2021-11-10T11:36:55-07:00 2020-12-31 990 2020-01-01 160743905 ARNOT OGDEN MEDICAL CENTER ARNO 6077374235 600 ROE AVENUE ELMIRA NY 14905 Jonathan Lawrence President & CEO 6077374235 2021-11-01 1 11 0 AAL2 X 2020 2022-09-23 18:48:47Z JONATHAN LAWRENCE 600 ROE AVE ELMIRA NY 14905 365191962 0 X www.arnothealth.org X 1889 NY Arnot Ogden Medical Center is a community based hospital with an open emergency room and selected highly specialized services that are part of a high quality health care delivery system that serves Chemung County, NY and the Twin Tier Regions of New York and Pennsylvania. 16 12 3713 155 0 0 3707477 14939370 343736840 338786863 8426798 3774184 4556205 5229259 360427320 362729676 0 0 0 0 234030490 222546256 0 0 0 129811464 135150857 363841954 357697113 -3414634 5032563 275524187 304855200 134829730 157077663 140694457 147777537 X Arnot Ogden Medical Center is a not-for-profit, 225-bed tertiary medical facility with more than 115 physicians from over 50 specialties. Arnot Ogden Medical Center offers specialty services at the Wilmot Cancer Center, Heart and Vascular Institute, Stroke Care, Maternity, Surgery. St Joseph's Hospital, merged with Arnot Ogden in March 2019, offers a Behavioral Science Unit, Acute Rehabilitation Unit, and Skilled Nursing Facility with some similar program services as Arnot Ogden offers. 0 0 293794187 0 304654282 The Arnot Ogden Medical Center continues to provide of health care related services since it opened in 1889, serving Chemung County and the Twin Tier Regions of New York and Pennsylvania. The Medical Center specialized in the fields of Cardiology, Oncology, Renal, Neonatology, Bariatric and Emergency Care. Other sub specialized services include, but are not limited to, Anesthesiology, Surgery, Laboratory, Imaging, Physical Therapy, Obstetrics, and Gynecology. In 2020, the Medical Center's 2,271 Full-time equivalent of employees cared for 9,193 inpatient admissions in its 179 staffed beds. The Medical Center provided Outpatient Services to approximately 456,485 Outpatient Visits in its subspecialty services. The approximately 178 Full-time equivalents of physicians provided for 309,132 office visits in the areas of primary care and specialty services. 656044 0 228587 The Arnot Ogden Medical Center School of Nursing began in 1889 and is finishing their last year offering the three year diploma program, while fully migrating over to offering a two-year associate program, both accredited by the National League for Nursing with approximately 41 students enrolled between both programs in 2020. The Arnot Ogden School of Radiologic Sciences began in 1953 continues to offer a two-year certificate program, which is accredited by the Joint Review Commission on Education in Radiologic Technology with approximately 17 students enrolled in 2020. Upon completion of their program of study, students are eligible to take the NYS licensing examinations for Registered Nurse or Radiologic Technologist. 0 0 0 294450231 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 899 0 1 3713 1 1 1 0 0 0 0 0 0 0 X 16 12 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 NY X X STEPHEN KENNEY 6072717037 600 ROE AVENUE ELMIRA NY 14905 Vidyasagar Mokureddy MD Pain Mgmt Physician 45 0 X 967017 0 40536 Matthew Brand MD Orthopediac Surgeon 60.00 0 X 777133 0 40536 Nche Zama MD Cardiothoracic Surgeon 50 0 X 788710 0 7861 Thomas Boman MD Orthopedics 60.00 0 X 743599 0 40536 Bryan Jarvis MD Orthopedics 60.00 0 X 699950 0 32898 Robert Lambert MD President & Chief Executive Officer 0 0 X 631075 0 0 Ronald J Kintz DHA CFO/Senior VP 1 0 X 195442 0 434174 Jonathan Lawrence President & Chief Executive Officer 50 20 X 546672 0 32898 Aleksander Rupik President AMS 45 0 X 389552 0 40744 Pallavi Kamjula MD Vice President, Medical Staff 45 0 X 341441 0 9776 Roberto deBara MD President AMS 0 0 X 334215 0 0 Kenneth Herzl-Betz MD Chief Medical Officer/Senior VP 48 5 X 272688 0 32638 Stephen Kenney Chief Financial Officer/Senior VP 40 20.00 X 264453 0 23004 Sandra McCarthy PhD Chief Nursing Officer 32 8 X 245449 0 31961 Craig Wilhelm Chief Information Officer 35 10 X 186327 0 6398 Elizabeth Weir Site Administrator & VP of Nursing IDMH 10 50 X 163046 0 29114 Donald Quick CPA Board Member / Chairman 2 0 X 0 0 0 Mark J Hagen Board Member/Vice-Chairman 2 0 X 0 0 0 Jan van den Blink Board Member/Vice-Chairman 2.00 0 X 0 0 0 John R Alexander Esq Secretary 1 0 X 0 0 0 Dr Jeffrey W Evenson PhD Board Member 1 0 X 0 0 0 Michael Hosey Board Member 1 0 X 0 0 0 John MacMahon Board Member 1 0 X 0 0 0 Robert McNamara Board Member 1 0 X 0 0 0 Richard Simons Board Member 1 0 X 0 0 0 Jeffrey Streeter Board Member 1 0 X 0 0 0 Louis DiFabio Board Member 1 0 X 0 0 0 Anders Tomson Board Member 1 0 X 0 0 0 Dr Joyce Carr Board Member 1 0 X 0 0 0 Kevin DeLuca MD Board Member/President Medical Staff 1 0 X 0 0 0 Patricia Baroody Board Member 1 0 X 0 0 0 7546769 0 803074 16 1 1 0 Strong Memorial Hospital 601 Elmwood Avenue Box 608 Rochester NY 14642 Physician & Medical Staffing 6905991 Streeter Associates PO 118 Elmira NY 14902 Construction Services 6903644 Medical Solutions PO Box 310737 Des Moines IA 50331 Contracted Clinical Staffing 2372932 FocusOne Solutions LLC PO Box 3037 Omaha NE 68103 Contracted Medical Staffing 2229448 University of Rochester 601 Elmwood Avenue Box 608 Rochester NY 14642 Physician & Medical Staffing 2019405 163 0 0 0 0 14347607 591763 0 14939370 Net Patient Service Revenue Hospital 622110 279958588 279958588 0 0 Net Patient Service Revenue Physicians 621110 24695694 24695694 0 0 School of Nursing 611600 162051 162051 0 0 School of Radiology 611600 66536 66536 0 0 Rx 340B Revenue 622110 33903994 33903994 0 0 0 0 0 0 338786863 2002249 0 0 2002249 0 0 0 0 0 0 0 0 502857 0 271283 0 231574 0 231574 0 0 231574 2473232 -2992 698305 0 1774927 -2992 1771935 0 0 1771935 126995 0 19822 107173 0 107173 0 0 0 0 0 0 787147 1472876 -685729 0 0 -685729 Pension Related Income 900099 2004037 2004037 0 0 Rebates/Discounts 900099 612964 612964 0 0 Delivery System Reform Incentive 921190 1628206 1628206 0 0 1331034 1331034 0 0 5576241 362729676 344363104 0 3427202 0 0 0 0 0 0 0 0 2653234 0 2653234 0 0 0 0 0 165796313 139226570 26569743 0 4716651 26876 4689775 0 38763743 205320 38558423 0 10616315 8436759 2179556 0 8584846 7555099 1029747 0 391683 18212 373471 0 130500 0 130500 0 19925 0 19925 0 0 0 60377 0 60377 0 18261741 17303967 957774 0 809013 1527 807486 0 4523165 2838119 1685046 0 7944838 4851299 3093539 0 0 0 0 0 3712180 659859 3052321 0 183461 167609 15852 0 0 0 0 0 267538 246184 21354 0 1233121 0 1233121 0 0 0 0 0 14114770 6654923 7459847 0 2596534 1899835 696699 0 Medical/Surgical/Pharmaceutical Supplies 58049516 57954510 95006 0 Maintenance Contracts/Purchased Svcs 13472222 9752745 3719477 0 Benefit Allocation 0 35705129 -35705129 0 Allocation of Expense to Affiliates -3606668 -1254596 -2352072 0 4402095 2200285 2201810 0 357697113 294450231 63246882 0 33249 32601 11492326 34878465 281607 2410569 37727691 34720218 0 0 0 0 3503966 7077562 2306880 3067989 2678890 3780412 382860382 269437226 113375954 113423156 60541881 33071635 0 0 0 0 0 0 43581743 72392593 275524187 304855200 32262342 41404008 0 0 68775 142955 24116200 23528000 0 0 0 0 7113643 7577950 0 0 71268770 84424750 134829730 157077663 X 129274620 136182432 11419837 11595105 140694457 147777537 275524187 304855200 X 5032563 581569 0 60377 -1340843 2749414 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 19875 19875 0 Schedule C, Part II-B, Line 1 Arnot Ogden Medical Center pays annual dues to Pandion, of which a percentage is for lobbying fees. 3017390 18000 0 0 0 0 3035390 2984490 32900 0 0 0 0 3017390 2980990 3500 0 0 0 0 2984490 2976955 4035 0 0 0 0 2980990 2969755 7200 0 0 0 0 2976955 0 1 0 0 1 1 0 7815458 7815458 1637305 163485271 97871348 67251228 0 2040521 936652 1103869 0 204146280 167206120 36940160 0 3735547 3423106 312441 113423156 INTEREST IN NET ASSETS OF FOUNDATIONS 28173229 DUE FROM RELATED PARTIES 2731972 457 PLAN INVESTMENT FUNDS 9087578 BOND PAYMENT FUND 1245545 SELF INSURANCE RESERVE FUND 1798255 A/R WORKERS COMP EXCESS INSURANCE 1308938 FOSTERHOUSE EMPLOYEE DEFERRED INVESTMENT 675125 FUNDED DEPRECIATION 6848040 FUNDED SELF INSURANCE 10187836 OTHER ASSETS 10336075 72392593 0 CMS ADVANCE 15000000 MINIMUM PENSION LIABILITY 19988807 NOTE PAYABLE-AOMC FOUNDATION INVESTMENT 23856963 457 PLAN LONG-TERM LIABILITY 9094567 SELF INSURANCE RESERVES 5345692 THIRD PARTY LIABILITIES 9523663 DUE TO RELATED PARTIES 395786 OTHER LIABILITIES 1219272 84424750 X 363901894 0 0 0 1763981 1763981 362137913 0 591763 591763 362729676 359400717 0 0 0 1763981 1763981 357636736 60377 0 60377 357697113 Schedule D, Part V, Line 4 The organization has interpreted the NYS Prudent Management of Institutional Funds Act Law, NYPMIFA as requiring the preservation of the historical dollar value of the corpus of the permanent restricted endowment funds absent of donor stipulations to the contrary. The net appreciation of the permanent restricted endowment funds absent of the donor stipulations to the contrary. The net appreciation of the permanently restricted net assets is considered temporarily restricted net assets until those amounts are appropriated for expenditure by the Organization in a manner consistent with the standard of prudence prescribed by NYPMIFA. If the fair value of the investments assets falls below the level of the donor, NYSMIFA requires the Center to retain the fund in perpetual duration. There were no such deficiencies as of December 31, 2020. To ensure the preservation of the corpus of the permanently restricted endowment funds, the total fair value of all commingled investment assets are classified first to the level of the permanently restricted endowment funds corpus, an endowment fund deficiency receivable from the unrestricted net assets would be recognized until the deficiency is recovered. Schedule D, Part X, Line 2 Arnot Ogden Medical Center is organized as not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and accordingly, are exempt from Federal Income taxes on related income pursuant to Section 501(a) of the Code. The organization accounts for uncertain tax positions in accordance with U.S. GAAP, which requires the recognition and measurement of uncertain tax positions that the Organization has taken or expects to take in the Organization's tax returns. Management believes there are no significant uncertain tax positions not reflected in the accompanying consolidated financial statements as of December 31, 2020 and 2019. Schedule D, Part XI, Line 2d Expenses deducted from Revenue: Rental Expenses $271,283; Children's Miracle Network Fundraising Expense $19,822; Nutritional Services Cost of Goods Sold $1,472,876 Schedule D, Part XI, Line 4b Arnot Ogden Medical Center and Arnot Ogden Children's Miracle Network donations to purchase capital equipment in the amount of $591,763 has been re-classed from Net Assets for 990 Reporting. Schedule D, Part XII, Line 2d Expenses deducted from Revenue: Rental Expenses $271,283; Children's Miracle Network Fundraising Expense $19,822; Nutritional Services Cost of Goods Sold $1,472,876 Golf Tournament 58810 0 58810 0 1513 8840 6295 0 283 Radiothon 68185 0 68185 0 0 0 191 175 2325 0 126995 0 126995 0 1513 8840 6486 175 2608 19622 107373 1 1 X 1 X 1 X 1 1 1 0 1 1 0 1635 1321922 15165 1306757 0.0037 0 10561 5904463 1864793 4039670 0.0113 0 0 0 0 0 0 0 12196 7226385 1879958 5346427 0.0150 1 116717 106976 3850 103126 0.0003 4 438 931296 355273 576023 0.0016 0 0 0 0 0 0 0 0 0 0 0 0 7 85000 77103 0 77103 0.0002 12 202155 1115375 359123 756252 0.0021 12 214351 8341760 2239081 6102679 0.0171 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 85000 956 0 956 0 1 85000 310 0 310 0 1 1427 2315 0 2315 0 0 85000 578299 0 578299 0.0016 0 0 0 0 0 0 4 256427 581880 0 581880 0.0016 0 8298134 2437721 64207783 80412937 -16205154 X 1 1 Ivy Street Development Corp Third-Party Collections Service 1 0 0 2 1 Arnot Ogden Medical Center 600 Roe Avenue Elmira NY 14905 www.arnothealth.org 0701000H X X X X Hospital with Open Emergency Room. A 2 St Josephs Hospital 555 St Josephs Blvd Elmira NY 14901 www.arnothealth.org X X Hospital with orthopedic care, physical rehabilitation, geriatric medicine, behavioral science A A 0 0 1 X X X X X X X X 19 1 1 1 1 X www.arnothealth.org/community-outreach X 1 19 1 www.arnothealth.org/community-outreach 0 0 1 X 200 400 X X X 1 1 X X X 1 X https://www.arnothealth.org/financial-assistance X https://www.arnothealth.org/financial-assistance X https://www.arnothealth.org/financial-assistance X X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Group A In 2019, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. Schedule H, Part V, Section B, Line 6a-Group A Arnot Ogden Medical Center prepares the Community Benefit Report for three hospitals- Arnot Ogden Medical Center, St. Joseph's Hospital, both in Elmira, NY and also for Ira Davenport Memorial Hospital in Bath, NY. Schedule H, Part V, Section B, Line 6b-Group A Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. Schedule H, Part V, Section B, Line 7d-Group A Arnot Health will use a variety of methods to disseminate the Community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPS for Chemung and Steuben Counties: Website documents will be posted on the healthcare system's website at the following URL: http://www.arnothealth.org/aboutus. Arnot Health developed a section of the system's website dedicated to community outreach in 2019, budget permitting to bring community service work to a more prominent place within the website. This can be assessed at: https://www.arnothealth.org/community-service-plans. Partner websites of Chemung and Steuben counties will post links to their CHA and CHIP on their websites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies. Schedule H, Part V, Section B, Line 11-Group A Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. The Chemung County Health Priority Partnership (HP2) has expanded to include insurance navigators. The Steuben County Health Priority Team (SHPT) worked to brand their coalition and has the new name, Smart Steuben. Both coalitions include organizations that are committed to improving the health of Chemung and Steuben County residents. The groups have met on a bi-monthly basis in Chemung County and monthly basis in Steuben County to conduct a Community Health Needs Assessment (CHNA) and develop a Community Health Improvement Plan (CHIP)/Community Service Plan (CSP). The members of HP2 and Smart Steuben have agreed to continue expanding their partnerships, and meet on a regular basis to ensure that the initiatives outlined in the Community Health Improvement and Community Service Plans are implemented, monitored, and evaluated. 2 Arnot Ogden Medical Center Health Center for Women 600 Fitch Street Elmira NY 14905 Hospital Extension Clinic- Diagnostic, Radiology, Obstetrics Arnot Ogden Medical Center Horseheads Medical Office Building 100 John Roemmelt Drive Horseheads NY 14845 Clinical Laboratory Service & Radiology Diagnostic Outpatient. Schedule H, Part I, Line 7 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The Medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. Schedule H, Part II Arnot Ogden Medical Center was significantly impacted by the COVID-19 pandemic and due to specific restrictions, the organization was unable to conduct as many community building activities compared to prior years. During the 2020 calendar year, Arnot Ogden Medical Center conducted the following programs that had community benefit and created expenses associated with our filing: Telehealth, Blood Pressure and Diabetes Screenings, Home Visits, Flu Shot Clinics, COVID-19 Vaccine Clinics, and provide COVID-19 testing sites. Schedule H, Part III, Section A, Line 4 The Organization determines the transaction price based on standard charges for services provided, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with its financial aid policies, and implicit price concessions. Estimates of contractual adjustments and discounts are determined based on contractual agreements, discount policies, and historical experience. For uninsured patients that do not qualify for charity care, the Organization recognizes revenue on the basis of its standard rates for services provided. Based on historical experience, a significant portion of the Organization's uninsured patients will likely be unable or unwilling to pay for services provided. Thus, the Organization records an implicit price concession to reduce accounts to their net realizable value at the time management believes it is probable a receivable will not be recovered. There are various factors that can impact collection trends, such as changes in the economy, unemployment rates, the number of uninsured and underinsured patients, the volume of patient through the emergency department, the increased burden of co-pays, co-insurance amounts and deductibles to be made by patients with insurance, and business practices related to collections efforts. These factors continuously change and can have an impact on collection trends and the estimation process. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Estimates of implicit price concessions are determined based on historical collection experience with these classes of patients using a portfolio approach as a practical expedient to account for patient contact as collective groups rather than as individual contracts. The financial statement effect of using this practical expedient is not materially different form an individual contract approach. In Line 2 & 3, the Organization's methodology to estimate bad debt expense is based on historical data of bad debt write-offs by Primary Financial Class. A percent of AR is calculated, and that percent is applied to Open Accounts Receivable and posted against the AR on the balance sheet. Schedule H, Part III, Section B, Line 8 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The Medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. Schedule H, Part III, Section C, Line 9b Self-pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self-pay accounts. These accounts are reviewed using the self-pay work list. If insurance is located, self-pay collectors must verify eligibility for the date of service. The self-pay staff will change the health plan to the correct one for all covered dates of service and Arnot Health Billing will submit claim or claims. If no insurance is located, it is confirmed if a patient may have qualified for Medicaid. If Medicaid coverage is approved, self-pay staff will change the health plan to Medicaid for all covered dates of service and follow the correct billing process. Self-Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self-pay staff will attempt to make payment arrangements and notify patients about the Arnot Health Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. Self-pay collectors document all activity in Soarian, and enter any necessary hold to support resolution. Self-pay collections staff enters the payment plan and documents comments in Soarian. A payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections. Schedule H, Part VI, Line 2 In 2019, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. The year-long process of assessing community health needs was facilitated by consultants contracted by the Chemung County Health Department from the S2AY Rural Health Network and Common Ground Health. Arnot Health, in partnership with this dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership) to collect and analyze data from a variety of sources. Valuable input was gained from data retrieved and analyzed by the Finger Lakes Health System Agency from the New York State Prevention Agenda Dashboard, multi-payer claims data, EBRFSS, SPARCS and additional sources. Also, input was gained from diverse community focus groups made of both Chemung and Steuben County residents. The focus group meetings were facilitated by S2AY, Chemung and Steuben County Health Departments, Arnot Health and other partnership members. The residents were engaged in discussions concerning their current health status and opinions on specific county-wide health challenges. Areas of disparity were assessed within each county. Findings from the Community Health Assessment (CHA) data and community focus groups identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties. Schedule H, Part VI, Line 3 The Arnot Health communicates our Community Care Program in the following ways: Signage in waiting rooms, brochures in waiting rooms and Admission Packets, notations on billing notices, staff education so they can share availability of program and contact information with patients. Communication and education of our Certified Application Counselor for patient insurance enrollment are done so they are informed of the program details and contact information. Communication is also done with collection agencies and collection attorneys so they can also share the availability of the program and contact information with prospective enrollees. The information is also posted on our website at: www.arnothealth.org. Schedule H, Part VI, Line 4 Arnot Health works diligently to partner with the organizations throughout the service area in an effort to enhance healthcare services for the most vulnerable residents. Due to the rural nature of Chemung and Steuben Counties, the high percentage of low-income residents and the limited resources available in the community, Arnot Health understands the need to create meaningful partnerships to best serve the community at large. Arnot Health has formed collaborative relationships with organizations throughout Chemung and Steuben Counties to address health concerns across the continuum. Chemung and Steuben Counties maintain coalitions to collaboratively meet the healthcare needs of the community. The Chemung County Health Priority Partnership (HP2) has expanded to include insurance navigators. The Steuben County Health Priority Team (SHPT) worked to brand their coalition and has the new name, Smart Steuben. Both coalitions include organizations that are committed to improving the health of Chemung and Steuben County residents. The groups have met on a bi-monthly basis in Chemung County and monthly basis in Steuben County to conduct a Community Health Needs Assessment (CHNA) and develop a Community Health Improvement Plan (CHIP)/Community Service Plan (CSP). The members of HP2 and Smart Steuben have agreed to continue expanding their partnerships, and meet on a regular basis to ensure that the initiatives outlined in the Community Health Improvement and Community Service Plans are implemented, monitored, and evaluated. Schedule H, Part VI, Line 5 Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. Schedule H, Part VI, Line 6 Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 Vidyasagar Mokureddy MD Pain Mgmt Physician 925417 0 46092 0 0 0 14250 0 26286 0 1012045 0 0 0 Nche Zama MD Cardiothoracic Surgeon 790154 0 0 0 0 0 0 0 7861 0 798015 0 0 0 Matthew Brand MD Orthopediac Surgeon 706262 0 73270 0 0 0 14250 0 26286 0 820068 0 0 0 Thomas Boman MD Orthopedics 670051 0 75947 0 0 0 14250 0 26286 0 786534 0 0 0 Bryan Jarvis MD Orthopedics 620538 0 84975 0 0 0 9776 0 23122 0 738411 0 0 0 Jonathan Lawrence President & Chief Executive Officer 504239 0 50000 0 0 0 9776 0 23122 0 587137 0 0 0 Aleksander Rupik President AMS 378177 0 16525 0 0 0 14250 0 26494 0 435446 0 0 0 Pallavi Kamjula MD Vice President, Medical Staff 324541 0 16900 0 0 0 9776 0 0 0 351217 0 0 0 Kenneth Herzl-Betz MD Chief Medical Officer/Senior VP 277433 0 0 0 0 0 9516 0 23122 0 310071 0 0 0 Stephen Kenney Chief Financial Officer/Senior VP 257120 0 15000 0 0 0 3231 0 19773 0 295124 0 0 0 Sandra McCarthy PhD Chief Nursing Officer 241613 0 10000 0 0 0 8630 0 23331 0 283574 0 0 0 Craig Wilhelm Chief Information Officer 186543 0 0 0 0 0 6398 0 0 0 192941 0 0 0 Elizabeth Weir Site Administrator & VP of Nursing IDMH 168610 0 0 0 0 0 5783 0 23331 0 197724 0 0 0 Ronald J Kintz DHA CFO/Senior VP 68544 0 557028 0 0 0 0 0 4044 0 629616 0 0 0 Robert Lambert MD President & Chief Executive Officer 0 0 631075 0 0 0 0 0 0 0 631075 0 0 0 Roberto deBara MD President AMS 0 0 337500 0 0 0 0 0 13340 0 350840 0 0 0 Schedule J, Part I, Line 1a The CEO has his dues paid at the Elmira City Club. The personal use portions is reported under Taxable Income. Schedule J, Part I, Line 3 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Managers. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Schedule J, Part I, Line 4 Robert deBara, former MD President of Arnot Medical Services and Robert Lambert, former President and CEO of Arnot Health, received severance pay in 2020 for $334,215 and $631,075, respectively. A Chemung County Capital Resource Corp 611684035 000000000 2015-06-25 29410000 Payoff Series A & B Bonds/Energy Infrastructure Upgrade 0 0 0 A 5882000 0 29410000 0 0 0 847745 0 0 8066714 0 0 2015 1 0 1 1 A 0 0 0 0 0 0 0 1 0 1 A 0 0 0 0 1 0 0 0 1 Kevin DeLuca Physician with Associated Anesthesiologists 2345597 Provides anesthesia services to Arnot Ogden patients 0 Jeffrey Streeter Owner of Streeter Associates 6527968 Streeter Associates performs construction services for the organization. 0 Louis DeFabio Executive Officer of Chemung Canal Trust Company 302696 Competitively bids loans 0 Form 990, Part III, Line 3 Services were significantly impacted by COVID-19. Form 990, Part VI, Section A, Line 2 Kevin DeLuca, M.D. is employed by Associated Anesthesiologists of the Finger Lakes and they perform anesthesiology services to the hospital. Jeffrey Streeter is President of Streeter Associates and performs construction services to the organization. Louis DiFabio is Vice President and Anders Tomson is CEO & President of Chemung Canal Trust Company. Chemung Canal Trust Company competitively bids loans and holds several bank accounts for our organizations. Form 990, Part VI, Section B, Line 11b Upon completion of the Form 990, a draft is sent to our auditing firm for review. It is reviewed by the Medical Center's Senior Vice President of Finance and then made available to the Board of Managers. The return is made available to all Board Members for review and questions. Form 990, Part VI, Section B, Line 12c All members of the Board of Managers, Officers and Management employees are required to annually file a Disclosure Statement setting forth any respect in which such a person, or any person associated with such person, has or may have any interest in a transaction in which there may be, or appear to be, a conflict between the interests of such person and the Arnot Ogden Medical Center. An Associate included (1) a spouse, a descendant or an ancestor, or a spouse of a descendant or ancestor; (2) an organization in which the person or an associate is a partner or employee, or such person or an associate owns a more that 10% beneficial interest; (3) a trust in which such a person is a trustee, or such person or an associate holds a more than 10% beneficial interest; and (4) a corporation in which such person or an associate is an officer or director or employee, or such person or an associate is an owner of more that 10% of any class of securities. Form 990, Part VI, Section B, Line 15 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Managers. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Form 990, Part VI, Section C, Line 19 Items required for public disclosure are made available for those who request the information. Form 990, Part XI, Line 9 Pension Charge to Equity $1,794,962; Net Assets Released from Restriction $317,199; Realized Gain/Loss on Temp Restricted investments ($27,212); Capital Funding $664,465 Arnot Health Foundation Accounting Dept 600 Roe Avenue Elmira NY 14905 161109472 Fundraising NY 501(c)(3) 12b N/A 0 Arnot Ogden Medical Center Auxiliary 600 Roe Avenue Elmira NY 14905 510192902 Fundraising NY 501(c)(3) 12b N/A 0 Ira Davenport Memorial Hospital Accounting Dept 7571 State Route 54 Bath NY 14810 160835446 Hospital NY 501(c)(3) 3 N/A 0 Keuka Health Care Foundation Accounting Dept 7571 State Route 54 Bath NY 14810 161461215 Fundraising NY 501(c)(3) 12a N/A 0 Arnot Health 600 Roe Avenue Elmira NY 14845 453049405 Parent Organization NY 501(c)(3) 12b N/A 0 Ivy Street Development Corporation 600 Ivy Street Elmira NY 14905 161009245 Real Estate NY N/A C 1 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 0 0 Arnot Health Foundation o 96180 Arnot Ogden Medical Center provided paid employees to the Arnot Health Foundation to perform accounting, administrative and materials management functions. The method of determining the amount involved was cost. Ivy Street Development Corporation o 33372 Arnot Ogden Medical Center provided paid employees to Ivy Street Development Corporation to perform property management services. The method of determining the amount involved is cost. Ivy Street Development Corporation p 63826 Arnot Ogden Medical Center was reimbursed by Ivy Street Development Corporation for maintenance and insurance expense. The method of determining the amount involved is cost. Ivy Street Development Corporation k 287100 Arnot Ogden Medical Center leased facilities from Ivy Street Development Corporation. The method of determining the amount involved is cost. Ira Davenport Memorial Hospital o 3468728 Arnot Ogden Medical Center provided paid employees to Ira Davenport Memorial Hospital to perform accounting, administrative, management information services, and various medical services. The method of determining the amount involved was cost. Form 8868 Application for Extension of Time to File was filed and approved with a new due date of November 15, 2021.