2018-11-02T08:23:24-05:00 2017-12-31 990 2017-01-01 200198518 Catholic Health System Infusion Pharmacy Inc CATH 7168282974 144 Genesee Street Buffalo NY 14203 David P Macholz VP Finance CHS Corp Controller 7168282974 2018-11-02 204.68.186.4 2018-11-02 08:22:23 ED P E6E6B1DEE2C3A01552DA3A94E9AF66566F60AB34 0E4C15207DC127BDB52450F77D4060F40C3F1AE4 2017 2019-02-21 02:37:17Z Joseph D McDonald 144 Genesee Street Buffalo NY 14203 11472188 0 X www.chsbuffalo.org X 2003 NY The Catholic Health System (CHS) Mission is to provide quality healthcare services in a home care setting. Committed to a common mission, CHS providers 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 2017 Community Service Plan can be found at https://www.chsbuffalo.org/about-us/community 11 7 45 0 57713 -380210 0 0 10873678 11412159 16469 10826 0 49203 10890147 11472188 0 0 0 0 2619425 3444339 0 0 0 7119300 7407223 9738725 10851562 1151422 620626 5150671 5689847 1137207 1127976 4013464 4561871 X The Catholic Health System (CHS) Mission is to provide quality healthcare services in a home care setting. Committed to a common mission, CHS providers 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 2017 Community Service Plan can be found at www.chsbuffalo.org. 0 0 9294348 11414475 Catholic Health System Infusion Pharmacy provides home health infusion care and supportive services to individuals throughout Western New York as well as pharmaceutical needs to Catholic Health System long term care facilities. Committed to a common mission, Western New York's Catholic Health providers continue the healing mission of Jesus. Seeking to improve the health of individuals and communities, we provide high quality service that is holistic, compassionate, and respectful of human dignity. Central to this endeavor is the service of persons who are poor and disadvantaged. For more detailed information, the 2017 Catholic Health Community Service report can be found at https://www.chsbuffalo.org/about-us/community 9294348 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 5 0 1 45 1 1 1 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X X David P Macholz 7168282974 144 Genesee Street Buffalo NY 14203 Mark Sullivan Executive VP / COO 0.00 55.00 X X 0 892421 161256 Joyce Markiewicz President & CEO Home and Community Based Care 0.00 55.00 X X 0 372553 82696 David Macholz Treasurer 0.00 55.00 X X 0 265735 51732 Brian Beitz Director 0.00 8.00 X 0 0 0 Marty Boryszak Director 0.00 55.00 X 0 326086 20914 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 Mark Jajkowski Director 0.00 55.00 X 0 24250 0 Raquel Martin DO Director 0.00 4.00 X 0 0 0 James Millard Director 0.00 55.00 X 0 322914 231028 Gary Tucker Director 0.00 55.00 X 0 323253 70511 Mary Turkiewiecz MD Director 0.00 4.00 X 0 0 0 Charles Urlaub Director 0.00 55.00 X 0 446938 47606 Katherine Vanderhorst Director 0.00 4.00 X 0 0 0 Monsignor Robert E Zapfel Director 0.00 4.00 X 0 0 0 Joseph McDonald President and CEO, CHS 0.00 55.00 X 0 1321419 187715 James A Dunlop Jr Executive VP, Finance / CFO 0.00 55.00 X 0 795936 278895 Thomas Gleason COO, Home and Community Based Care 0.00 55.00 X 0 169707 34570 Dr Michael Edbauer Chief Clinical Officer 0.00 28.00 X 0 429423 78470 Maria Foti Sr.VP, Strategic Planning 0.00 55.00 X 0 392400 91557 Dr Michael Galang Sr.VP, Chief Information Officer 0.00 55.00 X 0 546797 73371 Michael Moley Sr.VP, Human Resources 0.00 55.00 X 0 657728 135613 Nancy Sheehan Sr.VP Legal Service, General Counsel 0.00 55.00 X 0 488411 51193 Edward Dybala Pharmacist 55.00 0.00 X 140588 0 11795 Paul Bembenista Pharmacist 55.00 0.00 X 139617 0 71658 Gregory Blette Supervisor Pharmacy CHIP HC 55.00 0.00 X 127183 0 9283 Suzanne Eberle Pharmacist 55.00 0.00 X 117843 0 10830 Joan Twarog Pharmacist 55.00 0.00 X 110646 0 13182 635877 7775971 1713875 8 0 1 0 Grandview Construction Services 167 Young Street Tonawanda NY 14150 Construction Services 206186 1 Home Care Infusion Services 621610 7241107 7241107 Oral Pharmacy Services 621610 4162542 4162542 Retail Pharmacy Services 900099 8510 8510 11412159 10826 10826 Gift Shop Revenue 900099 49203 49203 49203 11472188 11414475 57713 0 2757937 1792659 965278 82936 53908 29028 440289 286188 154101 163177 106065 57112 57178 616 56562 6603773 6503482 100291 170538 170538 50284 43408 6876 2172 2172 5257 5257 44894 35596 9298 8785 8785 Bad Debt 301888 301888 Outside Services 138011 138011 Dues and Subscriptions 24443 24443 10851562 9294348 1557214 0 1695343 1953432 1402684 1263097 669555 951868 707992 623656 539538 217495 92145 322043 140000 140000 442952 435751 5150671 5689847 1120343 1107578 16864 20398 1137207 1127976 X 0 0 0 0 4013464 4561871 4013464 4561871 5150671 5689847 X 620626 -72219 X 0 1 X 1 0 X 9173440 10431317 10505257 10873678 11461362 52445054 9173440 10431317 10505257 10873678 11461362 52445054 0 0 0 52445054 2469 6417 13697 16469 10826 49878 2469 6417 13697 16469 10826 49878 9175909 10437734 10518954 10890147 11472188 52494932 0.99900 0.99900 0.00100 0.00950 X 539538 217495 322043 322043 Workers Comp Recovery 18279 Medical Malpractice Recovery 2119 Investment in Joint Venture 415353 435751 Accrued Workers Comp 18279 Accrued Medical Malpractice IBNR 2119 20398 0 0 0 0 0 0 0 0 0 Mark Sullivan Executive VP / COO 0 589554 0 181701 0 121166 0 134653 0 26603 0 1053677 0 181701 Joyce Markiewicz President & CEO Home and Community B 0 354692 0 0 0 17861 0 63393 0 19303 0 455249 0 0 David Macholz Treasurer 0 222439 0 34402 0 8894 0 25118 0 26614 0 317467 0 0 Marty Boryszak Director 0 313904 0 0 0 12182 0 12092 0 8822 0 347000 0 0 James Millard Director 0 305290 0 0 0 17624 0 206285 0 24743 0 553942 0 0 Gary Tucker Director 0 262727 0 0 0 60526 0 45307 0 25204 0 393764 0 0 Charles Urlaub Director 0 409653 0 0 0 37285 0 27553 0 20053 0 494544 0 0 Joseph McDonald President and CEO, CHS 0 748297 0 229770 0 343352 0 158886 0 28829 0 1509134 0 229770 James A Dunlop Jr Executive VP, Finance / CFO 0 528833 0 163443 0 103660 0 253453 0 25442 0 1074831 0 163443 Thomas Gleason COO, Home and Community Based Care 0 169561 0 0 0 146 0 10252 0 24318 0 204277 0 0 Dr Michael Edbauer Chief Clinical Officer 0 300713 0 106281 0 22429 0 65257 0 13213 0 507893 0 92418 Maria Foti Sr.VP, Strategic Planning 0 288899 0 86539 0 16962 0 80592 0 10965 0 483957 0 86539 Dr Michael Galang Sr.VP, Chief Information Officer 0 406244 0 122651 0 17902 0 63847 0 9524 0 620168 0 122651 Michael Moley Sr.VP, Human Resources 0 388982 0 112624 0 156122 0 114645 0 20968 0 793341 0 112624 Nancy Sheehan Sr.VP Legal Service, General Counsel 0 361936 0 108547 0 17928 0 30315 0 20878 0 539604 0 108547 Edward Dybala Pharmacist 140145 0 0 0 443 0 11637 0 158 0 152383 0 0 0 Paul Bembenista Pharmacist 136226 0 0 0 3391 0 53865 0 17793 0 211275 0 0 0 Susan Urlaub Wife of Mercy CEO, CJ Urlaub 90121 Corporate Nurse Educator 0 Kathleen Zapfel Sister-in-Law of BOD, Magr. Robert Zapfel 68944 HR Employee, CHS 0 Scott Markiewicz Son of Key Employee, Joyce Markiewicz 48434 Supervisor, Father Baker Manor 0 Julie Sullivan Daughter of Chief Operating Officer 33395 HR Employee, CHS 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 associates on the Merit program; all Physicians and Non Physician Practitioners as well as Physician groups who are independent contractors or employees of CHS; and all board members must 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 2017, the Catholic Health System utilized a Compensation Committee of the Board of Directors to monitor the Executive Compensation as per the Executive Compensation Philosophy and Strategy for the CHS CEO and top Senior Executives. 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: Minimum Pension Liability Adjustment -72,219. Catholic Health System Inc 144 Genesee Street Buffalo NY 14203 222565278 Health Care Delivery System NY 501 c 3 Schedule A line 10 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 Sisters of Charity Hospital 2157 Main Street Buffalo NY 14214 160743187 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 Fransican Sisters 291 North Street Buffalo NY 14201 160813142 Skilled Nursing Facility NY 501 c 3 Schedule A line 10 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 10 Catholic Health System Inc 0 St Francis Home in Williamsville 147 Reist Street Williamsville NY 14221 160743153 Skilled Nursing Facility NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 St Francis of Buffalo 34 Benwood Avenue Buffalo NY 14214 161523535 Skilled Nursing Facility NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 St Vincent Manor 319 Washington Street Dunkirk NY 14048 160743167 Adult Home NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 WNY Catholic Long Term Care Inc 6400 Powers Road Orchard Park NY 14127 161434368 Skilled Nursing Facility NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 Niagara Homemake Services (Mercy Home Care) 144 Genesee Street Buffalo NY 14203 161317960 Home Care Provider NY 501 c 3 Schedule A line 10 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 10 Catholic Health System Inc 0 CHS Continuing Care Foundation 144 Genesee Street Buffalo NY 14203 200947831 Foundation NY 501 c 3 Schedule A line 7 Catholic Health System Inc 0 OLV Renaissance Corporation 144 Genesee Street Buffalo NY 14203 200167745 Real Estate Holding Company NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 CHS Program of All-Inclusive Care for the Elderly 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 Road Cheektowaga NY 14225 272576645 Primary Care Provider NY 501 c 3 Schedule A line 12 Catholic Health System Inc 0 KMH Homes Inc 144 Genesee Street Buffalo NY 14203 161387890 Real Estate Holding Company NY 501 c 3 Schedule A line 10 Catholic Health System Inc 0 Mount St Marys 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 Catholic Health Home Respiratory 5200 Maryland Way Suite 400 Brentwood TN 370245018 454134007 Home Care Respiratory Services TN 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0