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      <Desc>SEE SCHEDULE O.THE OGH CAMPUS IN OLEAN, NY INCLUDES 186 PATIENT ROOMS, TOGETHER WITH COMPREHENSIVE PATIENT, ADMINISTRATIVE AND PHYSICIAN SERVICES AND ACCOMONDATIONS TO MEET THE DIAGNOSTIC, TREATMENT, ADMINISTRATIVE AND EDUCATIONAL NEEDS OF ITS PATIENTS AND MEDICAL STAFF. THE BRMC CAMPUS IN BRADFORD, PA INCLUDES 50 PATIENT ROOMS AND 95 SKILLED NURSING BEDS. OGH OFFERS PATIENTS AND THEIR FAMILIES A FULL RANGE OF DIAGNOSTIC AND MEDICAL SERVICES, AS WELL AS MANY SPECIALTY SERVICES. A WIDE ARRAY OF MULTI-SPECIALTY PHYSICIANS AND CLINICIANS OFFER SERVICES RANGING FROM ORTHOPEDIC, VASCULAR, NEUROLOGY TO GENERAL MEDICINE. THE HOSPITAL PROVIDES CANCER, CARDIAC AND VASCULAR CARE, OB/GYN, GENERAL SURGERY, UROLOGY, WOMEN'S HEALTH, INTERNAL MEDICINE, PEDIATRICS, SLEEP MEDICINE, AND PSYCHIATRIC CARE.HIGHLIGHTED BELOW ARE SOME OF THE INITIATIVES THAT WERE REALIZED IN 2024 AT OGH AND BRMC:- PROVIDER RECRUITMENT IS CRITICAL TO OFFER EXISTING AND EXPANDED SERVICES AT A HEALTH SYSTEM. DURING 2024, OGH WAS SUCCESSFUL IN RECRUITING AND PROGRAM DEVELOPMENT IN THE FOLLOWING AREAS:O PSYCHIATRY HIRED 3 PHYSICIANS, 1 MID-LEVELO INTERVENTIONAL RADIOLOGY CONTRACTED WITH 1 PHYSICIAN GROUPO VASCULAR SURGERY HIRED 1 MID-LEVELO ORTHOPEDICS HIRED 1 PHYSICIANO PRIMARY CARE HIRED 3 MID-LEVELS2024 FINANCIAL PERFORMANCE OLEAN GENERAL HOSPITAL (OGH) REPORTED A NET LOSS OF ($22,774,000) FOR 2024. REVENUE WAS OVER BUDGET $3,175,000 AND EXPENSES WERE OVER BUDGET BY ($5,928,000).DURING 2024 THE ORGANIZATION RECEIVED NY STATE FUNDING OF $1,268,000 AND IMPLEMENTED 24 INITIATIVES THAT HAD AN ESTIMATED VALUE OF $14,123,000. DURING 2024 QUALITY MATTERS OLEAN GENERAL HOSPITAL (OGH) DEVELOPS A QUALITY IMPROVEMENT PLAN ANNUALLY. WHILE 2024 WAS NO DIFFERENT THAN ANY OTHER PLANNING YEAR, THE SEVERAL PROJECTS WERE PURSUED DURING 2024 INCLUDED:- INCREASED SURVEILLANCE FOR HAIS AND BETTER REPORT OUTS- INCREASED PARTICIPATION WITH QUIPS LEADING TO IMPROVEMENT WITH SYSTEMNESS- INCREASED PARTICIPATION WITH THE DNV SURVEY PROCESS AND RECOGNITION OF THE NCS. WORKING TOGETHER AS A TEAM TO CORRECT. - IMPROVEMENT IN THE JOB DESCRIPTIONS FOR THE QUALITY STAFF AND ALIGNING WITH APPROPRIATE JOB DUTIES. NEED FOR OVERSIGHT IN SEVERAL SHARED AREAS FOR QUALITY TO INCREASE EFFICIENCY WITH LESS STAFF. - IMPROVED ABSTRACTION WITH THE SEPSIS REPORT OUT WITH INCREASED PARTICIPATION FOR IMPROVEMENT.- FALL INITIATIVE IN PLACE TO REDUCE/ PREVENT FALLS WITH INJURY. IMPROVED FALLS BY 40 %. - INCREASE IN REAL TIME COMPLAINT INVESTIGATION, RESULTING IN STAFF BEING TRANSPARENT AND ENCOURAGING FAMILIES AND PATIENTS TO REACH OUT TO QUALITY.DURING 2024 INFORMATION TECHNOLOGY MATTERS:- BLUE ORANGE RISK ASSESSMENT -TTO COMPLETED THE 2024 RISK ASSESSMENT WITH BLUE ORANGE COMPLIANCE, ADDRESSING ALL NEEDS OF THE PHYSICAL AND VIRTUAL WALKTHROUGH.- CHECKPOINT FIREWALL UPGRADESO UPGRADED THE CHECKPOINT FIREWALLS TO THE LATEST STABLE VERSION. COMPLETED THIS ACROSS BOTH DATA CENTERS AND ALL FIREWALL SERVICES. ALSO UPGRADED THE SMALLER CHECKPOINT APPLIANCES AT KEY LOCATIONS WITH A SITE-TO-SITE VPN- THE INFORMATION TECHNOLOGY DEPARTMENT MERGED UNDER KALEIDA HEALTH IN THE 4TH QUARTER 2024.</Desc>
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        <PersonNm>JIM STITT JR</PersonNm>
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        <PersonNm>CHERYL KLASS</PersonNm>
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        <PersonNm>LUIS GONZALEZ MD</PersonNm>
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        <PersonNm>JILL OWENS</PersonNm>
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        <PersonNm>P HENRI LAMOTHE</PersonNm>
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        <PersonNm>LESLEY ZUREK</PersonNm>
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        <PersonNm>DAVID MONROE</PersonNm>
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        <ExplanationTxt>PART V, SECTION B, LINE 5: OLEAN GENERAL HOSPITAL:OLEAN GENERAL HOSPITAL AND BRADFORD REGIONAL MEDICAL CENTER ARE A MERGED ORGANIZATION. IN 2022 THE TWO CAMPUS HOSPITAL CONDUCTED AN INDEPEDENT COMMUNITY HEALTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLAN THAT REPRESENT THE NEED OF BOTH FACILITIES. CHNAS FOR BOTH HOSPITALS APPEAR ON THE WEBSITE FOR OLEAN GENERAL HOSPITAL AND BRADFORD REIOGNAL MEDICAL CENTER (WWW.BRMC-OGH.ORG). THE 2022-2024 CATTARAUGUS COUNTY COMMUNITY SERVICE PLAN (CSP), COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHA-CHIP) WERE DEVELOPED BY OLEAN GENERAL HOSPITAL D/B/A BRADFORD REGIONAL MEDICAL CENTER (OGH/BRMC) AND THE CATTARAUGUS COUNTY HEALTH DEPARTMENT (CCHD). STRATEGY SOLUTIONS, INC. (SSI) WAS ENGAGED BY THE CCHD, OGH/BRMC TO ASSIST WITH THE CSP AND THE CHA-CHIP. REPRESENTATIVES FROM OGH/BRMC AND THE CCHD WORKED COLLABORATIVELY TO GUIDE AND CONDUCT COMPLETION OF THE CSP AND THE CHA-CHIP. A STEERING COMMITTEE MADE UP OF SENIOR LEADERS OF UPPER ALLEGHENY HEALTH SYSTEM (UAHS), OGH/BRMC, THE CCHD, AS WELL AS REPRESENTATIVES FROM COMMUNITY ORGANIZATIONS, WHICH INCLUDES LEADING HEALTH AND SOCIAL SERVICE ORGANIZATIONS AND MUNICIPALITIES, PROVIDED ADDITIONAL INPUT. THE COMBINED EXPERTISE, INPUT AND KNOWLEDGE OF THE MEMBERS OF THE STEERING COMMITTEE WAS VITAL TO THE PROJECT. THIS GROUP DESERVES SPECIAL RECOGNITION FOR THEIR TIRELESS OVERSIGHT AND SUPPORT OF THE CSP/CHA-CHIP PROCESS. DURING THE CSP/CHA-CHIP PROJECT, 23 STAKEHOLDERS WERE INTERVIEWED BY STRATEGY SOLUTIONS, INC. (SSI). SSI ADMINISTRATED A COMMUNITY HEALTH SURVEY WITH 1,656 SURVEYS COMPLETED. OGH/BRMC AND THE CCHD CONDUCTED A COMMUNITY HEALTH INTERCEPT SURVEY WITH 241 SURVEYS COMPLETED. FINALLY, INFORMATION WAS GATHERED BY THE PROJECT TEAM THROUGH A SERIES OF 12 FOCUS GROUPS, INCLUDING A CROSS SECTION OF COMMUNITY GROUPS. INFORMATION-GATHERING EFFORTS ALLOWED THE PROJECT TEAM AND STEERING COMMITTEE TO GAIN A BETTER UNDERSTANDING OF THE HEALTH STATUS, HEALTH CARE NEEDS, SERVICE GAPS, AND BARRIERS TO CARE FOR THOSE LIVING IN MCKEAN AND CATTARAUGUS COUNTIES.UPON COMPLETION OF COMMUNITY HEALTH ASSESSMENT (CHA), A PLANNING PROCESS WAS INITIATED TO CREATE THE 2022-2024 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE LEADERSHIP AT THE CCHD REVIEWED THE PAST PLAN AND DETERMINED THAT GIVEN THE IMPACT COVID-19 HAD ON IMPLEMENTATION OF THE 2019-2021 CHA AND THE CONTINUED PRIORITIZED FOCUS ON CHRONIC DISEASE AND BEHAVIORAL HEALTH, EXISTING STRATEGIES CURRENTLY UNDERWAY SHOULD BE CONTINUED. LEADERSHIP REACHED OUT TO COMMUNITY PARTNERS TO AFFIRM THEIR WILLINGNESS TO CONTINUE.THE 2022-2024 OGH/BRMC COMMUNITY SERVICE PLAN (CSP) AND THE CCHD'S COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHA-CHIP) WERE CONDUCTED TO IDENTIFY SIGNIFICANT HEALTH NEEDS AS OUTLINED BY THE NEW YORK STATE DEPARTMENT OF HEALTH'S 2019-2024 PREVENTION AGENDA, WHERE APPLICABLE. IT ALSO PROVIDES CRITICAL INFORMATION OGH/BRMC, THE CCHD, AND OTHERS IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE CSP/CHA-CHIP ENABLES THE HEALTH DEPARTMENT, HOSPITAL AND OTHER COMMUNITY PARTNERS TO STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF RESIDENTS LIVING IN THE SERVICE AREA.TO CONDUCT THE COLLABORATIVE STUDY, OGH/BRMC AND THE CCHD RETAINED STRATEGY SOLUTIONS, INC. (SSI), AN ERIE, PENNSYLVANIA PLANNING AND RESEARCH FIRM WHOSE MISSION IS TO CREATE HEALTHY COMMUNITIES. THE CSP/CHA-CHIP FOLLOWED BEST PRACTICES AS OUTLINED BY THE ASSOCIATION OF COMMUNITY HEALTH IMPROVEMENT (ACHI)3. THE CSP/CHA-CHIP AS ALSO DESIGNED TO ENSURE OGH/BRMC COMPLIANCE WITH CURRENT INTERNAL REVENUE SERVICE (IRS) GUIDELINES FOR CHARITABLE 501(C)(3) TAX-EXEMPT HOSPITALS PUBLISHED IN DECEMBER 2014.THE CSP/CHA-CHIP INCLUDES A DETAILED EXAMINATION OF PRIORITY AREAS IDENTIFIED IN THE NYS PREVENTION AGENDA: (1) PREVENT CHRONIC DISEASES; (2) PROMOTE A HEALTHY AND SAFE ENVIRONMENT; (3) PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN; (4) PROMOTE WELL-BEING AND PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS; AND (5) PREVENT COMMUNICABLE DISEASES.THE PREVENTION AGENDA IS A SIX-YEAR EFFORT TO MAKE NEW YORK THE HEALTHIEST STATE. DEVELOPED IN COLLABORATION WITH 140 ORGANIZATIONS, THE PLAN IDENTIFIES NEW YORK'S MOST URGENT HEALTH CONCERNS, AND SUGGESTS WAYS LOCAL HEALTH DEPARTMENTS, HOSPITALS, AND PARTNERS FROM HEALTH, BUSINESS, EDUCATION, AND COMMUNITY ORGANIZATIONS CAN WORK TOGETHER TO SOLVE THEM.TO MEET THE DECEMBER 2014 IRS REQUIREMENTS FOR A NON-PROFIT HOSPITAL, THE CSP/CHA-CHIP INCLUDES EVALUATION OF THE 2019-2021 CSP/CHA-CHIP, DEMOGRAPHICS AND SOCIO-ECONOMIC INDICATORS, PRIORITIZATION OF NEEDS, AND A CHIP/IMPLEMENTATION STRATEGY FOR THE NEXT THREE YEARS.PRIMARY AND SECONDARY DATA REVIEWED: SECONDARY PUBLIC HEALTH DATA ON DISEASE INCIDENCE AND MORTALITY AND BEHAVIORAL RISK FACTORS WERE GATHERED FROM NUMEROUS SOURCES INCLUDING THE PENNSYLVANIA DEPARTMENT OF HEALTH, NEW YORK STATE DEPARTMENT OF HEALTH'S PREVENTION AGENDA DASHBOARD, CENTERS FOR DISEASE CONTROL AND PREVENTION, HEALTHY PEOPLE 2030, COUNTY HEALTH RANKINGS, AND A NUMBER OF OTHER REPORTS AND PUBLICATIONS. PRIMARY QUALITATIVE DATA COLLECTED SPECIFICALLY FOR THIS ASSESSMENT INCLUDED 23 IN-DEPTH INTERVIEWS WITH STAKEHOLDERS REPRESENTING THE NEEDS OF THE SERVICE AREA, AS WELL AS 12 FOCUS GROUPS. FOUR COMMUNITY HEALTH SURVEYS WERE ALSO CONDUCTED DURING THIS PROCESS:(I) A CATTARAUGUS COUNTY CSP/CHA-CHIP COMMUNITY HEALTH SURVEY WITH 899 RESPONSES,(II) A CATTARAUGUS COUNTY HEALTH DEPARTMENT'S COMMUNITY INTERCEPT SURVEY WITH 223 RESPONSES,(III) A MCKEAN COUNTY CSP/CHA-CHIP COMMUNITY HEALTH SURVEY WITH 757 RESPONSES,(IV) A BRADFORD REGIONAL MEDICAL CENTER COMMUNITY INTERCEPT SURVEY WITH 18 RESPONSES, ANDIN ADDITION TO GATHERING INPUT FROM STAKEHOLDER INTERVIEWS, INPUT AND GUIDANCE ALSO CAME FROM 72 COMMUNITY REPRESENTATIVES (36 REPRESENTING MCKEAN COUNTY AND 36 REPRESENTING CATTARAUGUS COUNTY) WHO SERVED ON THE CSP/CHA-CHIP STEERING COMMITTEE. MANY MEMBERS OF THE STEERING COMMITTEE ARE AFFILIATED WITH THE HEALTHY LIVABLE COMMUNITIES CONSORTIUM OF CATTARAUGUS COUNTY.2019-2024 PREVENTION AGENDA PRIORITIES AND DISPARITIES: AFTER ALL PRIMARY AND SECONDARY DATA WERE REVIEWED AND ANALYZED BY THE STEERING COMMITTEE, THE DATA SUGGESTED A TOTAL OF 32 DISTINCT POSSIBLE PRIORITIES FOR POTENTIAL INTERVENTION TO BE CONSIDERED FOR THE CATTARAUGUS COUNTY CSP/CHA-CHIP AND 13 FOR MCKEAN COUNTY. MEMBERS OF THE STEERING COMMITTEE AND CSP/CHA-CHIP PROJECT COORDINATION TEAM MET ON MARCH 9, 2022 TO REVIEW THE DATA AND PRIORITIZE THE POSSIBLE PRIORITY AREAS. THE METHODOLOGY USED INCLUDED RATING EACH POSSIBLE PRIORITY AREA BY THREE DIFFERENT CRITERIA: (I) MAGNITUDE OF THE PROBLEM, (II) IMPACT ON OTHER HEALTH OUTCOMES AND (III) CAPACITY (SYSTEMS AND RESOURCES) TO ADDRESS THE ISSUE/NEED. BASED ON THIS PRIORITIZATION AND LOOKING AT EVIDENCED-BASED SOLUTIONS, THE FOLLOWING TOP TWO PRIORITIES, AS ALIGNED WITH THE NYS PREVENTION AGENDA (NYS PA), ARE THE AREAS THAT OGH/BRMC AND THE CCHD WILL BE WORKING ON FOR 2022-2024: (I) PREVENT CHRONIC DISEASES WITH A DISPARITY CONCENTRATION ON POVERTY; AND (II) PROMOTE WELL-BEING AND PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS WITH A DISPARITY CONCENTRATION ON POVERTY.A DETAILED PLAN OF IMPLEMENTATION IS DESCRIBED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN ON PAGES 192-209.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>OLEAN GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: OLEAN GENERAL HOSPITAL:IN DEVELOPING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CATTARAUGUS COUNTY AND MCKEAN COUNTY, OTHER MEMBERS CONSULTED INCLUDED UNITED WAY, CATTARAUGUS COUNTY DEPARTMENT OF COMMUNITY SERVICES, NURSE PRACTITIONER/AMISH CONNECTION, ST. BONAVENTURE UNIVERSITY, CASA-TRINITY INC., CUTCO, UNIVERSAL PRIMARY CARE, YMCA TWIN TIERS, DEPARTMENT OF SOCIAL SERVICES, CATTARAUGUS COUNTY HEALTH DEPARTMENT, DIRECTORS IN INDEPENDENT LIVING, AND CONNECTING COMUNITIES IN ACTION.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>OLEAN GENERAL HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: OLEAN GENERAL HOSPITAL:THE HOSPITAL FACILITIES CHNA HAS IDENTIFIED THE NEEDED AREAS OF FOCUS TO BE THE PREVENTION OF CHRONIC DISEASES WITH A DISPARITY CONCENTRATION ON POVERTY; AND PROMOTE WELL-BEING AND PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS WITH A DISPARITY CONCENTRATION ON POVERTY. THE HOSPITALS WILL BE IN PARTNERSHIP WITH COUNCIL ON ALCOHOL AND SUBSTANCE ABUSE - TRINITY, CONNECTING COMMUNITIES IN ACTION, CATTARAUGUS COUNTY HEALTH DEPARTMENT, CATTARAUGUS COUNTY SCHOOLS, CORNELL COOPERATIVE EXTENSION, DEPARTMENT OF AGING, DEPARTMENT OF SOCIAL SERVICES, GENESIS HOUSE, HEALTH COMMUNITY ALLIANCE, OLEAN MEDICAL GROUP, REALITY CHECK AND UNIVERSAL PRIMARY CARE. 1. INCREASE FOOD SECURITY THROUGH: NUMBER OF PARTNERS THAT SCREEN FOR FOOD INSECURITY AND FACILITATE REFERRALS TO SUPPORTIVE SERVICES.2. PREVENT INITIATION OF TOBACCO USE, INCLUDING COMBUSTIBLE TOBACCO AND VAPING PRODUCTS (DEFINED AS E-CIGARETTES AND SIMILAR DEVICES) BY NYS YOUTH AND YOUNG ADULTS THROUGH: (I) USE MEDIA AND HEALTH COMMUNICATIONS TO HIGHLIGHT THE DANGERS (II) USE EVIDENCE-BASED PROGRAMMING (CATCH MY BREATH) SPECIFIC TO MIDDLE AND HIGH SCHOOL STUDENTS; AND (III) USE HEALTH COMMUNICATIONS TARGETING HEALTH CARE PROVIDERS: # OF SCHOOLS AND STUDENTS REACHED RECEIVING DANGERS OF TOBACCO PRESENTATIONS, WORK WITH DEPARTMENTAL HEALTH SYSTEM GRANTEES TO PROMOTE THE DELIVERY OF EVIDENCED-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS, NUMBER OF INDIVIDUALS REFERRED.3. INCREASE CANCER SCREENING RATES FOR BREAST, CERVICAL AND COLORECTAL CANCERS THROUGH: NUMBER OF HEALTH SYSTEMS THAT IMPLEMENT/IMPROVE PROVIDER/PATIENT REMINDERS, NUMBER OF PATIENTS SCREENED AND REACHED THROUGH PATIENT REMINDER SYSTEMS.4. PROMOTE EVIDENCE-BASED CARE TO PREVENT AND MANAGE CHRONIC DISEASES IN THE CLINICAL SETTING INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES AND PREDIABETES, AND OBESITY: NUMBER OF PATIENTS TESTED FOR PREDIABETES.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>OLEAN GENERAL HOSPITAL HAS IMPLEMENTED AND COMMUNICATES ITS FINANCIAL ASSISTANCE (CHARITY CARE) POLICY, WHICH ASSISTS LOW INCOME, UNINSURED OR UNDERINSURED INDIVIDUALS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR MEDICAL SERVICES RENDERED. THE AMOUNT OF THE DISCOUNT VARIES BASED ON THE PATIENT'S INCOME AND SIZE OF FAMILY. THE FINANCIAL ASSISTANCE POLICY PROVIDES THE FOLLOWING INFORMATION:- FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS WITH LIMITED INCOMES AND HEALTH INSURANCE.- ANYONE WHO NEEDS EMERGENCY SERVICES CAN RECEIVE CARE AND GET A DISCOUNT IF THEY MEET THE INCOME LIMITS.- EVERYONE WHO LIVES IN THE SERVICE AREAS CAN GET A DISCOUNT ON NON-EMERGENCY MEDICALLY NECESSARY SERVICES IF THEY MEET THE INCOME LIMITS. MEDICAL TREATMENT CANNOT BE DENIED BECAUSE OF YOUR FINANCIAL STATUS.- FINANCE ASSISTANCE IS CONTINGENT UPON A PATIENT'S COOPERATION IN FOLLOWING THE ENTITIES APPLICATION REQURIEMENTS.- THE DISCOUNT IS DEPENDENT ON INCOME AND FAMILY SIZE.- THE ENTITY HAS THE ABILITY TO WORK ON PAYMENT PLANS, DEPENDENT ON INCOME IF NOT ELIGIBLE FOR FINANCIAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY ADDRESSES ALL PATIENT SEGMENTS THROUGHOUT THE SERVICES OFFERED AT THE ORGANIZATION. AS REPORTED ON THE COST REPORT, COSTS WERE MULTIPLIED BY THE RATIO OF COSTS TO CHARGES TO DETERMINE THE MEDICARE COST. THE TOTAL COST FROM DIRECT GME ALLOWABLE COSTS WERE SUBTRACTED FROM THE MEDICARE COST TO CALCULATE THE TOTAL MEDICARE ALLOWABLE COST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7G:</FormAndLineReferenceDesc>
        <ExplanationTxt>SUBSIDIZED PROGRAMS ARE NOT RECORDED AT THIS LEVEL OF DETAIL. ALL COSTS ASSOCIATED WITH THESE PROGRAMS, INCLUDING INPATIENT PSYCHIATRIC DEPARTMENT, EMERGENCY DEPARTMENT AND SALAMANCA CLINIC ARE INCLUDED IN THE AMOUNTS PROVIDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>OVER THE LAST 10 YEARS, THE OLEAN AND BRADFORD AREAS HAD SIGNIFICANT PRIMARY CARE AND SPECIALIST CARE SHORTFALLS. AFTER A FEW YEARS OF SUCCESSFUL RECRUITING, NUMEROUS MID-LEVEL PRIMARY CARE PROVIDERS HAVE BEEN RECRUITED, HOWEVER THERE ARE STILL PHYSICIAN SHORTAGES IN THE PRIMARY CARE SPACE. SPECIALIST PHYSICIANS ARE STILL IN GREAT DEMAND IN THE AREA. THE MOST PRESSING NEEDS CURRENTLY ARE IN: CARDIOLOGY, UROLOGY, ENT, OBSTETRICS, PSYCHIATRY, GENERAL SURGERY AND GASTROENTEROLOGY.THE HOSPITAL ALSO PROVIDES CLINICAL ROTATIONS FOR ST BONAVENTURE UNIVERSITY PRE-MEDICAL STUDENTS PARTICIPATE IN A 14 WEEK ROTATION PROVIDING EXPOSURE TO VARIOUS CLINICAL SPECIALTIES AND DIAGNOSTIC MODALITIES, FOR AN IN-DEPTH EXPOSURE TO THE REALITIES OF A CAREER IN MEDICINE. THE UNIVERSITY OF PITTSBURGH AT BRADFORD, JAMESTOWN COMMUNITY COLLEGE, ALFRED STATE, AND SAINT BONAVENTURE UNIVERSITY NURSING STUDENTS PARTICIPATE IN CLINICAL ROTATIONS THROUGH THE OLEAN CAMPUS. THE SCHOOL OF RADIOGRAPHY, PART OF THE IMAGING SERVICES DEPARTMENT AT THE BRADFORD CAMPUS, IS A FULL TIME 24-MONTH PROGRAM THAT PROVIDES DIDACTIC AND CLINICAL INSTRUCTION TO EACH ENROLLED STUDENT. A CNA COURSE IS OFFERED AT THE BRADFORD NURSING HOME, THE COURSEWORK INCLUDES COMBINATION OF CLASSROOM, SKILLS LAB AND CLINICAL EXPERIENCES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>DUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING 2024 AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS.OLEAN GENERAL HOSPITAL DETERMINES PATIENT SERVICE REVENUE BY REDUCING THE STANDARD CHARGE TO THIRD-PARTY PAYORS BY ANY CONTRACTUAL AMOUNTS OR DISCOUNTS (EXPLICIT CONCESSIONS) AND ESTIMATES ROUTINE UNCOLLECTIBLE AMOUNTS ASSOCIATED WITH THE SERVICE, INCLUDING DEDUCTIBLES, CO-PAYS AND AMOUNTS DUE FROM UNINSURED PATIENTS (COLLECTIVELY, IMPLICIT PRICE CONCESSIONS). OLEAN GENERAL HOSPITAL DETERMINES ITS ESTIMATES OF EXPLICIT CONCESSIONS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. OLEAN GENERAL HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. ADJUSTMENTS ARISING FROM A CHANGE IN TRANSACTION PRICE WERE NOT SIGNIFICANT IN 2024 AND 2023.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ALLOWABLE COSTS REPORTED ON LINE 6 ARE DIRECTLY FROM THE HOSPITAL'S 2024 MEDICARE COST REPORT, WHICH IS PREPARED USING A RATIO OF COST TO CHARGES BASIS (RCC) AS REQUIRED BY MEDICARE. THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION PROVIDES CARE TO LOW INCOME, UNINSURED OR UNDERINSURED INDIVIDUALS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR MEDICAL SERVICES RENDERED, INCLUDING THOSE WHO ARE COVERED BY MEDICARE. FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL, MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO OUR PATIENTS, WHICH FORCES THE ORGANIZATION TO USE OTHER FUNDS TO COVER THE DEFICIT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION PRACTICES:I) OGH WILL NOT CAUSE THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE.II) OGH WILL NOT SEND ACCOUNT TO COLLECTION IF THE PATIENT HAS SUBMITTED A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE, INCLUDING THE REQUIRED DOCUMENTATION, WHILE AN APPLICATION IS PENDING.III) OGH WILL PROVIDE WRITTEN NOTIFICATION TO A PATIENT AT LEAST 30-DAYS BEFORE AN ACCOUNT IS SENT TO COLLECTION. THIS WRITTEN NOTICE MAY BE INCLUDED ON A BILL.IV) OGH REQUIRES THAT A COLLECTION AGENCY HAVE ITS WRITTEN CONSENT PRIOR TO STARTING LEGAL ACTION FOR COLLECTION.V) OGH WILL TRAIN ALL GENERAL HOSPITAL STAFF WHO INTERACT WITH PATIENTS OR HAVE RESPONSIBILITY FOR BILLING AND COLLECTION.VI) OGH WILL MEASURE OUR COMPLIANCE WITH THESE POLICIES.VII) OGH REQUIRES ANY COLLECTION AGENCY UNDER CONTRACT TO FOLLOW OUR FINANCIAL ASSISTANCE POLICY AND PROVIDES INFORMATION TO PATIENT'S ON HOW TO APPLY, WHERE APPROPRIATE.VIII) OGH DOES NOT ALLOW COLLECTION ACTIVITY IF THE PATIENT IS DETERMINED ELIGIBLE FOR MEDICAID FOR THE SERVICES THAT WERE RENDERED AND OGH IS ABLE TO COLLECT MEDICAID PAYMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE LEADERSHIP AT OLEAN GENERAL HOSPITAL WITH COLLABORATION FROM KALEIDA HEALTH, CONTINUES TO REFINE THE STRATEGIC PLAN TO REACT AND PLAN FOR THE ONGOING CHALLENGES FACING HEALTH CARE. ONE OF THE STRATEGIC GOALS IS TO PROVIDE CONTINUITY OF CARE FOR PATIENTS AS THEY TRAVEL FROM RURAL TO TERTIARY FACILITIES, THE HOSPITAL (OGH) IS UNDERGOING AN EMR SYSTEM CONVERSION THAT WILL ALLOW FOR THIS. THE HOSPITAL CONTINUES TO WORK CLOSELY WITH KALEIDA HEALTH GROW SPECIALTY SERVICES THROUGH DIRECT RECRUITMENT AND/OR EXTENSION CLINICS.CRITICAL HEALTH CARE ISSUES:ACCESS TO QUALITY HEALTH CARE REMAINS A SERIOUS CHALLENGE IN RURAL AREAS, OLEAN GENERAL IS NO DIFFERENT. THE GEOGRAPHIC'S OF THE HOSPITAL ARE A DIRECT CORRELATION TO THE COMMUNITY CHALLENGES, SUCH AS SHORTAGE OF HEALTH FACILITIES, LACK OF MEDICAL PROFESSIONALS, POOR INFRASTRUCTURE, AND ECONOMIC DIFFICULTIES. THESE ISSUES CONTRIBUTE TO POOR HEALTH OUTCOMES AND WIDEN THE GAP BETWEEN RURAL AND URBAN POPULATIONS.A MAJOR CHALLENGE IS LIMITED ACCESS TO HOSPITALS AND CLINICS. PEOPLE LIVING IN RURAL REGIONS OFTEN HAVE TO TRAVEL LONG DISTANCES FOR TREATMENT, WHICH CAN DELAY CARE AND WORSEN MEDICAL CONDITIONS. IN EMERGENCIES, THIS CAN LEAD TO PREVENTABLE DEATHS AND COMPLICATIONS. HAVING ADEQUATE HEALTH SERVICES, SUCH AS VACCINATIONS AND REGULAR CHECK-UPS LEAD TO BETTER PATIENT OUTCOMES.THE SHORTAGE OF DOCTORS, NURSES, AND SPECIALISTS ADDS TO THE PROBLEM. MOST MEDICAL PROFESSIONALS PREFER TO WORK IN URBAN AREAS WHERE THERE ARE BETTER FACILITIES, HIGHER PAY, AND MORE CAREER OPPORTUNITIES. AS A RESULT, RURAL CLINICS ARE OFTEN UNDERSTAFFED, AND PATIENTS MAY NOT RECEIVE TIMELY OR SPECIALIZED CARE.ECONOMIC AND SOCIAL FACTORS FURTHER IMPACT RURAL HEALTH. MANY RESIDENTS CANNOT AFFORD MEDICAL CARE OR LACK HEALTH INSURANCE. LOW EDUCATION LEVELS AND CULTURAL BELIEFS MAY ALSO DISCOURAGE PEOPLE FROM SEEKING TREATMENT EARLY.OVERALL, THESE CHALLENGES LEAD TO HIGHER RATES OF DISEASE AND MORTALITY IN RURAL AREAS. TO ADDRESS THEM, GOVERNMENTS AND COMMUNITIES MUST INVEST IN BETTER INFRASTRUCTURE, PROVIDE INCENTIVES FOR HEALTH WORKERS, AND EXPAND EDUCATION AND TELEHEALTH SERVICES. ENSURING EQUAL ACCESS TO HEALTH CARE IS VITAL FOR IMPROVING THE QUALITY OF LIFE IN RURAL COMMUNITIES.1. QUALITY: HEALTH CARE QUALITY AND SAFETY HAVE BEEN STRATEGICALLY IMPORTANT FOR SEVERAL YEARS. WIDESPREAD PUBLIC REPORTING OF HOSPITAL QUALITY RESULTS AND VALUE BASED PAYMENT MODELS HAVE POSITIONED QUALITY AT THE FOREFRONT OF HEALTHCARE DELIVERY. RECRUITMENT AND RETENTION OF HIGHLY SKILLED DOCTORS AND NURSES, COMBINED WITH CAPABLE INFORMATION SYSTEMS ARE CRITICAL TO MEET THE HIGH STANDARDS SET TODAY IN HEALTHCARE. CONCEPTS SUCH AS: "RE-ADMISSIONS", HOSPITAL ACQUIRED INFECTIONS, FALL FREQUENCY AND PREVENTABLE MEDICATION ERRORS ARE HOUSEHOLD WORDS WHEN IT COMES TO EVALUATING A HOSPITAL'S QUALITY TODAY. HOSPITALS MUST MARSHAL THE KNOWN RESOURCES AND PROVIDE HIGH-END CARE AS COMPARED TO OTHERS. THE VALUE BASED PAYMENT METHODOLOGIES ALSO HAVE SIGNIFICANT FINANCIAL IMPLICATIONS FOR HOSPITALS TODAY. CONSUMERS WILL CONTINUE TO SEEK OUT MORE AND MORE QUALITY DATA UPON WHICH TO BASE CARE DECISIONS ON.2. INFORMATION TECHNOLOGY: HEALTH INFORMATION TECHNOLOGY INCLUDES COMPUTER BASED TOOLS DEVELOPED SPECIFICALLY FOR HEALTH CARE DELIVERY. THESE TOOLS CAN PROVIDE UP-TO-DATE INFORMATION ON THEIR PATIENTS, ACCESS TO THE LATEST MEDICAL KNOWLEDGE AND BEST PRACTICES THROUGH DECISION SUPPORT SYSTEMS. IT IS UNDERSTOOD THAT INVESTMENTS IN NEW CLINICAL AND INFORMATION TECHNOLOGY CAN SIGNIFICANTLY ENHANCE PATIENT SAFETY AND CLINICAL OUTCOMES. COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE), BAR CODING AND ITS POTENTIAL TO REDUCE MEDICATION ERRORS, AND ELECTRONIC MEDICAL RECORDS (EMRS) AND THEIR POSITIVE IMPACT ON MEDICAL ERRORS ARE ALL EXAMPLES OF HEALTH CARE'S USE OF IT SOLUTIONS TO IMPROVE QUALITY. THE FEDERAL GOVERNMENT HAS HIGHLIGHTED THE ROLE OF HEALTH INFORMATION TECHNOLOGY AS A MEANS TO IMPROVE HEALTH CARE QUALITY, SAFETY PROVIDED STIMULUS AND INCENTIVE PAYMENTS TO PROVIDERS TO FACILITATE AND HASTEN THEIR ADOPTION INTO THE CARE DELIVERY PROCESS. EMR'S HAVE BECOME A PREREQUISITE OF ANY DELIVERY SYSTEM THAT INTENDS TO PROVIDE COORDINATED COST EFFECTIVE CARE.3. PHYSICIANS: PHYSICIANS HAVE EMERGED AS CRITICAL OPERATIONAL AND STRATEGIC PARTNERS TO HOSPITALS. THOSE THAT ARE SUCCESSFUL IN ENGAGING AND COLLABORATING WITH THEIR MEDICAL STAFF WILL BE BEST ABLE TO DEMONSTRATE HIGH QUALITY MANDATES. THE ABILITY TO SUCCESSFULLY RECRUIT PHYSICIAN WILL BE CRITICAL. AT A TIME WHEN HEALTHCARE EMPHASIZES THE ROLE OF PRIMARY CARE, THERE IS A SPECIAL NEED TO INTENSIFY EFFORTS RECRUIT, RETAIN AND AGGREGATE PRIMARY CARE PROVIDERS. BECAUSE THE VAST MAJORITY OF NEW PHYSICIANS PREFER EMPLOYMENT AS THEIR PRACTICE PREFERENCE, THE ABILITY OF HOSPITALS TO BE ABLE TO OFFER PHYSICIANS A CONTEMPORARY AND COMPETITIVE "EMPLOYMENT PLATFORM" IS ESSENTIAL.4. FINANCE AND CAPITAL: FINANCIAL PERFORMANCE AND ACCESS TO CAPITAL WILL CONTINUE TO BE AMONG THE MOST CRITICAL ISSUES CONFRONTING HOSPITALS. EVEN WITH HEALTHCARE REFORM EFFORTS, HEALTHCARE COSTS WILL CONTINUE TO OUTPACE INFLATION. INCREASING WAGE AND SALARY COSTS, AND RISING HEALTH CARE COSTS IN GENERAL WILL CONTINUE TO OUTPACE INFLATION. INCREASING WAGE AND SALARY COSTS, AND RISING HEALTH CARE COSTS IN GENERAL WILL CONTINUE TO IMPACT OPERATING PERFORMANCE AND PRESS HOSPITALS TO CONTINUE A RELENTLESS FOCUS ON COST MANAGEMENT. ADDITIONALLY, REVENUE STRATEGIES WILL NEED TO BE DEVELOPED TO GENERATE PROFITABLE GROWTH IN PATIENT VOLUME, AS WILL THE NEED TO ENSURE OPTIMAL MANAGEMENT OF ALL REVENUE ACTIVITIES. HOSPITALS ARE FACING SIGNIFICANT ANNUAL PAYMENT REDUCTIONS IN TERMS OF DECREASES IN MEDICARE UPDATES, DISPROPORTIONATE SHARE, SNF AND HOMECARE PAYMENTS, AND MEDICAID PAYMENT LEVELS. AS HOSPITALS CONTINUE TO POST LOW OR NO PROFIT MARGINS, INVESTMENT INCOME WILL BE MORE IMPORTANT THAN EVER. HOWEVER, GIVEN THE FACT THAT INVESTMENT INCOME IS A HIGHLY UNCERTAIN COMPONENT OF A HOSPITAL'S OVERALL FINANCIAL HEALTH, HOSPITALS WILL BE DRIVEN TO PURSUE MORE PHILANTHROPY. HOSPITAL CAPITAL SPENDING WILL BE DRIVEN BY GROWING DEMANDS FOR ADVANCED TECHNOLOGY NEEDED TO ENSURE PATIENT QUALITY AND SAFETY, THE NEED TO REPLACE AND UPDATE AGING FACILITIES, AND THE DESIRE AND NEED TO IMPROVE TECHNOLOGY BASED SERVICES.5. RISK MANAGEMENT AND COMPLIANCE: HEALTHCARE'S TECHNOLOGY HAS NEVER BEEN MORE COMPLICATED, PATIENTS' DEMANDS HIGHER, AND THE BUSINESS CHALLENGES GREATER. ACCORDINGLY, COMPREHENSIVE RISK MANAGEMENT PROGRAM ARE ESSENTIAL IN ASSURING CARE DELIVERY SYSTEMS THAT ARE HIGHLY EFFECTIVE IN TERMS OF ASSURING APPROPRIATE LEVELS OF PATIENT SAFETY AND QUALITY. THE DEPARTMENT OF JUSTICE ESTIMATES THAT THE FEDERAL GOVERNMENT LOSSES BILLIONS OF DOLLARS ANNUALLY IN HEALTH CARE FRAUD. CONSEQUENTLY, THE GOVERNMENT'S HEALTHCARE FRAUD ENFORCEMENT ACTIVITIES WITH RESPECT TO ALL HEALTHCARE PROVIDERS CONTINUE TO GROW AND EXPAND. WELL ESTABLISHED CORPORATE COMPLIANCE PROGRAMS ARE ESSENTIAL IN TERMS OF ALLOWING HOSPITALS TO IDENTIFY POTENTIAL AREAS OF LIABILITY AND TO CORRECT PROBLEMS.6. NURSING:NURSES AND NURSING CARE ARE CENTRAL TO THE DELIVERY OF SAFE AND EFFECTIVE PATIENT CARE. ACCORDINGLY, ENSURING AN ADEQUATE NURSING WORKFORCE AND CREATING A WORK ENVIRONMENT THAT SUPPORTS NURSING PRACTICE AND INTER-DISCIPLINARY COLLABORATION ARE IMPORTANT PRIORITIES FOR HOSPITALS TODAY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>INSURANCE INFORMATION IS GATHERED DURING THE SCHEDULING AND/OR REGISTRATION PROCESS. IF THE PATIENT INDICATES THAT THEY HAVE NO INSURANCE, REGISTRATION STAFF WILL ASK THE PATIENT FOR PERMISSION TO TRANSFER THEM TO SOUTHERN TIER HEALTHCARE SYSTEMS FOR ASSISTANCE WITH SCREENING FOR ELIGIBILITY FOR GOVERNMENT PROGRAMS (I.E. MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS). SOUTHERN TIER HEALTHCARE SYSTEMS' PERSONNEL WILL CONTACT THE PATIENT AND DISCUSS OPTIONS, INCLUDING THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND CAN DISCUSS AND SHARE INFORMATION WITH PATIENTS AT ANY TIME BEFORE, DURING OR AFTER THE EPISODE OF CARE. BILLING STATEMENTS CONTAIN THE FOLLOWING MESSAGE: "IF YOU HAVE ANY QUESTIONS OR WOULD LIKE TO APPLY FOR OUR FINANCIAL ASSISTANCE PROGRAM, PLEASE CALL OUR OFFICE AT " THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL WEBSITE TO HELP EDUCATE THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>OLEAN GENERAL HOSPITAL IS LOCATED IN OLEAN, NEW YORK, THE LARGEST CITY IN CATTARAUGUS COUNTY. THE HOSPITAL SERVES APPROXIMATELY 86,000 RESIDENTS OF CATTARAUGUS COUNTY AND THE SURROUNDING AREA. THE POPULATION OF THE AREA IS DISTRIBUTED AS FOLLOWS: 22% UNDER THE AGE OF 18, 60% AGE 18 TO 64, AND 18% 65 AND OLDER. APPROXIMATELY ONE IN TEN FAMILIES (10.5%0 ARE LIVING IN POVERTY, WHICH IS SLIGHTLY HIGHER THAN THE STATE (9.9%). IT IS ESTIMATED THAT 55.0% OF THE POPULATION AGE 16 AND OLDER IS CIVILIAN EMPLOYED, WHILE 2.5% ARE UNEMPLOYED. OF THOSE AGE 16 AND OLDER, 42.5% ARE NOT IN THE WORKFORCE. AVERAGE HOUSEHOLD INCOME $71,678, MEDIAN HOUSEHOLD INCOME $54,151. THE BRADFORD CAMPUS IS LOCATED IN BRADFORD, PA. THE HOSPITAL SERVES APPROXIMATELY 40,500 RESIDENTS OF MCKEAN COUNTY AND THE SURROUNDING AREA. THE MEDIAN HOUSEHOLD INCOME IS $56,117.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER(S) ACTIVITIES FOCUS AROUND PROVIDING ACCESS QUALITY CARE TO CATTARAUGUS COUNTY IN NEW YORK, MCKEAN COUNTY IN PENNSYLVANIA, AND SURROUNDING RURAL AREAS. THE MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY BY THE ELECTION OF A COMMUNITY BASED BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS REPRESENTED BY A DEDICATED AND DIVERSE GROUP OF COMMUNITY LEADERS WHOSE PURPOSE IS TO REMAIN FAITHFUL TO THE MISSION OF THE MEDICAL CENTER(S) - TO PROVIDE QUALITY, COMPASSIONATE, ACCESSIBLE CARE. THE MEDICAL CENTER(S) PARTNER WITH LOCAL COMMUNITY PROVIDERS TO EXTEND THE AVAILABILITY OF SERVICES PROVIDED WITHIN THE CAMPUS. THE BROADER USE OF THE MEDICAL FACILITY BY LOCAL PROVIDERS ALLOWS FOR THE GROWTH OF THE MEDICAL CENTER AND ITS SERVICES. ALL EFFORTS ARE MADE BY THE MEDICAL CENTER MANAGEMENT AND BOARD OF DIRECTORS TO MODERNIZE THE CAPITAL NEEDS OF THE CENTER AND IMPROVE THE QUALITY OF CARE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>OLEAN GENERAL HOSPITAL IS PART OF THE UPPER ALLEGHENY HEALTH SYSTEM (UAHS), ORIGINALLY AN INTEGRATION OF TWO REGIONAL HOSPITALS UNDER A COMMON PARENT ORGANIZATION. UAHS HAS A MISSION OF COLLABORATIVE HEALTH CARE IN THE TWO COMMUNITIES SERVED BY THE INTEGRATED HOSPITALS TO MEET THE HEALTH CARE NEEDS OF THE RESIDENTS AND SURROUNDING AREAS. TO FURTHER THIS INTEGRATION, BRMC WAS MERGED INTO OGH ON JANUARY 12, 2018 AND IS NOW PART OF A 2 CAMPUS HOSPITAL. UAHS, WHICH INCLUDES OLEAN GENERAL HOSPITAL, IS FURTHER INCLUDED AS PART OF THE KALEIDA HEALTH AFFILIATED HEALTH CARE SYSTEM. THE FOLLOWING MEMBERS ARE INCLUDED IN THIS GROUP: THE UPPER ALLEGHENY HEALTH SYSTEM, KALEIDA HEALTH FOUNDATION, VISITING NURSING ASSOCIATION OF WNY, INC., VNA HOMECARE SERVICE, INC., AND OISHEI CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>NY,PA</ExplanationTxt>
      </SupplementalInformationDetail>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THADDEUS WOJCIK</PersonNm>
        <TitleTxt>MEDICAL STAFF PRES (AS OF 4/24)</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>145924</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>7296</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>819</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>154039</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>CERTAIN INDIVIDUALS QUALIFIED TO RECEIVE BONUS/INCENTIVE COMPENSATION PAYMENTS BASED ON CERTAIN PERFORMANCE METRICS BEING MET. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>CATTARAUGUS COUNTY CAPITAL RESOURCES CORPORATION</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>273458026</BondIssuerEIN>
        <CUSIPNum>999999999</CUSIPNum>
        <BondIssuedDt>2010-10-06</BondIssuedDt>
        <IssuePriceAmt>21585000</IssuePriceAmt>
        <PurposeDesc>REFUNDING OF BONDS, FINANCE AND NEW AMBULATORY SURGERY CENTER &amp; HIS</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <BondDefeasedAmt>21585000</BondDefeasedAmt>
        <IssuanceCostsFromProceedsAmt>431700</IssuanceCostsFromProceedsAmt>
        <SubstantialCompletionYr>2012</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I &amp; III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION (CONT.)</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION OF ORGANIZATION MISSION: (CONTINUED) THE HOSPITAL IS GOVERNED BY A 17 MEMBER BOARD OF DIRECTORS COMPRISED OF 16 VOLUNTARY INDIVIDUALS WHO RESIDE THROUGHTOUT THE OLEAN GENERAL HOSPITAL AND BRADFORD REGIONAL MEDICAL CENTER SERVICE AREAS AND THE CEO OF UPPER ALLEGHENY HEALTH SYSTEM. WITH A LICENSED CAPACITY OF 186 BEDS ON THE OLEAN CAMPUS, 20 BEDS AT THE BRADFORD CAMPUS AND 95 BEDS AT THE BRADFORD NURSING HOME, THE HOSPITAL PROVIDES THE COMMUNITY WITH VITAL HEALTH CARE SERVICES INCLUDING MEDICAL/SURGICAL, PEDIATRIC, OBSTETRICAL CARE, BEHAVIORAL HEALTH, AND LONG-TERM CARE. THE HOSPITAL ALSO PROVIDES INTENSIVE AND CORONARY CARE, CHRONIC DIALYSIS, AND 24 HOURS EMERGENCY SERVICES WITH ACCESS TO HELICOPTERS FOR EMERGENCY TRANSFER OF PATIENTS REQUIRING TERTIARY CARE. ADDITIONAL SERVICES INCLUDE DIAGNOSTIC IMAGING, LABORATORY, CARDIOPULMONARY, OCCUPATIONAL WELLNESS, DIABETES EDUCATION, PATIENT EDUCATION, RADIATION ONCOLOGY SPECIFICALLY ON THE OGH CAMPUS, A SLEEP DISORDERS CENTER AT BRMC CAMPUS, OUTPATIENT PRIMARY CARE, AND A DENTAL CENTER AT OGH CAMPUS, IN CONJUNCTION WITH THE STATE UNIVERSITY OF NEW YORK AT BUFFALO, SPONSORS NEW YORK STATE'S ONLY RURAL TRACK POST GRADUATE MEDICAL EDUCATION/RESIDENCY TRAINING PROGRAM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>UPPER ALLEGHENY HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNANCE DECISIONS ARE SUBMITTED FOR APPROVAL BY KALEIDA HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>A DRAFT COPY OF THE FORM 990 IS REVIEWED FOR ACCURACY AND COMPLETENESS BY THE SITE DIRECTOR OF FINANCE AND OTHER SENIOR MANAGEMENT OF THE UPPER ALLEGHENY HEALTH SYSTEM. IN ADDITION, A FINAL DRAFT COPY OF THE 990 IS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND COMMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL'S CONFLICT OF INTEREST POLICY IS PRESENTED AND REVIEWED ANNUALLY. EACH MEMBER OF THE BOARD COMPLETES A DISCLOSURE FORM. SEE THE FORMAL POLICY, AS OUTLINED IN THE ORGANIZATION'S BYLAWS, BELOW. THIS POLICY IS ALSO APPLICABLE TO OFFICERS OF THE ORGANIZATION. CONFLICTS OF INTEREST: EACH DIRECTOR, PRIOR TO TAKING HIS/HER POSITION ON THE BOARD, AND ALL PRESENT DIRECTORS AS SOON AS PRACTICABLE AFTER THE ADOPTION ON THESE BYLAWS, SHALL SUBMIT IN WRITING OF THE CHAIRMAN OF THE BOARD AND THE CHIEF EXECUTIVE OFFICER A LIST OF ALL BUSINESS OR OTHER ORGANIZATIONS OF WHICH HE/SHE IS AN OFFICER, DIRECTOR, TRUSTEE, MEMBER, HOWEVER (EITHER AS SOLE PROPRIETOR OR PARTNER), SHAREHOLDER WITH 5% OR GREATER INTEREST IN ALL OUTSTANDING VOTING SHARE, EMPLOYEE OR AGENT, WITH WHICH THE CORPORATE HAS, OR MIGHT BE REASONABLY IN THE FUTURE ENTER INTO, A RELATIONSHIP OR A TRANSACTION IN WHICH THE DIRECTOR WOULD HAVE CONFLICTING INTERESTS. EACH WRITTEN STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL DIRECTORS IN ORDER TO GUIDE HIS/HER CONDUCT SHALL A CONFLICT ARISE. THE CHAIRMAN-ELECT OF THE BOARD SHALL BE FAMILIAR WITH THE STATEMENT FILED BY THE CHAIRMAN. SHOULD THE CHAIRMAN-ELECT POSITION BE VACANT, THE MOST SENIOR MEMBER OF THE EXECUTIVE COMMITTEE WILL ASSUME THIS RESPONSIBILITY. AS SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD IN SUCH A WAY AS TO GIVE RISE TO A CONFLICT OF INTEREST, THE AFFECTED DIRECTOR SHALL MAKE KNOWN THE POTENTIAL CONFLICT WHETHER DISCLOSED BY HIS WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED OF HIM/HER, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO A VOTE, THE AFFECTED DIRECTOR SHALL NOT VOTE ON IT. IN THE EVENT THE CONFLICT OF INTEREST AFFECTS THE CHAIRMAN, THE CHAIRMAN-ELECT IN EMPOWERED AND SHALL REQUIRE THAT THE CHAIRMAN REMOVE HIM/HERSELF IN THE SAME MANNER, AND FOR THE DURATION OF DISCUSSION AND ACTION ON THE MATTER THE CHAIRMAN-ELECT SHALL PRESIDE. SHOULD THE CHAIRMAN-ELECT POSITION BE VACANT, THE MOST SENIOR MEMBER OF THE EXECUTIVE COMMITTEE WILL ASSUME THIS RESPONSIBILITY. IF THE MATTER IS THE ITEM OF BUSINESS FOR WHICH A SPECIAL MEETING OF THE BOARD WAS CALLED, THE AFFECTED DIRECTOR SHALL NOT BE COUNTED TO ESTABLISH A QUORUM, NOR SHALL HE/SHE PARTICIPATE IN THE DELIVERATIONS OR VOTE ON IT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE COMMITTEE OF THE HOSPITAL D/B/A THE EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) IS APPOINTED BY THE BOARD OF DIRECTORS TO ASSIST THE BOARD IN ESTABLISHING AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM OF THE HOSPITAL. THE COMMITTEE IS RESPONSIBLE FOR ADHERING TO THE OVERALL COMPENSATION PHILOSOPHY OF THE HOSPITAL. THE COMPENSATION PHILOSOPHY IS A TOTAL COMPENSATION CONCEPT THAT WILL EMPLOY A COMBINATION OF BASE SALARY, VARIABLE OPPORTUNITY, FLEXIBLE BENEFITS, DEFERED COMPENSATION AND OTHER PREREQUISITES AS MAY BE NEEDED FROM TIME TO TIME TO MAINTAIN A COMPETITIVE POSITION WITH PEER INSTITUTIONS IN THE REGION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL HAS AVAILABLE, UPON REQUEST TO ADMINISTRATION, ITS MOST RECENTLY FILED FORM 990, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS. THE HOSPITAL ALSO REPORTS ANNUALLY ITS COMMUNITY BENEFIT EFFORTS AND ISSUES ANNUAL REPORT THAT INCLUDES FINANCIAL AND OTHER INFORMATION OF INTEREST TO THE PUBLIC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 24,875,371. MANAGEMENT AND GENERAL EXPENSES 694,617. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,569,988. MEDICAL EQUIPMENT SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 1,461,743. MANAGEMENT AND GENERAL EXPENSES 3,525,775. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,987,518. BUILDING AND EQUIPMENT MAINTENANCE AND REPAIRS: PROGRAM SERVICE EXPENSES 743,740. MANAGEMENT AND GENERAL EXPENSES 681,532. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,425,272. COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 456,617. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 456,617. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 17,482,374. MANAGEMENT AND GENERAL EXPENSES 8,373,514. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,855,888. NON-HEALTHCARE PROVIDER FEES: PROGRAM SERVICE EXPENSES 5,935,944. MANAGEMENT AND GENERAL EXPENSES 1,664,612. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,600,556.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>MINIMUM PENSION LIABILITY ADJUSTMENT 4,007,000. NET ASSET CONTRIBUTIONS 3,758,000. NET ASSETS RELEASED BY FOUNDATION 3,997.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT AND COMPLIANCE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, AS WELL AS THE CHOICE OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AS PART OF KALEIDA HEALTH, THE FINANCIAL STATEMENTS OF OLEAN GENERAL HOSPITAL ARE PART OF THE CONSOLIDATED STATEMENTS ISSUED BY KALEIDA HEALTH. ADDITIONAL INFORMATION IS CONTAINED WITHIN THE KALEIDA HEALTH LONG-FORM REPORT. ANY AUDIT ISSUES RAISED BY THE KALEIDA HEALTH AUDITORS ARE REVIEWED BY THE OGH AUDIT AND COMPLIANCE COMMITTEE. KALEIDA HEALTH HAS AN AUDIT AND COMPLIANCE COMMITTEE THAT OVERSEES THE PROCESS AND SELECTED THE INDEPENDENT ACCOUNTANT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>OLEAN GENERAL HOSPITAL FOUNDATION</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>515 MAIN STREET</AddressLine1Txt>
          <CityNm>OLEAN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14670</ZIPCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>KALEIDA HEALTH</BusinessNameLine1Txt>
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          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
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        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>BRADFORD HOSPITAL FOUNDATION</BusinessNameLine1Txt>
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        <USAddress>
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          <CityNm>BRADFORD</CityNm>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA HOME CARE SERVICES</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
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          <StateAbbreviationCd>NY</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>HOME HLTH CAR</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA OF WESTERN NEW YORK</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VISK</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
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        <EIN>222738425</EIN>
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        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>KALEIDA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
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        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>KH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION</BusinessNameLine1Txt>
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          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
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          <BusinessNameLine1Txt>KH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S HEALTH HOME OF WNY INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
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        <EIN>814086046</EIN>
        <PrimaryActivitiesTxt>PED HOME HLTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>UPPER ALLEGHENY HEALTH SYSTEM INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>515 MAIN STREET</AddressLine1Txt>
          <CityNm>OLEAN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14760</ZIPCd>
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        <EIN>271255425</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
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        <PublicCharityStatusTxt>12A</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>KH</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BRADFORD REGIONAL MED SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>116 INTERSTATE PARKWAY</AddressLine1Txt>
          <CityNm>BRADFORD</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>16701</ZIPCd>
        </USAddress>
        <EIN>232875157</EIN>
        <PrimaryActivitiesTxt>PHYS. GROUP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OGH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HEALTH SYSTEM PHYSICIAN PC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>130 SOUTH UNION STREET</AddressLine1Txt>
          <CityNm>OLEAN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14760</ZIPCd>
        </USAddress>
        <EIN>464304317</EIN>
        <PrimaryActivitiesTxt>PHYS. GROUP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OGH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>OLEAN GENERAL HEALTHCARE SYSTEMS LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>85 WOODRIDGE DRIVE</AddressLine1Txt>
          <CityNm>AMHERST</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14228</ZIPCd>
        </USAddress>
        <EIN>161544460</EIN>
        <PrimaryActivitiesTxt>PROVIDER OF DURABLE MEDICAL EQUIPMENT, HOME CARE PRODUCTS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OGH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <PredominantIncomeTypeTxt>RELATED</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>132178</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>946778</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HARLEM ROAD LEASING LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>3435 MAIN STREET</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14214</ZIPCd>
        </USAddress>
        <EIN>205588135</EIN>
        <PrimaryActivitiesTxt>EQUIPMENT LEASING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>AMTON IMAGING LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>199 PARK CLUB LANE SUITE 300</AddressLine1Txt>
          <CityNm>WILLIAMSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14221</ZIPCd>
        </USAddress>
        <EIN>262925470</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SITE E LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>REAL ESTATE MGMNT</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>272124795</EIN>
        <PrimaryActivitiesTxt>REAL ESTATE MGMT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SOUTHTOWNS IMAGING LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5959 BIG TREE RD SUITE 105</AddressLine1Txt>
          <CityNm>ORCHARD PARK</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14127</ZIPCd>
        </USAddress>
        <EIN>471123230</EIN>
        <PrimaryActivitiesTxt>EQUIPMENT LEASING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>COLLABORATIVE CARE VENTURES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>472365690</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GREAT LAKES MED BILLING SERVICES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>199 PARK CLUB LANE SUITE 300</AddressLine1Txt>
          <CityNm>WILLIAMSVILLE</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14221</ZIPCd>
        </USAddress>
        <EIN>461668448</EIN>
        <PrimaryActivitiesTxt>MEDICAL BILLING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ALTUS MANAGEMENT LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>840 AERO DRIVE SUITE 150</AddressLine1Txt>
          <CityNm>CHEEKTOWAGA</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14225</ZIPCd>
        </USAddress>
        <EIN>900149133</EIN>
        <PrimaryActivitiesTxt>GROUP PURCH ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>SOUTHTOWNS SURGERY CENTER LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>464742028</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>OLEAN GENERAL SERVICES CORP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>515 MAIN STREET</AddressLine1Txt>
          <CityNm>OLEAN</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14760</ZIPCd>
        </USAddress>
        <EIN>161447054</EIN>
        <PrimaryActivitiesTxt>JOINT VENTURE HOLDING COMPANY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>OLEAN GENERAL HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>576539</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>5835975</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>KALEIDA PROPERTIES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>222738483</EIN>
        <PrimaryActivitiesTxt>PROP MGMT SERV</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WESTLINK CORPORATION</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>161354421</EIN>
        <PrimaryActivitiesTxt>MED &amp; DIAG SE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>KHBC INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>462164089</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GREAT LAKES INTEGRATED NETWORK INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 200</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>823184375</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>OLEAN MEDICAL PRACTICE PLLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>726 EXCHANGE STREET SUITE 515</AddressLine1Txt>
          <CityNm>BUFFALO</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14210</ZIPCd>
        </USAddress>
        <EIN>881324896</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>