2019-11-01T16:27:37-05:00 2018-12-31 990 2018-01-01 160743187 Sisters of Charity Hospital SIST 7168282974 144 Genesee Street Buffalo NY 14203 David P Macholz Treasurer, CHS MS Board 7168282974 2019-11-01 204.68.186.4 2019-11-01 16:27:33 ED P 924F5484B370A9FF257601B07D0C5CFB195EBBD3 06E798C64FE9B4A74D95EF11437255C02E87A9E2 2018 2020-01-14 16:20:31Z Mark Sullivan 144 Genesee Street Administration 6th Floor Buffalo NY 14203 327505882 0 X www.chsbuffalo.org X 1849 NY The Mission of Sisters of Charity Hospital, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Sisters of Charity Hospital continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2018 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community 9 6 2569 1779 129303 -10510 1154995 2257675 325670625 321415287 8843242 -4049647 12259888 7882567 347928750 327505882 0 0 0 0 161309002 164094371 0 0 0 169177306 171582567 330486308 335676938 17442442 -8171056 342096232 337336484 249178040 246364779 92918192 90971705 X The Mission of Sisters of Charity Hospital, as part of the Catholic Health System (CHS) in Western New York, is to provide quality healthcare services in an acute care setting. Committed to a common mission, the providers of Sisters of Charity Hospital continue the healing ministry of Jesus, seeking to improve the health of individuals and communities. We provide high quality service that has reverence, compassion, justice, and excellence. The 2018 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community 0 0 164180885 180931661 Inpatient Services:64,572 Acute Care Patient Days18,137 Newborn Patient Days26,311 Skilled Nursing Patient Days5,116 I/P Surgeries 108408464 120185574 Outpatient Services:60,615 ED Visits net of Admits241,266 Referred Ambulatory Visits9,245 Operating Room6,490 G.I. Laboratory1,193 Interventional Radiology (IXR)821 Transfusion/Infusion 18638138 20298051 Primary Care Clinics:31,345 Clinic/Primary Care Center Visits423,324 Substance Abuse Visits 291227487 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 246 0 1 2569 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X David P Macholz VP Finance Corporate Controller CHS 7168282974 144 Genesee Street Buffalo NY 14203 Joseph McDonald President and CEO, CHS 0.00 55.00 X X 0 1217317 29530 Mark Sullivan President and CEO, CHS 0.00 55.00 X X 0 1126042 93913 David Macholz Treasurer 0.00 55.00 X X 0 286087 33427 Charles Urlaub Director 0.00 55.00 X 0 461578 45568 Gary Tucker Director 0.00 55.00 X 0 379138 49345 Martin Boryszak President and CEO, Sisters 55.00 0.00 X X 371258 0 27945 Joyce Markiewicz Director 0.00 55.00 X 0 425967 78638 Walt Ludwig Director 0.00 55.00 X 0 296019 49141 Brian Beitz Director 0.00 8.00 X 0 0 0 Lynn Catalano Director 0.00 4.00 X 0 0 0 John Davanzo Director 0.00 4.00 X 0 0 0 Georgiana Ford Esq Director 0.00 4.00 X 0 0 0 Dr Donald J Largo Jr Director 0.00 55.00 X 0 93606 0 Mary Turkiewiecz MD Director 0.00 4.00 X 0 0 0 Katherine Vanderhorst Director 0.00 4.00 X 0 0 0 Monsignor Robert E Zapfel Director 0.00 4.00 X 0 0 0 James A Dunlop Jr Executive VP, Finance / CFO 0.00 55.00 X 0 774324 18105 Dr Brian D'Arcy Senior VP, Medical Affairs 0.00 55.00 X 0 559472 43350 John Sperrazza Chief Operating Officer 55.00 0.00 X 225793 0 19246 Michael Moley Sr.VP, Human Resources 0.00 55.00 X 0 604916 42703 Dr Michael Galang Sr. VP, Chief Information Officer 0.00 55.00 X 0 533930 33302 Nancy Sheehan SVP Legal Service, General Counsel 0.00 55.00 X 0 393915 46854 Dr Nady Shehata VP, Medical Affairs 55.00 0.00 X 408081 0 53816 Dr Michael Edbauer Chief Clinical Officer 0.00 28.00 X 0 508629 18325 Maria Foti Sr. VP, Strategic Planning 0.00 55.00 X 0 391140 46311 Dr Bruce Rodgers Physician 55.00 0.00 X 360839 0 19367 Dr Ali Ghomi Physician 55.00 0.00 X 657716 0 32994 Dr Margaret McDonnell Physician 55.00 0.00 X 358125 0 44394 Dr Jaime Obst Physician 55.00 0.00 X 314772 0 28994 Dr Paul Updike Physician 55.00 0.00 X 291937 0 31260 Jim Millard Former Director 0.00 0.00 X 0 316719 -50019 2988521 8368799 836509 90 1 1 0 Buffalo Medical Group 325 Essjay Williamsville NY 14221 Physician Services 3925698 Sodexho Inc & Affiliates PO Box 81049 Woburn MA 018131049 Environmental Services 2934378 AMN Healthcare Inc 3735 Collection Center Drive Chicago IL 60693 Healthcare Services 2673824 Telco Construction Inc 500 Buffalo Road East Aurora NY 14052 Construction Services 2436714 Quest Diagnostics 3 Giralda Farms Madison NJ 07940 Laboratory Services 1565706 53 251600 2006075 2257675 Patient Services 900099 212135348 212006045 129303 Medicaid/Medicare 900099 109279939 109279939 321415287 -4049647 54847 -4104494 721513 0 721513 721513 721513 Shared Lab Services 900099 2581171 2581171 Medicaid health home care coordin 900099 2424867 2424867 Periodic Pension Costs 900099 -3155900 -3155900 5310916 1251468 4059448 7161054 327505882 324442437 129303 676467 127655965 119082319 8573646 6417293 5976936 440357 20975522 19543506 1432016 9045591 8439275 606316 118219 118219 21393 21393 14440940 11131513 3309427 15512 4890 10622 9901528 4842663 5058865 383608 76186 307422 3273019 2454764 818255 52381 46993 5388 80734 80241 493 2833880 2368593 465287 11302177 9402796 1899381 3404138 3022398 381740 Medical Supplies 54053283 54561327 -508044 Shared Services 52230899 38392734 13838165 Purchased Services & Ot 16379047 9322419 7056628 Non-Medical Supplies 3091809 2477934 613875 335676938 291227487 44449451 0 4736 4688 53902049 56909051 183004 119973 34783501 31310822 6779921 6112814 1705110 1431053 188678583 117488174 71048415 71190409 96545038 91654117 837820 856474 76306638 77747083 342096232 337336484 37021837 37308771 407414 349183 23948381 21631641 7833390 10593115 179967018 176482069 249178040 246364779 X 88900723 87726506 3894946 3122676 122523 122523 92918192 90971705 342096232 337336484 X -8171056 6224569 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 21393 21393 0 Part II-B, Line 1: Lobbying expenses of $21,393 represent the total of dues paid to national and state associations that is specifically allocable to lobbying. Sisters of Charity Hospital does not participate in or intervene in (including the publishing or distributing of statement) any political campaign on behalf of (or opposition to) any candidate. 1958968 1958968 25708857 18531181 7177676 50839804 18333694 32506110 106951683 80623299 26328384 3219271 3219271 71190409 Ascension Investment Management 91654117 F 91654117 Other Receivables 2552957 Due from Affiliates 10938976 Workers Comp Insurance Recoveries 4309731 HPL Insurance Recoveries 31020107 Investment in Net Assets of the SOC Foundation 9851744 Assets Whose Use is Limited - DSRIP Funds 19073568 77747083 Due to Affiliates 23398946 Pension Obligation 79533231 Asset Retirement Obligation 2901034 L/T Disposables 140102 L/T General Liability IBNR 36702068 L/T Workers Comp IBNR 15121634 DSRIP - Funds 19073568 Debt Issuance Costs -388514 176482069 326541551 276556 276556 326264995 1240887 1240887 327505882 336440993 764055 764055 335676938 0 335676938 Part XI, Line 2d - Other Adjustments: SOC Foundation Revenue Part XI, Line 4b - Other Adjustments: Distributions from Foundations and Grant Revenue Part XII, Line 2d - Other Adjustments: Foundation Expense less the SOC Foundation Contributions to the Hospital 1 1 X 1 X 1 X 500.000000000000 1 1 1 0 1 1 4496783 148437 4348346 0.01300 94837205 64950372 29886833 0.08900 99333988 65098809 34235179 0.10200 1062415 1062415 0.00320 16070090 2371006 13699084 0.04080 9065971 6242474 2823497 0.00840 571983 571983 0.00170 328447 328447 0.00100 27098906 8613480 18485426 0.05510 126432894 73712289 52720605 0.15710 10623 10623 0.00000 10623 10623 0.00000 0 41343504 40400590 942914 X 1 1 2 1 Sisters of Charity Hospital 2157 Main Street Buffalo NY 14214 www.chsbuffalo.org 1401013H X X X X X Ambulatory Surgery - Multi Specialty 2 Sisters of Charity Hospital - St Joseph Campus 2605 Harlem Road Cheektowaga NY 14225 www.chsbuffalo.org X X X X X Ambulatory Surgery - Multi Specialty Sisters of Charity Hospital 0 0 1 X X X X X X X X X 16 1 1 1 1 X See Part V, Line 7a Page 8 X 1 16 1 See Part V, Line 10a Page 8 0 1 X 200.000000000000 500.000000000000 X X X X 1 1 X X X X 1 X https://www.chsbuffalo.org/billing-insurance/financial-assistance X https://www.chsbuffalo.org/sites/default/files/files/billing/catholic-healt X https://www.chsbuffalo.org/sites/default/files/files/billing/catholic-healt X X X X X X X 1 X 0 X 1 X 0 0 Part V, Section A: Sisters of Charity Hospital continuedAudiology O/P Chemical Dependence - Rehabilitation O/PClinic Part Time Services Clinical Laboratory ServiceCoronary Care Dental O/P Emergency Department Intensive CareLevel III Perinatal Care MaternityMedical Services - Other Medical SpecialtiesMedical Services - Primary Care Medical Social Services Medical/Surgical Neonatal Continuing Care Neonatal Intensive Care Neonatal Intermediate Care Nuclear Medicine - Diagnostic Nuclear Medicine - Therapeutic Physical Medical Rehabilitation Podiatry O/P Primary Stroke Center Radiology - Diagnostic Renal Dialysis - AcuteTherapy - Occupational O/P Therapy - Physical O/P Therapy - Speech Language PathologyTherapy - Vocational Rehabilitation O/P "Sisters of Charity Hospital - St. Joseph Campus continued Clinic Part Time ServicesClinical Laboratory ServicesCoronary Care Emergency Department Intensive CareMedical Services - Other Medical SpecialtiesMedical Services - Primary Care Medical Social Services Medical/Surgical Nuclear Medicine - Diagnostic Radiology - Diagnostic Renal Dialysis - Acute Therapy - Speech Language Pathology Part V, Section B Facility Reporting Group A Group A-Facility 2 -- Sisters of Charity Hospital - St. Joseph Part V, Section B, line 5: "The Hospital, as part of Catholic Health utilized a variety of sources to develop the health needs assessment to ensure the inclusion of persons who represent the broad interest of the community and have special expertise in, or knowledge of, public health issues and concerns: * Disseminating and promoting the completion of a fifty-seven question survey developed by the Erie County Department of Health to the community at large including Catholic Health's own staff. * Two focus groups including representation from a broad range of health care and social service organizations in Erie County * Western New York Community Health Needs Assessment (December 2014) jointly sponsored by the two Performing Provider Systems in the region linked the Delivery System Reform Incentive Program (DSRIP). * 50 patient interviews (verbal survey) targeting individuals utilizing services at Catholic Health clinics operating within federally designated Health Professional Shortage Areas (HPSA)Focus group participants: Catholic Charities Brylin Hospitals Erie County DOH P2 Collaborative of WNY City of Buffalo community Physician representation Erie County Department of Health Community Meeting Participants Catholic Health American Cancer Society Cazenovia Recovery Systems Friends of Night People Buffalo Fire Department Northwest Community Center Mid Erie Counseling and Treatment Center American Heart Association Meals on Wheels Evergreen Services Pride Center of Western New York United WayFor more information about our CHNA, go to https://www.chsbuffalo.org/mission/social-responsibility-community-benefit" Group A-Facility 2 -- Sisters of Charity Hospital - St. Joseph Part V, Section B, line 6a: Sisters Hospital was conducted with Sisters St. Joseph Campus, Mercy: Mercy Hospital was conducted with Mercy Ambulatory Care Center Group A-Facility 2 -- Sisters of Charity Hospital - St. Joseph Part V, Section B, line 6b: Sisters Hospital was conducted with Mercy Hospital and Kenmore Mercy Hospital and Mount St. Mary's Hospital as well as the Erie County Department of Health. Group A-Facility 2 -- Sisters of Charity Hospital - St. Joseph Part V, Section B, line 11: "Through the needs assessment, numerous areas were identified as important and clearly impact the health of the community. Catholic Health identified the "significant" needs as the New York State Department of Health Prevention Agenda priorities. Within the "priorities", Catholic Health will address numerous health needs as described in the publicly available CHNA report. One priority area was prioritized lower and not addressed in the implementation plan: Promote a Healthy and Safe Environment. Contributing to this lower priority was lack of available funds and potential for less impact upon the community. Although, should opportunity arise, with resources available to effectively address this need, Catholic Health will reconsider for incorporation in the future.Other needs were identified as part of the Community Health Needs Assessments conducted by Erie County Department of Health, the local DSRIP PPS organizations, and Catholic Health. However, a number of those needs were not incorporated into CH's individual 2016-2018 Community Health Implementation Plans for each of its acute care operations for one or more of the following reasons: Was not deemed as impactful on the overall health of the community as compare to other identified need Is being targeted or addressed by other entities within the community Requires resources that CH does not currently have available without compromising otherimportant initiatives. But, should community circumstances change or additional resources become available, CH will consider incorporating other initiatives into its plan.Among those additional needs not addressed in the 2016-2018 CHIP are: Need for greater integration of primary care and behavioral health services (being addressed by local PPS organizations via NYS DSRIP *) Need to address childhood obesity through improved nutrition especially in urban "fooddeserts and increased exercise programming for children Continued need to improve access to smoking cessation programs (Roswell Park Cancer Institute leading efforts of local PPS organizations as part of the NYS DSRIP program) Need to improve educational services to parents in urban areas with regard to asthmamanagement and dangers of lead poisoning Slowing the rate of HIV infection especially within minority communities (NYS Prepprogram with local support from Evergreen)The 2016 Erie County Community Health Needs Assessment began by first re-evaluating theneeds prioritized in the previous cycle (2013) and the impact of the projects corresponding tothose needs that were selected for implementation. Catholic Health's understanding of thecommunities it serves was then updated by soliciting new input from the public and severalcommunity organizations as outlined in the Process and Methods section of this report. Thisassessment represents a collaborative effort across Catholic Health's facilities as well as withexternal organizations to identify the health needs of the community and to develop a strategyfor addressing them. The systematic process used helped identify significant health needsacross Catholic Health's Erie County service area including vulnerable and under-representedpopulations. "Part V, Line 7a page 8: https://www.chsbuffalo.org/mission/social-responsibility-community-benefitPart V, line 10a, page 8: https://www.chsbuffalo.org/mission/social-responsibility-community-benefit Group A-Facility 2 -- Sisters of Charity Hospital - St. Joseph Part V, Section B, line 16j: Includes information in both English and Spanish on all signage and brochures for financial assistance. 10 1 - Harvey Austin School #97 1405 Sycamore Street Buffalo NY 14211 Extension Clinic:Health Education O/P ImmunologyMedical Social Services O 2 - Pathways Methadone 158 Holden Ave Buffalo NY 14214 Extension Clinic:Methadone Maintenance O/PPart 822 Opioid Treatment progr 3 - Rochester Pathways 79 Howell Street Rochester NY 14614 Extension Clinic:Methadone Maintenance O/P 4 - St Vincent Health Center 1500 Broadway Avenue Buffalo NY 14212 Extension Clinic:Prenatal O/PPrimary Medical Care O/PTherapy Physical O/P 5 - Sisters Health Center Amherst 210 John Glenn Drive Amherst NY 14228 Extension Clinic:Chemical Dependence - Rehabilitation O/PMedical Services 6 - West Hertel Academy 489 Hertal Avenue Buffalo NY 14212 Extension Clinic:Health Education O/PImmunology Medical Social Services O 7 - Southside Elementary School #93 430 Southside Pkwy Buffalo NY 14210 Extension Clinic:Health Education O/P Immunology Medical Social Services 8 - St Catherine Laboure Health Care Center 2157 Main Street Buffalo NY 14214 Long Term Care:BaselineAdult Day Health Care (25)Clinical Laboratory Serv 9 - Sisters Health Center Depew 6199 Transit Road Depew NY 14043 Medical Services - Other Medical SpecialtiesMedical Services - Primary Care 10 - Pace Health Center 55 Melroy Avenue Lackwanna NY 14218 Extension Clinic:Medical Services - Primary Care Part I, Line 6a: Sisters Hospital Community Benefit Report is contained in the annual report prepared by the Catholic Health System. Part I, Line 7: Costing is a full step down methodology of cost from non-revenue producing departments to revenue producing departments', with assignment of cost to individual charge items based on volume and charge amount. All patient accounts are cost with the same methodology regardless of patient type (inpatient, outpatient, emergency room, etc.) or insurance coverage (Medicare, Medicaid, private insurance, uninsured, etc.). Part II, Community Building Activities: Community Building Activities for Sisters Hospital included Community Support - for $10,623. Part III, Line 2: The Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue. Part III, Line 3: The Hospital did not report bad debt on their financial statements, as they adopted ASU 2014-09 Revenue from Contracts with Customers in 2018. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the statement of operations and changes in net assets is treated as an implicit price concession that reduces the transacton price, which is reported as net patient service revenue. Part III, Line 4: The hospital does not have a footnote that describes bad debt in the financial statements. Part III, Line 8: Sisters Hospital does not treat Medicare shortfall as a community benefit, as serving Medicare patients is not a differentiating feature of tax-exempt healthcare organizations. The existing community benefit framework allows community benefit programs that serve the Medicare population to be counted in other community benefit categories. Part III, Line 9b: The hospital's collection policies contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance. The hospital has implemented billing and collection practices for patient payment obligations that are fair, consistent, and compliant with state and federal regulations and no extraordinary collection practices are followed. Part VI, Line 2: In addition to its CHNA, Sisters Hospital as part of Catholic Health utilizes multiple methods to assess the health care needs of the communities it serves, including:* Evaluations administered by Sisters Hospital in coordination with the Catholic Health Community Education Department after each class, workshop, or program it sponsors seeking input on other programs or topics of interest participants would like to see. Based on this feedback, program planners meet with leadership to develop programs or workshops that match community interest/need;* Input from physician community during doctor to doctor education programs. Based on this feedback, program planners meet with leadership to develop physician continuing education programs that address gaps in care or other pressing community health needs. * Patient, resident and caregiver satisfaction surveys conducted in our hospitals, health centers, and nursing homes and among our home care patients, help alert us to health care needs among our patient population; * Physician and leadership participation in community boards, coalitions and forums to define the health needs of patient populations and seek community solutions; * Surveys conducted among high risk, high need Medicaid populations through our collaborative Health Home Program help alert us to the needs of individuals with developmental disabilities and behavioral health issues; * Participation in NYS Delivery System Reform Incentive Program (DSRIP) with Community Partners of WNY initiatives that look at transforming the care of the Medicaid population; * Information management obtains from administrative data and payer mix to assist in evaluating the health needs and trends of the community; and* Input from Catholic Health Board including Board Committee (e.g. Mission Integration Committee). Part VI, Line 3: Catholic Health's Sisters Hospital inform and educate patients and persons who may be billed for medical services about their eligibility for assistance under federal, state, or local government programs or our own Healthcare Assistance Program (HAP) in a variety of ways. For example, Sisters Hospital, like our other Catholic Health facilities, has posters and brochures available, which include eligibility and contact information for the Patient Financial Services Team. This information is available in admissions areas, emergency rooms, primary care and outpatient rehabilitation centers, the Administrative and Regional Training Center (ARTC) and other areas throughout Catholic Health where eligible patients and family members are likely to be present. This information is also on the website https://www.chsbuffalo.org/billing-insurance/financial-assistance and includes general information, our policy and application and is translated in Spanish and Arabic. In addition, information on financial assistance is included on our website.Sisters Hospital also provides information about financial assistance and Healthcare Assistance program (HAP) contact information to patients as part of the intake process and during or within 90 days of their discharge from the hospital via patient statements or outreach. To further assist patients, all patient bills include the following language: "If you need financial assistance: Catholic Health offers a healthcare assistance program to help those in need. For more details please visit www.chsbuffalo.org/financial assistance, or call our Patient Financial Services Team at (716) 601-3600". For free, confidential assistance in applying for financial assistance, patients can also call our Patient Financial Services team at 716-601-3600. A counselor will work with them to see if they qualify for free or low-cost insurance or other financial assistance. For patients who do not have insurance and need care at a Catholic Health hospital, a registration clerk can put the patient in touch with one of our Certified Application Counselors. Interpreting services are also available for patients who do not speak English. We offer case management services, and our Certified Application Counselors who discuss with patients the availability of various government benefits, such as Medicaid or other state and federal programs, and assist patients and families with eligibility and applications when necessary. Part VI, Line 4: Catholic Health is a not-for-profit integrated healthcare delivery system that operates four acute care operations in Erie County and one in Niagara County. For all intents and purposes, the primary service area for Catholic Health's Erie County based acute care operations is Erie County. In fact, Erie County residents account for 79% of all inpatient volume.Sisters Hospital is located in Erie County, which consists of a mix of urban, suburban and rural populations, with about one-third of the population residing in the City of Buffalo. Buffalo is New York State's second largest city, surrounded by a ring of older suburbs. Beyond the first ring suburbs are newer suburban communities and established rural communities. The current population of Erie County is over nine hundred thousand.Erie County is less racially and ethnically diverse than New York State or the rest of the country, and the Non-White populations are concentrated in and immediately around the City of Buffalo. All of the 11 zip codes in Erie County that have a Non-White population of 50% or more are in Buffalo. Part VI, Line 5: One of the fundamental reasons for the creation of Catholic Health was to ensure the continued viability of faith-based health care to meet the needs of residents in Erie County and the surrounding communities. The Mission statement of the Sisters Hospital, as part of Catholic Health - We are called to reveal the healing love of Jesus to those in need further articulates why we exist. Integral to this effort is caring for the needs of those who are poor and disadvantaged. The services provided by Sisters Hospital are in response to identified community needs, and reflect the Hospitals's emphasis on caring for the underserved. The Hospital collaborates with other charitable organizations and social service agencies (i.e. Catholic Charities, Spectrum Human Services, Evergreen Health Services, Erie County Department of Health, etc.), to maximize its ability to provide needed services to the residents of our region.The governing Board of Directors of Sisters Hospital is comprised of community representatives from universities, legal communities, and business leaders. Religious orders are represented, as well as active and retired medical staff members. The Sisters Hospital medical staff is considered an "open" medical staff, as any physician can apply for privileges. Each application is reviewed by a vigorous credentialing verification process. The hospitals have robust health professional education programs. Mercy Hospital and Sisters Hospital are physician teaching facilities. All sites participate in teaching programs for other allied health professionals. Our six emergency departments are open to all people regardless of their ability to pay. Our primary care centers are strategically located in areas deemed economically disadvantaged or where other medical services are lacking. Each year, Sisters Hospital, as part of Catholic Health touches tens of thousands of area residents through its community health education programs, health screenings, clinical and support services, and community service activities. Most of these program are free to encourage participation by people from all walks of life. Catholic Health will continue to meet community needs by providing charity care to the uninsured and underinsured, traditional Medicaid services, and community benefit programs, including collaborative community health improvement initiatives, health professional education programs, volunteering and community service activities, and cash and in-kind contributions to community organizations that serve the poor and disadvantaged. In 2018, the Catholic Health System provided more than $126 million in charity care and community benefit activities to help make our community a healthier place, especially for the poor and underserved. These activities included: - Spearheading Project Homeless Connect An outreach initiative to link homeless individuals and families with medical and other support services; - Supporting charitable and educational organizations, like the Global Health Ministry, United Way, Harvest House, St. Luke's Mission of Mercy, The CRIB Maternity Group Home in Niagara Falls, MY (part of Family & Children Services of Niagara), Care and Share Food Pantry, and the Project Connect Niagara that help the poor and vulnerable in our community; -Hosting numerous health education and screening programs to help people learn their health risks and take steps to improve their health; - Offering a Healthcare Assistance Program to ensure that people without insurance or financial means get the care they need; - Providing health and wellness information in places of worship through our Faith Community Nursing program; - Helping refugees access quality medical care through our Primary Care and School Based Health Centers, including the Mercy Comprehensive Care Center in Buffalo's Old First Ward; - Providing free care and services to those in need, like our "Cribs for Kids" program, which helps families provide a safe sleeping environment for their newborns; - Supporting children and families in need through our Reach Out and Read Program; Backpack Program for Kids; and Bridget Closet (clothes for the needy); - Sponsoring programs at the Mercy Comprehensive Care Center, which serve the local community, including refugees from Burma, Somalia, the Middle East, and Nepal ; - Providing services through our Social Work Department, which link patients with necessary services including: ESL (English as a Second Language), job opportunities, substance abuse treatment, health care navigators, senior services, insurance information, parenting assistance and more; and - Supporting nationally recognized "green" initiatives to remain good stewards of our natural resources and protect the environment.Additional initiatives that the hospital participates in as part of CHS provide benefit to the community including: Advanced Directive / MOLST education, Community Health Fairs , Footprints on the Heart(perinatal bereavement) , McGowan Grant for Health Care Tabling Events , Marian Building & Springville, OB/GYN Clinics, Medicaid Enrollment Assistance, Neonatal Abstinence Syndrome Program in Mercy, NICU Cuddler Program, Open Access Scheduling, Osteoporosis Screening, Prenatal-perinatal Network of WNY, Quest Fit Testing, Refugee Programs, Transitional contact to Catholic Charities from Primary Care Sites, and Transportation Assistance. One of the innovative ways Catholic Health is leading the transformation of healthcare is by supporting other organizations whose work has a direct impact on community health. For the third year, Catholic Health has allocated a portion of its net income ($139,000) for Community Benefit Grants to support programs that serve the poor and disadvantaged and address unmet health needs in our community. Recipients of the 2018 Community Benefit Grants include: Durham's Central City Baby Caf - $7,000 The Canopy of Neighbors Programming to Address Social Isolation - $12,000 Buffalo Go Green Healthy Community Fruits & Vegetables Rx Program (FVRx) - $16,920 RAHAMA: Trauma-informed domestic violence program for Muslim, Immigrant and Refugee Women - $20,000 Buffalo United Charter School Moral Focus: Focus on Building Up Our Future - $13,000 Urban Christian Ministries: Brothers With A Purpose - $18,100 Catholic Health Neighborhood Legal Services: Medical-Legal Partnership - $25,000 Ransom House - $19,780 Part VI, Line 7, Reports Filed With States NY X X X X X 1 0 0 0 0 0 0 0 0 Joseph McDonald President and CEO, CHS 0 124093 0 191491 0 901733 0 8633 0 20897 0 1246847 0 191491 Mark Sullivan President and CEO, CHS 0 695527 0 156198 0 274317 0 65865 0 28048 0 1219955 0 156198 David Macholz Treasurer 0 229943 0 47229 0 8915 0 5658 0 27769 0 319514 0 0 Charles Urlaub Director 0 423637 0 0 0 37941 0 26189 0 19379 0 507146 0 0 Gary Tucker Director 0 270048 0 72907 0 36183 0 22058 0 27287 0 428483 0 72907 Martin Boryszak President and CEO, Sisters 354592 0 0 0 16666 0 2824 0 25121 0 399203 0 0 0 Joyce Markiewicz Director 0 407828 0 0 0 18139 0 58453 0 20185 0 504605 0 0 Walt Ludwig Director 0 277875 0 0 0 18144 0 22756 0 26385 0 345160 0 0 James A Dunlop Jr Executive VP, Finance / CFO 0 547002 0 140504 0 86818 0 -8500 0 26605 0 792429 0 140504 Dr Brian D'Arcy Senior VP, Medical Affairs 0 515961 0 0 0 43511 0 16137 0 27213 0 602822 0 0 John Sperrazza Chief Operating Officer 217033 0 0 0 8760 0 1428 0 17818 0 245039 0 0 0 Michael Moley Sr.VP, Human Resources 0 354293 0 96820 0 153803 0 23426 0 19277 0 647619 0 96820 Dr Michael Galang Sr. VP, Chief Information Officer 0 413567 0 102217 0 18146 0 23361 0 9941 0 567232 0 102217 Nancy Sheehan SVP Legal Service, General Counsel 0 374956 0 25 0 18934 0 26085 0 20769 0 440769 0 0 Dr Nady Shehata VP, Medical Affairs 406006 0 0 0 2075 0 29480 0 24336 0 461897 0 0 0 Dr Michael Edbauer Chief Clinical Officer 0 173522 0 117972 0 217135 0 10293 0 8032 0 526954 0 321406 Maria Foti Sr. VP, Strategic Planning 0 299755 0 74394 0 16991 0 36561 0 9750 0 437451 0 74394 Dr Bruce Rodgers Physician 356252 0 0 0 4587 0 18977 0 390 0 380206 0 0 0 Dr Ali Ghomi Physician 657102 0 0 0 614 0 7840 0 25154 0 690710 0 0 0 Dr Margaret McDonnell Physician 355939 0 0 0 2186 0 26762 0 17632 0 402519 0 0 0 Dr Jaime Obst Physician 314598 0 0 0 174 0 4279 0 24715 0 343766 0 0 0 Dr Paul Updike Physician 291505 0 0 0 432 0 6056 0 25204 0 323197 0 0 0 Jim Millard Former Director 0 8001 0 0 0 308718 0 -68320 0 18301 0 266700 0 0 Part I, Line 4a Change of Control Payments were made to: Joseph McDonald: $618,613 Jim Millard: $305,963 Certain portions of the incentive compensation paid in 2018 are a result of the targets that were achieved in previous years. Deferred compensation reported in 2018 includes both qualified deferred pension compensation, as well as deferred compensation and employer contribution for 403b for certain associates for the amounts that are able to be estimated in 2018. Actual W-2 compensation paid to the executive is as per Schedule J Part II B. A Dormitory Authority of the State of New York 146000293 64983Q584 2006-11-29 30295000 SeePartVI 0 0 0 B Dormitory Authority of the State of New York 146000293 64983Q5U9 2006-11-29 8435000 SeePartVI 0 0 0 C Buffalo and Erie County Industrial Land Development Corporation 222413596 SeePartVI 2015-04-30 4725000 SeePartVI 0 0 0 A 30295000 1120911 179286 28994803 1994 1 0 1 1 B 8435000 341581 49919 8043500 2005 1 0 1 1 C 5239482 344971 153575 4606669 134267 2014 0 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 1 1 1 HSBC Bank NA 18.500000000000 0 1 0 1 B 1 1 1 JP Morgan Chase 18.500000000000 0 1 0 1 C 0 0 0 0 0 0 0 1 A 1 B 1 C 1 Part I A (f) Part I A (f) Description of Purpose: To refund Sisters of Charity of Buffalo Insured Revenue Bonds, Series 2003, which were bonds issued for the purpose of refunding a series of bonds issued in 1991, the proceeds of which were applied to finance the construction and renovation of the Sisters of Charity facilities and to refinance outstanding indebtedness. Part I B (f) Description of Purpose: To finance the cost of the St. Joseph Campus emergency room expansion project. Part IV 4 (e) The interest rate swaps through HSBC Bank and JP Morgan Chase associated with the 2006 series were unwound and terminated on 11/26/14. Part I C (c) CUSIP #: The 2015 Bond Series were issued under numerous CUSIP #s with varying maturity dates. The associated CUSIP #s are as follows: 11943KBH4, 11943KBJ0, 11943KBK7, 11943KBL5, 11943KBM3, 11943KBN1, 11943KBP6, 11943KBQ4, 11943KBR2, 11943KBS0, 11943KBT8, 11943KBU5, 11943KBV3, 11943KBW1, 11943KBX9, 11943KBY7 Part I C (f) Description of Purpose: To finance the costs of improvements made to the Ambulatory Surgery Center at Sisters Hospital, St. Joseph Campus. Susan Urlaub Wife of Mercy CEO, C.J. Urlaub 93874 Corporate Nurse educator 0 Kathleen Zapfel Sister-in-law of BOD, Msgr. Robert Zapfel 63506 HR Employee of CHS 0 Scott Markiewicz Son of Key Employee, Joyce Markiewicz 52480 Supervisor, Father Baker Manor 0 Julie Sullivan Daughter of Chief Executive Officer 54655 HR employee, CHS 0 Jacob Tucker Son of Director, Gary Tucker 5403 Imaging associate, MSMH 0 Form 990, Part VI, Section A, line 6 CHS has two members: Trinity Health, and the Diocese of Buffalo, NY. Each member is able to participate equally in electing the governing body, approving significant decisions of the governing body, and in receiving a share of net assets upon dissolution, according to the CHS Bylaws. Form 990, Part VI, Section A, line 7a According to the CHS Bylaws, each member is equally allowed to appoint one representative and one alternative representative to serve on the Corporate Member Council and to serve as a voting director on the Catholic Health System Board of Directors. Form 990, Part VI, Section A, line 7b Yes, the corporate members do have reserve powers Form 990, Part VI, Section B, line 11b Yes, an electronic copy of the Form 990 was provided to the CHS Boards of Directors before it was filed. The CHS Board of Directors has delegated the responsibility to review the 990 to the Audit Committee. The CHS Audit Committee reviewed in detail selected information for all CHS entities that file a 990. Reviewed with the Audit Committee: 1. Core Form Part IV: Checklist of required schedules 2. Core Form Part VI: Governance, Management and Disclosure 3. Core Form Part VII: Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees and Independent Contractors 4. Schedule H: Hospitals 5. Schedule K: Supplemental information on Tax Exempt Bonds 6. Schedule J: Compensation Information 7. Schedule L: Transactions with Interested Persons 8. Schedule R: Related Organizations and Unrelated Partnerships 9. Process for which remaining Core Form was completed, utilizing audited financial information Form 990, Part VI, Section B, line 12c All officers, directors, and key employees complete a Conflict of Interest Disclosure Statement (COIDS) in order to fulfill the annual requirements. COIDS are distributed to all parties, as per applicable policy, and once complete are followed up with as follows: 1. Associate and Physician completed COIDS are reviewed and signed off by the manager. If a disclosure is noted, it is discussed with the manager, and the document is forwarded to the Compliance officer who reviews and follows up as appropriate. Once review/follow up is completed the Compliance Officer will sign the COIDS, maintain a copy in the compliance office and return the original to HR for filing in the Personnel file. 2. All board member COIDS are returned to Compliance Officer for review and follow up as warranted. The compliance officer will sign each COIDS and retain on file in the compliance office in a confidential manner. Form 990, Part VI, Section B, line 15 CHS, in determining the compensation for the CEO, utilizes a process of review and approval, governed by the Board of Directors that includes an outside nationally recognized independent compensation consultant experienced in compensation and benefit matters for non-profit healthcare organizations, and comparability data. In 2018, the Catholic Health System utilized a Compensation Committee of the corporation Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives . 16. b. The Catholic Health System has a process to evaluate its participation in joint venture arrangements under applicable federal tax law, and has taken steps to safeguard the organization's exempt status with respect to such arrangements, and has developed a formal policy to formalize the process. Form 990, Part VI, Section C, line 19 We make our form 990 open for public inspection upon request. Our website includes an annual report which includes selected financial information. Our financial statements, governing documents and conflict of interest policy are provided upon request according to applicable federal and state laws. Form 990, Part XI, line 9: Change in Minimum Pension Liability Adjustment 5,182,514. Equity Transfer to Affiliates 1,300,728. Change in unrestricted interest in Net Assets of Sisters Foundation -618,325. Interest Rate Swap Adjustment 1,131,922. Change in temporary restricted interest in Net Assets of Sisters Foundation -772,270. Catholic Health System Inc 144 Genesee Street Buffalo NY 14203 222565278 Health Care Delivery System NY 501(c)(3) Schedule A line 3 0 Mercy Hospital of Buffalo 565 Abbott Road Buffalo NY 14220 160756336 Acute Care Hospital NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Kenmore Mercy Hospital 2950 Elmwood Avenue Kenmore NY 14217 160762843 Acute Care Hospital NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Nazareth Home of the Franciscan Sisters 291 North Street Buffalo NY 14201 160813142 Skilled Nursing Facility NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 St Elizabeth Home for the Aged 5539 Broadway Lancaster NY 14086 160743154 Adult Home NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 St Francis Home of Williamsville 147 Reist St Williamsville NY 14221 160743153 Skilled Nursing Facility NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 St Francis of Buffalo Inc 34 Benwood Ave Buffalo NY 14214 161523535 Skilled Nursing Facility NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 St Vincent Manor 319 Washington Avenue Dunkirk NY 14048 160743167 Adult Home NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 WNY Catholic Long Term Care Inc 6400 Powers Rd Orchard Park NY 14127 161434368 Skilled Nursing Facility NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Niagara Homemaker Services (Mercy Home Care) 144 Genesee Street Buffalo NY 14203 161317960 Home Care Provider NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 McAuley Seton Home Care 144 Genesee Street Buffalo NY 14203 161310062 Home Care Provider NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Catholic Health System Infusion Pharmacy Inc 6350 Transit Road Depew NY 14043 200198518 Home Care Infusion Services NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 CHS Program of All-Inclusive Care for the Elderly Inc 55 Melroy Avenue Lackawanna NY 14218 261252884 All-inclusive Care for the Elderly NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Trinity Medical WNY PC 2625 Harlem Rd Cheektowaga NY 14225 272576645 Primary Care Provider NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Sisters Hospital Foundation 2130 Main Street Buffalo NY 14214 222283077 Foundation NY 501(c)(3) Schedule A line 3 Sisters of Charity Hospital 0 KMH Homes Inc 144 Genesee Street Buffalo NY 14203 161387890 Real Estate Holding Company NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Mount St Mary's Hospital of Niagara Falls 5300 Military Road Lewiston NY 14092 161523353 Acute Care Hospital NY 501(c)(3) Schedule A line 3 Catholic Health System Inc 0 Health Home Partners of WNY LLC 227 Thorn Avenue Box 631 Orchard Park NY 14127 455343851 Health Home NY related 84274 890265 0 0 Caritas Medical Arts Building LLC 350 Essjay Road Suite 101 Williamsville NY 14221 161521486 Rental Real Estate NY related -76216 -20873 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1