V, Section C 0 0 1 X 100 400 X X X X 1 1 X X X X 1 X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X 1 X 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-The Frederick Ferris Thompson Hospital Ontario County Public Health was charged with working with local hospitals and other key partner agencies to select two key health priorities and one disparity to address in the community. To this end, we partnered with Ontario County Public Health, the S2AY Rural Health Network and Common Ground Health in a comprehensive process involving other local hospitals, community organizations, and county residents. The S2AY Rural Health Network counties data analysis began with an update for the eight county region conducted by Common Ground Health, Focusing on data related to priorities in the 2016 CHA. Public health and hospital systems also requested data collection from DSRIP'S needs assessment of emerging issues as a result of their work in the community. This data was presented to public health and hospital representatives (OCHC) along with data sources from 2016 behavioral risk factor surveillance survey (EBRFSS), 2010 census bureau, 2015 American community services estimates, 2010-2014 SPARCS Data set, NY State prevention agenda data set (updated 2016), 2014 Aggregated claims data, 2014 NY state vital statistics and 2016 regional high blood pressure registry summary. The review was county-specific data, as well as county prevention agenda dashboard (Updated 2016), community health indicator reports (2010-2014), Sub-county data reports (2017 Report), leading causes of death indicators (2012-2014) and county rankings (2017). Other data was also obtained from a public health system assessment survey called "My Health Story" and information obtained from community focus groups. The Ontario county health collaborative which include many of the community stakeholders, along with public health and hospital organizations and not-for-profit organizations contributed to the process. This group oversaw the assessment process and development of the CHIP. After identifying high priority needs for the county, 9 diverse focus groups met to review all the data and share perceptions. These focus group participants were invited to a priority-setting meeting. After this meeting another invitation for community involvement and input occurred. Schedule H, Part V, Section B, Line 6a-The Frederick Ferris Thompson Hospital The Frederick Ferris Thompson Hospital conducted its CHNA jointly with Geneva General Hospital (Finger Lakes Health) and Clifton Springs Hospital. Schedule H, Part V, Section B, Line 6b-The Frederick Ferris Thompson Hospital The Frederick Ferris Thompson Hospital - Organizations that participated in the community health assessment process included: Ontario County Public Health Department, S2AY Rural Health Network, Common Ground Health, Ontario County Administration, UR Medicine/Thompson Health, Finger Lakes Community College, Health & Human Services Ontario County, Ontario County Mental Health, Finger Lakes Health, City of Canandaigua, Smola Consulting, Lifespan, Stop DWI, Cancer Services, Geneva Head Start, Tobacco Action Coalition of the Finger Lakes, Private Medical Professionals, City of Geneva, Law NY, Office for Aging, Chamber of Commerce, Ontario ARC, United Way, Geneva CSD, URMC Center for Community Health and Prevention, Pioneer Library System, New York Kitchen, Rochester Regional Health, Community member, GW Lisk, Finger Lakes Prevention Resource Center, Finger Lakes Area Counseling and Recovery Agency (FLACRA), Clifton Springs YMCA, Catholic Charities, Ontario County Office of the Aging, Canandaigua Chamber of Commerce, Center for Community Health Partnership, Substance Abuse Prevention Coalition, Clifton Springs Hospital/Rochester Regional Health System, WIC and YMCA. Schedule H, Part V, Section B, Line 7a-The Frederick Ferris Thompson Hospital https://www.thompsonhealth.com/About-Us/News-Room/Publications Schedule H, Part V, Section B, Line 7b-The Frederick Ferris Thompson Hospital https://www.S2AYNETWORK.org/UPLOADS/2/9/6/7/29678331/ONTARIO_CHA_2014-2017.pdf; https://www.commongroundhealth.org/ Schedule H, Part V, Section B, Line 7d-The Frederick Ferris Thompson Hospital Yearly community benefit report and media release (delineating community priorities was distributed to media outlets and posted on websites of OCHC partners). Schedule H, Part V, Section B, Line 10a-The Frederick Ferris Thompson Hospital https://www.thompsonhealth.com/About-Us/News-Room/Publications Schedule H, Part V, Section B, Line 11-The Frederick Ferris Thompson Hospital The Hanlon method was used to rank the issues. This method of ranking focuses most heavily on how effective any interventions might be. The Hanlon method utilizes the following formula to rank priorities: (A&2B) x C where A=the size of the problem, B=the severity of the problem and C=the effectiveness of the solution. The effectiveness of the solution is given a lot more weight than the size or seriousness of the problem, with the hope of making wise use of limited resources by targeting solutions that are known to be effective. Participants also consider the weight of the propriety, economic feasibility, acceptability, resources and legality (Pearl) of issues in this ranking system. Numerical values were determined by each participant for size, severity and effectiveness, and then plugged into the formula along with average pearl scores. It is important to note that while the Hanlon method offers a numerical and systematic method of ranking public health priorities, it is still a method that is largely subjective, but which represents a quantitative way to rank qualitative and non-comparable quantitative information. Since respondents ranked each component (size, seriousness and effectiveness of the solution) individually using a paper ranking form, the ranking were not heavily influenced by group dynamics. Based upon the ranking through the Hanlon method, Ontario County's scores on the top health related issues in the county were: Cerebrovascular disease (stroke, hypertension), cancer (lung, ovarian, prostate), poor nutrition (unhealthy eating), obesity (including lack of physical activity & fitness), behavioral problems in children, dental health, depression/other mental illnesses, smoking/tobacco use/secondhand smoke, access to specialty health care, drug & alcohol abuse, abuse of prescription drugs, CLRD (COPD) and unintentional injuries. Community partners discussed all the identified needs but concentrated on the top ranked ones. The assemblage acknowledged there were other areas of need that would require attention or in some cases, the need was already being addressed. The group was also mindful of the New York state prevention agenda focused areas. After reviewing, discussing and considering county assessments, data, previous initiatives, along with available resources, the group decided to focus on the two areas in which they felt they could have the most impact on as a collaborating body. 1. Obesity 2. Hypertension and the following disparity: Obesity in the low-income population. The group then sat down together and developed their community service plan/community health improvement plan (CHIP) initiatives. The focused areas listed above have several action items listed out on the community service plan for both areas and cites what specifically is being done to address each area. Schedule H, Part V, Section B, Line 16a-The Frederick Ferris Thompson Hospital https://www.thompsonhealth.com/Portals/0/_Finance/2018/FS.02.017FinancialAid_CommunityCarePolicy_Program2018.pdf?ver=2018-03-08-124948-970 Schedule H, Part V, Section B, Line 16b-The Frederick Ferris Thompson Hospital http://www.thompsonhealth.com/Portals/0/_Patients%20and%20Visitors/_Financial%20Services/_Documents/SlidingFeeGuideApplicationWorksheet-2016.pdf?ver=2016-03-02-150257-603 Schedule H, Part V, Section B, Line 16c-The Frederick Ferris Thompson Hospital https://www.thompsonhealth.com/Portals/0/_Finance/2018/2018FinancialAidSummary.pdf?ver=2018-03-08-114909-837 Schedule H, Part I, Line 3c All patients with no insurance receive a discount. Inpatient discount applied to charges to bring to the Medicare inpatient DRG reimbursement. A 50% discount to charges is applied for all outpatient services. Schedule H, Part I, Line 7 Patient cost to charge calculated according to the IRS 990 Schedule H worksheet. Schedule H, Part I, Line 7, Column f Due to the adoption of new accounting pronouncement ASC 606, current year implicit price concessions are treated as a contra-revenue item on the statement of revenue. Schedule H, Part I, Line 7g There are no physician clinic costs included in these services Schedule H, Part II Refer to Schedule H, Part VI, Line 2 Schedule H, Part III, Section A, Line 4 As stated in the footnotes of the Financial statements, "Patient service revenue, net of contractual allowances and discounts (but before the provision for uncollectible account)." Bad debt expense is not included in the community benefit number or treated as community benefit. Bad debt expenses are reported net of recoveries and per the audited financials. Schedule H, Part III, Section B, Line 8 Consistent with the charitable healthcare mission of the hospital and the community benefit standard set forth in IRS revenue ruling 69-545, the hospital provides care for all patients covered by Medicare seeking medical care. Such care is provided regardless of whether the reimbursement provided for such services meets or exceeds the costs incurred by the hospital to provide such services. Schedule H, Part III, Section C, Line 9b Collection practices are the same for insured and uninsured patients. Patients are billed for any balance due after insurance. Patients who are uninsured are billed at the inpatient and outpatient discounted rates. Patients who are known to qualify for financial assistance are identified on the patient account and any collection activity is sent to the patient, only after any financial assistance has been provided. For patients who have applied for additional financial aid, collection on these accounts is discontinued until the financial aid application is reviewed and either approved or denied. Patients receiving partial financial aid will continue with the collection process for the balance due after financial aid discounts have been applied. Patients denied further financial aid assistance will continue with the collection process. All patients received balance due statements for 120 days in 30 day cycles. Payment arrangements are available to patients. If payment arrangements are made patients will receive a monthly statement with the arranged monthly payment. Schedule H, Part VI, Line 2 Based on its commitment to the community, FF Thompson Hospital completed a community health assessment to better understand the needs of the community members. The following identifies the participants in the process of conducting the community health assessments. Participants: the hospital worked with a broad-base of area community agencies known as "The Ontario County Health Collaboration" to continue actions and implement the community health assessment. Then participants in this committee included FF Thompson Health, The Ontario County Department of Public Health, The Ontario County Office of Aging, The Ontario County Youth Bureau, The United Way, and The Canandaigua Churches in Action (a local church consortium). Together this group developed and implemented a community health assessment to determine the ongoing needs of the county and to continue laying the groundwork for a county plan to address these needs. Thompson Health maintains many links and affiliations with community and health organizations to enhance its ability to develop and deliver community programs. Through these partnerships Thompson Health has established a diverse array of community health programs to meet the communities' specific needs, some of our partnerships include work with the county, school districts, colleges and industry as well as other non-profit community organizations. Schedule H, Part VI, Line 3 The Thompson Health community care program is communicated in appropriate detail in several mediums. All efforts to provide information at a variety of locations using a variety of media techniques are attempted. Thompson Health makes its best effort to make the program information available to the patients prior to them receiving services; however it is recognized that in many cases patients will investigate the financial aid/community care program after services are rendered. Thompson Health makes its best efforts to verbally communicate the program through its associates recognizing that there are levels of associate involvement. Patient registration staff verbally informs all self-pay patients of the available benefit. There are pamphlets and information sheets available for all patients in the registration area. Thompson Health associates are given information sheets to assist them with the ability to communicate the program to patients. Translation services are available as needed through a translation line. A variety of written communications are also used; information sheets-located in the same area as the signs, will be informational sheets regarding the availability of a financial aid/community care program along with identifying contacts for further information. Application and directions-these documents provide the patient with the program application, directions on how to complete the application, and the additional information required for a complete application. These applications are handed out in the emergency department to self-pay patients. Patient bills and collection correspondence-self-pay patients are mailed information regarding the program when the financial counselors verify they have no other insurance. The patient billing statements include a statement regarding the existence of the program and who to contact. Similar information included in the "collection" letters. Electronic Media: intranet-Thompson health's intranet included this policy and directions in the policy & procedures manual on the intranet making the policy and program available to all associates. Internet web site-Thompson Health incorporates general information about the policy, sliding fee application, and directions on its website. Non-patient communication-Financial counselors communicate the program with community health & human service agencies and social service organizations and agencies (I.e. Navigators, Office of the Aging, Etc.) as well as companies it utilized in its collection efforts. Schedule H, Part VI, Line 4 The method of which FF Thompson Hospital defines its service area includes an analysis of its primary and secondary service are as well as the area demographics. The following defines the service areas and provides a demographic summary of the region. Definition of primary and secondary service areas: Thompson Health provides services to persons in Ontario County and parts of Wayne, Monroe, Livingston, Yates and Seneca counties. Thompson health defines its primary service area as including those zip codes that cumulatively add up to 70% of its inpatient admissions and where we receive greater than 50% of the market share. At the 70th percentile the remaining zip codes (up to the 90th percentile) comprise the secondary service area. Distribution by age group for the community is a Follows: 21.6% 0-17, 31.4% 18-44, 30.5% 45-64, and 16.5% 65+. The current household incomes fall into the following groups: 38% under$50K, 36% $50-100K, 19% $100-200K, 7% over 200K. Schedule H, Part VI, Line 5 A majority of Thompson Health's governing body is comprised of persons who reside in our primary service area and are neither employees, contractors, nor family members thereof, our organization extends privileges to all qualified physicians in our community for all departments. All surplus funds are rolled into a fund balance for future year capital growth purposes which ensures improvement of our patient care areas. Thompson Hospital is committed to staying connected to our community members. Each of our executives and many of our directors serve on at least one or two boards of directors for the businesses in our community. Also in response to a national shortage of physicians, Thompson continues to recruit new physicians specializing in several areas as well as additional family practitioners ensuring physician coverage for our community members. Thompson Hospital is a New York State Department of Health designated stroke center. We strive to use our resources effectively and efficiently to promote health and to reduce the overall cost of health care, address a multitude of issues and populations, address the health needs of the individual that go beyond medical and physical issues, and ensure services are locally based. Schedule H, Part VI, Line 6 The University of Rochester Medical Center is an integrated academic health center that comprises the school of medicine and dentistry, including its faculty practice (University of Rochester medical Faculty Group), Strong Memorial Hospital, Golisano Children's Hospital, James P Wilmot Cancer Center, School of Nursing, Eastman Dental Center, and its affiliates, Highland Hospital, Visiting Nurse Service, Highlands Living Center, Highland Community Development Corporation (dba The Highlands at Pittsford), and the Meadows at Westfall, Inc. (dba The Highlands at Brighton), Jones Memorial Hospital and Noyes Health-one of the nation's top academic medical centers, The University of Rochester medical Center forms the centerpiece of the university's health research, teaching, patient care, and community outreach missions with more than $145 million in federal research funding. UR School of Medicine research funding ranks in the top one-quarter among U.S. medical centers while The School of Nursing ranks 12th highest in funding. The university's health care delivery network is anchored by Strong Memorial Hospital-a 800 bed, university-owned teaching hospital. Patients benefit from the medical center's robust teaching and biomedical research programs-Golisano Children's Hospital, housed in Strong Memorial Hospital, is a 132-bed Children's Hospital that serves as the referral center for update New York, surrounding states and Canada. It combines award-winning research, internationally acclaimed education and compassionate care to serve children and families. Pediatric specialties include Orthopedics, Eurology/Neurosurgery, Cancer and Neonatal Care-The James P Wilmot Cancer Center is organized around a multidisciplinary care model, which leading cancer experts believe is the gold standard in cancer care in the 21st Century. Its model underscores a commitment to provide patients in the Rochester area with the most up-to-date information and available treatments, basing its recommendations on the best evidence it is one of the only centers in western New York offering this team approach to care-Eastman Dental Center provides community dental care in a number of clinics as well as clinical education to dental students enrolled at the University of Rochester School of Medicine and Dentistry. It offers General Dentistry, Pediatric and Orthodontic Clinics and has recently added in Urgent Care Dental Clinic that sees approximately 50 patients a day-Highland Hospital is a full-services community hospital that also offers numerous specialty services that draw patients from the region and Canada-bariatric surgery, joint replacement, geriatrics, women's services and maternity. Highland Hospital's evolution as a full-service community Hospital, with a full complement of subspecialty services, enables the hospital to accept patient from Strong Memorial's ED and floors-important to assuring access of care, since Strong is often at or near full capacity-Visiting Nurse Service provides home community-based care to more than 14,000 annually, including nursing, therapy, personal care support, and meals on wheels, FF Thompson Hospital located in Canandaigua, NY is a 113-bed acute care community Hospital serving Ontario County, New York, and a 178-bed skilled nursing facility. FF Thompson also operates satellite clinics providing Urgent Care, Primary Care, Rheumatology Services and treatment of Sleep Disorders-The Highlands at Pittsford campus includes two separate corporations with different activities offering nursing care as well as assisted and intendent living for seniors. The Highlands center is a 122-bed skilled nursing facility that also offers an adult day care program. The assisted living 171-bed independent facility are provided by community development corporation the Highlands at Pittsford and Laurelwood. The Highlands offer a series of community education on current health topics, including health, nutrition, oral health and prevention, to name a few-The Highlands at Brighton is a 145-bed skilled facility that specializes in care for the medically complex cases. Jones Memorial Hospital is a 70-bed acute care facility located in Wellsville, NY. The hospital also provides a primary care network with sites throughout the Alleghany County in The Jones Memorial Medical Practices. The Jones Memorial Medical Practices involve the specialties of pediatrics, podiatry, pulmonology, internal medicine, family practice, orthopedics, nurse midwife, and obstetrical and gynecological care. Noyes Health (includes Noyes Memorial Hospital, Noyes Health Services, Noyes Kidney Disease and Dialysis Center and Noyes metal Health Services). Noyes Memorial Hospital is a 67-bed facility located in Dansville, NY. Services include birth center, cardiology, infusion center, diagnostic imaging, emergency care, hospice care, inpatient care, laboratory, prenatal, rehabilitation therapy, respiratory therapy, surgery and sleep lab. Noyes Health Services is located in Geneseo, NY and provides physician offices and after hour care to the residents of Livingston, Monroe, Ontario and Wyoming counties. Noyes Kidney Disease and Dialysis Center is located in Geneseo, NY and is dedicated to treating patients with chronic kidney disease. Up to 12 patients can receive care simultaneously. Noyes Mental Health Services located in Dansville, NY supports the wellness and recovery of area residents that struggle with everyday challenges, as well as those with sever and persistent mental illness. Schedule H, Part VI, Line 7 New York X X X X X 0 1 0 0 0 0 0 1 0 Steven Goldstein Board Member 0 1326628 0 0 0 1838821 0 193001 0 22222 0 3380672 0 889000 Mark Taubman MD Board Member 0 1535308 0 0 0 34790 0 183601 0 20873 0 1774572 0 0 Michael Apostolakos MD Board Member 0 659140 0 0 0 19624 0 83601 0 27482 0 789847 0 0 A David Peter MD Board Member and Surgeon 573728 0 500 0 21967 0 8642 0 29320 0 634157 0 0 0 Cynthia Teerlinck MD Board Member and Physician 112241 0 69263 0 240 0 4835 0 15607 0 202186 0 0 0 Michael F Stapleton JR President/CEO 0 506044 0 207307 0 132172 0 84301 0 29267 0 959091 0 80052 Mark Prunoske Senior VP & CFO 0 299619 0 65308 0 51524 0 48187 0 25251 0 489889 0 32572 Kurt Koczent EVP/COO 217016 54254 60550 15138 39730 9933 31987 7997 24464 6116 373747 93438 23499 5875 David Baum MD SVP Medical Affairs & Emergency Physician 0 370888 0 68509 0 41874 0 57432 0 30752 0 569455 0 24202 Elizabeth Talia VP Legal & Regulatory Affairs and General Counsel 0 201109 0 18075 0 11731 0 11779 0 27992 0 270686 0 0 Jeffrey Goldstein Gastroenterologist 544980 0 0 0 448 0 14500 0 13485 0 573413 0 0 0 Joseph Talarico MD Physician 499999 0 0 0 310 0 14500 0 1633 0 516442 0 0 0 Matthew Osborne MD Medical Director Chief of Emergency Medicine 388212 0 60472 0 456 0 14500 0 29204 0 492844 0 0 0 Jennifer Wills Physician 378036 0 35198 0 30953 0 8642 0 1650 0 454479 0 0 0 Robert L Smith Physician 351039 0 75752 0 13303 0 14500 0 28144 0 482738 0 0 0 Jennifer DeVault VP Associate Services and Wellness 186989 0 25710 0 8379 0 16224 0 29296 0 266598 0 0 0 Hazel Robertshaw VP Patient Care Services/CNO 195788 0 26300 0 9404 0 11646 0 11422 0 254560 0 0 0 Robert Scott MD Board Member - President of Medical Staff 203737 0 15000 0 674 0 11585 0 30395 0 261391 0 0 0 Schedule J, Part I, Line 3 The CEO of the FF Thompson Hospital's compensation is established by the manners' described and also described in Form 990 Part VI, Section B, line 15. Schedule J, Part I, Line 4 The following individuals participated in a supplemental nonqualified retirement plan and received employer paid amounts that are included in deferred compensation. 457(f) plan payments were: Michael Stapleton - $69,801, Mark Prunoske - $27,887, Kurt Koczent - $25,484, David Baum - $37,132. SERP plan payments were: Steven Goldstein - $159,400, Mark Taubman - $150,000 and Michael Apostolakos - $50,000. These payments were made by a related organization. The following individual participated in a supplemental nonqualified retirement plan and received employer paid amounts that are included in other reportable compensation. 457(f) plan payments were: Steven Goldstein - $1,749,057. These amounts represent employee deferrals of compensation, plus investment earnings, over several years that vested and were paid pursuant to the requirements of the plan. The employee deferrals were reported as deferred compensation in schedule J, Part II, column C in prior years and are also reflected, net of investment earnings, in schedule J, Part II, column (f). This payment was made by a related organization. Schedule J, Part I, Line 7 The President/CEO, Executive VP/COO, and Senior VP of Finance/CFO are eligible for a variable % YE incentive based on predetermined goals. The goals are operational, financial and managerial in nature. The financial goal ties in part to the net earnings of the organization and its affiliates. A Ontario County Local Development Corporation 272435489 000000000 2017-12-27 33400000 Refund a prior issue 0 0 0 A 1570000 0 33400000 0 0 0 805472 0 0 0 0 0 2017 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 Randall Farnsworth Greater than 35% of a vendor 103965 Rent 0 Form 990, Part V, Line 2a Employees and certain officers, directors, and key employees of The Frederick Ferris Thompson Hospital's related organizations receive compensation from the Hospital, through a common paymaster. Because employees are included in the common paymaster, a portion of the salaries of these individuals is allocated to its affiliates and is included as part of other salary and wages on their statement of functional expenses. None of the board members of the Hospital are compensated for their board services. Form 990, Part VI, Section A, Line 2 Given that many of our Board Members include professionals in industries such as banking, law, and financial advisement, it is our understanding that some board members engage with each other in professional business activities. Given the comprehensive conflict of interest forms the board members complete, we do not believe any such relationship impacts their decision making as to Thompson activities and to the extent there is a potential conflict of interest is disclosed by a Board member, the Board member is instructed to follow our conflict of interest policy as described in Part VI, Section B, Line 12c. Form 990, Part VI, Section A, Line 6 The sole member of The Frederick Ferris Thompson Hospital is FF Thompson Health System Inc. (System). The System, the University of Rochester Medical Center and the University of Rochester (UR) are parties in an affiliation agreement whereby UR is the sole corporate member of the System. The System acting through its board of directors, has the authority to elect the governing body of Thompson Hospital and approve certain decisions. Such decisions include appointment of the Hospital President and CEO, amendment of the certificate of incorporations and bylaws, approval of extraordinary corporate actions such as merger or dissolution, approval of capital and operating budgets, strategic plans, and incurrence of certain debt. Additionally, certain decisions of the Hospital are subject to the approval of UR. Such decisions include appointment and removal of board members, approve appointment and removal of the President and CEO, approve changes to the Hospital bylaws and certificate of incorporation and, under certain circumstances, approve strategic plans, capital and operating budgets and incurrence of debt. Form 990, Part VI, Section A, Line 7a Refer to Schedule O, Membership information, Form 990, Part VI, Section A, Line 6 Form 990, Part VI, Section A, Line 7b Refer to Schedule O, Membership information, Form 990, Part VI, Section A, Line 6 Form 990, Part VI, Section B, Line 11b The Director of Finance and Reimbursement and the CFO review the return. In addition, the return is reviewed by an independent accounting firm. The return is then made available to the Board of Directors and a summary presentation is made at the board meeting. Questions are entertained during both meetings as well as after the meeting prior to filing. Form 990, Part VI, Section B, Line 12c Consistent with the written system-wide conflict of interest (COI) policy, Board members, officers and key employees complete annual conflict of interest forms to identify actual and potential conflicts of interest that may exist relative to their duties with the organization. The Audit Committee and General Counsel monitor completion of these forms and review the statements made therein for compliance with the COI policy. An individual management plan is developed that stipulates how each potential or actual COI will be addressed in order to mitigate each conflict identified. Each individual management plan is reviewed, modified as necessary and approved by the Audit Committee and General Counsel. The approved plan is then delivered to each person with an identified potential or actual COI. To help ensure compliance with the COI policy, each individual management plan stipulates that the person with a potential or actual COI will not be allowed to participate in any discussion or decision of the Board in any area of identified conflict. Furthermore, unless a specific question is asked by the Board, the person with the COI will be asked to leave the room during a discussion and/or decision by the Board that involves an area covered by the COI individual management plan. The Audit Committee and General Counsel review these procedures annually to assess their effectiveness and recommend (or make) appropriate changes as needed to ensure the COI policy is consistently and effectively enforced. Form 990, Part VI, Section B, Line 15 Executive compensation is established by the Compensation Committee of the Board of Directors. The committee uses an outside company to gather comparable data in determining compensation levels for the President/CEO and senior level executives. The full Board of Directors is surveyed by the Compensation Committee on executive performance which is also considered in determining compensation levels. The committee is involved in setting goals for the executive team which ties back to their performance reviews and compensation rates. This process is completed each year. Form 990, Part VI, Section C, Line 19 These documents are available upon request by contacting the Administrative Office Form 990, Part VII, Section A, Line 1a Refer to Schedule O, Employment information, Form 990, Part V, Line 2a Form 990, Part IX, Line 7 Refer to Schedule O, Employment information, Form 990, Part V, Line 2a Form 990, Part IX, Line 11g Bank Fees Company Cash - $1,005, Consultants Accounting - $3,533, Reference Labs - $5,339,498, Consultants Training Services - $1,631, Cleaning Contract services - $333,025, HealthWorks Misc Exp - ($66,881), Collection fees - $239,935, Other Purchased services - $13,793,991, Physician Professional fees - $388,922, Professional Licenses - $8,766, Rounding - $1 Form 990, Part XI, Line 9 Change in value of charitable gift annuities ($2,130), Net periodic pension cost ($841,074), Change in funded status of pension plan $5,420,418, Change in beneficial interest in charitable remainder trust ($30,998), Change in beneficial interest in the net assets of the FF Thompson Foundation ($158,890), Other non-operating activity $750,000, rounding - $1. Form 990, Part XII, Line 3b The Frederick Ferris Thompson Hospital's single audit is included in the consolidated single audit of the University of Rochester. University of Rochester 910 Genesee Street STE 200 Rochester NY 14611 160743209 School NY 501(c)(3) 2 N/A 0 Highland Hospital of Rochester 1000 South Avenue Rochester NY 14620 160743037 Hospital NY 501(c)(3) 3 Strong Partners Health System 0 The Highland Foundation Inc 1000 South Avenue Rochester NY 14620 237310662 Fundraising NY 501(c)(3) 12A, 1 Highland Hospital 0 Highland Facilities Development Corp 1000 South Avenue Rochester NY 14620 223039077 Medical Building NY 501(c)(3) 10 Highland Hospital 0 Highland Community Development Corp 100 Hahnemann Trail Pittsford NY 14534 223154715 Elder Care NY 501(c)(3) 10 Strong Partners Health System 0 The Highlands Living Center Inc 500 Hahnemann Trail Pittsford NY 14534 223240227 Healthcare NY 501(c)(3) 10 Strong Partners Health System 0 The Meadows at Westfall Inc 5901 Lac De Ville Blvd Rochester NY 14618 161502303 Healthcare NY 501(c)(3) 10 Strong Partners Health System 0 Strong Partners Health System Inc 601 Elmwood Avenue Box 706 Rochester NY 14642 161499099 Support Org NY 501(c)(3) 12A, 1 University of Rochester 0 UR Medicine Home Care Inc 2180 Empire Boulevard Webster NY 14580 222577664 Fundraising NY 501(c)(3) 7 University of Rochester 0 UR Medicine Home Care Certified Services Inc 2180 Empire Boulevard Webster NY 14580 160743215 Healthcare NY 501(c)(3) 10 URMHC 0 UR Medicine Home Care Licensed Services Inc 2180 Empire Boulevard Webster NY 14580 161561691 Healthcare NY 501(c)(3) 10 URMHC 0 Excell Partners Inc 343 State Street Kodak Tower 2nd Floor Rochester NY 14650 201862628 Economic Dev NY 501(c)(4) N/A University of Rochester 0 Rochester Bioventure Center Inc 601 Elmwood Avenue Box 706 Rochester NY 14642 202485999 Biotech Incub NY 501(c)(3) 12A, 1 University of Rochester 0 NextCorps Inc 260 East Main Street Suite 6000 Rochester NY 14604 161195028 Business Incu NY 501(c)(3) 7 University of Rochester 0 U of R Broadcasting Corporation 201 Wilson Commons Rochester NY 14627 160743209 Broadcast Lic NY 501(c)(4) N/A University of Rochester 0 UR Real Estate Corporation 263 Wallis Hall Rochester NY 14627 271140014 Support Org NY 501(c)(3) 12A, 1 University of Rochester 0 Meliora Real Estate Corporation 263 Wallis Hall Rochester NY 14627 452464788 Support Org NY 501(c)(3) 12A, 1 University of Rochester 0 FF Thompson Health System Inc 350 Parrish Street Canandaigua NY 14424 222959987 Support Org NY 501(c)(3) 12A, 1 University of Rochester Medical Center 0 M M Ewing Continuing Care Center 350 Parrish Street Canandaigua NY 14424 237046583 Healthcare NY 501(c)(3) 3 FF Thompson Health System 0 FFT Senior Communities Inc 1 Ferris Hills Canandaigua NY 14424 161557494 Elder Care NY 501(c)(3) 10 FF Thompson Health System 0 The FF Thompson Foundation Inc 350 Parrish Street Canandaigua NY 14424 222959984 Fundraising NY 501(c)(3) 7 FF Thompson Health System 0 Finger Lakes Home Care Inc 756 Pre-Emption Road Geneva NY 14456 161489133 Healthcare NY 501(c)(3) 10 URM Home Care Certified Srvcs 0 The Memorial Hospital of William F and Gertrude F Jones Inc 191 North Main Street Wellsville NY 14895 222807681 Hospital NY 501(c)(3) 3 University of Rochester 0 Livingston Health Care System Inc 111 Clara Barton Street Dansville NY 14427 161455240 Support Org NY 501(c)(3) 12A, 1 University of Rochester 0 Nicholas H Noyes Memorial Hospital Inc 111 Clara Barton Street Dansville NY 14427 160743979 Hospital NY 501(c)(3) 3 Livingston Health Care System Inc 0 Red Jacket Center Inc 111 Clara Barton Street Dansville NY 14427 161037658 Medical Bldg NY 501(c)(3) 12A,1 Livingston Health Care System Inc 0 The Foundation for Noyes Memorial Health System Inc 111 Clara Barton Street Dansville NY 14427 161584778 Fundraising NY 501(c)(3) 7 Livingston Health Care System Inc 0 Jones Memorial Hospital Foundation 191 North Main Street Wellsville NY 14895 473763374 Support Org NY 501(c)(3) 7 Jones Hospital 0 Jones Medical Services PC 191 North Main Street Wellsville NY 14895 465210222 Medical Clinic NY 501(c)3 3 Jones Hospital 0 St James Hospital 7329 Seneca Road North Hornell NY 14843 160743310 Hospital NY 501(c)3 3 University of Rochester 0 St James Hospital Foundation Inc 7329 Seneca Road North Hornell NY 14843 161486437 Fundraising NY 501(c)3 7 St James Hospital 0 UR Medicine Home Care Community Services Inc 2180 Empire Boulevard Webster NY 14580 825091873 Healthcare NY 501(c)3 10 URMHC 0 UR Medicine Home Care Foundation Inc 2180 Empire Boulevard Webster NY 14580 831912967 Support Org NY 501(c)3 12A, 1 URMHC 0 Excell Innovate NY Fund LP 343 State Street Kodak Tower 2nd Floor Rochester NY 14650 462405519 Investment Fund NY ETV Inc Excell Minority and Women owned Business Investment Fund LP 343 State Street Kodak Tower 2nd Floor Rochester NY 14650 810723223 Investment Fund NY ETV Inc Excell Partners Innovation TC Fund LP 343 State Street Kodak Tower 2nd Floor Rochester NY 14650 810711015 Investment Fund NY ETV Inc Finger Lakes Ventures Fund LP 344 State Street Kodak Tower 2nd Floor Rochester NY 14651 833941257 Investment Fund NY ETV Inc Medical Administrative Associates Inc 777 South Clinton Avenue Rochester NY 14620 161354319 Retail Pharmacy NY Highland Hospital C 0 UR Equity Holdings Inc 110 Office Park Way Pittsford NY 14534 273040889 Holding Co DE University of Rochester C 0 FFTH Properties and Services Inc 350 Parrish Street Canandaigua NY 14424 161286518 Holding Co NY FF Thompson Health System C 0 Excell Technology Ventures Inc 343 State Street Kodak Tower 2nd Floor Rochester NY 14650 800909149 Biotech Incubator NY Rochester Bioventure C 0 Accountable Health Partners LLC 135 Corporate Woods Ste 320 Rochester NY 14623 300787967 Acct Care Network NY University of Rochester C 0 Accountable Health Partners IPA LLC 135 Corporate Woods Ste 320 Rochester NY 14623 371746016 Indep Practice Asso NY AHP LLC C 0 AHP Insurance Company 76 St Paul Street Suite 500 Burlington VT 05401 814644839 Captive Insurance Company VT AHP LLC C 0 Luminate Venture Challenge Corp 260 East Main Street Suite 6000 Rochester NY 14604 823954131 Business Incu NY Nextcorps Inc C 0 Hornell Medical Village LLC 7100 Route 70A Hornell NY 14843 611886763 Hold Real Estate NY St James Hosp C 0 0 0 1 0 1 0 0 0 0 1 1 0 1 0 1 0 1 0 0