2019-11-08T12:47:28-07:00 2018-12-31 990 2018-01-01 160743024 FREDERICK FERRIS THOMPSON HOSPITAL FRED 5853966000 350 Parrish Street Canandaigua NY 14424 Mark Prunoske Sr VP Finance CFO 5853966280 2019-11-08 128.151.71.11 2018 2020-03-31 21:24:44Z Michael F Stapleton Jr 350 Parrish Street Canandaigua NY 14424 141941703 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 18 1629 152 231173 0 1317864 884558 129316031 136104381 -871531 -274196 2514129 3825902 132276493 140540645 0 0 0 0 72224994 84480811 0 0 493188 51918516 55751827 124143510 140232638 8132983 308007 125696214 159137451 72751600 104617548 52944614 54519903 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 112542832 0 139699110 Inpatient care: 5,609 Inpatient discharges, 22,100 Inpatient Days. Outpatient: 1,653,391 Lab visits/tests, 28,256 ED visits, 74,969 Diagnostic Imaging visits, 29,926 Urgent Care visits, 107,771 Primary Care visits, 35,775 Rehabilitation visits, and 6,566 Surgical Services visits. Charity Care was provided in the amount of $997,537 (at cost). Community Benefit was $2,707,694. Uncompensated Care was $4,508,761. 0 0 0 112542832 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 0 0 0 0 0 0 1 0 0 0 1 X 196 0 1 1629 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 24 18 0 0 1 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 0.5 71 X 0 1196035 504848 Michael Apostolakos MD Board Member 0.5 64 X 0 649551 52865 Mark Taubman MD Board Member 0.5 75 X 0 2070504 248883 James H Barr CPA Board Chair 0.5 1.5 X X 0 0 0 Daniel Fuller Board Vice Chair 0.5 1.5 X X 0 0 0 Brian Meath Esq Board Secretary 0.5 1.5 X X 0 0 0 Deborah Price Board Treasurer 0.5 1.5 X X 0 0 0 Mark Blazey Board Member 0.5 1.5 X 0 0 0 David G Case Board Member 0.5 2 X 0 0 0 Lauren Dixon Board Member 0.5 2 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 Dale Hunt Board Member 0.5 2 X 0 0 0 William R Kenyon Esq Board Member 0.5 1.5 X 0 0 0 A David Peter MD Board Member 25 1.5 X 289839 0 13497 Robert Sands Esq Board Member 0.5 1.5 X 0 0 0 Margaret Somerset Esq Board Member 0.5 1.5 X 0 0 0 Cynthia Teerlinck MD Board Member 0.5 1.5 X 0 0 0 Lori Van Dusen Board Member 0.5 1.5 X 0 0 0 Michael F Stapleton JR President/CEO 31 9 X X 0 648914 90981 Ben C Wandke MD President of Medical Staff 0.5 55 X 0 541888 51487 Lauren Sands Esq Board Member 0.5 2.00 X 0 0 0 David Baum MD SVP Medical Affairs & Emergency Physician 20 20 X 241840 210644 53463 Kurt Koczent EVP/COO 36 4 X 251455 77369 53985 Mark Prunoske Senior VP & CFO 27 13 X 0 329106 54864 Jennifer DeVault VP Associate Services and Wellness 36 4 X 181858 0 23941 Hazel Robertshaw VP Patient Care Services/CNO 40 0 X 191924 0 11378 Elizabeth Talia VP Legal & Regulatory Affairs and General Counsel 25 15 X 0 204860 27794 Joseph Talarico MD Physician 40 0 X 498816 0 20644 Matthew Osborne MD Medical Director Chief of Emergency Medicine 46 0 X 466128 0 29776 Sarah Dobrzynski MD Physician 40 0 X 457429 0 21991 Timothy Pitler MD Physician 42 0 X 411537 0 30999 Peter Fenton MD Physician 42 0 X 392294 0 22841 Vijay Bansal MD VP of the Medical Staff 22 0 X 205019 0 11730 Ann Robenstien Emergency Physician 41 0 X 408135 0 15144 3996274 5928871 1341111 109 1 1 0 Cumberland Consulting Group 720 Cool Springs Blvd Suite 550 Franklin TN 37067 IT Consultants 3835911 Dr Henry Maglente 177 Fresh Water Lane Mooresville NC 28117 Nocturnist Services 1018575 Medical Staffing Network PO Box 840292 Dallas TX 752840292 Employment Agency 481610 Sunbelt Staffing Dept CH 14430 Palatine IL 600554430 Employment Agency 446267 Canandaigua Orthopaedic Assoc PC 229 Parrish Street Suite 100 Canandaigua NY 14424 Orthopaedic Services 436540 36 0 0 0 868785 0 15773 0 884558 Community Health Svc 622110 115457551 115457551 0 0 Medicare/Medicaid Pymts 622110 20415657 20415657 0 0 Lab Revenue 621500 231173 0 231173 0 0 0 0 0 136104381 134445 0 0 134445 0 0 0 0 0 0 0 0 0 0 554508 437909 426160 974898 128348 -536989 -408641 0 0 -408641 0 Associate/Patient Support 622000 3825902 3825902 0 0 0 0 0 0 3825902 140540645 139699110 231173 -274196 X 0 0 0 0 0 0 0 0 1156916 531679 625237 0 0 0 0 68829538 59466075 9363463 0 2522018 2162067 359951 0 7261673 6225263 1036410 0 4710666 4038344 672322 0 370282 22004 348278 0 156048 0 156048 0 235968 0 235968 0 0 0 0 0 0 0 0 0 0 0 9643816 6438108 3205708 105841 0 22573 83268 1792840 1554138 238702 0 3922695 1904756 2017939 2518303 2369111 149192 86993 59859 27134 0 203681 187572 16109 1324293 96454 1227839 8449153 5286970 3162183 738816 209434 529382 Medical Supplies 20292175 20245614 46561 0 Health System Assessment 3330310 116561 3213749 0 Facility Services 1004455 625692 378763 0 New York State Assessment 480156 480156 0 0 1096002 522975 163107 409920 140232638 112542832 27196618 493188 19202019 22444033 12851442 11007928 0 9275636 10537210 0 0 0 1770388 2028172 4556212 4465374 189244822 99112367 61429069 90132455 1196077 679053 0 0 0 15415371 17843226 125696214 159137451 15003222 23337701 0 0 0 0 33400000 33400000 0 0 776500 262871 23571878 47616976 72751600 104617548 X 50089055 49121446 2855559 5398457 0 0 52944614 54519903 125696214 159137451 X 308007 -189565 0 0 0 1456847 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9096199 0 104438 0 324948 0 8875689 8302363 0 1208679 0 414843 0 9096199 7960641 22273 417315 0 97866 0 8302363 8410147 39879 -52633 20000 416752 0 7960641 8160115 60504 440305 0 250777 0 8410147 0.94 0.06 0 0 1 1 0 58076 58076 0 103529648 41491309 62038339 0 2599966 898681 1701285 0 69232083 54278025 14954058 0 13825049 2444352 11380697 90132455 Other Assets 9067354 Due from Affiliates 2194222 Assets Limited as to Use 377635 Beneficial Interest in Charitable Remainder Trust 351909 Beneficial Interest in net assets of FFTH Foundation 5046548 Deferred Financing Costs, net 805558 17843226 0 Accrued Pension Liability 14422297 Charitable Gift Annuity Payment Liability 76209 Estimated third party payor settlements, net 1359217 Acc Ins Reserve 174891 MCIC Tail Liability 911629 Workers Comp 3272970 CARO 195386 Taxable bonds 1910000 Due to URMC 2855113 CMG Capital Lease 22439264 47616976 X 141807927 -189565 0 0 1456847 1267282 140540645 0 0 0 140540645 140232638 0 0 0 0 0 140232638 0 0 0 140232638 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, 2018 and 2017, the Hospital does not have a liability for unrecognized tax positions. The Hospital files informational tax returns in the U.S. federal jurisdiction and New York State. Schedule D, Part XI, Line 2d Change in fair value of interest rate swap $61,725, Change in value of charitable gift annuities ($5,225), Change in funded status of pension plan ($1,150,474), Change in beneficial interest in the net assets of F.F. Thompson Foundation Inc $2,551,089, Change in beneficial interest in charitable remainder trust ($268). 1 1 1 X 1 X 1 1 1 0 1 1 1272171 274634 997537 0.0071 18136241 13945602 4190639 0.0299 0 0 19408412 14220236 5188176 0.0370 417199 21002 396196 0.0028 6034387 5053762 980625 0.007 26925 26925 0.0002 0 0 6478511 5074764 1403746 0.0100 0 0 25886923 19295000 6591922 0.0470 102512 102512 0.0007 2898 2898 0 1047107 1047107 0.0075 0 0 1152517 0 1152517 0.0082 1 4508761 90175 18547784 22950894 -4403110 X 1 1 1 1 The Fredrick Ferris Thompson Hospital 350 Parrish Street Canandaigua NY 14424 www.thompsonhealth.org 3429000H X X X The Fredrick Ferris Thompson Hospital 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X See Part V, Section C X See Part V, Section C X X 1 16 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 Fredrick Ferris Thompson Hospital 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 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 FLSHA (Now Common ground), Focusing on data related to priorities in the 2013 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 2013-2014 expanded behavioral risk factor surveillance survey (EBRFSS), 2010 census bureau and 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 2015 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 (2016 Report), leading causes of death indicators (2012-2014) and county rankings (2016). Other data was also obtained from partnership for Ontario County's young adult survey (2015), a public health system assessment survey 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. This was the year the state was arranging for public health to line up with the reporting timeline of hospitals. The timeline to update and do a CHNA and update the CHIP/CSP was a very short timeline. Schedule H, Part V, Section B, Line 6a-The Fredrick Ferris Thompson Hospital 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 Fredrick Ferris Thompson Hospital The Frederick Ferris Thompson Hospital - Organizations that participated in the community health assessment process included: Ontario County Public Health Department, Clifton Springs Hospital and Clinic, FF Thompson Hospital, Geneva General Hospital, S2AY Rural Health Network, Geneva Housing Authority, Churches in Action, Ontario County Youth Bureau, Ontario County Office of the Aging, Ontario County DSS, Ontario County Sheriff's Office, Ontario County Mental Health Department, Ontario County United Way, Ontario County Workforce Development, Ontario County Correctional Facility, Finger Lakes Visiting Nurse Services, Courts of Ontario County, Canandaigua Red Cross, The Salvation Army Rushville Health Center (RPCN), Geneva Head Start, Canandaigua Veterans Affairs Medical Center, Finger Lakes Cerebral Palsy/Happiness House, NAACP-Geneva, Geneva Community Health, Ontario County ARC, Catholic Charities, The Monroe Plan for Medical Care, Lifetime Care, Finger Lakes Addictions Counseling and Referral Agency (FLACRA), Cornell Cooperative Extension, Partnership for Ontario County Council on Alcoholism & Addictions in the Finger Lakes, Council of Churches, Our Lady of Peach Parish, Success for Geneva's Children, Finger Lakes Community College, Finger Lakes WIC Program, Town of Hopewell, Tobacco Coalition of the Finger lakes, Youth For Youth, Ontario Finger Lakes BOCES, Hobart William Smith Colleges, Hubbs Health Center, Finger lakes Health Systems Agency; which is now Common Ground and Child and Family Resources, Inc. Schedule H, Part V, Section B, Line 7a-The Fredrick Ferris Thompson Hospital https://www.thompsonhealth.com/Portals/0/_News%20Room/Publications/Annual%20Reports/TH-AnnualReport-2019.pdf?ver=2019-05-03-174105-517 Schedule H, Part V, Section B, Line 7b-The Fredrick Ferris Thompson Hospital Schedule H, Part V, Section B, Line 7b-The Frederick Ferris Thompson Hospital-http://www.S2AYNETWORK.org/UPLOADS/2/9/6/7/29678331/ONTARIO_CHA_2016-2018.pdf Schedule H, Part V, Section B, Line 7d-The Fredrick 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 Fredrick Ferris Thompson Hospital https://www.thompsonhealth.com/Portals/0/_News%20Room/Publications/Annual%20Reports/TH-AnnualReport-2019.pdf?ver=2019-05-03-174105-517 Schedule H, Part V, Section B, Line 11-The Fredrick Ferris Thompson Hospital 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 Fredrick 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 Fredrick 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 Fredrick 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 is 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 Bad debt in the amount of $4,508,761 is removed for the purpose of calculating the percentage on schedule H, Part I , line 7, column F. 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 2 The cost methodology for determining bad debt expense is based on actual charges written off as bad debts during the year net of bad debt recoveries. Schedule H, Part III, Section A, Line 4 The text of the Bad Debt Footnote for FF Thompson Hospital can be found on page 9 of the electronically attached Audited Financial Statements. 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 Financial Statements. 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. As a result, the hospital views any shortfall reported in line 7 as an additional item of community benefit provided by the organization. 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 Partners for Community Solutions" 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 are 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: 18% 0-14, 8% 15-17, 10% 18-24, 12% 25-34, 29% 35-54, 13% 55-64. The current household incomes fall into the following groups: 27% $25-50K, 22% $50-75K, 19% over $100K. 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 1116420 0 0 0 79615 0 485802 0 19046 0 1700883 0 0 Ben C Wandke MD President of Medical Staff 0 506388 0 17000 0 18500 0 25943 0 25544 0 593375 0 0 Mark Taubman MD Board Member 0 1126391 0 300000 0 644113 0 226402 0 22481 0 2319387 0 612699 Michael Apostolakos MD Board Member 0 631051 0 0 0 18500 0 26402 0 26463 0 702416 0 0 Michael F Stapleton JR President/CEO 0 418171 0 144000 0 86743 0 73750 0 17231 0 739895 0 56232 Mark Prunoske Senior VP & CFO 0 244987 0 50492 0 33626 0 37866 0 16998 0 383969 0 23886 Kurt Koczent EVP/COO 182255 56077 44857 13802 24343 7490 28106 8648 13177 4054 292738 90071 17251 5308 Elizabeth Talia VP Legal & Regulatory Affairs and General Counsel 0 175000 0 22226 0 7633 0 10560 0 17233 0 232652 0 0 Jennifer DeVault VP Associate Services and Wellness 156857 0 20574 0 4427 0 9550 0 14391 0 205799 0 0 0 Hazel Robertshaw VP Patient Care Services/CNO 167613 0 20577 0 3734 0 9565 0 1813 0 203302 0 0 0 David Baum MD SVP Medical Affairs & Emergency Physician 210015 182925 19616 17086 12208 10633 19687 17148 8887 7740 270413 235532 10334 9001 Ann Robenstien Emergency Physician 386318 0 21505 0 312 0 2750 0 12394 0 423279 0 0 0 Vijay Bansal MD VP of the Medical Staff 197108 0 7701 0 210 0 6268 0 5461 0 216748 0 0 0 A David Peter MD Board Member 282261 0 7500 0 79 0 2750 0 10747 0 303337 0 0 0 Joseph Talarico MD Physician 491163 0 7500 0 153 0 8250 0 12394 0 519460 0 0 0 Matthew Osborne MD Medical Director Chief of Emergency Medicine 416277 0 49627 0 224 0 13750 0 16026 0 495904 0 0 0 Sarah Dobrzynski MD Physician 375046 0 51405 0 30978 0 8250 0 13741 0 479420 0 0 0 Timothy Pitler MD Physician 379079 0 16990 0 15467 0 19250 0 11749 0 442535 0 0 0 Peter Fenton MD Physician 369573 0 22172 0 549 0 10452 0 12389 0 415135 0 0 0 Schedule J, Part I, Line 3 The CEO of the FF Thompson Hospital receives compensation from the Hospital. However because the Hospital is a common paymaster, the CEO's salary is allocated to an affiliate. In addition the affiliated entities collectively establish CEO compensation by the manner's described. 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 - $60,000, Mark Prunoske - $24,116, Kurt Koczent - $23,003, David Baum - $17,585, Steven Goldstein - $300,000 and Mark Taubman - $75,000. SERP plan payments were: Steven Goldstein - $159,400 and Mark Taubman - $125,000. These payments were made by a related organization. The following individuals participated in a supplemental nonqualified retirement plan and received employer paid amounts that are included in other reportable compensation. 457(f) plan payments were: Mark Taubman - $612,699. 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 0 0 33400000 0 0 0 313026 0 0 0 33086974 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 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 it's 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 Refer to Schedule O Form 990 Part VI, Section B, Line 12c note. Form 990, Part VI, Section A, Line 4 The Frederick Ferris Thompson Hospital filed a Restated Certificate of Incorporation dated May 2018. The purpose now states "The Corporation is formed for the charitable purposes of: (1) owning, maintaining and operating a hospital as defined in Article 28 of the Public Health Law of the State of New York, (2) providing other necessary and proper facilities for the provision of health care to the residents of the Finger Lakes region and surrounding region, and (3) continuously improving the health of the residents and communities of the Finger Lakes region and surrounding region." Form 990, Part VI, Section A, Line 6 The sole member of 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. 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 CFO reviewed the return as well as a review by an independent accounting firm. The return was also made available to the Board of Directors and Audit Committee via a shared intranet website. The return is reviewed with the Audit Committee in detail and with the Board in summary. Questions are entertained during both meetings and for several days after the meetings prior to the final filing. Form 990, Part VI, Section B, Line 12c Consistent with the written system-wide conflict of interest policy, Board members, officers, and key employees complete conflict of interest forms annually to identify actual and potential conflicts of interest that may exist relative to their duties with the organization. The Audit Committee and the General Counsel monitor the 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 the General Counsel, and 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 an actual or potential conflict of interest will not be allowed to participate in any discussion or decision of the Board in any area of conflict identified. 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 conflict of interest policy is consistently and effectively enforced. Form 990, Part VI, Section B, Line 15 Executive compensation at Thompson is established by the compensation committee of the Board of Directors. The committee uses an independent 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; this is considered in determining compensation levels. The compensation committee is also involved in goal setting for the CEO, which ties back to his performance reviews and incentive compensation rates. The year in which this process was last undertaken for each person was 2018. 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 XI, Line 9 Change in value of interest rate swap $61,725, Change in value of charitable gift annuities ($5,225), Change in funded status of pension plan ($1,150,474), Change in beneficial interest in charitable remainder trust ($268), Change in beneficial interest in the net assets of the FF Thompson Foundation $2,551,089. The FF Thompson Foundation Inc 350 Parrish Street Canandaigua NY 14424 222959984 Fundraising NY 501(c)(3) 7 FF Thompson Health System 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 FF Thompson Senior Communities Inc 1 Ferris Hills Canandaigua NY 14424 161557494 Elder Care NY 501(c)(3) 10 FF Thompson Health System 0 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 Strong Home Care Group 2180 Empire Boulevard Webster NY 14580 222577664 Fundraising NY 501(c)(3) 7 University of Rochester 0 Visiting Nurse Srvc of Rochester & Monroe 2180 Empire Boulevard Webster NY 14580 160743215 Healthcare NY 501(c)(3) 10 Strong Home Care Group 0 Community Care of Rochester 2180 Empire Boulevard Webster NY 14580 161561691 Healthcare NY 501(c)(3) 10 Strong Home Care Group 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 260 East Main Street Suite 6000 Rochester NY 14604 161195028 Business Incu NY 501(c)(3) 7 University of Rochester 0 University of Rochester Employee Ben Trs 910 Genesee Street Suite 200 Rochester NY 14611 161600112 Empl Ben Trst NY 501(c)(9) N/A 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 Finger Lakes Home Care Inc 756 Pre-Emption Road Geneva NY 14456 161489133 Healthcare NY 501(c)(3) 10 Visiting Nurse Srvc of Rochester & Monroe 0 Finger Lakes Visiting Nurse Service Inc 756 Pre-Emption Road Geneva NY 14456 223067627 Healthcare NY 501(c)(3) 10 Visiting Nurse Srvc of Rochester & Monroe 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 411 Canisteo Street Hornell NY 14844 160743310 Hospital NY 501(c)3 3 University of Rochester 0 St James Mercy Foundation 411 Canisteo Street Hornell NY 14844 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 Strong Home Care Group 0 UR Medicine Home Care Foundation Inc 2180 Empire Boulevard Webster NY 14580 831912967 Support Org NY 501(c)3 12A, 1 Strong Home Care Group 0 Excell Innovate NY Fund LP 222 West Ridge Road Bldg 28 Suite 156-1 Rochester NY 14615 462405519 Investment Fund NY ETV Inc Excell Minority and Women owned Business Investment Fund LP 222 West Ridge Road Bldg 28 Suite 156-1 Rochester NY 14615 810723223 Investment Fund NY ETV Inc Excell Partners Innovative TC Fund LP 222 West Ridge Road Bldg 28 Suite 156-1 Rochester NY 14615 810711015 Investment Fund NY ETV Inc Finger Lakes Community Care Network 350 Parrish Street Canandaigua NY 14424 161423442 Inactive NY FF Thompson Health System C 0 FFTH Properties and Services Inc 350 Parrish Street Canandaigua NY 14424 161286518 Plans, develops, implements, owns and manages health related ventures NY FF Thompson Health System C 0 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 NY University of Rochester C 0 Excell Technology Ventures Inc 222 West Ridge Road Bldg 28 Ste 156-1 Rochester NY 14615 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 0 0 1 0 1 0 0 0 0 1 1 0 1 0 1 0 1 0 0