2021-11-15T16:12:59-06:00 2020-12-31 135565207 KPMG LLP 515 BROADWAY 4TH FLOOR ALBANY NY 12207 990 2020-01-01 141338413 GLENS FALLS HOSPITAL GLEN 5189265013 100 PARK STREET GLENS FALLS NY 12801 DIANNE SHUGRUE PRESIDENT/CEO 5189265013 2021-11-15 1 DIANNE SHUGRUE 999009999 TODD P TERESCO P00247720 5184274600 2021-11-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z DIANNE SHUGRUE 100 PARK STREET GLENS FALLS NY 12801 360629359 0 5980 X WWW.GLENSFALLSHOSPITAL.ORG X 1897 NY SEE SCHEDULE O. 18 14 2752 206 3743761 0 9875463 32681969 326668033 309285653 5664436 1381698 5581749 3102350 347789681 346451670 12000 12000 0 0 179481366 173372095 0 0 329888 171691638 173943773 351185004 347327868 -3395323 -876198 265741933 356058419 159704948 206102158 106036985 149956261 X SEE SCHEDULE O. 0 1 265815100 12000 310547977 GLENS FALLS HOSPITAL PROVIDES A COMPREHENSIVE HEALTH CARE SYSTEM THAT STRETCHES ACROSS 6,000 SQUARE MILES ACROSS 5 DIVERSE COUNTIES. WE PROVIDE HIGH QUALITY CARE TO PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. WE ARE A 391 BED FACILITY WITH MORE THAN 380 CERTIFIED PHYSICIANS IN OVER 25 SPECIALTIES. OUR SERVICES INCLUDE, BUT ARE NOT LIMITED TO, EMERGENCY CARE, SURGICAL SERVICES, MENTAL HEALTH, CANCER CARE, PRIMARY CARE, AND PREVENTATIVE HEALTH EDUCATION. IN 2020, WE HAD 46,180 PATIENT DAYS AND 11,043 DISCHARGES. THE EMERGENCY CARE CENTER PROVIDED CARE TO 38,579 PATIENTS. OUR MENTAL HEALTH DEPARTMENT PROVIDED 39,846 OUTPATIENT TREATMENTS AND 6,617 INPATIENT DAYS. OUR SURGERY CENTER PERFORMED 9,149 PROCEDURES. SEE CONTINUATION ON SCHEDULE O. THROUGHOUT THE COVID-19 PANDEMIC, GLENS FALLS HOSPITAL HAS DEMONSTRATED THE ESSENTIAL NATURE OF OUR SERVICES FOR THE REGION AND HAS CONTINUED TO BE THE SAFETY NET HOSPITAL FOR OUR SURROUNDING COMMUNITIES. AT THE HOSPITAL, A COVID COMMAND CENTER WAS IMMEDIATELY ESTABLISHED AT THE ONSET OF THE PANDEMIC TO MANAGE COMMUNITY-BASED TESTING, SUPPLIES (ACQUISITION AND DEPLOYMENT), EQUIPMENT NEEDS, STAFFING, NEW DIRECTIVES AND LOCAL AND STATE-WIDE RESPONSES, INCLUDING DATA REQUESTS. IT WAS OPEN 7 DAYS PER WEEK FROM 7AM TO 7PM TO COVER ALL SHIFTS OF THE HOSPITAL UNTIL IT WAS SCALED BACK IN MAY 2020. IT WAS STAFFED BY AT LEAST TWO SENIOR LEADERS AT ALL TIMES, AS WELL AS A SUPPORT PERSON WHO ASSISTED WITH ANSWERING CALLS, SECURING SUPPLIES AND COORDINATING WITH OTHERS THROUGHOUT THE HOSPITAL. DESPITE SIGNIFICANT DECLINES IN VOLUMES AT THE ONSET OF THE PANDEMIC, THE HOSPITAL SECURED AND RETAINED AGENCY CONTRACTED LABOR AT PREMIUMS DURING THIS TIME TO MAINTAIN STAFF FOR THE NYS SURGE PLAN AND REQUIRED PREPAREDNESS MEASURES, AS WELL AS SECURED APPROPRIATE PHYSICIAN COVERAGE. THE HOSPITAL ALSO SET UP EMERGENCY TESTING TENT SITES IN OUR EMERGENCY DEPARTMENT PARKING LOT TO ADDRESS THE COMMUNITY TESTING NEED EARLY IN THE PANDEMIC. ADDITIONAL SIGNIFICANT COSTS WERE INCURRED TO: INCREASE PPE AVAILABILITY, SECURE CAPITAL NEEDED TO EXECUTE A SURGE PLAN, IMPLEMENT ADDITIONAL CLEANING PROCESSES AND PROCEDURES, IMPLEMENT TELEHEALTH, MAINTAIN OVERHEAD STRUCTURE, AND EXECUTE TESTING (AMONG OTHER ITEMS). EXAMPLES OF CAPITAL ITEMS PURCHASED INCLUDE IV PUMPS, A TELEMETRY SYSTEM, A UV MASK REPROCESSING ROOM, AIR PURIFYING EQUIPMENT, VACCINE FREEZERS, AND IPADS/EQUIPMENT FOR TELEHEALTH AND PATIENT/FAMILY COMMUNICATION. ADDITIONAL SUPPLY EXPENSES INCLUDE PATIENT SEPARATION BARRIERS FOR SOCIAL DISTANCING, N95 MASKS, HAND SANITIZER AND DISINFECTANTS, AND REFERENCE LAB COSTS RELATED TO THE PROCESSING OF COVID-19 TESTING RELATED TO IP, OBSERVATION, AND ED VISITS. FACILITY RELATED EXPENSES INCLUDE LEASED TENTS/TRAILERS SET UP OUTSIDE FOR COVID TESTING AND SCREENING. WE ALSO ADJUSTED OUR HVAC SYSTEMS TO CREATE NEGATIVE PRESSURE CARE ROOMS FOR COVID PATIENTS. THE HOSPITAL ALSO INVESTED MONEY IN ADVERTISING AND COMMUNITY EDUCATION TO PRODUCE COVID-RELATED EDUCATIONAL MATERIALS, BROCHURES, AND VIDEOS TO HELP THE COMMUNITY BETTER UNDERSTAND COVID AND THE SAFETY MEASURES IN PLACE AT GFH FOR THEMSELVES AND THEIR FAMILY MEMBERS. THE HOSPITAL ALSO RAPIDLY, EFFICIENTLY AND EFFECTIVELY SET UP A MASS VACCINATION CLINIC IN DECEMBER AS VACCINES BECAME AVAILABLE. THE HOSPITAL NOT ONLY SERVICED HOSPITAL-EMPLOYEES IN GETTING THEIR VACCINE ADMINISTRATION, BUT ALL ADMINISTERED TO COMMUNITY AGENCIES AND OTHER FIRST-RESPONDERS, THEREBY ENSURING THAT THESE GROUPS IN THE COMMUNITY WERE ABLE TO ALSO BE VACCINATED IN AN EFFICIENT MANNER. 265815100 1 1 0 1 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 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 173 0 1 2752 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 18 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NY X CRAIG LETOURNEAU 5189265013 100 PARK STREET GLENS FALLS NY 12801 DIANNE SHUGRUE PRESIDENT & CEO 40.00 0.00 X X 3797476 0 13529 STEVEN FRISCH MD BOARD MEMBER 1.00 57.00 X 0 1217996 118555 SEAN BAIN MD BOARD MEMBER 40.00 0.00 X 401783 0 16418 GEOFFREY SERFILIPPI MD BOARD MEMBER 40.00 0.00 X 161574 0 480 MARK L BEHAN VICE CHAIR 1.00 0.00 X X 0 0 0 TENEE' CASACCIO BOARD MEMBER 1.00 0.00 X 0 0 0 CARL CEDRONE BOARD MEMBER 1.00 0.00 X 0 0 0 GREGORY CHAMPION BOARD MEMBER 1.00 0.00 X 0 0 0 KATHIE L DUNCAN BOARD MEMBER 1.00 0.00 X 0 0 0 GEORGE FERONE SECRETARY 1.00 0.00 X X 0 0 0 MARGARET GILLIS BOARD MEMBER 1.00 0.00 X 0 0 0 THOMAS GUAY BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM HART BOARD MEMBER 1.00 0.00 X 0 0 0 COURTNEY HASKINS BOARD MEMBER 1.00 0.00 X 0 0 0 GARY R HICKS BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM G POWERS JR CHAIR 1.00 0.00 X X 0 0 0 KATE HERLIHY SCHWENKER BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID WESTFALL MD BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL SCIMECA COO 40.00 1.00 X 382676 0 17237 MITCH AMADO CFO 40.00 1.00 X 370840 0 16906 HOWARD FRITZ MD CMO 40.00 1.00 X 371110 0 12120 DONNA KIRKER CNO 40.00 1.00 X 278458 0 11415 ADAM BROD MD ORTHOPEDIC PHYSICIAN 40.00 0.00 X 732566 0 19270 JOHN STOUTENBURG MD ONCOLOGY PHYSICIAN 40.00 1.00 X 619386 0 19270 MATTHEW DICKSON ENT PHYSICIAN 40.00 1.00 X 609661 0 16997 ANDRE JOHNSON MD ORTHOPEDIC PHYSICIAN 40.00 0.00 X 607465 0 16997 MICHAEL LIEBERTH MD SURGICAL PHYSICIAN 40.00 0.00 X 594443 0 19270 PATTI HAMMOND VP PHYSICIAN PRACTICES 40.00 0.00 X 291017 0 16363 9218455 1217996 314827 253 1 1 0 HUDSON HEADWATERS HEALTH NETWORK 9 CAREY RD QUEENSBURY NY 12804 MEDICAL SERVICES 6058229 KAUFMAN HALL & ASSOCIATES 8610 SOLUTION CENTER CHICAGO IL 60677 CONSULTANTS 2326439 MEDICAL ANESTHESIA SPECIALISTS OF NY PC PO BOX 744883 ATLANTA GA 30374 ANESTHESIA SERVICES 1847614 COMPHEALTH PO BOX 972651 DALLAS TX 75397 CONTRACT LABOR 1568237 REVMD PARTNERS 1111 PASQINELLI DR SUITE 400 WESTMONT IL 60559 COLLECTION SERVICES 1088502 40 1131813 31301792 248364 32681969 PATIENT SERVICE REVENUE 622110 297854308 297854308 OUTPATIENT PHARMACY 446110 4855420 4855420 HOSPITAL LAB SERVICES 621500 3052207 3052207 MEDICAL HOME PROJECT 621110 676383 676383 PHARMACY REBATES 900099 551367 551367 2295968 2072695 223273 309285653 1336087 1336087 13858206 365094 13711629 466060 146577 -100966 45611 45611 INVESTMENT IN YANKEE ALLIANCE 900099 1531502 1063221 468281 CAFETERIA VENDING REVENUE 900099 861598 861598 INVESTMENT IN NORTH COUNTRY EYE C 621990 199103 199103 510147 510147 3102350 346451670 307272497 3743761 2753443 X 12000 12000 5852022 5852022 2167 2167 141682494 114656193 26843242 183059 4868044 3785468 1076532 6044 11349296 8893905 2441191 14200 9618072 7479166 2126965 11941 3378612 972074 2402788 3750 599002 599002 191916 182401 9515 33493 33493 41575684 27041253 14482977 51454 776298 2464 773834 89175400 82307263 6857374 10763 7877604 133379 7744225 3671574 991033 2680541 118616 56555 62061 176600 148214 28116 270 2214930 1725115 489815 18691908 14558331 4133577 3237918 2466837 771081 ASSESSMENT 1155066 1155066 LICENSE AND TAXES 301782 282148 19634 RERUITEMENT FEES 216964 216964 DONATED FUNDS EXPENSE 173694 106407 28721 38566 376712 195128 181258 326 347327868 265815100 81182880 329888 12464353 52795776 12780819 11015446 32588007 28626471 133432 110127 4453968 6272680 3921101 2807816 421333935 269244560 118127453 152089375 71730843 81664766 9541957 20675962 265741933 356058419 55457255 95675319 49461136 46900000 13233166 25853656 41553391 37673183 159704948 206102158 X 98206366 140572385 7830619 9383876 106036985 149956261 265741933 356058419 X -876198 4632323 40163151 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 33493 33493 0 PART II-B, LINE 1: IN 2020, GLENS FALLS HOSPITAL PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE HOSPITAL ASSOCIATION OF NEW YORK AND IROQUOIS HEALTHCARE ALLIANCE, A PORTION OF WHICH WENT TOWARDS LOBBYING EXPENSES AS DETERMINED BY THE ASSOCIATIONS AND ALLIANCE. 0 1506672 53846 12000 41846 1506672 1506672 423632 12000 411632 1506672 1506672 218087 12000 206087 1506672 1506672 154101 12900 141201 1506672 1506672 393967 15300 378667 1506672 0.00000 1.00000 0.00000 0 0 15397305 15397305 226053843 128099422 97954421 4412390 535666 3876724 175470397 140609472 34860925 152089375 INVESTMENT IN ISNENY -284970 INVESTMENT IN YANKEE ALLIANCE 828093 INVESTMENT IN YASCS 3359170 PROF. LIABILITY REC. 460000 RIGHT OF USE ASSETS 10848841 INTEREST IN NET ASSETS OF FDTN 5464828 20675962 DEFERRED COMP PAYABLE 9449836 SELF INSURED LIABILITY RESERVE 10245259 ASSET RETIREMENT OBLIGATION 403890 LONG TERM PAYABLE 17574198 37673183 X 391235144 4632323 40167450 44799773 346435371 16299 16299 346451670 347315868 0 347315868 12000 12000 347327868 PART V, LINE 4: PERMANENTLY RESTRICTED NET ASSETS ARE INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT THE FOLLOWING: DENTAL CARE - $1,053,285 INDIGENT CARE - $148,927 GENERAL OPERATING EXPENSES - $169,975 HEALTH EDUCATION - $134,485 TOTAL - $1,506,672 PART X, LINE 2: GLENS FALLS HOSPITAL IS CLASSIFIED FOR TAX PURPOSES AS AN ORGANIZATION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND AS SUCH ARE GENERALLY EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(A) OF THE CODE. GLENS FALLS HOSPITAL 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 UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2020 AND 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN NET ASSETS OF GFH FOUNDATION 1,112,063. EFFECT OF BUSINESS COMBINATION 39,055,387. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECEIPT OF FOUNDATION FUNDS TO BALANCE SHEET ACCOUNTS 4,299. OTHER GRANTS PAID 12,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER GRANTS PAID 12,000. 1 1 1 X 130.000000000000 1 X 330.000000000000 1 1 1 0 1 1 4395382 4557342 0 0.00000 50147028 38432469 11714559 0.03370 54542410 42989811 11714559 0.03370 2332503 383943 1948560 0.00560 996681 0 996681 0.00290 51138673 44230582 6908091 0.01990 141485 70682 70803 0.00020 11065 0 11065 0.00000 54620407 44685207 9935200 0.02860 109162817 87675018 21649759 0.06230 131747 27500 104247 0.00030 75653 0 75653 0.00020 207400 27500 179900 0.00050 1 60418569 101868166 -41449597 X 1 0 1 IMAGING SVCS OF NENY DIAGNOSTIC RADIOLOGY 0.50000 0.50000 0.50000 2 NORTH CTRY EYE EYE CENTER 0.30000 0.30000 0.30000 1 1 GLENS FALLS HOSPITAL 100 PARK STREET GLENS FALLS NY 12801 GLENSFALLSHOSPITAL.ORG 5601000H X X X GLENS FALLS HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE SECTION C X 1 19 1 SEE SECTION C 0 1 X 130.000000000000 330.000000000000 X X X 1 1 X X X 1 X SEE SECTION C X SEE SECTION C X X X X 1 X 0 X X X 1 X 0 0 GLENS FALLS HOSPITAL PART V, SECTION B, LINE 5: GFH CONDUCTED THE CHNA TO IDENTIFY AND PRIORITIZE THE COMMUNITY HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES WITHIN THE GFH SERVICE AREA. THE FINDINGS IN THIS CHNA RESULT FROM A YEAR-LONG PROCESS OF COLLECTING AND ANALYZING DATA AND CONSULTING WITH STAKEHOLDERS THROUGHOUT THE COMMUNITY AND REGION. THE CHNA CAN BE USED AS A ROADMAP TO GUIDE SERVICE PROVIDERS, ESPECIALLY PUBLIC HEALTH, IN THEIR EFFORTS TO DEVELOP PROGRAMS AND SERVICES TARGETED TO IMPROVE THE OVERALL HEALTH AND WELL-BEING OF PEOPLE AND COMMUNITIES IN THE REGION.WORKING WITHIN THE FRAMEWORK PROVIDED BY NYS' PREVENTION AGENDA, GFH AND WARREN, WASHINGTON AND SARATOGA COUNTY PUBLIC HEALTH DEPTS. COLLABORATED IN THE DEVELOPMENT OF THE CHNA. ADDITIONALLY, GFH COORDINATED WITH FULTON, ESSEX, HAMILTON, FRANKLIN, AND CLINTON COUNTY PUBLIC HEALTH, AS WELL AS WITH SEVERAL OTHER HOSPITALS IN THE REGION, THROUGH THE REGIONAL HEALTH ASSESSMENT AND PLANNING EFFORTS COORDINATED BY THE ADIRONDACK RURAL HEALTH NETWORK (ARHN). SINCE 2002, ARHN HAS BEEN RECOGNIZED AS THE LEADING SPONSOR OF FORMAL COMMUNITY HEALTH PLANNING IN THE REGION. THE COMMUNITY HEALTH ASSESSMENT (CHA) COMMITTEE, FACILITATED BY ARHN, IS MADE UP OF HOSPITALS AND COUNTY HEALTH DEPARTMENTS WORKING TOGETHER TO UTILIZE A SYSTEMATIC APPROACH TO COMMUNITY HEALTH PLANNING AND ASSESSMENT.A VARIETY OF DATA SOURCES WERE USED TO INFORM THE COUNTY AND HOSPITAL ASSESSMENTS. THE TWO MOST SIGNIFICANT RESOURCES USED WERE DEVELOPED AND PROVIDED BY ARHN COLLABORATION: 1) PUBLICLY AVAILABLE COUNTY HEALTH INDICATOR DATA AND 2) DATA COLLECTED FROM A REGIONAL COMMUNITY STAKEHOLDER SURVEY. EACH COUNTY PUBLIC HEALTH DEPARTMENT, AS WELL AS GFH, USED ADDITIONAL DATA SOURCES TO SUPPLEMENT THIS INFORMATION AND INFORM THE PROCESS BASED ON THEIR NEEDS. ADDITIONAL DATA SOURCES USED BY GFH INCLUDE THE NYS PREVENTION AGENDA DASHBOARD, COUNTY HEALTH RANKINGS, THE NYS CANCER REGISTRY, THE GOVERNOR'S CANCER RESEARCH INITIATIVE WARREN COUNTY CANCER INCIDENCE REPORT, AND AN ATTITUDINAL TOBACCO ASSESSMENT CONDUCTED IN WARREN, WASHINGTON AND SARATOGA COUNTIES. GLENS FALLS HOSPITAL PART V, SECTION B, LINE 6A: HOSPITALS: ADIRONDACK HEALTH, NATHAN LITTAUER HOSPITAL, UVM HEALTH NETWORK-ALICE HYDE MEDICAL CENTER, UVM HEALTH NETWORK-CHAMPLAIN VALLEY PHYSICIANS HOSPITAL, AND UVM HEALTH NETWORK-ELIZABETHTOWN COMMUNITY HOSPITAL. GLENS FALLS HOSPITAL PART V, SECTION B, LINE 6B: OTHER ORGS: PUBLIC HEALTH DEPTS. OF CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN, WASHINGTON AND AHRN GLENS FALLS HOSPITAL PART V, SECTION B, LINE 11: AFTER CAREFUL CONSIDERATION AND EXTENSIVE INTERNAL AND EXTERNAL DISCUSSIONS, GFH DETERMINED THAT THE MOST EFFECTIVE STRATEGY WOULD BE TWOFOLD: 1) ENSURE THE HOSPITAL COORDINATED WITH AND/OR PARTICIPATED IN EACH OF THE PUBLIC HEALTH DEPARTMENT'S ASSESSMENT PROCESSES AND 2) UTILIZE THE RESULTS OF EACH OF THE COUNTIES ASSESSMENTS TO INFORM A COORDINATED AND COMPLEMENTARY REGIONAL CHNA FOR THE GFH SERVICE AREA.IN ADDITION TO EVALUATING THE PRIORITIES AND COUNTY LEVEL DATA INDICATORS FOR OUR LOCAL COUNTY HEALTH DEPARTMENTS, GFH CONSIDERED OUR EXPERTISE CAPACITY, FUNDING, AND POTENTIAL IMPACT. THE FOLLOWING HAVE BEEN IDENTIFIED AS THE MOST SIGNIFICANT HEALTH NEEDS FOR THE POPULATION SERVED BY GFH. THESE NEEDS WILL BE THE MAJOR FOCUS OF GFH'S COMMUNITY HEALTH STRATEGIES FOR 2019-2021.PRIORITY AREA: PREVENT CHRONIC DISEASEFOCUS AREA 1 - HEALTHY EATING AND FOOD SECURITYFOCUS AREA 2 - PHYSICAL ACTIVITYFOCUS AREA 3 - TOBACCO PREVENTIONFOCUS AREA 4 - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT.GFH IS EXPANDING THE SCOPE OF WORK TO INCLUDE AN ADDITIONAL PRIORITY AREA.PRIORITY AREA: PREVENT COMMUNICABLE DISEASESFOCUS AREA 5 - ANTIBIOTIC RESISTANCE AND HEALTHCARE-ASSOCIATED INFECTIONSIN REGARDS TO REGIONAL PRIORITIES, AND IN ADDITION TO GFH CHOOSING THE FOUR FOCUS AREAS UNDER THE PREVENT CHRONIC DISEASES PRIORITY AREA, AS PART OF THE COMMUNITY HEALTH PLANNING AND ASSESSMENT PROCESS, THE CHA COMMITTEE IDENTIFIED AND SELECTED PREVENT CHRONIC DISEASES AS ONE OF THE REGIONAL PRIORITIES IN SUPPORT OF THE NYS PREVENTION AGENDA 2019-2024. THE CHA COMMITTEE ALSO SELECTED AN ADDITIONAL PRIORITY, PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS.ADDITIONAL ANALYSIS REVEALED AN INCREASING DEMAND AND NEED FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES THROUGHOUT THE THREE-COUNTY REGION. GFH RECOGNIZES THIS TREND AND THE NEED FOR QUALITY SERVICES AND PROGRAM, HOWEVER, HAS NOT HISTORICALLY FORMALIZED STRATEGIES INTO THE PLAN DUE TO LACK OF RESOURCES AND CAPACITY. CURRENTLY, GLENS FALLS HOSPITAL IS THE CONTRACTED BEHAVIORAL HEALTH PROVIDER FOR WARREN AND WASHINGTON COUNTIES. THE NEED WILL ONLY INCREASE, AND WE ARE WORKING TO PROACTIVELY ENSURE PATIENTS HAVE ACCESS TO THE CARE THEY NEED. MOST RECENTLY, GLENS FALLS HOSPITAL IS WORKING WITH WARREN AND WASHINGTON COUNTIES TO CONDUCT A THOUGHTFUL AND DELIBERATE PARTNERSHIP EXPLORATION PROCESS FOR OUTPATIENT BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES. BEHAVIORAL HEALTH SERVICES NORTH HAS STEPPED IN TO TAKE OVER THE OUTPATIENT BEHAVIORAL HEALTH SERVICE TO HELP US BETTER SERVE PATIENTS, WITH A GOAL TO EXPAND ACCESS TO MUCH NEEDED SPECIALIZED BEHAVIORAL HEALTH SERVICES IN OUR COMMUNITY. SIMULTANEOUSLY, GFH WILL CONTINUE TO WORK THROUGH INITIATIVES SUCH AS HEALTH HOME AND DSRIP TO WORK WITH ALL PROVIDERS ON INTEGRATED CARE MODELS AND POPULATION HEALTH STRATEGIES. ADDITIONAL COMMUNITY HEALTH NEEDS, SUCH AS HOUSING, TRANSPORTATION, AND OTHER SOCIAL DETERMINANTS OF HEALTH, ARE NOT ADDRESSED IN THE ACTION PLAN DUE TO LACK OF RESOURCES, EXPERTISE AND/OR QUANTITATIVE DATA TO SUPPORT A PROPER ASSESSMENT AND PLAN. PART V, LINE 7A AND 10A THE HOSPITAL'S CHNA AND IMPLEMENTATION STRATEGY IS POSTED ON ITS WEBSITE: WWW.GLENSFALLSHOSPITAL.ORG/SERVICES/COMMUNITY-SERVICES/HEALTH-PROMOTION-CENTERPART V, LINE 16A & 16B: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND APPLICATION FORM IS POSTED ON ITS WEBSITE: WWW.GLENSFALLSHOSPITAL.ORG/PATIENTS-AND-VISITORS/PATIENTS/PATIENT-FINANCIAL-ASSISTANCE PART V, LINE 20D IN 2020, THE HOSPITAL DID NOT HAVE A PRESUMTIVE ELIGIBILITY TOOL IN PLACE. WE HAVE SELECTED A VENDOR TO PROVIDE THE SOFTWARE TOOL AND WILL HAVE IT IMPLEMENTED IN THE 3RD QUARTER OF 2021 19 1 - ADIRONDACK CARDIOLOGY 6 HEARTS WAY QUEENSBURY NY 12804 HOSPITAL EXTENSION CLINIC - CARDIOLOGY AND CARDIAC REHABILITATION 2 - SURGICAL SPECIALISTS OF GLENS FALLS 14 HUDSON AVE GLENS FALLS NY 12801 HOSPITAL EXTENSION CLINIC - SURGICAL SERVICES, UROLOGY, THORACIC, ORTHOPEDIC 3 - THE REHAB CENTER & HEARING CENTER 2 COUNTRY CLUB RD QUEENSBURY NY 12804 HOSPITAL EXTENSION CLINIC - OUTPATIENT PT, OT, SPEECH, AUDIOLOGY 4 - GLENS FALLS BROAD ST MEDICAL CENTER 2 BROAD ST GLENS FALLS NY 12801 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, ENT 5 - CAMBRIDGE MEDICAL CENTER AND URGENT CARE 35 GILBERT ST CAMBRIDGE NY 12816 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, PT 6 - GREENWICH MEDICAL CENTER 1134 COUNTY RT 29 GREENWICH NY 12834 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, PT 7 - THE REHAB CENTER & HEARING CENTER 4 IRONGATE CTR GLENS FALLS NY 12801 HOSPITAL EXTENSION CLINIC - O/P PT, OT, SPEECH, AUDIOLOGY 8 - GRANVILLE MEDICAL CENTER 79 NORTH ST GRANVILLE NY 12832 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, LAB, REHAB 9 - PHYSICAL THERAPY AT MAIN ST 17 MAIN ST GLENS FALLS NY 12801 HOSPITAL EXTENSION CLINIC - O/P PHYSICAL THERAPY 10 - MEDICAL IMAGING AND LAB 1299 RT 9 GANSEVOORT NY 12831 HOSPITAL EXTENSION CLINIC - MEDICAL IMAGING AND LAB 11 - CENTER FOR RECOVERY 101 RIDGE ST GLENS FALLS NY 12801 HOSPITAL EXTENSION CLINIC - CHEMICAL DEPENDENCE, O/P REHAB 12 - BEHAVIORAL HEALTH SERVICESRIDGE COMMONS 1 LAWRENCE ST LAWRENCE ST NY 12801 HOSPITAL EXTENSION CLINIC - O/P MENTAL HEALTH SERVICES 13 - HUDSON FALLS MEDICAL CENTER 325 MAIN ST HUDSON FALLS NY 12839 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE 14 - EVERGREEN MEDICAL CENTER 13 PALMER AVE CORINTH NY 12822 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, PT, MENTAL 15 - THE CENTER FOR RECOVERY 340 MAIN ST HUDSON FALLS NY 12839 HOSPITAL EXTENSION CLINIC - CHEMICAL DEPENDENCE, O/P REHAB 16 - ADVANCED IMAGING AT BAYBROOK 22 WILLOWBROOK RD QUEENSBURY NY 12804 HOSPITAL EXTENSION CLINIC - DIAGNOSTIC OP RADILOGY, CT SCANNER 17 - WHITEHALL MEDICAL CENTER 65 POULTNEY ST WHITEHALL NY 12887 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, LAB 18 - SALEM MEDICAL CENTER 213 MAIN ST SALEM NY 12865 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P PT 19 - WILTON MEDICAL CENTER 135 NORTH RD GANSEVOORT NY 12831 HOSPITAL EXTENSION CLINIC - PRIMARY MEDICAL CARE, O/P RADIOLOGY, PT PART I, LINE 6A: GLENS FALLS HOSPITAL DEVELOPS AND PRODUCES THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY (IS) PER IRS GUIDELINES AND PUBLISHES THE REPORT ON THE WEBSITE. IN ADDITION, A COMMUNITY SERVICE PLAN IS PRODUCED PER NYS DEPT OF HEALTH GUIDELINES, AND ALSO MADE AVAILABLE ON THE WEBSITE. THESE REPORTS ALSO INCLUDE THE AMERICAN COLLEGE OF SURGEONS COMM. ON CANCER REQUIREMENTS FOR THE CR WOOD CANCER CENTER. PAPER COPIES ARE AVAILABLE FOR PICK UP IN PERSON OR BY MAIL BY REQUEST. IN ADDITION, GLENS FALLS HOSPITAL PRODUCES AN ANNUAL REPORT, WHICH IS MAILED TO APPROXIMATELY 60,000 HOUSEHOLDS, AND AVAILABLE AT MULTIPLE LOCATIONS THROUGHOUT THE HOSPITAL. A COMMUNITY NEWSLETTER IS ALSO DISTRIBUTED MULTIPLE TIMES PER YEAR. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST-TO-CHARGE RATIO AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. PART II, COMMUNITY BUILDING ACTIVITIES: GLENS FALLS HOSPITAL REGULARLY ASSESSES THE MAKEUP OF THE REGION'S PHYSICIAN POPULATION, PAYING PARTICULAR ATTENTION TO PHYSICIANS WHO MAY BE APPROACHING RETIREMENT AGE AND SPECIALTIES THAT MAY HAVE A PHYSICIAN SHORTAGE DUE TO RETIREMENT OR RELOCATION. THE HOSPITAL EMPLOYS A FULL-TIME PHYSICIAN RECRUITER WHO FOCUSES ON THE RECRUITMENT AND RETENTION OF HIGH QUALITY PROVIDERS. THE POSITION ACTIVELY RECRUITS FOR VACANCIES AND SHORTAGES AMONG HOSPITAL EMPLOYED PHYSICIANS, AND PARTNERS WITH INDEPENDENT PRACTICES TO HELP THEM KEEP A FULL COMPLEMENT OF PHYSICIANS ACROSS SPECIALTIES.THE HOSPITAL ALSO MONITORS AND ACTIVELY ENGAGES IN PREVENTING THE SPREAD OF INFECTIOUS DISEASE THROUGH SCHOOL BASED HEALTH AND THE HOSPITAL'S INFECTION CONTROL PROGRAM. THIS INCLUDES VACCINATIONS FOR CHILDREN, AND ACCESS TO FLU VACCINES FOR THE RESIDENTS OF OUR SERVICE AREA, (FREE OR AT A SIGNIFICANTLY REDUCED COST), INCLUDING AN ANNUAL HPODS DRILL.THE HOSPITAL MEETS REGULARLY WITH COMMUNITY GROUPS IN PLANNING FOR EMERGENCY PREPAREDNESS. COORDINATING WITH POLICE DEPARTMENTS, FIRE DEPARTMENTS, EMS AND COUNTY OFFICIALS. EMERGENCY DRILLS ARE CARRIED OUT FOR SUCH THINGS AS NATURAL DISASTERS, TERRORISM, ACCIDENTS WITH MASS CASUALTIES AND BIO HAZARDS. COMMUNITY MEMBERS PLAY AN ACTIVE ROLL IN THESE DRILLS.THROUGHOUT THE CORONAVIRUS (COVID-19) PANDEMIC, GFH HAS DEMONSTRATED THE ESSENTIAL NATURE OF OUR SERVICES FOR THE REGION AND HIS CONTINUED TO BE THE SAFETY NET HOSPITAL FOR OUR SURROUNDING COMMUNITIES. THE COVID-19 PANDEMIC HAD A DEVASTATING AND MULTI-FACETED IMPACT ON THE UPSTATE NEW YORK AREA. THREE SIGNIFICANT CHALLENGES, PARTICULARLY AT THE ONSET OF THE PANDEMIC, INCLUDED: 1) COVID-19 INFECTIONS AND ASSOCIATED COST OF CARE, 2) PLANNING FOR UNKNOWN HEALTH CARE SYSTEM SURGE CAPACITY AS DIRECTED BY THE GOVERNOR OF NY, AND 3) EXTREME AND CATASTROPHIC REVENUE LOSS DUE TO SOCIAL DISTANCING AND NYS MANDATED DELAY OF ROUTINE AND ELECTIVE CARE/PROCEDURES. WITHIN THE COST OF CARE FOR COVID-19 INCLUDED THE ADDITIONAL EXPENSE AND COMPLEXITY OF RESOURCES REQUIRED FOR MASS TESTING AND VACCINATION EFFORTS, FOR BOTH EMPLOYEES AND THE COMMUNITY AT LARGE, AS WELL AS INTERNAL CONTACT TRACING FOR EXPOSURE OF OUR EMPLOYEE WORKFORCE AND PATIENTS. ALL FACTORS WERE HEIGHTENED BY THE UNKNOWNS REGARDING WHAT, IF ANY, FUNDING ASSISTANCE WAS GOING TO BE AVAILABLE TO HEALTHCARE PROVIDERS IN ADDITION TO THE EVER CHANGING LANDSCAPE OF REGULATORY REQUIREMENTS, EXECUTIVE ORDERS AND NYS MANDATES ON HOSPITALS.AT THE BEGINNING OF THE COVID-19 PANDEMIC IN MARCH 2020, PREDICTIVE MODELING INDICATED POTENTIAL CATASTROPHIC VOLUMES OF COVID-19 CASES AND HOSPITALIZATIONS IN NYS, NATIONALLY, AND GLOBALLY. IN THE FIRST WEEKS AND MONTHS OF COVID-19 EMERGENCE IN NYS, THERE WAS EXTREME UNCERTAINTY REGARDING GEOGRAPHICAL COVID-19 CLUSTERS/SURGES AND THE IMPACT ON THE HEALTHCARE (AND SUPPLY CHAIN) SYSTEMS. PROJECTIONS INDICATED THAT VOLUMES OF COVID-19 HOSPITALIZATIONS WOULD EXCEED HEALTHCARE SYSTEM BED AND WORKFORCE CAPACITY. CONSEQUENTLY, NYS HEAVILY CONTROLLED AND MANAGED THE COVID-19 RESPONSE. PER NYS GOVERNOR'S EXECUTIVE ORDERS, OFFICIALLY EFFECTIVE MARCH 22, 2020, ELECTIVE SURGERIES AND PROCEDURES WERE CANCELLED TO ENSURE THAT NYS WOULD BE PREPARED FOR THE PREDICTED SURGE LEVELS REGARDING BED CAPACITY, SUPPLIES AND LABOR. AS A RESULT, THE HOSPITAL INCURRED SIGNIFICANT DECLINES IN NET PATIENT SERVICE REVENUE, WHILE INCURRING COSTS TO SECURE A LABOR FORCE, PERSONAL PROTECTIVE EQUIPMENT (PPE), AND CAPITAL TO BE IN A STATE OF READINESS FOR A SURGE AND THE ACUITY OF PATIENTS SEEN IN THE PANDEMIC. AS RESTRICTIONS HAVE LOOSENED, MANY PATIENTS WHO HAVE DELAYED THEIR CARE OR HAD THEIR CARE RESTRICTED DURING THE PANDEMIC, ARE ONCE AGAIN SEEKING TREATMENT. THESE EXTREMELY VOLATILE DAILY VOLUMES AND CENSUS CONTINUE TO CREATE MAJOR CHALLENGES FOR WORKFORCE AND FINANCIAL PLANNING. PART III, LINE 3: PART III, SECTION A, LINE 2 AND 3 BAD 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 STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING WHICH DESCRIBES THE PRONOUNCEMENT: UPON ADOPTION THE MAJORITY OF WHAT IS CURRENTLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS PRESENTED AS A REDUCTION TO NET PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSET IS TREATED AS A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS NET PATIENT SERVICE REVENUE. DURING 2020 AND 2019, THE HOSPITAL INCURRED ($315,066) AND $564,057 IN PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS, RESPECTIVELY. PART III, LINE 4: FOOTNOTE 1G OF THE AUDITED FINANCIALS "CONSISTENT WITH THE HOSPITAL'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND WHO QUALIFY FOR CHARITY CARE UNDER ITS PATIENT FINANCIAL ASSISTANCE PROGRAM. CHARITY CARE IS DEFINED AS SERVICES FOR WHICH PATIENTS HAVE THE OBLIGATION AND WILLINGNESS TO PAY BUT DO NOT HAVE THE ABILITY TO DO SO. THE SYSTEM DOES NOT REPORT CHARITY CARE AS NET PATIENT SERVICE REVENUE. THE COST OF CHARITY CARE WAS ~1.892M AND $1.855M FOR 2020 AND 2019, RESPECTIVELY, AS DETERMINED BASED ON THE APPLICATION OF A RATIO OF OVERALL HOSPITAL COSTS TO PATIENT CHARGES. INCLUDED IN PATIENT SERVICE REVENUES FOR 2020 AND 2019 IS APPROXIMATELY $3.498M AND $2.709M, RESPECTIVELY, FROM UNCOMPENSATED CARE POOLS AND INCOME FROM RESTRICTED ENDOWMENTS. THE HOSPITAL ANNUALLY CONDUCTS A COMPREHENSIVE ASSESSMENT OF THE COMMUNITY BENEFITS IT PROVIDES. THE MOST RECENT ASSESSMENT WAS COMPLETED IN THE FALL OF 2020 AND CULMINATED WITH THE ISSUANCE OF THE GLENS FALLS HOSPITAL COMMUNITY SERVICE PLAN, A COPY OF WHICH IS AVAILABLE FROM MANAGEMENT UPON REQUEST. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT, AS REFLECTED ON LINE 6, IS THE METHODOLOGY PRESCRIBED BY MEDICARE IN THE COMPLETION FOR FORM CMS-2552-96 AND CONFORMS TO THE REQUIREMENTS AND PRINCIPALS SET FORTH IN 42 CFR, PART 412, 42 CFR, PART 413 AND IN THE PROVIDER REIMBURSEMENT MANUAL, PART 1. GLENS FALLS HOSPITAL CONSIDERS 100% OF THE AMOUNT REPORTED IN PART III, LINE 7 A COMMUNITY BENEFIT. GFH IS THE ONLY COMPREHENSIVE ACUTE-CARE HOSPITAL SERVING A PREDOMINANTLY RURAL, 6,000 SQ. MILE AREA OF UPSTATE NEW YORK THAT ENCOMPASSES WARREN, WASHINGTON, HAMILTON, ESSEX, AND NORTHERN SARATOGA COUNTIES. IN A VERY REAL SENSE, IT IS THE SAFETY NET HOSPITAL FOR THE MEDICARE PATIENTS IN THESE COMMUNITIES. DESPITE THE FACT THAT THE PAYMENTS RECEIVED FROM MEDICARE FOR THE SERVICES PROVIDED ARE GENERALLY BELOW THE RATES THAT THE HOSPITAL RECEIVES FROM MANAGED CARE PAYERS AND PRIVATE INSURERS THE HOSPITAL REMAINS COMMITTED TO SERVING ELDERLY PATIENTS AND IMPROVING THE HEALTH STATUS OF THE ELDERLY. PART III, LINE 9B: IT IS GFH POLICY TO DELAY FINAL COLLECTION EFFORTS WHILE A PATIENT FINANCIAL ASSISTANCE APPLICATION IS IN PROCESS. A FINAL DETERMINATION IS REQUIRED BEFORE OUTSIDE COLLECTION EFFORTS ARE INITIATED. PART III, SECTION B, LINES 5-7 IN ADDITION TO THE AMOUNT INCLUDED IN THE MEDICARE COST REPORT AND REPORTED ON LINES 5, 6, & 7, THE HOSPITAL INCURRED LOSSES ON SERVICES PROVIDED TO MEDICARE PATIENTS AND PAID FOR UNDER THE PART B FEE SCHEDULE AND NOT REPORTABLE ON THE MEDICARE COST REPORT. PART VI, LINE 2: IN ADDITION TO COMPLETING A CHNA, HOSPITALS IN NYS ARE REQUIRED TO WORK TOGETHER WITH COUNTY PUBLIC HEALTH DEPARTMENTS TO COMPLETE A COMMUNITY SERVICE PLAN (CSP) THAT MIRRORS THE CHNA AND IMPLEMENTATION STRATEGY (IS) PER THE ACA. FURTHERMORE, ALL AMERICAN COLLEGE OF SURGEONS (ACOS) COMMISSION ON CANCER (COC) PROGRAMS ARE REQUIRED TO COMPLETE A COMMUNITY NEEDS ASSESSMENT AS WELL. TO ENSURE THE MOST EFFICIENT USE OF HOSPITAL RESOURCES AND SUPPORT A COMPREHENSIVE APPROACH TO COMMUNITY HEALTH AND POPULATION HEALTH MANAGEMENT IN THE REGION, GFH CHOSE TO ALIGN AND COMBINE THE REQUIREMENTS OF THE THREE ENTITIES. WORKING WITHIN THE FRAMEWORK PROVIDED BY THE NYS PREVENTION AGENDA, GFH AND WARREN, WASHINGTON, AND SARATOGA COUNTY PUBLIC HEALTH COLLABORATED IN THE DEVELOPMENT OF THE CHNA IN A WAY THAT CAN MEET THE REQUIREMENTS FOR THE THREE ENTITIES. ADDITIONALLY, GFH COORDINATED WITH FULTON, ESSEX, HAMILTON, FRANKLIN AND CLINTON COUNTY PUBLIC HEALTH IN ADDITION TO SEVERAL OTHER HOSPITALS IN THE REGION, THROUGH THE REGIONAL HEALTH ASSESSMENT AND PLANNING EFFORTS COORDINATED BY ARHN. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE BROCHURES ARE GIVEN AT THE POINT OF SERVICE. ALL PATIENT'S STATEMENTS ADVERTISE CHARITY CARE PROGRAMS. CUSTOMER SERVICE REPS ARE TRAINED TO OUTLINE AND ENCOURAGE PARTICIPATION IN THE PROGRAM. VENDOR MEDICAID ELIGIBILITY PROCESS INCLUDES CHARITY CARE SCREENING STEP FOR ALL INPATIENT AND OUTPATIENT. WEBSITE CONTAINS INFORMATION ON CHARITY CARE PROGRAMS AND WEB PORTAL HAS AN APPLICATION FORM ONLINE THAT CAN BE PRINTED AND FILLED OUT. PART VI, LINE 4: THE GFH HEALTHCARE SYSTEM SERVICES A LARGE AREA OF UPSTATE NY THAT INCLUDES ALL OR PORTIONS OF THE FOLLOWING COUNTIES: WARREN, WASHINGTON, HAMILTON, ESSEX AND NORTHERN SARATOGA. THE SERVICE AREA COVERS APPROXIMATELY 350K PEOPLE. THE POPULATION IS LARGELY WHITE, NON-HISPANIC (95.9%). PEOPLE OVER THE AGE OF 65 CONSTITUTE 17.4% OF THE POPULATION; CHILDREN UNDER THE AGE OF 17 MAKE UP 20.2% OF THE POPULATION. THE AVERAGE HOUSEHOLD INCOME IS $79,547, LOWER THAN THE NYS AVERAGE OF $93,443. JUST OVER 1/4 OF THE POPULATION HAS OBTAINED A BACHELOR'S DEGREE OR HIGHER LEVEL OF EDUCATION (29.8%). THE AGE GROUP THAT WILL SEE THE GREATEST GROWTH ARE PEOPLE AGED 65 AND OLDER. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTHTHE GOVERNANCE OF GFH IS VESTED IN THE BOARD OF GOVERNORS (THE BOARD), WHICH IS COMPRISED OF DULY ELECTED COMMUNITY MEMBERS AND PHYSICIANS. THE BOARD CONSISTS OF NOT LESS THAN TWELVE AND NOT MORE THAN EIGHTEEN MEMBERS. ANY AND ALL PHYSICIANS LIVING IN THE SERVICE ARE WHO ARE QUALIFIED, AND WHO MEET REQUIREMENTS AS DOCUMENTED IN THE MEDICAL STAFF BYLAWS, ARE EXTENDED PRIVILEGES. FUNDS IN EXCESS OF EXPENSES ARE ALLOCATED FOR CAPITAL PROJECTS, MEDICAL RESEARCH AND CLINICAL TRIALS, PATIENT CARE IMPROVEMENTS AND SYSTEM IMPROVEMENTS. CAPITAL PROJECTS ARE PRIORITIZED BY AN INTERDISCIPLINARY COMMITTEE. PART VI, LINE 7 GFH FILES A COMMUNITY BENEFIT REPORT IN NEW YORK STATE. 1 NURSING SCHOLARSHIPS 3 12000 PART I, LINE 2: EVERY GRANT THAT IS APPLIED FOR AND RECEIVED IS OVERSEEN BY A MANAGER OR DIRECTOR WITHIN THE ORGANIZATION. THESE INDIVIDUALS WORK CLOSELY WITH THE ACCOUNTING FUNCTION TO ENSURE ALL EXPENSES RELATED TO GRANTS ARE USED APPROPRIATELY AND TRACKED CORRECTLY. FINANCE MAINTAINS A TRACKING LOG OF GRANT FUNDS RECEIVED. X X X X X X 1 1 0 0 0 0 0 1 0 DIANNE SHUGRUE PRESIDENT & CEO 616329 0 0 0 3181147 0 7692 0 5837 0 3811005 0 0 0 STEVEN FRISCH MD BOARD MEMBER 0 824345 0 279144 0 114507 0 95504 0 23051 0 1336551 0 65476 ADAM BROD MD ORTHOPEDIC PHYSICIAN 412525 0 303125 0 16916 0 11400 0 7870 0 751836 0 0 0 JOHN STOUTENBURG MD ONCOLOGY PHYSICIAN 528543 0 90213 0 630 0 11400 0 7870 0 638656 0 0 0 MATTHEW DICKSON ENT PHYSICIAN 480756 0 128275 0 630 0 11400 0 5597 0 626658 0 0 0 ANDRE JOHNSON MD ORTHOPEDIC PHYSICIAN 412787 0 194258 0 420 0 11400 0 5597 0 624462 0 0 0 MICHAEL LIEBERTH MD SURGICAL PHYSICIAN 327740 0 265737 0 966 0 11400 0 7870 0 613713 0 0 0 SEAN BAIN MD BOARD MEMBER 280173 0 120644 0 966 0 11400 0 5018 0 418201 0 0 0 PAUL SCIMECA COO 360480 0 0 0 22196 0 11400 0 5837 0 399913 0 0 0 MITCH AMADO CFO 349974 0 0 0 20866 0 11069 0 5837 0 387746 0 0 0 HOWARD FRITZ MD CMO 351610 0 0 0 19500 0 11400 0 720 0 383230 0 0 0 PATTI HAMMOND VP PHYSICIAN PRACTICES 274873 0 0 0 16144 0 11074 0 5289 0 307380 0 0 0 DONNA KIRKER CNO 264579 0 0 0 13879 0 10635 0 780 0 289873 0 0 0 GEOFFREY SERFILIPPI MD BOARD MEMBER 143802 0 15000 0 2772 0 0 0 480 0 162054 0 0 0 PART I, LINES 4A-B PART 1, LINE 4A ON SEPTEMBER 23, 2020, MS. SHUGRUE TENDERED RESIGNATION FOR "GOOD REASON" UNDER TERMS OF HER EMPLOYMENT AGREEMENT, DATED 6/18/13, TRIGGERING SEVERANCE OF $956,250 AND A PRO RATA OF HER SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) OF $920,541, PER SCHEDULE A OF HER SERP AGREEMENT, DATED JANUARY 1, 2016. PART 1, LINE 4B EFFECTIVE JANUARY 1, 2016, A SERP WAS ESTABLISHED BETWEEN GLENS FALLS HOSPITAL AND DIANNE SHUGRUE. IN ACCORDANCE WITH SCHEDULE A OF MS. SHUGRUE'S SERP, SHE MET THE FOLLOWING VESTING REQUIREMENT IN 2020: "THE PARTICIPANT SHALL BE ENTITLED TO A FIXED BENEFIT EQUAL TO $1,300,000 IF THE PARTICIPANT REMAINS IN CONTINUOUS EMPLOYMENT AND HAS NOT INCURRED A SEPARATION FROM SERVICE, WITH THE EMPLOYER THROUGH THE DATE THE PARTICIPANT ATTAINS AGE 62, AT WHICH TIME THIS BENEFIT SHALL BECOME VESTED." PART I, LINE 7 PHYSICIANS ARE ELIGIBLE AND DID RECEIVE ADDITIONAL COMPENSATION THROUGH PARTICIPATION IN AN INCENTIVE PROGRAM THAT ADDRESSED QUALITY, PATIENT SATISFACTION AND THEIR PERSONAL PRODUCTIVITY. A GLENS FALLS CIVIC DEVELOPMENT CORP-SERIES 2015 451673501 NONEAVAIL 2015-09-21 67000000 REFUND 2003 BONDS, FINANCE CAPITAL PROJECTS 0 0 0 A 20100000 67000000 360205 17520856 49118939 2015 1 0 1 1 A 0 1 1 1 0 0.01700 0.00000 0.01700 0 0 1 A 0 0 0 1 0 0 0 0 0 A 1 PART IV, LINE 2 C: A THIRD-PARTY WAS USED TO PERFORM AN ARBITRAGE CALCULATION WHICH WAS COMPLETED ON NOVEMBER 20, 2020. IT WAS DETERMINED THAT THERE IS NO POSITIVE ARBITRAGE ASSOCIATED WITH THE ABOVE REFERENCED BOND ISSUE. DAVID WESTFALL MD DIRECTOR 22500 JV 0 SCHEDULE L, PART IV DR. WESTFALL IS A DIRECTOR OF THE GLENS FALLS HOSPITAL BOARD, AND IS ALSO A MEMBER IN AN ENTITY INVOLVED IN A JOINT VENTURE WITH GFH FOR A PORTION OF 2020. GFH'S INVESTMENT IN THIS JOINT VENTURE, NEW YORK EYE SURGERY CENTER, LLC, EXCEEDS $10,000. IN 2020, GFH SOLD ITS INTEREST IN THE JOINT VENTURE TO NEW YORK EYE SURGERY CENTER, LLC.ALL OF GFH'S BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY TO ENSURE THAT THE HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. ACTIVITIES, ARRANGEMENTS AND SERVICES ARE THE RESULT OF ARM'S LENGTH BARGAINING REFLECTING REASONABLE PAYMENTS FOR GOODS AND SERVICES. BOARD BYLAWS STIPULATE THAT BOARD MEMBERS RECUSE THEMSELVES REGARDING ANY SUBJECT THAT PERTAINS TO A POTENTIAL CONFLICT OF INTEREST. FORM 990, PART III, LINE 3 ON JUNE 11, 2020, BEHAVIORAL HEALTH SERVICES NORTH (BHSN) RECEIVED ENDORSEMENT FROM GLENS FALLS HOSPITAL (GFH) AND WARREN/WASHINGTON COMMUNITY SERVICE BOARD TO MOVE FORWARD WITH BECOMING THE PROVIDER FOR OUTPAIENT SUBSTANCE ABUSE, MENTAL HEALTH TREATMENT AND CHILD AND FAMILY SERVICES FOR THE GLENS FALLS REGION. THESE SERVICES TRANSITIONED FROM GFH TO BHSN IN NOVEMBER 2020. PART I, LINE 1 & PART III, LINE 1 THE MISSION OF GFH IS TO IMPROVE THE HEALTH OF PEOPLE IN OUR REGION BY PROVIDING ACCESS TO EXCEPTIONAL, AFFORDABLE, AND PATIENT-CENTERED CARE IN EVERY SETTING. OUR CORE VALUES ARE CENTERED ON COLLABORATION, ACCOUNTABILITY, RESPECT, EXCELLENCE, AND SAFETY. GFH MAINTAINS A SERVICE AREA THAT SPANS 6,000 SQ. MILES ACROSS 5 COUNTIES. WE ALSO OPERATE 20 REGIONAL HEALTHCARE FACILITIES THROUGHOUT OUR SERVICE AREA. GFH HAS OVER 550 MEDICAL STAFF, INCLUDING OVER 170 EMPLOYED PHYSICIANS, PAS, AND NPS. FORM 990, PART VI, SECTION A, LINE 4 ON JULY 1, 2020 GLENS FALLS HOSPITAL BECAME AN AFFILIATE OF THE ALBANY MED HEALTH SYSTEM. AS PART OF THE AFFILIATION, THE GLENS FALLS HOSPITAL BY-LAWS WERE UPDATED TO INCLUDE ALBANY MED HEALTH SYSTEM AS ITS SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B AN OVERVIEW OF THE FORM 990 WAS PRESENTED TO THE FULL BOARD IN OCTOBER 2021. AN ELECTRONIC COPY OF THE 990 WAS POSTED ON THE BOARD PORTAL PRIOR TO FILING, THAT CAN BE ACCESSED BY THE BOARD FOR THEM TO REVIEW AND COMMENT ON. IN ADDITION, THE 990 WAS REVIEWED BY THE CFO, CONTROLLER, SR. DIRECTOR OF FINANCE, AND OUR INDEPENDENT ACCOUNTANT, KPMG, TO MAKE SURE IT WAS FILLED OUT COMPLETELY AND ACCURATELY. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON, A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. REVIEWS SHALL INCLUDE THE FOLLOWING SUBJECTS: A) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S LENGTH BARGAINING, B) WHETHER ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT, AND C) WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN THE INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. IN CONDUCTING REVIEWS, THE CORPORATION MAY USE OUTSIDE ADVISORS. FORM 990, PART VI, SECTION B, LINE 15 GFH IS COMMITTED TO DEVELOPING AND MAINTAINING A TOTAL COMPENSATION PROGRAM THAT IS COMPETITIVE WITH PROGRAMS OFFERED BY OTHER HEALTH CARE ORGANIZATIONS THAT ARE COMPARABLE TO GFH IN REVENUE, STRUCTURE, MISSION AND SCOPE OF SERVICES. THE COMPENSATION PHILOSOPHY INCLUDES: BASE SALARY RANGES POSITIONED IN THE 50TH PERCENTILE OF A NATIONAL AND REGIONAL PEER GROUP, ANNUAL INCENTIVE OPPORTUNITIES TIED TO PERFORMANCE GOALS ESTABLISHED BY THE BOARD, BENEFITS DELIVERED IN THE 50TH PERCENTILE OF A NATIONAL PEER GROUP AND TOTAL COMPENSATION POSITIONED AT APPROXIMATELY THE 50TH PERCENTILE FOR EXPECTED PERFORMANCE, AND SOMEWHAT ABOVE THAT FOR EXCEPTIONAL PERFORMANCE. EXECUTIVE PAY IS REVIEWED ANNUALLY BY A THIRD PARTY CONSULTANT. THIS REVIEW INCLUDES A COMPARISON OF GFH EXECUTIVE PAY PRACTICES WITH NATIONAL AND REGIONAL BENCHMARK STUDIES AS APPROPRIATE. THE CONSULTANT IS ENGAGED DIRECTLY BY THE GFH BOARD OF GOVERNORS AND REPORTS THEIR FINDINGS TO BOARD PERSONNEL COMMITTEE FOR REVIEW AND ACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 5,343,431. MANAGEMENT AND GENERAL EXPENSES 68,305. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,411,736. P/S STAFFING: PROGRAM SERVICE EXPENSES 8,556,681. MANAGEMENT AND GENERAL EXPENSES 4,823,446. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,380,127. P/S REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 2,546,322. MANAGEMENT AND GENERAL EXPENSES 5,582,926. FUNDRAISING EXPENSES 573. TOTAL EXPENSES 8,129,821. P/S COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,448,392. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,448,392. P/S TRANSCRIPTION AND MICROFILMING: PROGRAM SERVICE EXPENSES 159,098. MANAGEMENT AND GENERAL EXPENSES 85,596. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 244,694. MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,136,483. MANAGEMENT AND GENERAL EXPENSES 2,474,312. FUNDRAISING EXPENSES 50,881. TOTAL EXPENSES 8,661,676. INFECTIOUS OUTBREAK MISC: PROGRAM SERVICE EXPENSES 4,299,238. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,299,238. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF GFH FOUNDATION 1,112,063. FOUNDATION TRANSFER TO BALANCE SHEET ACCOUNTS -4,299. EFFECT OF BUSINESS COMBINATION 39,055,387. GLENS FALLS HOSPITAL FOUNDATION 100 PARK ST GLENS FALLS NY 12801 141790805 SUPPORT NY 501(C)(3) LINE 10 N/A 0 ADIRONDACK HEALTH SERVICES 100 PARK ST GLENS FALLS NY 12801 141667492 PARENT NY 501(C)(3) LINE 12B, II N/A 0 GLENS FALLS MEDICAL PLLC 100 PARK ST GLENS FALLS NY 12801 823943636 PHYSICIANS NY 501(C)(3) LINE 10 N/A 1 ALBANY MEDICAL CENTER FOUNDATION 47 NEW SCOTLAND AVE ALBANY NY 12208 146023119 FUNDRAISING NY 501(C)(3) LINE 7 N/A 0 ALBANY MEDICAL CENTER HOSPITAL 43 NEW SCOTLAND AVE ALBANY NY 12208 141338307 HOSPITAL SERVICES NY 501(C)(3) LINE 3 N/A 0 ALBANY MEDICAL CENTER KIDSKELLER 47 NEW SCOTLAND AVE ALBANY NY 12208 222635792 EDUCATION DAY PROGRAM NY 501(C)(3) LINE 2 ALBANY MED HEALTH SYSTEM 1 ALBANY MEDICAL COLLEGE 47 NEW SCOTLAND AVE ALBANY NY 12208 141338310 MEDICAL DEGREE PROGRAMS NY 501(C)(3) LINE 2 N/A 0 BETTER HEALTH FOR NORTHEAST NY 47 NEW SCOTLAND AVE ALBANY NY 12208 811861104 DSRIP NY 501(C)(6) AMC HOSPITAL 1 CENTER FOR DONATION AND TRANSPLANT 218 GREAT OAKS BLVD ALBANY NY 12203 141820447 ORGAN AND TISSUE BANK NY 501(C)(3) LINE 12A, I ALBANY MEDICAL COLLEGE 0 COLUMBIA MEMORIAL HEALTH FOUNDATION 71 PROSPECT AVE HUDSON NY 12534 141761112 FUNDRAISING NY 501(C)(3) LINE 10 COLUMBIA MEMORIAL HOSPITAL 1 COLUMBIA MEMORIAL HOSPITAL 71 PROSPECT AVE HUDSON NY 12534 141338373 HOSPITAL SERVICES NY 501(C)(3) LINE 3 N/A 0 HEALTHCARE PARTNERS OF SARATOGA LTD 211 CHURCH STREET SARATOGA SPRINGS NY 12886 563303309 EMERGENT CARE NY 501(C)(3) LINE 3 N/A 0 KAATERSKILL COMMONC INC 163 JEFFERSON HEIGHTS CATSKILL NY 12414 205700964 HOUSING NY 501(C)(3) LINE 7 COLUMBIA MEMORIAL HOSPITAL 1 SARATOGA HOSPITAL 211 CHURCH STREET SARATOGA SPRINGS NY 12886 141338547 HOSPITAL SERVICES NY 501(C)(3) LINE 3 N/A 0 SARATOGA CARE INC 211 CHURCH STREET SARATOGA SPRINGS NY 12886 141775218 PROMOTING HEALTH NY 501(C)(3) LINE 12B, II SARATOGA HOSPITAL 0 SARATOGA REGIONAL MED PC 211 CHURCH STREET SARATOGA SPRINGS NY 12886 472468259 HEALTHCARE SERVICES NY 501(C)(3) LINE 3 SARATOGA HOSPITAL 1 IMAG SVC OF NENY 100 PARK STREET GLENS FALLS NY 12801 141820955 DIAG. RADIOLOGY NY N/A RELATED 347871 62901 0 0 0.50000 NORTH COUNTRY EYE CENTER LLC 465B MAPLE AVE SARATOGA NY 12866 453715451 EYE CENTER NY N/A RELATED 0 0 0.30000 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 NORTH COUNTRY EYE CENTER LLC G 225000 CASH PART V, LINE 2 DURING 2020, GLENS FALLS HOSPITAL SOLD ITS INTEREST IN NORTH COUNTRY EYE CENTER LLC (FEIN 45-3715451) TO THE PRIMARY PARTNER FOR $225,000.