KALEIDA HEALTH: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: KALEIDA HEALTH (EIN 16-1533232)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-15
IRS object ID: 201723199349311347
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-15T13:53:03-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	515 Broadway 4th Floor	AddressLine1Txt
City	Albany	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	122072974	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	161533232	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KALEIDA HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% REBECCA HASLINGER	InCareOfNm
Business Name Control	KALE	BusinessNameControlTxt
Phone	7168598528	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	726 EXCHANGE STREET Suite 200	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14210	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JON SWIATKOWSKI	PersonNm
Person Title	CFO/TREASURER	PersonTitleTxt
Phone	7168598528	PhoneNum
Signature	2017-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MARILYN E FARLEY	PreparerPersonNm
PTIN	P01231880	PTIN
Phone	5184274600	PhoneNum
Preparation	2017-11-15	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.102.5	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	14012520173195000007	FederalOriginalSubmissionId
Federal Original Submission Id	2017-11-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	C69C12BFB41E5F2DBF989315BF73D8AC917A0741	AtSubmissionCreationDeviceId
At Submission Filing Device Id	9495D134D490A6B84E3CD7F5ECF2B12979C5F68F	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JODY LOMEO	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 HIGH STREET	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14203	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,399,460,625	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.KALEIDAHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1998	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	KALEIDA HEALTH PROVIDES HEALTHCARE SERVICES FOR THE EIGHT COUNTIES OF WNY AT FOUR ACUTE CARE, TWO LT CARE, AND OTHER OUTPATIENT AND PRIMARY CARE SITES.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	9565	TotalEmployeeCnt
Total Volunteers	1758	TotalVolunteersCnt
Total Gross UBI	$4,919,671	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,320,875	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$21,313,490	PYContributionsGrantsAmt
CY Contributions Grants	$39,715,656	CYContributionsGrantsAmt
PY Program Service Revenue	$1,161,013,584	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,218,391,196	CYProgramServiceRevenueAmt
PY Investment Income	$7,497,945	PYInvestmentIncomeAmt
CY Investment Income	$9,121,642	CYInvestmentIncomeAmt
PY Other Revenue	$30,359,860	PYOtherRevenueAmt
CY Other Revenue	$18,538,520	CYOtherRevenueAmt
PY Total Revenue	$1,220,184,879	PYTotalRevenueAmt
CY Total Revenue	$1,285,767,014	CYTotalRevenueAmt
PY Grants And Similar Paid	$191,300	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$464,634	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$663,521,603	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$687,042,053	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$520,408,012	PYOtherExpensesAmt
CY Other Expenses	$535,475,509	CYOtherExpensesAmt
PY Total Expenses	$1,184,120,915	PYTotalExpensesAmt
CY Total Expenses	$1,222,982,196	CYTotalExpensesAmt
PY Revenues Less Expenses	$36,063,964	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$62,784,818	CYRevenuesLessExpensesAmt
Total Assets BOY	$1,138,382,417	TotalAssetsBOYAmt
Total Assets EOY	$1,202,747,678	TotalAssetsEOYAmt
Total Liabilities BOY	$948,334,948	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,009,880,563	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$190,047,469	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$192,867,115	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$1,099,192,356	ExpenseAmt
Grant	$464,634	GrantAmt
Revenue	$1,219,881,229	RevenueAmt
Desc	KALEIDA HEALTH IS A VOLUNTARY, NOT-FOR-PROFIT; NEW YORK STATE DEPARTMENT OF HEALTH ARTICLE 28 LICENSED HOSPITAL-BASED HEALTHCARE DELIVERY SYSTEM SERVICING THE COMMUNITIES OF WESTERN NEW YORK STATE AT VARIOUS LEVELS AND WITH FACILITIES IN MULTIPLE LOCATIONS THROUGHOUT THE REGION. KALEIDA HEALTH INCLUDES THE BUFFALO GENERAL MEDICAL CENTER (BUFFALO GENERAL), MILLARD FILLMORE SUBURBAN HOSPITAL (MILLARD SUBURBAN), WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO (WOMEN & CHILDREN'S), AND DEGRAFF MEMORIAL HOSPITAL (DEGRAFF). IN ADDITION TO THE FOUR KALEIDA HEALTH (KALEIDA) HOSPITALS, KALEIDA OPERATES TWO SKILLED NURSING FACILITIES, AND NUMEROUS OUTPATIENT CLINICS. THE ABOVE FACILITIES OPERATE UNDER ONE TAX IDENTIFICATION NUMBER. OUR FAMILY OF HEALTH CARE ORGANIZATIONS IS BLENDED TOGETHER INTO ONE FRAMEWORK FOR LEADERSHIP, GOVERNANCE, SHARED SERVICES, FINANCIAL INFRASTRUCTURE AND INFORMATION TECHNOLOGY PLATFORMS. COLLECTIVELY, KALEIDA HEALTH'S MARKET SHARE IS 31.8% IN WESTERN NEW YORK, 40.0% IN ERIE COUNTY AND 29.5% IN NIAGARA COUNTY. ANNUALLY ONE MILLION COMBINED INPATIENT, EMERGENCY DEPARTMENT AND OUTPATIENT VISITS OCCUR AT THE HEALTH CARE FACILITIES IN THE KALEIDA HEALTH SYSTEM, WHICH EMPLOYS APPROXIMATELY 9,600 STAFF AND HAVE APPROXIMATELY 2,300 MEDICAL STAFF MEMBERS. DURING 2016, THERE WERE 55,696 INPATIENT DISCHARGES, OF WHICH 26% WERE MEDICAID AND MEDICAID MANAGED, 41% MEDICARE AND MEDICARE MANAGED CARE AND 1% WERE UNINSURED. KALEIDA HEALTH'S MISSION IS TO ADVANCE THE HEALTH OF OUR COMMUNITY. OUR VISION IS TO PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE. OUR VALUES CLEARLY STATE WHO WE ARE AND HOW WE PERFORM OUR WORK: CENTERED: REMAIN CENTERED AROUND THE PATIENT AND FAMILY. ACCOUNTABLE: BE ACCOUNTABLE TO PATIENTS AND EACH OTHER. RESPECT: SHOW RESPECT AND INTEGRITY. EXCELLENCE: PROVIDE EXCELLENCE IN ALL WE DO. KALEIDA HEALTH'S PROGRAMS AND AFFILIATES ARE LICENSED BY THE STATE OF NEW YORK DEPARTMENT OF HEALTH AND ACCREDITED BY DNV. KALEIDA IS CERTIFIED BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PARTICIPATION IN MEDICARE AND MEDICAID. THE ACCREDITATION COUNSEL FOR GRADUATE MEDICAL EDUCATION APPROVES ALL RESIDENCY PROGRAMS FOR PHYSICIANS, AND THE AMERICAN DENTAL ASSOCIATION APPROVES ITS DENTAL AND ORAL SURGERY PROGRAMS. KALEIDA IS ALSO A MEMBER OF THE COUNCIL OF TEACHING HOSPITALS, THE AMERICAN DENTAL ASSOCATION, THE AMERICAN MEDICAL ASSOCATION AND THE GREATER NEW YORK HOSPITAL ASSOCATION. OPERATION OF EMERGENCY ROOMS: KALEIDA HEALTH OPERATES FOUR EMERGENCY ROOMS, ONE IN EACH OF THE ACUTE CARE HOSPITALS, GENERATING A TOTAL OF 167,318 PATIENT VISITS DURING 2016. THE EMERGENCY DEPARTMENTS, WHICH OPERATE 24 HOURS A DAY, SEVEN DAYS EACH WEEK, ARE OPEN TO ANYONE, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. BOARD OF DIRECTORS AND COMMUNITY GUIDANCE: KALEIDA HEALTH MAINTAINS COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF KALEIDA HEALTH. THE MAJORITY OF THE DIRECTORS RESIDE IN WESTERN NEW YORK AND EACH DIRECTOR SERVES A THREE-YEAR TERM. OPEN MEDICAL STAFF: AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATON, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING OUR MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED. USE OF SURPLUS FUNDS: SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY. COMMUNITY BENEFIT PROGRAMS AND SERVICES: KALEIDA HEALTH OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS AND SERVICES IN RESPONSE TO THE COMMUNITY'S NEEDS, BY IMPROVING ACCESS TO CARE, IMPROVE PUBLIC HEALTH, ADVANCE KNOWLEDGE AND RELIEVE GOVERNMENT PROGRAMS. THESE PROGRAMS ARE CONDUCTED IN COMMUNITY-BASED SETTINGS SUCH AS SCHOOLS, CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS AND PROGRAMS ARE ALSO OFFERED AT KALEIDA'S HOSPITAL CAMPUSES AND FACILITIES. COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE HEALTH FAIRS, HEALTH SCREENINGS, HEALTH EDUCATION LECTURES AND WORKSHOPS FOR COMMUNITY GROUPS AND THE GENERAL PUBLIC, SCHOOL HEALTH EDUCATION PROGRAMS, AND CONSUMER HEALTH INFORMATION IN THE KALEIDA HEALTH LIBRARIES. KALEIDA ALSO OFFERS A NUMBER OF SUBSIDIZED HEALTH SERVICES SUCH AS OUTPATIENT CLINICS, LONG-TERM CARE SERVICES, WOMEN'S HEALTH CENTERS, DIALYSIS SERVICES, BEHAVIORAL HEALTH SERVICES, SCHOOL-BASED HEALTH CENTERS, EARLY CHILDHOOD PROGRAM, EARLY INTERVENTION SERVICES, FAMILY PLANNING SERVICES, WESTERN NEW YORK CLINICAL INFORMATION EXCHANGE AND HEALTH-E-LINK AND DIAGNOSTIC, THERAPEUTIC AND REHABILITATION SERVICES FOR CHILDREN WITH SPECIAL NEEDS. KALEIDA'S HOSPITALS SERVE AS A MAJOR TEACHING AFFILIATE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND DENTAL MEDICINE, WITH TRAINING TO 400 MEDICAL AND DENTAL RESIDENTS EACH YEAR. KALEIDA IS INVOLVED IN AND SPONSORS RESEARCH PROJECTS, AND WE PROVIDE LOAN FORGIVENESS FOR PHYSICIANS TO ESTABLISH OR JOIN EXISTING PRACTICES THAT SERVE THE UNDERSERVED COMMUNITIES OF BUFFALO AND WESTERN NEW YORK. KALEIDA OFFERS CLINICAL TRAINING FACILITIES AND SUPPORT FOR NURSING AND A NUMBER OF ALLIED HEALTH PROFESSIONAL TRAINING PROGRAMS AT LOCAL COLLEGES AND UNIVERSITIES, AND OTHER PROFESSIONAL DEVELOPMENT/CONTINUING EDUCATION TRAINING PROGRAMS FOR COLLEAGUES FROM HEALTH CARE ORGANIZATIONS ACROSS THE REGION.	Desc
Total Program Service Expenses	$1,099,192,356	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	600	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	9565	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Own Website	Yes (X)	OwnWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	REBECCA HASLINGER	PersonNm
Phone	7168598528	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	726 EXCHANGE STREET SUITE 200	AddressLine1Txt
City	BUFFALO	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14210	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JODY LOMEO
PRES/CEO EX-OFFICIO W/VOTE	40.0	1.0	Yes (X)	Yes (X)	$1,385,574	$0	$511,484
EVAN EVANS MD
DIRECTOR	1.0	0.0	Yes (X)		$64,419	$0	$276
JOHN R KOELMEL
FORMER CHAIRMAN (THRU 4/27/16)	1.0	0.0	Yes (X)		$0	$0	$0
DAVID A MILLING MD
SECRETARY	1.0	0.0	Yes (X)		$0	$0	$0
FRANCISCO VASQUEZ PHD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
AMY L CLIFTON
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
CHRISTOPHER T GREENE ESQ
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
DARREN J KING
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
FRANK CURCI
CHAIRMAN	1.0	0.0	Yes (X)		$0	$0	$0
KEVIN GIBBONS MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
GEORGE MATTHEWS
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
NICHOLAS J AQUINO MD
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
WILLIAM I MAGGIO
VICE CHAIR	1.0	0.0	Yes (X)		$0	$0	$0
CHRISTOPHER C ROSS
TREASURER	1.0	0.0	Yes (X)		$0	$0	$0
MARY LOU RUSIN EDD RN
DIRECTOR	1.0	0.0	Yes (X)		$0	$0	$0
ALYSON SPAULDING
GENERAL COUNSEL	40.0	0.0		Yes (X)	$456,679	$0	$255,681
DAVID HUGHES MD
EVP, CMO	40.0	0.5		Yes (X)	$582,882	$0	$225,249
TONI BOOKER
EVP, CHIEF HUMAN RESOURCES OFC	40.0	0.0		Yes (X)	$565,935	$0	$52,521
JONATHAN SWIATKOWSKI
EVP, CFO	40.0	0.5		Yes (X)	$600,904	$0	$204,595
JAMAL GHANI
FORMER EVP, COO	40.0	0.0		Yes (X)	$765,388	$0	$15,950
DONALD BOYD
EVP BUSINESS DEVELOPMENT	40.0	1.0		Yes (X)	$720,411	$0	$75,077
CHRISTOPHER LANE
VP PRESIDENT BGMC	40.0	0.0			$516,243	$0	$69,558	Yes (X)
CHERYL KLASS
EVP, CHIEF NURSE EXECUTIVE	40.0	0.0			$656,776	$0	$57,498	Yes (X)
ALLEGRA JAROS
SVP OPERATIONS WCHOB	40.0	0.0			$423,719	$0	$66,719	Yes (X)
MICHAEL HUGHES
SVP, PUBLIC AFFAIRS MARKETING	40.0	0.0			$353,581	$0	$114,218	Yes (X)
AARON HOFFMAN MD
EMPLOYED PHYSICIAN	40.0	0.0			$830,325	$0	$49,624		Yes (X)
CHRISTOPHER MALLAVARAPU MD
EMPLOYED PHYSICIAN	40.0	0.0			$901,132	$0	$47,987		Yes (X)
CARROLL HARMON MD
EMPLOYED PHYSICIAN	40.0	0.0			$639,019	$0	$10,242		Yes (X)
KATHRYN BASS MD
EMPLOYED PHYSICIAN	40.0	0.0			$586,856	$0	$40,774		Yes (X)
LAN ADAMS MD
EMPLOYED PHYSICIAN	40.0	0.0			$601,518	$0	$40,118		Yes (X)
JAMES KASKIE
FORMER CEO	0.0	0.0			$192,017	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$10,843,378	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,837,571	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	640	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SODEXO MANAGEMENT INC
PO BOX 81049	WOBURN	MA	018131049	CLEANING & DIETARY	$5,234,925
WNY RADIOLOGY LLC
PO BOX 4029	BUFFALO	NY	14240	RADIOLOGY SVCS	$5,203,248
P2P STAFFING INC
PO BOX 4729	WINTER PARK	FL	327934729	CLINICAL DOCUMENTING	$2,077,985
MACRO HELIX INC
PO BOX 742256	ATLANTA	GA	303742256	340B SOFTWARE FEES	$1,719,220
WE CARE TRANSPORTATION
401 EAST AMHERST ST	BUFFALO	NY	14215	PATIENT TRANSPORT	$1,206,360

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	71	CntrctRcvdGreaterThan100KCnt
Related Organizations	$26,490,261	RelatedOrganizationsAmt
Government Grants	$12,313,942	GovernmentGrantsAmt
All Other Contributions	$911,453	AllOtherContributionsAmt
Noncash Contributions	$3,764,608	NoncashContributionsAmt
Total Contributions	$39,715,656	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	623990	$1,212,542,689	$1,212,542,689
MANAGEMENT FEES	561000	$72,900		$72,900
LAB SERVICES	621500	$5,775,607		$5,775,607

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,218,391,196	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,977,167	TotalRevenueColumnAmt
Unrelated Business Revenue	-$1,159,658	UnrelatedBusinessRevenueAmt
Exclusion	$9,136,825	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,374,861	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,374,861	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,374,861	TotalRevenueColumnAmt
Unrelated Business Revenue	$73,363	UnrelatedBusinessRevenueAmt
Exclusion	$2,301,498	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$114,754,788	SecuritiesAmt
Other	$83,298	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$113,659,437	SecuritiesAmt
Other	$34,174	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,095,351	SecuritiesAmt
Other	$49,124	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,144,475	TotalRevenueColumnAmt
Exclusion	$1,144,475	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
REBATE REVENUE	900099	$10,388,942	$10,388,942
UNIVERSITY LEASE INCOME	531120	$1,234,980	$1,234,980
MANAGEMENT & CONSULTING FEES	541610	$980,891		$976,416	$4,475

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,558,846	TotalRevenueColumnAmt
Related Or Exempt Func Income	$513,617	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$152,984	UnrelatedBusinessRevenueAmt
Exclusion	$2,892,245	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$16,163,659	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,285,767,014	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,214,032,722	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,919,671	UnrelatedBusinessRevenueAmt
Exclusion	$27,098,965	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$464,634	TotalAmt
Program Services	$464,634	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$7,161,170	TotalAmt
Management And General	$7,161,170	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$94,559	TotalAmt
Management And General	$94,559	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$502,266,131	TotalAmt
Program Services	$468,050,420	ProgramServicesAmt
Management And General	$34,215,711	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$32,289,571	TotalAmt
Program Services	$28,692,513	ProgramServicesAmt
Management And General	$3,597,058	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$108,519,661	TotalAmt
Program Services	$98,619,175	ProgramServicesAmt
Management And General	$9,900,486	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$36,710,961	TotalAmt
Program Services	$34,146,172	ProgramServicesAmt
Management And General	$2,564,789	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,756,022	TotalAmt
Program Services	$827,405	ProgramServicesAmt
Management And General	$928,617	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$517,761	TotalAmt
Program Services	$72,765	ProgramServicesAmt
Management And General	$444,996	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$247,505	TotalAmt
Management And General	$247,505	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$135,092,966	TotalAmt
Program Services	$124,809,177	ProgramServicesAmt
Management And General	$10,283,789	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,481,269	TotalAmt
Program Services	$2,964,877	ProgramServicesAmt
Management And General	$516,392	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,410,316	TotalAmt
Program Services	$1,987,923	ProgramServicesAmt
Management And General	$422,393	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$16,928,052	TotalAmt
Program Services	$4,966,273	ProgramServicesAmt
Management And General	$11,961,779	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,020,416	TotalAmt
Program Services	$748,591	ProgramServicesAmt
Management And General	$271,825	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$13,339,740	TotalAmt
Program Services	$10,671,792	ProgramServicesAmt
Management And General	$2,667,948	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$61,449,993	TotalAmt
Program Services	$45,405,019	ProgramServicesAmt
Management And General	$16,044,974	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$7,355,934	TotalAmt
Program Services	$4,994,309	ProgramServicesAmt
Management And General	$2,361,625	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
HEALTH CARE SUPPLIES	$209,184,629	$209,621,824	-$437,195
EQPT RENTAL & MAINTENANCE	$29,678,019	$13,022,180	$16,655,839
OTHER	$26,531,307	$27,677,845	-$1,146,538
SERVICE CONTRACTS	$11,776,819	$9,971,280	$1,805,539

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$14,704,761	TotalAmt
Program Services	$11,478,182	ProgramServicesAmt
Management And General	$3,226,579	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,222,982,196	TotalAmt
Program Services	$1,099,192,356	ProgramServicesAmt
Management And General	$123,789,840	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$41,396,112	BOYAmt
EOY	$23,733,732	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$44,682,583	BOYAmt
EOY	$10,080,703	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$159,866,006	BOYAmt
EOY	$164,283,239	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$25,724,911	BOYAmt
EOY	$27,764,208	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$10,908,230	BOYAmt
EOY	$15,364,653	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,697,240,957	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,136,335,001	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$481,932,950	BOYAmt
EOY	$560,905,956	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$74,551,845	BOYAmt
EOY	$118,829,598	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$66,484,188	BOYAmt
EOY	$49,738,308	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$232,835,592	BOYAmt
EOY	$232,047,281	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,138,382,417	BOYAmt
EOY	$1,202,747,678	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$149,661,885	BOYAmt
EOY	$155,402,146	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$9,843,323	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$313,990,121	BOYAmt
EOY	$349,965,673	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$484,682,942	BOYAmt
EOY	$494,669,421	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$948,334,948	BOYAmt
EOY	$1,009,880,563	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$67,087,683	BOYAmt
EOY	$86,795,710	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$103,226,405	BOYAmt
EOY	$85,831,208	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$19,733,381	BOYAmt
EOY	$20,240,197	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$190,047,469	BOYAmt
EOY	$192,867,115	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,138,382,417	BOYAmt
EOY	$1,202,747,678	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$62,784,818	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$207,690	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$59,757,482	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	Yes (true)	VolunteersInd
Paid Staff Or Management	Yes (true)	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$89,156	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$158,349	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$247,505	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	GRANTS TO OTHER ORGANIZATIONS & DIRECT CONTACT WITH LEGISLATIVE BODY	FormAndLineReferenceDesc
Explanation	SCHEDULE C, PART II-B, QUESTIONS 1F AND 1G THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1F REPRESENTS THE PORTION OF THE DUES PAID TO THE GREATER NEW YORK HOSPITAL ASSOCIATION ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1G REPRESENTS PAYMENTS MADE TO ORGANIZATIONS IN AN EFFORT TO ADVOCATE ON THE ORGANIZATION'S BEHALF AT THE NEW YORK STATE AND FEDERAL LEVELS AS IT SPECIFICALLY RELATES TO HEALTH CARE LEGISLATION AND REGULATORY ISSUES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$29,821,659	BeginningYearBalanceAmt
Contributions	$1,770,884	ContributionsAmt
Investment Earnings Or Losses	-$6,512,169	InvestmentEarningsOrLossesAmt
Other Expenditures	-$2,358,931	OtherExpendituresAmt
End Year Balance	$27,439,305	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$30,738,989	BeginningYearBalanceAmt
Contributions	$1,435,796	ContributionsAmt
Investment Earnings Or Losses	-$1,046,152	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,306,974	OtherExpendituresAmt
End Year Balance	$29,821,659	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$30,087,437	BeginningYearBalanceAmt
Contributions	$1,656,821	ContributionsAmt
Investment Earnings Or Losses	$850,732	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,856,001	OtherExpendituresAmt
End Year Balance	$30,738,989	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$28,644,541	BeginningYearBalanceAmt
Contributions	$1,589,183	ContributionsAmt
Investment Earnings Or Losses	$1,819,135	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,965,422	OtherExpendituresAmt
End Year Balance	$30,087,437	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$46,995,623	BeginningYearBalanceAmt
Contributions	$3,133,756	ContributionsAmt
Investment Earnings Or Losses	$2,880,650	InvestmentEarningsOrLossesAmt
Other Expenditures	$24,365,488	OtherExpendituresAmt
End Year Balance	$28,644,541	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.74670	BoardDesignatedBalanceEOYPct
Term Endowment Balance EOY	0.25330	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,713,867	OtherCostOrOtherBasisAmt
Book Value	$6,713,867	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$509,115,193	OtherCostOrOtherBasisAmt
Depreciation	$358,135,110	DepreciationAmt
Book Value	$150,980,083	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,165,959,196	OtherCostOrOtherBasisAmt
Depreciation	$768,173,500	DepreciationAmt
Book Value	$397,785,696	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,452,701	OtherCostOrOtherBasisAmt
Depreciation	$10,026,391	DepreciationAmt
Book Value	$5,426,310	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$560,905,956	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDesc	Book ValueBookValueAmt
DEFERRED FINANCING	$11,069,506
INTEREST IN NET ASSETS OF FDNS	$136,548,290
OTHER RECEIVABLES	$39,724,716
OTHER ASSETS	$27,668,244
ESTIMATED 3RD PARTY PAYOR REC	$14,451,655
GRANT RECEIVABLE - LT	$2,584,870

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$232,047,281	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DUE TO THIRD PARTY PAYORS	$18,883,081
SELF INSURANCE LIABILITY	$146,611,429
OTHER LIABILITIES	$20,359,841
PENSION LIABILITY	$288,441,474
ASSET RETIREMENT OBLIGATIONS	$13,600,635
CAPITAL LEASE OBLIGATIONS	$6,772,961

Field	Value	IRS element (for citing)
Total Liability	$494,669,421	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
INTENDED USE OF ENDOWMENTS:	SCHEDULE D, PART V, QUESTION 4 THE FOLLOWING ARE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS: 1) CAPITAL EXPANSION AND IMPROVEMENT 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES 3) SUPPORT PEDIATRIC HEALTH CARE SERVICES
FIN 48 FOOTNOTE:	SCHEDULE D, PART X, QUESTION 2 KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$32,679,282	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Spent	$32,679,282	SubtotalSpentAmt
Total Spent	$32,679,282	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	Yes (true)	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,104,216	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,403,369	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,700,847	NetCommunityBenefitExpnsAmt
Total Expense	0.00380	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$355,749,804	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$256,839,481	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$98,910,323	NetCommunityBenefitExpnsAmt
Total Expense	0.08090	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$367,854,020	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$264,242,850	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$103,611,170	NetCommunityBenefitExpnsAmt
Total Expense	0.08470	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,306,184	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,306,184	NetCommunityBenefitExpnsAmt
Total Expense	0.00520	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$53,734,461	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,423,801	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$31,310,660	NetCommunityBenefitExpnsAmt
Total Expense	0.02560	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,765,829	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,420,955	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$27,344,874	NetCommunityBenefitExpnsAmt
Total Expense	0.02240	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$95,806,474	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$30,844,756	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$65,099,043	NetCommunityBenefitExpnsAmt
Total Expense	0.05330	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$463,660,494	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$295,087,606	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$168,710,213	NetCommunityBenefitExpnsAmt
Total Expense	0.13800	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	172	ActivitiesOrProgramsCnt
Persons Served	38992	PersonsServedCnt
Total Community Benefit Expns	$93,426	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$93,426	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	172	ActivitiesOrProgramsCnt
Persons Served	38992	PersonsServedCnt
Total Community Benefit Expns	$93,426	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$93,426	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$9,391,417	BadDebtExpenseAmt
Bad Debt Expense Attributable	$575,224	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$184,107,379	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$166,009,319	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$18,098,060	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (13 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
MFSC LLC
PHYSICIAN SERVICES	0.55768	0.44232
COMMUNITY MEDICAL
PHYSICIAN SERVICES		1.0
GENERAL PHYSICIANS
PHYSICIAN SERVICES		1.0
HARLEM ROAD LEASING
MRI EQUIPMENT LEASING	0.5
AMTON IMAGING LLC
HEALTH CARE SERVICES	0.5
WNY HEALTHENET LLC
HEALTH CARE SERVICES	0.14286
SITE E LLC
REAL ESTATE LEASING CO	0.50151
ALTUS MANAGEMENT
GROUP PURCHASING ORGANIZATION	0.49917
SOUTHTOWNS IMAGING
IMAGING EQUIPMENT LEASING	0.7
COLLABORATIVE CARE
HEALTH CARE SERVICES	0.6
GL MEDICAL BILLING
MEDICAL BILLING	0.5
GREAT LAKES PHYS PC
PHYSICIAN SERVICES		1.0
SOUTHTOWNS SURG CTR
PHYSICIAN SERVICES	0.63171	0.36829

Field	Value	IRS element (for citing)
Hospital Facilities	4	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd	Childrens HospitalChildrensHospitalInd
BUFFALO GENERAL MEDICAL CENTER
1	100 HIGH STREET	BUFFALO	NY	14203	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
WOMEN & CHILDREN'S HOSPITAL OF BUFFAL
2	219 BRYANT STREET	BUFFALO	NY	14222	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A	Yes (X)
MILLARD FILLMORE SUBURBAN HOSPITAL
3	1540 MAPLE ROAD	WILLIAMSVILLE	NY	14221	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
DEGRAFF MEMORIAL HOSPITAL
4	445 TREMONT STREET	NORTH TONAWANDA	NY	14120	WWW.KALEIDAHEALTH.ORG	1401014H	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GROUP A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	14	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.kaleidahealth.org/community	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.kaleidahealth.org/community	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.KALEIDAHEALTH.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.KALEIDAHEALTH.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.KALEIDAHEALTH.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	false	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 5	GROUP A IN CONDUCTING ITS 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY SERVICE PLAN (CHNA-CSP), KALEIDA HEALTH TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITALS LOCATED IN ERIE AND NIAGARA COUNTIES, THE PRIMARY SERVICE AREA. FOR EACH COUNTY, KALEIDA HEALTH PARTICIPATED IN COLLABORATIVE WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH AND COMPRISED OF REPRESENTATIVES FROM OTHER HOSPITALS, ORGANIZATIONS, AGENCIES, AND SCHOOLS; AND INCLUDED INPUT FROM THE COMMUNITY INCLUDING THE MEDICALLY UNDERSERVED. FROM MARCH THROUGH AUGUST 2016, THE ERIE COUNTY WORK GROUP CONDUCTED COUNTY-WIDE ASSESSMENT ACTIVITIES INCLUDING A CONSUMER SURVEY WITH 1,839 RESPONSES AND FIVE COMMUNITY FOCUS GROUP SESSIONS. THERE WERE SEVERAL SURVEY DISTRIBUTION SITES ACROSS THE COUNTY AND OF THE 1,839 SURVEY RESPONSES, 21.3% WERE FROM RESPONDENTS INDICATING AN INCOME BELOW $35,000. KALEIDA HEALTH DISTRIBUTED THE SURVEY IN ITS PRIMARY CARE CLINICS OF WHICH A SIGNIFICANT NUMBER OF PATIENTS ARE INSURED THROUGH MEDICAID. FOCUS GROUP SESSIONS WERE HELD AT A GEOGRAPHIC CROSS-SECTION OF SITES INCLUDING THE CAZENOVIA LIBRARY, UNITED WAY, AND MERRIWEATHER LIBRARY IN BUFFALO, SPRINGVILLE FIRE HALL IN SPRINGVILLE, AND THE ERIE COUNTY FIRE TRAINING ACADEMY IN CHEEKTOWAGA. KALEIDA HEALTH PROMOTED THE MERRIWEATHER LIBRARY EVENT LOCATED ON BUFFALO'S EAST SIDE, A LOW INCOME AND MEDICALLY UNDERSERVED COMMUNITY, THROUGH A PROMOTIONAL EMAIL TO THE MEMBERS OF THE NEAR EAST SIDE AND WEST SIDE TASK FORCE. KALEIDA HEALTH PROVIDED LINKS TO THE CONSUMER SURVEY AND PROMOTED THE FOCUS GROUP SESSIONS ON ITS PUBLIC WEBSITE, EMPLOYEE WEBSITE, AND ON FACEBOOK. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES, AND ARE INCLUDED IN KALEIDA HEALTH'S 2016-2018 CHNA-CSP AND ALIGNED WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN. FROM MARCH THROUGH AUGUST 2016, THE NIAGARA COUNTY WORK GROUP CONDUCTED COUNTY-WIDE ASSESSMENT ACTIVITIES INCLUDING A CONSUMER SURVEY WITH 2,111 RESPONSES AND NINE COMMUNITY FOCUS GROUP SESSIONS. THERE WERE SEVERAL SURVEY DISTRIBUTION SITES AND OF THE 1,655 SURVEY RESPONDENTS WHO ANSWERED THE QUESTION ON ANNUAL HOUSEHOLD INCOME, 26.7% HAD AN INCOME OF LESS THAN $35,000. KALEIDA HEALTH'S DEGRAFF MEMORIAL HOSPITAL DISTRIBUTED THE SURVEY IN HOSPITAL WAITING AREAS, FRONT DESK, SWITCHBOARD, PHYSICIAN OFFICES, OB/GYN CLINICS, AND THE DEGRAFF MCLAUGHLIN CENTER FOR SENIOR WELLNESS. COMMUNITY FOCUS GROUP SESSIONS WERE HELD AT A GEOGRAPHIC CROSS-SECTION OF SITES INCLUDING THOSE LOCATED IN MEDICALLY UNDERSERVED COMMUNITIES. SITES INCLUDED THE NEIGHBORHOOD HEALTH CENTER AND BETHANY BAPTIST CHURCH IN NIAGARA FALLS, WOODLANDS SENIOR VILLAGE AND DEGRAFF COMMUNITY CENTER IN NORTH TONAWANDA; HARTLAND BIBLE CHURCH IN GASPORT; OLCOTT UNITED METHODIST CHURCH AND NEWFANE FOOD PANTRY IN NEWFANE; EASTERN NIAGARA HOSPITAL IN LOCKPORT; AND MOUNT ST. MARY'S HOSPITAL IN LEWISTON. A COUNTY-WIDE FOCUS GROUP SESSION WAS ALSO HELD TO GET INPUT FROM SEVERAL COMMUNITY-BASED HEALTH, MENTAL HEALTH, AND SOCIAL SERVICE ORGANIZATIONS ACROSS THE COUNTY. KALEIDA HEALTH PROVIDED LINKS TO THE CONSUMER SURVEY AND PROMOTED THE FOCUS GROUP SESSIONS ON ITS PUBLIC WEBSITE, EMPLOYEE WEBSITE, AND ON FACEBOOK. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES INCLUDED IN KALEIDA HEALTH'S CHNA-CSP AND ALIGNED WITH THE NIAGARA COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN. THE KALEIDA HEALTH 2016-2018 CHNA-CSP IS AVAILABLE TO THE PUBLIC IN THE COMMUNITY HEALTH SECTION OF THE KALEIDA HEALTH WEBSITE AT WWW.KALEIDAHEALTH.ORG AND SPECIFICALLY AT HTTP://KALEIDAHEALTH.ORG/COMMUNITY/PUBLICATIONS.ASP. A PAPER VERSION IS AVAILABLE UPON REQUEST AT NO CHARGE. WRITTEN COMMENTS ON THE CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN" LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. THIS INFORMATION IS DOCUMENTED IN THE CHNA-CSP IN THE DISSEMINATION TO THE PUBLIC SECTION. NO COMMENTS ON THE CHNA-CSP WERE RECEIVED IN 2016.
PART V, SECTION B, LINE 6A	GROUP A KALEIDA HEALTH'S FOUR HOSPITALS ARE INCLUDED IN ITS 2016-2018 CHNA-CSP: BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, WOMEN & CHILDREN'S HOSPITAL OF BUFFALO, ALL LOCATED IN ERIE COUNTY, AND DEGRAFF MEMORIAL HOSPITAL LOCATED IN NIAGARA COUNTY. IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND INCLUDED UNRELATED HOSPITAL FACILITIES OF THE CATHOLIC HEALTH SYSTEM. IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE NIAGARA COUNTY DEPARTMENT OF HEALTH, AND INCLUDED THE FOLLOWING UNRELATED HOSPITAL FACILITIES: NIAGARA FALLS MEMORIAL MEDICAL CENTER, MOUNT ST MARY HOSPITAL, AND EASTERN NIAGARA HOSPITAL SYSTEM.
PART V, SECTION B, LINE 6B	GROUP A IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2016-2018 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: ERIE COUNTY DEPARTMENT OF HEALTH, UNITED WAY OF BUFFALO AND ERIE COUNTY, P2 COLLABORATIVE OF WNY, BUFFALO STATE COLLEGE, UB SCHOOL OF PUBLIC HEALTH, UB FAMILY MEDICINE PRIMARY CARE RESEARCH CENTER, DAEMEN COLLEGE, AND D'YOUVILLE COLLEGE. IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2016-2018 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: NIAGARA COUNTY DEPARTMENT OF HEALTH, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH, AND THE P2 COLLABORATIVE OF WNY.
PART V, SECTION B, LINE 11	GROUP A WITH HOSPITALS LOCATED IN BOTH ERIE AND NIAGARA COUNTIES, KALEIDA HEALTH WORKED COLLABORATIVELY WITH WORK GROUPS LED BY THE ERIE COUNTRY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH TO REVIEW HEALTH CARE DATA, DISSEMINATE CONSUMER SURVEYS AND CONDUCT FOCUS GROUP SESSIONS TO PRIORITIZE SIGNIFICANT HEALTH NEEDS AND IMPLEMENTATION STRATEGIES FOR EACH COUNTY. THE STRATEGIES FURTHER ALIGN WITH THE PRIORITY AREAS OF THE NEW YORK STATE PREVENTION AGENDA. KALEIDA HEALTH INCLUDED THESE COLLABORATIVE PRIORITY AREAS IN ITS 2016-2018 CHNA-CSP. HEALTH CARE NEEDS ADDRESSED IN KALEIDA HEALTH'S 2016-2018 CHNA-CSP: IN ERIE COUNTY AND NIAGARA COUNTY, CARDIOVASCULAR DISEASE IS THE NUMBER ONE CAUSE OF DEATH (2014, NYS VIRAL STATISTICS), AND THERE IS A HIGH INCIDENCE OF RISK FACTORS AMONG RESIDENTS INCLUDING HIGH BLOOD PRESSURE, DIABETES, OBESITY, AND SMOKING. OUTREACH THROUGH PUBLIC EDUCATION EVENTS HOSTED BY KALEIDA HEALTH HOSPITALS HAVE BEEN HELD IN COLLABORATION WITH NUMEROUS ORGANIZATIONS INCLUDING THOSE REPRESENTING THE MEDICALLY UNDERSERVED. ADDITIONALLY, CARDIOVASCULAR EDUCATION AND SCREENING TARGETING LOW INCOME WOMEN IS ADDRESSED IN THE CLINICAL SETTING THROUGH A PROGRAM FOR PATIENTS OF KALEIDA HEALTH'S OB-GYN CENTERS, WHERE 73% OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID. THIS STRATEGY ALIGNS WITH THE NYS PREVENTION AGENDA PRIORITY TO PREVENT CHRONIC DISEASE AND TO INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT IN CLINICAL AND COMMUNITY SETTINGS. THE HEALTH BENEFITS OF BREASTFEEDING FOR BOTH INFANT AND MOTHER ARE WELL DOCUMENTED AND THE NEW YORK STATE PREVENTION AGENDA SUPPORTS THE PROMOTION OF BREASTFEEDING TO INCREASE THE PROPORTION OF NEW YORK STATE BABIES WHO ARE BREASTFED. IN ERIE COUNTY, THE PERCENT OF INFANTS FED ANY BREAST MILK IN A DELIVERY HOSPITAL WAS 72.1% AND EXCLUSIVELY FED BREAST MILK WAS 51.1% (2012-2014, NYS VITAL STATISTICS). KALEIDA HEALTH IS WORKING TO INCREASE BREASTFEEDING RATES AT ITS DELIVERY HOSPITALS THROUGH EVIDENCE-BASED PROMOTION AND EDUCATION INITIATIVES. THE NEEDS OF THE MEDICALLY UNDERSERVED ARE ADDRESSED GIVEN THAT 68.85% OF INPATIENT DISCHARGES, ED VISITS AND OUTPATIENT VISITS AT WOMEN & CHILDREN'S HOSPITAL OF BUFFALO AND 11.8% AT MILLARD FILLMORE SUBURBAN HOSPITAL ARE REIMBURSED BY MEDICAID. HIGH RATES OF POOR MENTAL HEALTH, DRUG ADDICTION, AND BINGE DRINKING IN NIAGARA COUNTY; IN ADDITION TO A SUICIDE DEATH RATE OF 16% VS THE NEW YORK STATE RATE OF 7.9% (2012-2014, NYS PREVENTION AGENDA DASHBOARD) INDICATE A DIRE NEED TO ADDRESS MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES IN THE COUNTY. ACCESS TO ADEQUATE MENTAL HEALTH CARE AND RESOURCES IS AN ADDED CHALLENGE. IN RESPONSE, KALEIDA HEALTH'S DEGRAFF MEMORIAL HOSPITAL WILL PROMOTE BOTH PROVIDER AND PUBLIC AWARENESS AND KNOWLEDGE OF MENTAL HEALTH CONDITIONS AND SUBSTANCE ABUSE; AND THE AVAILABLE RESOURCES. THIS PROJECT ADDRESSES THE NEEDS OF THIS POPULATION AS A MEDICALLY UNDERSERVED DISPARITY POPULATION. IT ALSO ALIGNS WITH THE NYS PREVENTION AGENDA PRIORITY TO PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE. THE CHILDREN'S PSYCHIATRY CLINIC OF KALEIDA HEALTH'S WOMEN & CHILDREN'S HOSPITAL OF BUFFALO IN NEIGHBORING ERIE COUNTY, PROVIDES AN ADDED RESOURCE FOR PEDIATRIC MENTAL HEALTH SERVICES FOR NIAGARA COUNTY RESIDENTS. HEALTH CARE NEEDS NOT ADDRESSED IN KALEIDA HEALTH'S 2016-2018 CHNA-CSP: THE RISING OPIOID ADDICTION PROBLEM IS AN EMERGING AREA OF CONCERN IN BOTH ERIE AND NIAGARA COUNTIES. THE ERIE COUNTY DEPARTMENT OF HEALTH INCLUDED IT IN ITS COMMUNITY HEALTH IMPROVEMENT PLAN. HOWEVER, IT WAS NOT INCLUDED IN KALEIDA HEALTH'S CHNA-CSP DUE TO AN ADMINISTRATIVE TIMING ISSUE. HOWEVER, ERIE COUNTY IS AWARE THAT KALEIDA HEALTH IS COMMITTED TO WORKING WITH ITS ERIE COUNTY PARTNERS TO ADDRESS THE PROBLEM. IN 2016, THROUGH A PARTNERSHIP WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, KALEIDA HEALTH HOSPITALS INCLUDING BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, DEGRAFF MEMORIAL HOSPITAL, AND WOMEN & CHILDREN'S HOSPITAL OF BUFFALO EMERGENCY DEPARTMENTS BEGAN TO DISPENSE THE NARCAN OPIOID OVERDOSE KITS TO PATIENTS AND CAREGIVERS FOR PATIENTS WITH AN OPIOID OVERDOSE OR IS AT RISK FOR AN OPIOID OVERDOSE. THE COUNTY SUPPLIED THE KITS AND EMERGENCY DEPARTMENT PHYSICIANS PROVIDED THE PATIENT/CAREGIVER EDUCATION ON THE USE OF NARCAN. KALEIDA HEALTH WILL CONTINUE TO PARTNER WITH THE COUNTY AND OTHERS TO ADDRESS THIS SIGNIFICANT HEALTH CARE PROBLEM. THE NIAGARA COUNTY DEPARTMENT OF HEALTH IS ADDRESSING THE OPIOID PROBLEM AS IT ADDRESSES MENTAL HEALTH AND SUBSTANCE ABUSE IN ITS COMMUNITY HEALTH IMPROVEMENT PLAN. KALEIDA HEALTH IS A PARTNER IN THIS NIAGARA COUNTY PRIORITY AREA THROUGH ITS DEGRAFF MEMORIAL HOSPITAL AS IDENTIFIED ABOVE AND IN THE WORK PLAN SECTION OF KALEIDA HEALTH'S 2016-2018 CHNA-CSP. FALLS PREVENTION AMONG NIAGARA COUNTY'S SENIOR POPULATION WAS ADDRESSED THROUGH IMPLEMENTATION STRATEGIES INCLUDED IN KALEIDA HEALTH'S LAST CHNA CONDUCTED IN 2013. THE STEP UP TO STOP FALLS PROGRAM WAS HIGHLY SUCCESSFUL AND WHILE NOT INCLUDED AS A PRIORITY AREA IN THE NIAGARA COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN AND KALEIDA HEALTH'S CHNA-CSP, THE PROGRAM WILL CONTINUE TO EXIST. THE NIAGARA COUNTY COLLABORATIVE WORK GROUP DECIDED TO PRIORITIZE OTHER COMMUNITY HEALTH NEEDS FOR 2016-2018. WHILE CANCER IS IDENTIFIED AS THE NUMBER TWO CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES AND IS A PUBLIC HEALTH CONCERN, IT IS NOT ADDRESSED AS A FOCUS AREA IN THE COUNTY COMMUNITY HEALTH IMPROVEMENT PLANS OR IN KALEIDA HEALTH'S CHNA-CSP FOR 2016-2018, AS THE COUNTY WORK GROUPS DECIDED TO PRIORITIZE OTHER AREAS OF CONCERN. HOWEVER, CANCER IS ADDRESSED BY SEVERAL HOSPITALS AND COMMUNITY BASED PREVENTION, EDUCATION, AND TREATMENT INITIATIVES THROUGHOUT THE REGION. KALEIDA HEALTH PROVIDES ONCOLOGY SERVICES AT SEVERAL FACILITIES AND IN 2015, KALEIDA HEALTH ACQUIRED CANCER CARE OF WESTERN NEW YORK, AN ONCOLOGY TREATMENT PRACTICE. IN 2016, KALEIDA HEALTH HELD TWO MEN'S PROSTATE CANCER OUTREACH AND SCREENING EVENTS TARGETING BUFFALO'S AFRICAN AMERICAN AND HISPANIC POPULATIONS IN COLLABORATION WITH WNY UROLOGY AND CANCER CARE OF WNY.
PART V, SECTION B, LINE 16J	GROUP A INFORMATION THAT EXPLAINS HOW QUALIFIED PATIENTS CAN ACCESS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL IS INCLUDED ON BILLS AND STATEMENTS TO PATIENTS. APPLICATION MATERIALS INCLUDE A NOTICE TO THE PATIENTS THAT ONCE THEY SUBMIT A COMPLETED APPLICATION AND DOCUMENTATION, THEY MAY DISREGARD ANY BILLS UNTIL THE HOSPITAL HAS RENDERED A WRITTEN DECISION ON THE APPLICATION. THE HOSPITAL MAY NOT FORWARD ACCOUNTS TO COLLECTION WHILE AN APPLICATION IS PENDING.

Field	Value	IRS element (for citing)
Facility	29	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (29 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
HIGHPOINTE ON MICHIGAN
1031 MICHIGAN AVE	BUFFALO	NY	14203	INPATIENT SKILLED NURSING FACILITY
CENTER FOR LABORATORY MEDICINE
115 FLINT ROAD	AMHERST	NY	14226	HOSPITAL BASED LAB SERVICES
DEGRAFF SKILLED NURSING FACILITY
445 TREMONT STREET	NORTH TONAWANDA	NY	14120	INPATIENT SKILLED NURSING FACILITY
MILLARD FILLMORE SURGERY CENTER
215 KLEIN ROAD	WILLIAMSVILLE	NY	14221	AMBULATORY SURGERY CENTER FACILITY
ELMWOOD OBGYN
239 BRYANT STREET	BUFFALO	NY	14222	MEDICAL SERVICES - PRIMARY CARE, PRENATAL OUTPATIENT
MAPLE WEST MEDICAL COMPLEX
705 MAPLE ROAD	AMHERST	NY	14221	MEDICAL SERVICES - PRIMARY CARE, OTHER SPECIALTIES OUTPATIENT THERAPY SERVICES
NORTH BUFFALO MEDICAL PARK
900 HERTEL AVE	BUFFALO	NY	14207	MEDICAL SERVICES - PRIMARY CARE, RADIOLOGY OUTPATIENT, OUTPATIENT THERAPY SERVICES
KALEIDA HEALTH FAMILY PLANNING CENTER
1313 MAIN STREET	BUFFALO	NY	14209	OUTPATIENT FAMILY PLANNING
COMMUNITY MENTAL HEALTH CENTER
1028 MAIN STREET	BUFFALO	NY	14203	HOSPITAL BASED OUTPATIENT BEHAVIORAL HEALTH SERVICES
HODGE PEDIATRICS
125 HODGE STREET	BUFFALO	NY	14222	HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES
TOWNE GARDEN PEDIATRICS
461 WILLIAM STREET	BUFFALO	NY	14204	HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES
SOUTHTOWNS SURGERY CENTER
5959 BIG TREE ROAD SUITE 100	ORCHARD PARK	NY	14217	AMBULATORY SURGERY CENTER PRIMARY CARE SERVICES
WCHOB SPECIALTY CLINICS
140 HODGE STREET	BUFFALO	NY	14222	HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES
WCHOB WOMEN'S OBGYN HEALTH CENTER
462 GRIDER STREET	BUFFALO	NY	14215	HOSPITAL BASED OUTPATIENT PRIMARY CARE SERVICES
WCHOB LANCASTER OBGYN
6363 TRANSIT ROAD	LANCASTER	NY	14086	MEDICAL SERVICES - PRIMARY CARE, PRENATAL OUTPATIENT
WCHOB MCKINLEY OBGYN
3860 MCKINLEY PARKWAY	HAMBURG	NY	14219	MEDICAL SERVICES - PRIMARY CARE, PRENATAL OUTPATIENT
WCHOB CHILD PROTECTION CENTER
556 FRANKLIN STREET	BUFFALO	NY	14202	MEDICAL SERVICES - PRIMARY CARE
STANLEY MAKOWSKI SBHC
1095 JEFFERSON AVE	BUFFALO	NY	14214	SCHOOL BASED PRIMARY CARE SERVICES
WCHOB LOCKPORT OBGYN
475 SOUTH TRANSIT ROAD	LOCKPORT	NY	14094	MEDICAL SERVICES - PRIMARY CARE, PRENATAL OUTPATIENT
HILLERY PARK #27 SBHC
72 PAWNEE PARKWAY	BUFFALO	NY	14210	SCHOOL BASED PRIMARY CARE SERVICES
WESTMINSTER #68 SBHC
24 WESTMINSTER AVE	BUFFALO	NY	14215	SCHOOL BASED PRIMARY CARE SERVICES
BENNETT HIGH SCHOOL SBHC
2885 MAIN STREET	BUFFALO	NY	14214	SCHOOL BASED PRIMARY CARE SERVICES
DR LYDIA WRIGHT #89 SBHC
106 APPENHEIMER STREET	BUFFALO	NY	14214	SCHOOL BASED PRIMARY CARE SERVICES
BUILD ACADEMY #91 SBHC
340 FOUGERON STREET	BUFFALO	NY	14211	SCHOOL BASED PRIMARY CARE SERVICES
BUFFALO SCHOOL OF TECHNOLOGY SBHC
414 SOUTH DIVISION STREET	BUFFALO	NY	14201	SCHOOL BASED PRIMARY CARE SERVICES
HERMAN BADILLO #76 SBHC
315 CAROLINE STREET	BUFFALO	NY	14201	SCHOOL BASED PRIMARY CARE SERVICES
ML KING #39 SBHC
487 HIGH STREET	BUFFALO	NY	14211	SCHOOL BASED PRIMARY CARE SERVICES
THE CHILDRENS PSYCHIATRY CLINIC
1404 SWEET HOME ROAD	AMHERST	NY	14228	CERTIFIED MENTAL HEALTH OUTPATIENT SERVICES
SOUTHTOWNS CLINIC
4535 SOUTHWESTERN BLVD	HAMBURG	NY	14075	MEDICAL SERVICES - PRIMARY CARE

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, FINANCIAL ASSISTANCE - LINE 3C	KALEIDA HEALTH 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. LEVELS OF DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION AND IN ACCORDANCE WITH THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. INDIVIDUALS ARE PROVIDED FINANCIAL ASSISTANCE CONTACT INFORMATION DURING INTAKE AND REGISTRATION. THE APPLICANT FOR FREE OR REDUCED PRICE CARE WORKS DIRECTLY WITH A MEMBER OF THE FINANCIAL COUNSELING OR CHARITY CARE TEAM FOR FINANCIAL SCREENING AND ENROLLMENT IN A GOVERNMENT-FUNDED PROGRAM, IF ELIGIBLE. AFTER REVIEW OF INCOME AND ASSETS, AN INDIVIDUAL MAY BE APPROVED FOR FREE CARE (100% DISCOUNT) OR A DISCOUNT LEVEL OF 50, 60, 75, OR 90%, FOR MEDICALLY NECESSARY SERVICES RENDERED AT A KALEIDA FACILITY, AS FOLLOWS: LESS THAN 200% OF FEDERAL POVERTY GUIDELINE IS AWARDED 100% DISCOUNT 200% - 249% OF FEDERAL POVERTY GUIDELINE IS AWARDED 90% DISCOUNT 250% - 299% OF FEDERAL POVERTY GUIDELINE IS AWARDED 75% DISCOUNT 300% - 349% OF FEDERAL POVERTY GUIDELINE IS AWARDED 60% DISCOUNT 350% - 400% OF FEDERAL POVERTY GUIDELINE IS AWARDED 50% DISCOUNT
PART I, LINE 7	THE AMOUNTS REPORTED IN THE TABLE UNDER PART 1, LINE 7 WERE DETERMINED USING THE HEALTH SYSTEM'S DECISION SUPPORT SOFTWARE PROGRAM AND REVENUE AND EXPENSES FROM THE GENERAL LEDGER. THE OVERALL REVENUE AND EXPENSES INCLUDED IN THE DECISION SUPPORT SOFTWARE PROGRAM WERE RECONCILED TO THE GENERAL LEDGER WHICH RECONCILES TO THE AUDITED FINANCIAL STATEMENTS. THE DECISION SUPPORT SOFTWARE PROGRAM ALLOCATES DIRECT COSTS TO EACH PATIENT ACCOUNT BASED ON THE RESOURCES USED BY THAT PATIENT WITHIN THE SPECIFIC COST CENTER. INDIRECT COSTS ARE ALLOCATED USING SIMILAR STEPDOWN METHODOLOGY USED BY CMS IN THE INSTITUTIONAL COST REPORT.
PART II	KALEIDA HEALTH'S COMMUNITY HEALTH SERVICES SUPPORTS A COMPREHENSIVE PROGRAM OF COMMUNITY HEALTH IMPROVEMENT ADVOCACY. OUTREACH IS CONDUCTED IN MULTIPLE WESTERN NEW YORK COMMUNITIES TARGETING VARIED POPULATIONS OF ALL AGES AND ETHNICITIES, INCLUDING THE MEDICALLY UNDERSERVED. PROGRAMS AND EVENTS PROMOTE THE REDUCTION OF HEALTH DISPARITIES, ACCESS TO CARE, AND PROMOTE OVERALL COMMUNITY HEALTH AND WELLNESS; AND INCLUDE HEALTH EDUCATION AND SCREENING, SPEAKERS ON HEALTH-RELATED TOPICS, AND COMMUNITY REFERRALS. TOPICS RANGE FROM HEALTH INSURANCE ENROLLMENT TO DIABETES, STROKE, HEART DISEASE, MATERNAL AND CHILD HEALTH, AND HEALTH CAREER EXPLORATION. IN 2016, KALEIDA HEALTH PARTNERED WITH SEVERAL ORGANIZATIONS AND PARTICIPATED IN 172 EVENTS TO REACH 38,992 INDIVIDUALS WITH COMMUNITY SERVICE PROGRAMMING. WHILE MULTIPLE EVENTS WERE HELD IN VARIOUS COMMUNITIES ACROSS WESTERN NEW YORK, THE FOLLOWING TOOK PLACE IN BUFFALO, A CITY WITH SEVERAL CENSUS TRACTS FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS: - NEAR EAST SIDE AND WEST SIDE TASK FORCE - PASSPORT TO WELLNESS, AN OUTREACH/WELLNESS/MEDICAL SCREENING PROGRAM AT LOCAL TOPS GROCERY MARKETS TARGETING MOSTLY LATINO AND AFRICAN AMERICAN COMMUNITIES; AND ALSO REACHES THIS POPULATION WITH HEALTH SCREENING PROVIDED AT THE BROADWAY MARKET ON BUFFALO'S EAST SIDE. - NIAGARA FRONTIER TRANSPORATION AUTHORITY - OUTREACH AND WELLNESS EDUCATION TO THE UNDERSERVED AT THE MAIN & UTICA SUBWAY STATION. - BUFFALO EAST HIGH SCHOOL - FAMILY WELLNESS DAYS AT THE BUFFALO PUBLIC SCHOOL LOCATED IN AN UNDERSERVED AREA ON BUFFALO'S EAST SIDE. - BUFFALO PUBLIC LIBRARY - A COMMUNITY WELLNESS EVENT AT THE LIBRARY DURING HISPANIC HERITAGE MONTH. - BUFFALO MUNICIPAL HOUSING AUTHORITY - FAMILY WELLNESS PROGRAM AT THE MARTHA MITCHELL CENTER, FREDERICK DOUGLASS COMMUNITY CENTER, AND SHAFFER VILLAGE, ALL UNDERSERVED. - JUNETEENTH FESTIVAL - HEALTH AND WELLNESS EDUCATION PROVIDED AT THIS FESTIVAL ON BUFFALO'S EAST SIDE THAT ATTRACTS THOUSANDS OF PEOPLE OF ALL AGES AND RACES. - IN 2016, KALEIDA HEALTH CONDUCTED TWO MEN'S PROSTATE CANCER OUTREACH AND SCREENING EVENTS TARGETING BUFFALO'S AFRICAN AMERICAN AND HISPANIC POPULATION AT THE JOHNNIE B. WILEY STADIUM AND THE FREDERICK DOUGLASS COMMUNITY CENTER. KALEIDA HEALTH COLLABORATED WITH WNY UROLOGY AND CANCER CARE OF WNY, AND WITH COMMUNITY AND FAITH BASED ORGANIZATIONS TO PROMOTE THE EVENTS INCLUDING BUFFALO MUNICIPAL HOUSING AUTHORITY, BUFFALO BRANCH NAACP, BUFFALO UNITED FRONT, INC., HISPANIC HERITAGE COUNCIL OF WNY, HISPANIC PASTORS ASSOCIATION OF WNY, AREA FRATERNITIES, AND MILLENIUM COLLABORATIVE CARE PPS. THE PROGRAMS SUPPORTED KALEIDA HEALTH'S PLEDGE TO HELP TO INCREASE COLORECTAL CANCER SCREENING RATES BY SUPPORTING THE 80% BY 2018 INITIATIVE, LED BY THE AMERICAN CANCER SOCIETY (ACS), THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL COLORECTAL CANCER ROUNDTABLE (AN ORGANIZATION CO-FOUNDED BY ACS AND CDC). COLORECTAL CANCER IS ONE OF THE MOST COMMON CANCERS IN BOTH MEN AND WOMEN AND IS ONE OF THE MOST PREVENTABLE AND TREATABLE WHEN DETECTED EARLY. - WUFO 1080 AM - THROUGH THE GREAT LAKES HEALTH RADIO PROGRAM, KALEIDA HEALTH PROVIDES GUEST SPEAKERS EVERY OTHER WEEK FOR 1/2 HOUR ON A VARIETY OF HEALTH AND WELLNESS TOPICS. THE WUFO LISTENERSHIP IS PREDOMINANTLY URBAN AND REPRESENTS ALL AGES, RACES, AND ETHNIC GROUPS IN WNY. - A NUMBER OF BLOCK CLUBS AND FAITH-BASED ORGANIZATIONS ALSO PARTNER WITH KALEIDA HEALTH TO PROVIDE HEALTH AND WELLNESS OUTREACH AND EDUCATION AT MULTIPLE LOCATIONS.
PART III, LINES 2 AND 3	BAD DEBT EXPENSE IS RECORDED USING THE VALUATION METHOD AS OUTLINED IN HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15, WHICH REQUIRES BAD DEBT EXPENSE TO BE RECORDED AT THE AMOUNT THAT THE PAYER IS EXPECTED TO PAY. IN ORDER TO REPORT THE COSTS ASSOCIATED WITH BAD DEBT EXPENSE, THE REPORTED BAD DEBT EXPENSE NEEDS TO BE ADJUSTED SO THAT THE AMOUNT EXPECTED TO BE PAID REFLECTS GROSS CHARGES, PRIOR TO THE APPLICATION OF A RATIO OF COSTS TO CHARGES (RCC). KALEIDA HEALTH ADJUSTS BAD DEBT EXPENSE PRIOR TO THE APPLICATION OF AN RCC SO THAT THE REPORTED BAD DEBT EXPENSE AT COST, ON PART III, LINE 2 OF IRS FORM 990, SCHEDULE H REFLECTS THE TRUE COST OF THE BAD DEBTS. THE ORGANIZATION HAS A CHARITY CARE POLICY, AND ANY WRITE-OFFS AS A RESULT OF THIS POLICY ARE RECORDED AS CHARITY CARE ALLOWANCES AND ARE A REDUCTION OF THE NET PATIENT REVENUE. INDIVIDUALS WHO MAY QUALIFY FOR CHARITY CARE ASSISTANCE UNDER THE POLICY, BUT DO NOT VOLUNTEER TO COMPLETE THE APPLICATION PROCESS WOULD NOT BE GRANTED CHARITY CARE ASSISTANCE. KALEIDA ALSO USES A PRESUMPTIVE CHARITY CARE PROCESS, WHICH HAS DETERMINED THAT 55% OF SELF-PAY BAD DEBT EXPENSE IN 2016 WOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE ASSISTANCE. THEREFORE, WE BELIEVE THAT THE LEVEL OF CHARITY CARE INCLUDED IN BAD DEBT EXPENSE TO BE APPROXIMATELY $1,110,919. WE ESTIMATED THIS AMOUNT BY USING THE 2016 CALCULATED PRESUMPTIVE ELIGIBILITY PERCENTAGE ON BAD DEBT WRITE-OFFS AMOUNTS OVER $500 (55%), AND APPLIED THIS PERCENTAGE TO THOSE BAD DEBT WRITE-OFFS AMOUNTS UNDER $500, TO DETERMINE THE BAD DEBT WRITE-OFFS THAT WOULD HAVE BEEN ELIGIBLE, IF THEY WERE SCORED USING THE PRESUMPTIVE ELIGIBILITY PROCESS. BAD DEBT IS NOT INCLUDED AS COMMUNITY BENEFIT.
Part III, LINE 4	KALEIDA PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE KALEIDA DOES NOT ANTICIPATE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. KALEIDA GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED BY COMMERCIAL AND GOVERNMENT INSURANCE PLANS. ADDITIONS TO THE ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION OF BAD DEBTS. THE PROVISION FOR BAD DEBTS PRIMARILY RELATES TO PATIENTS WITHOUT INSURANCE AND TO THOSE THAT ARE EITHER UNDERINSURED OR WITHOUT THE NECESSARY RESOURCES TO PAY COINSURANCE AND DEDUCTIBLE BALANCES. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED DEBT COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS.
Part III, LINE 8	THERE ARE NO MEDICARE SHORTFALLS INCLUDED IN THE CALCULATION OF COMMUNITY BENEFIT. COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT, AS REFLECTED IN PART III, LINE 6: KALEIDA HEALTH USED THE FILED, BUT UNAUDITED 2015 CMS MEDICARE COST REPORT TO DETERMINE THE AMOUNTS REPORTED ON THESE LINES.
PART III, SECTION C, LINE 9B	ONCE PATIENT LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE, THE PATIENT STATEMENT IS MAILED FOR PAYMENT RECOVERY. KALEIDA HEALTH HAS A PRE-COLLECTION PROCESS FOR ACCOUNTS WITH A POSITIVE PATIENT BALANCE GREATER THAN $4.99 AND A FIRST BILL DATE OLDER THAN 60 DAYS, BUT NOT PREVIOUSLY PAID IN FULL BY THE PATIENT (EXCLUDING ACCOUNTS FOR PATIENTS THAT HAVE SUBMITTED A COMPLETED APPLICATION FOR CHARITY CARE, MEDICAID, OR CHILD HEALTH PLUS, AND AN ELIGIBILITY DETERMINATION IS PENDING). UPON A PATIENT EXPRESSING FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE (CHARITY CARE). ONCE THE PATIENT SUBMITS THE COMPLETED APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THEN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THEN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KALEIDA HEALTH ASSESSES THE NEEDS OF THE COMMUNITY THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP) WITH ITS MOST RECENT PLAN COMPLETED IN 2016. THE 2016-2018 CHNA-CSP IS AVAILABLE TO THE PUBLIC ON THE KALEIDA HEALTH WEBSITE AT WWW.KALEIDAHEALTH.ORG/COMMUNITY/PUBLICATIONS.ASP AND A PRINTED COPY IS AVAILABLE UPON REQUEST AT NO CHARGE. WRITTEN COMMENTS ON THE 2016-2018 CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN," LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. IN ADDITION TO THE 2016-2018 CHNA-CSP (AS REPORTED IN PART V, SECTION B), KALEIDA HEALTH STAFF ENGAGE IN OTHER METHODS TO ASSESS THE NEEDS OF THE COMMUNITY. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH, AND LOCAL COMMUNITY HEALTH NEEDS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING SERVICES AND PROGRAMS. RESPONSIVE TO COMMUNITY PRIORITIES, PROGRAM DEVELOPMENT AND SERVICES FILL IDENTIFIED GAPS OR SUPPLEMENT EXSITING PROGRAMS. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE KALEIDA HEALTH INFORMS INDIVIDUALS OF FINANCIAL ASSISTANCE MADE AVAILABLE AT THE TIME OF REGISTRATION INTO THE INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT AND LONG-TERM CARE FACILITY. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE AVAILABLE THROUGHOUT THE KALEIDA LOCATIONS. BROCHURES AND PAMPHLETS INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AS WELL AS APPLICATION IS ALSO MADE AVAILABLE THROUGH KALEIDA HEALTH'S WEBSITE. KALEIDA HEALTH OFFERS ASSISTANCE TO INDIVIDUALS IN OUR COMMUNITY FOR ACCESSING AFFORDABLE HEALTH CARE, INCLUDING: NYS HEALTH MARKETPLACE: ASSISTS WITH NAVIGATING, EDUCATING AND ENROLLMENT IN THE NYS HEALTH MARKETPLACE OFFERINGS. DEDICATED AND STATE-TRAINED STAFF IS AVAILABLE TO ASSIST INDIVIDUALS IN PERSON OR VIA THE PHONE. KALEIDA HEALTH OFFERS IN-PERSON APPOINTMENTS AT (5) FIVE DIFFERENT SITE LOCATIONS. FACILITATED ENROLLMENT: ASSISTS ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, ESSENTIAL PLANS, STATE AID PROGRAM FOR CHILDREN WITH SPECIAL NEEDS AND ALL QUALIFIED HEALTH PLANS MADE AVAILABLE THROUGH THE AFFORDABLE CARE ACT. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN BROCHURES AT KALEIDA SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. FINANCIAL ASSISTANCE PROGRAM: AS DESCRIBED ABOVE, THE KALEIDA FINANCIAL ASSISTANCE PROGRAM, IF ELIGIBLE, PROVIDES FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT KALEIDA HEALTH HOSPITALS OR LONG-TERM CARE FACILITIES. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. PRESUMPTIVE ELIGIBILITY: KALEIDA HEALTH HAS SHOWN A WILLINGNESS TO EXTEND FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH OUTSTANDING BILLS WHO HAVE NOT COMPLETED THE CHARITY APPLICATION PROCESS. THIS IS ACHIEVED THROUGH AN AUTOMATED PARO SCORING PROCESS USING PUBLIC RECORDS, REGIONAL COST OF LIVING, ESTIMATED HOUSEHOLD INCOME THRESHOLDS, AND COMMUNITY DEMOGRAPHICS TO DERIVE AN ESTIMATED FINANCIAL POSITION FOR EACH PATIENT. THOSE PATIENTS SCREENED THROUGH THIS AUTOMATED PROCESS AND DEEMED ELIGIBLE ARE ADJUSTED OFF TO CHARITY CARE IN LIEU OF BAD DEBT. COMMUNITY INFORMATION KALEIDA HEALTH SERVES WESTERN NEW YORK'S EIGHT COUNTIES OF ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS, AND WYOMING. THE POPULATION FOR THE REGION IS APPROXIMATELY 1.5 MILLION WITH ERIE COUNTY AND NIAGARA COUNTY COMPRISING AN ESTIMATED 1.1 MILLION OF THIS TOTAL. THREE KALEIDA HEALTH HOSPITALS INCLUDING BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO ARE LOCATED IN ERIE COUNTY, THE HOSPITALS' PRIMARY SERVICE AREA. DEGRAFF MEMORIAL HOSPITAL IS LOCATED IN NIAGARA COUNTY, ITS PRIMARY SERVICE AREA. DEGRAFF ALSO SERVES A NUMBER OF ERIE COUNTY RESIDENTS GIVEN ITS LOCATION IS LESS THAN ONE MILE FROM THE ERIE COUNTY BORDER. EACH HOSPITAL'S PRIMARY SERVICE AREA IS DEFINED AS THE COUNTY WITH THE HIGHEST PERCENTAGE OF ALL WNY COUNTIES FOR 2015 INPATIENT DISCHARGES, EMERGENCY DEPARTMENT VISITS, AND OUTPATIENT VISITS AS IDENTIFIED IN THE 2016-2018 CHNA-CSP. ERIE COUNTY ERIE COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE BORDERING LAKE ERIE, AND ALSO LIES ON THE INTERNATIONAL BORDER BETWEEN THE UNITED STATES AND CANADA. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM MEDSTAT MARKET EXPERT 2016, THE US CENSUS: QUICK FACTS, 2014 AMERICAN COMMUNITY SURVEY, AND 2015 POPULATION ESTIMATES AS INDICATED IN KALEIDA HEALTH'S 2016-2018 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 930,801 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. ERIE COUNTY'S MEDIAN HOUSEHOLD INCOME IS $51,050, ITS POVERTY RATE IS 15.2%, AND 17.4% OF ITS POPULATION IS OVER 65 YEARS OF AGE. ITS LARGEST CITY AND COUNTY SEAT IS BUFFALO WITH A POPULATION OF 277,181. tHE 2014 AMERICAN COMMUNITY SURVEY RANKED BUFFALO AS THE FOURTH POOREST CITY IN THE NATION. THE CITY HAS A 30.9% POVERTY RATE (INCOME BELOW THE FEDERAL POVERTY LEVEL PER US CENSUS) AND 38.6% OF HOUSEHOLDS HAVE AN AVERAGE INCOME LESS THAN $25,000. BUFFALO ALSO HAS A HIGH MINORTY POPULATION WITH 35.7% OF ITS RESIDENTS BEING BLACK NON-HISPANIC AND 11.7% HISPANIC AS COMPARED TO 13% BLACK NON-HISPANIC AND 5.3% HISPANIC FOR ALL OF ERIE COUNTY. PERSONS UNDER AGE 65 WITHOUT HEALTH INSURANCE COMPRISE 6.9% OF ERIE COUNTY'S POPULATION AND 10.7% OF BUFFALO'S POPULATION. BUFFALO GENERAL MEDICAL CENTER AND WOMEN & CHILDREN'S HOSPITAL OF BUFFALO ARE LOCATED IN THE CITY OF BUFFALO AND SERVE A HIGH PERCENTAGE OF BUFFALO'S POOR AND UNDERSERVED POPULATION. MOST CENSUS TRACTS IN BUFFALO ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE TOWN OF AMHERST IS ONE OF THE COUNTY'S LARGEST SUBURBS WITH A POPULATION OF 139,363 AND IS HOME TO MILLARD FILLMORE SUBURBAN HOSPITAL. IN CONTRAST TO BUFFALO, THE TOWN OF AMHERST HAS A POVERTY RATE OF 9.4% AND 33.9% OF HOUSEHOLDS HAVE AN AVERAGE INCOME OVER $100,000. AMHERST'S POPULATION IS 80.7% WHITE NON-HISPANIC. THE TOWN ALSO HAS 8.8% ASIAN-PACIFIC ISLANDER POPULATION, COMPARABLE TO THE NYS RATE OF 8.6% WHILE THE ERIE COUNTY RATE IS 3.1%. THE TOWN HAS A SIGNIFICANT SENIOR POPULATION WITH 19.4% OF RESIDENTS 65 YEARS AND OVER, AND MILLARD FILLMORE SUBURBAN HOSPITAL SERVES A HIGH PERCENTAGE OF THE TOWN'S AGING POPULATION. NIAGARA COUNTY NIAGARA COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE, JUST NORTH OF BUFFALO (ERIE COUNTY), ADJACENT TO LAKE ONTARIO ON ITS NORTHERN BORDER WITH THE NIAGARA RIVER AND CANADA ON ITS WESTERN BORDER. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR NIARAGA COUNTY ARE FROM MEDSTAT MARKET EXPERT, THE US CENSUS: QUICK FACTS, 2014 AMERICAN COMMUNITY SURVEY, AND 2015 POPULATION ESTIMATES AS INDICATED IN KALEIDA HEALTH'S 2016-2018 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 212,170 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. NIAGARA COUNTY'S MEDIAN HOUSEHOLD INCOME IS $49,091, ITS POVERTY RATE IS 13.4% (INCOME BELOW THE FEDERAL POVERTY LEVEL PER US CENSUS), AND 18.2% OF ITS POPULATION IS OVER 65 YEARS OF AGE. ITS CITIES INCLUDE NIAGARA FALLS, POPULATION 63,520; NORTH TONAWANDA, POPULATION 45,253; AND ITS COUNTY SEAT OF LOCKPORT, POPULATION 58,397. THESE CITIES INCLUDE A HIGH PROPORTION OF THE COUNTY'S LOW INCOME AND UNDERSERVED POPULATION. 17.2% OF NIAGARA FALLS RESIDENTS ARE BLACK NON-HISPANIC AND THE CITY HAS A 25.3% POVERTY RATE. ADDITIONALLY, NIAGARA FALLS IS FEDERALLY DESIGNATED AS AN AREA WITH A MEDICALLY UNDERSERVED POPULATION. THE POVERTY RATE FOR NORTH TONAWANDA IS 10.6% AND 18.9% FOR LOCKPORT. FURHTERMORE, NIAGARA FALLS AND

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (17 entries)

Address Line1USAddress/AddressLine1Txt	Address Line2USAddress/AddressLine2Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
UNIVERSITY ORTHOPEDIC SERVICE
5500 MAIN STREET	SUITE 107	BUFFALO	NY	14221	161406947	N/A	$50,000	FMV	CONTRIBUTION CONTRIBUTION CONTRIBUTION SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP
JACOBS INSTITUTION INC
875 ELLICOTT STREET 5TH FLOOR		BUFFALO	NY	14203	263085485	N/A	$200,000	FMV	SPONSORSHIP CONTRIBUTION
UPSTATE NY TRANSPLANT INC
110 BROADWAY		BUFFALO	NY	14203	161172453	501(C)(3)	$25,000	FMV	Uncompensated Care SPONSORSHIP CONTRIBUTION
UB FOUNDATION
3435 MAIN STREET	SUITE 107	BUFFALO	NY	14231	160865182	501(C)(3)	$58,500	FMV	CONTRIBUTION SPONSORSHIP SPONSORSHIP
MERCY FLIGHT
455 DELAWARE AVE		BUFFALO	NY	14202	161573408	N/A	$20,000	FMV	GALA SPONSORSHIP
MARCH OF DIMES FOUNDATION
1275 MAMARONECK AVE	SUITE 125	WHITE PLAINS	NY	10605	131846366	501(C)(3)	$10,000	FMV	SPONSORSHIP SPONSORSHIP
SUSAN G KOMEN FOR THE CURE
ELM CARLTON STREETS		BUFFALO	NY	14263	751835298	501(C)(3)	$6,000	FMV	SPONSORSHIP
ECMC LIFELINE FOUNDATION
462 GRIDER STREET		BUFFALO	NY	14215	160371125	501(C)(3)	$13,434	FMV	SPONSORSHIP
HOSPICE BUFFALO INC
225 COMO PARK BLVD		BUFFALO	NY	14227	510202066	501(C)(3)	$12,200	FMV	SPONSORSHIP
43NORTH BPC INC
640 ELLICOTT ST SUITE 108		BUFFALO	NY	14203	472878159	501(C)(3)	$12,000	FMV	SPONSORSHIP
ST JOSEPH COLLEGIATE INSTITUTE
845 KENMORE AVENUE		BUFFALO	NY	14223	160743159	N/A	$10,000	FMV	SPONSORSHIP
CYSTIC FIBROSIS FDN
6931 ARLINGTON RD SUITE T 200		BETHESDA	MD	20814	131930701	501(C)(3)	$10,000	FMV	SPONSORSHIP
DEAF ACCESS SERVICES INC
2495 MAIN STREET SUITE 446		BUFFALO	NY	14214	161433932	N/A	$10,000	FMV	SPONSORSHIP
WECK CULVER COMMUNICATIONS COR
2900 GENESEE STREET		CHEEKTOWAGA	NY	14225	261247618	N/A	$8,000	FMV	SPONSORSHIP
KEVIN GUEST HOUSE
782 ELLICOTT STREET		BUFFALO	NY	14203	237218160	501(C)(3)	$7,250	FMV	SPONSORSHIP
AMERICAN CANCER SOCIETY
101 JOHN JAMES AUDUBON PKWY		AMHERST	NY	14228	160743902	501(C)(3)	$6,500	FMV	SPONSORSHIP
AMERICAN DIABETES ASSOCIATION
569 HIGHLAND AVE		TONAWANDA	NY	14223	131623888	501(C)(3)	$5,750	FMV	SPONSORSHIP

Field	Value	IRS element (for citing)
Total501c3 Org	11	Total501c3OrgCnt
Total Other Org	6	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE I:	FormAndLineReferenceDesc
Explanation	PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: KALEIDA HEALTH MAKES CONTRIBUTIONS TO ORGANIZATONS IN WESTERN NEW YORK THAT ALSO HAVE HEALTH CARE RELATED ACTIVITIES. ALL CONTRIBUTIONS MUST BE APPROVED BY THE GOVERNING BODY BEFORE MONEY IS DISTRIBUTED.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JODY LOMEO
PRES/CEO EX-OFFICIO W/VOTE	$995,974	$0	$354,600	$0	$35,000	$0	$494,299	$0	$17,185	$0	$1,897,058	$0	$0	$0
ALYSON SPAULDING
GENERAL COUNSEL	$347,679	$0	$84,000	$0	$25,000	$0	$241,499	$0	$14,182	$0	$712,360	$0	$0	$0
DAVID HUGHES MD
EVP, CMO	$474,757	$0	$83,125	$0	$25,000	$0	$210,902	$0	$14,347	$0	$808,131	$0	$0	$0
TONI BOOKER
EVP, CHIEF HUMAN RESOURCES OFC	$331,080	$0	$54,450	$0	$180,405	$0	$46,187	$0	$6,334	$0	$618,456	$0	$149,905	$0
JONATHAN SWIATKOWSKI
EVP, CFO	$449,904	$0	$126,000	$0	$25,000	$0	$190,281	$0	$14,314	$0	$805,499	$0	$0	$0
JAMAL GHANI
FORMER EVP, COO	$86,253	$0	$113,750	$0	$565,385	$0	$13,520	$0	$2,430	$0	$781,338	$0	$0	$0
DONALD BOYD
EVP BUSINESS DEVELOPMENT	$507,339	$0	$85,000	$0	$128,072	$0	$60,796	$0	$14,281	$0	$795,488	$0	$103,072	$0
CHRISTOPHER LANE
VP PRESIDENT BGMC	$443,743	$0	$52,500	$0	$20,000	$0	$55,343	$0	$14,215	$0	$585,801	$0	$0	$0
CHERYL KLASS
EVP, CHIEF NURSE EXECUTIVE	$566,776	$0	$65,000	$0	$25,000	$0	$50,940	$0	$6,558	$0	$714,274	$0	$0	$0
ALLEGRA JAROS
SVP OPERATIONS WCHOB	$351,219	$0	$52,500	$0	$20,000	$0	$52,537	$0	$14,182	$0	$490,438	$0	$0	$0
MICHAEL HUGHES
SVP, PUBLIC AFFAIRS MARKETING	$274,581	$0	$54,000	$0	$25,000	$0	$113,585	$0	$633	$0	$467,799	$0	$0	$0
AARON HOFFMAN MD
EMPLOYED PHYSICIAN	$830,325	$0	$0	$0	$0	$0	$34,985	$0	$14,639	$0	$879,949	$0	$0	$0
CHRISTOPHER MALLAVARAPU MD
EMPLOYED PHYSICIAN	$901,132						$33,508		$14,479		$949,119
CARROLL HARMON MD
EMPLOYED PHYSICIAN	$639,019	$0	$0	$0	$0	$0	$9,127	$0	$1,115	$0	$649,261	$0	$0	$0
KATHRYN BASS MD
EMPLOYED PHYSICIAN	$586,856	$0	$0	$0	$0	$0	$39,737	$0	$1,037	$0	$627,630	$0	$0	$0
LAN ADAMS MD
EMPLOYED PHYSICIAN	$601,518	$0	$0	$0	$0	$0	$39,050	$0	$1,068	$0	$641,636	$0	$0	$0
JAMES KASKIE
FORMER CEO	$0	$0	$0	$0	$192,017	$0	$0	$0	$0	$0	$192,017	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
HEALTH OR SOCIAL CLUB DUES	SCHEDULE J, PART I, LINE 1A AS PART OF THEIR COMPENSATION PACKAGE, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE ENTITLED TO CHOOSE AS AN EXECUTIVE PERK THE BENEFIT OF BUSINESS RELATED SOCIAL DUES OR INITIATION FEES.
SEVERANCE PAYMENTS	SCHEDULE J, PART I, LINE 4A THE FOLLOWING FORMER EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A, RECEIVED SEVERANCE PAYMENTS DURING 2016: JAMES KASKIE, FORMER CEO, $192,017 JAMAL GHANI, FORMER COO, $562,500
EXECUTIVE DEFERRED RETIREMENT PLAN	SCHEDULE J, PART I, LINE 4B DURING THE YEAR, THE FOLLOWING OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A PARTICIPATED IN THE EXECUTIVE DEFERRED RETIREMENT PLAN: JODY LOMEO, JONATHAN SWIATKOWSKI, TONI BOOKER, DAVID HUGHES, MD, DONALD BOYD, MICHAEL HUGHES, CHERYL KLASS AND ALYSON SPAULDING. EMPLOYER AND EMPLOYEE CONTRIBUTIONS DURING THE YEAR TO THIS PLAN HAVE BEEN REPORTED, AS REQUIRED, ON SCHEDULE J, PART II COLUMNS (B) (III) AND (C). DURING 2016, THE FOLLOWING OFFICERS AND KEY EMPLOYEES RECEIVED PAYMENTS UNDER AN EXECUTIVE DEFERRED RETIREMENT PLAN: TONI BOOKER $149,905 DONALD BOYD $103,072

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
DORMITORY AUTHORITY - STATE OF NEW YORK (SCH 1)
A	146000293	2016-09-30	$7,650,258	LEASE OF EQUIPMENT	false	false	false
DORMITORY AUTHORITY - STATE OF NEW YORK (SCH 2)
B	146000293	2016-09-30	$7,349,742	LEASE OF EQUIPMENT	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$168,499	$0	$7,650,258	$0	$0	$0	$104,266	$0	$0	$7,348,433	$0	$197,559	false	false	false	Yes (true)
B	$161,880	$0	$7,349,742	$0	$0	$0	$0	$0	$0	$2,825,269	$0	$4,524,473	false	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	false	0	false	false	false	false
B	false	false	Yes (true)	Yes (true)	false	0	false	false	false	false

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	Yes (true)	false	false	false	false	false	0	false	false
0
B	false	Yes (true)	false	false	false	false	false	0	false	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	false
B	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART III, LINE 8, PART IV, LINE 7 AND PART V	FormAndLineReferenceDesc
Explanation	KALEIDA HEALTH DOES NOT CURRENTLY HAVE WRITTEN POLICIES AND PROCEDURES IN PLACE BUT MANAGEMENT REGULARLY REVIEWS POST-ISSUANCE COMPLIANCE OBLIGATIONS TO ENSURE THERE ARE NO VIOLATIONS OF FEDERAL TAX REQUIREMENTS. KALEIDA HEALTH IS CURRENTLY IN THE PROCESS OF ADOPTING WRITTEN POLICIES AND PROCEDURES.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
SUSAN EVANS
SEE PART V	$94,559	SEE PART V	false
WALSH INSURANCE
SEE PART V	$16,215	SEE PART V	false
TOPS MARKETS LLC
SEE PART V	$2,663,004	SEE PART V	false
QUAKER BROOKBRIDGE REAL ESTATE
SEE PART V	$1,800,469	SEE PART V	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	FormAndLineReferenceDesc
Explanation	SCHEDULE L, PART IV SUSAN EVANS: SUSAN EVANS IS A FAMILY MEMBER OF A BOARD MEMBER, EVAN EVANS, MD, WHO RECEIVED COMPENSATION FROM THE ORGANIZATION IN THE NORMAL COURSE OF BUSINESS FOR PERFORMANCE OF SERVICES AS A UTILIZATION REVIEW COORDINATOR. WALSH INSURANCE: THEODORE B.K. WALSH IS A FAMILY MEMBER OF A BOARD MEMBER, AMY CLIFTON, AND A GREATER THAN 35% OWNER OF WALSH INSURANCE, WHICH PROVIDED INSURANCE BROKERAGE SERVICES TO THE ORGANIZATION DURING THE YEAR. TOPS MARKETS LLC: FRANK CURCI IS A BOARD MEMBER AND A GREATER THAN 35% OWNER OF TOPS MARKETS LLC, WHICH HAD A PHARMACY DISPENSING CONTRACT WITH THE ORGANIZATION DURING THE YEAR. QUAKER BROOKBRIDGE REAL ESTATE: KEVIN GIBBONS IS A BOARD MEMBER AND A GREATER THAN 35% OWNER OF QUAKER BROOKBRIDGE REAL ESTATE, WHICH LEASED PROPERTY TO THE ORGANIZATION DURING THE YEAR.	ExplanationTxt

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp
Securities Publicly Traded		SecuritiesPubliclyTradedGrp
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	VARIOUS MEDICAL EQUIPMENT	Desc
Contribution	2	ContributionCnt
Noncash Contributions Rpt F990	$3,764,608	NoncashContributionsRptF990Amt
Method Of Determining Revenues	REPLACEMENT COST	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ORGANIZATION'S MISSION	KALEIDA HEALTH IS THE LARGEST HEALTHCARE PROVIDER IN WNY, SERVING THE AREA'S EIGHT COUNTIES WITH COMPREHENSIVE SERVICES & PROGRAMS PROVIDED AT FOUR ACUTE CARE, TWO LONG TERM CARE, AS WELL AS OUTPATIENT & PRIMARY CARE SITES. REVIEW PROCESS FOR FORM 990 ORGANIZATION'S MANAGEMENT IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, KPMG, REVIEW THE FORM 990. THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE FORM 990 IS FILED WITH THE IRS, THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE SAME TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, QUESTION 12C UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE POTENTIAL, ACTUAL, OR EVEN APPEARANCE, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. THE COMPLETED CONFLICTS OF INTEREST AND DISCLOSURE FORMS FOR DIRECTORS ARE RETURNED TO THE ORGANIZATION.
COMPENSATION APPROVAL PROCESS	FORM 990, PART VI, SECTION B, QUESTIONS 15A & 15B ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATIONS OFFICERS AND KEY EMPLOYEES FOR REVIEW AND APPROVAL. SUCH INFORMATION IS COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT AND INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENTS BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
ACCESS TO ORGANIZATIONAL DOCUMENTS	FORM 990, PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS OFFICE AT 726 EXCHANGE STREET, SUITE 200, BUFFALO, NY 14210. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART XI	OTHER CHANGES IN NET ASSETS OR FUND BALANCES MINORITY INTEREST IN SUBSIDIARY (303,778) DECREASE IN PENSION LIABILITY (42,554,848) TRANSFER FROM KALEIDA FOUNDATIONS (1,905,000) OTHER TRANSFERS NET (1,937,441) CHANGE IN VALUE OF FOUNDATIONS (13,056,415) ------------ TOTAL (59,757,482)
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED PHYSICIAN FEES TOTAL FEES:74653316
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:25044810
FORM 990 PART IX LINE 11G	DESCRIPTION:INTERNS & RESIDENTS FEES TOTAL FEES:26597730
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER TOTAL FEES:8797110

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
KALEIDA MCO LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161570311	DORMANT	NY	$0	$0	KH
KALEIDA IPA LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161570380	DORMANT	NY	$0	$0	KH
KALEIDA WNYI LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	453189404	HEALTH CARE	NY	-$402,601	$4,340,148	KH
KALEIDA SERVICES LLC
2100 WEHRLE DRIVE	WILLIAMSVILLE	NY	14221	000000000	ADULT DAYCARE	NY	$197,196	$808,195	KH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
MILLARD FILLMORE AMBULATORY SURGER CTR
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161307129	SUPPORT ORG	NY	501(C)(3)	12A	KH	Yes (true)
VNA HOME CARE SERVICES
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161491203	HOME HLTHCARE	NY	501(C)(3)	10	KH	Yes (true)
VNA OF WESTERN NEW YORK
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	160743214	HOME HLTHCARE	NY	501(C)(3)	10	KH	Yes (true)
VISK
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	222738425	SUPPORT ORG	NY	501(C)(3)	10	KH	Yes (true)
KALEIDA HEALTH FOUNDATION
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161579143	FUNDRAISING	NY	501(C)(3)	7	KH	Yes (true)
THE WOMEN & CHILDREN'S HOSP OF BFLO FDN
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161332044	FUNDRAISING	NY	501(C)(3)	7	KH	Yes (true)
CHILDREN'S HOME HEALTH OF WNY INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	814086046	PED HLTH HOME	NY	501(C)(3)	10	KH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
HARLEM ROAD LEASING LLC
3435 MAIN STREET	BUFFALO	NY	14214	205588135	EQUIPMENT LEASING	NY	KALEIDA HEALTH	UNRELATED	$95,520	$138,196	false	$0	Yes (true)	0.50000
AMTON IMAGING LLC
199 PARK CLUB LANE SUITE 300	WILLIAMSVILLE	NY	14221	262925470	HEALTH CARE	NY	KALEIDA WNYI	RELATED	-$51,165	$1,675,196	false	$0	Yes (true)	0.50000
SITE E LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	272124795	REAL ESTATE MGMT	NY	KPI	EXCLUDED	$111,986	$1,642,671	false	$0	false	0.50160
MSFC LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	261582864	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	$439,259	$1,843,351	false	$0	false	0.55297
SOUTHTOWNS IMAGING LLC
5959 BIG TREE ROAD SUITE 105	ORCHARD PARK	NY	14127	471123230	EQUIPMENT LEASING	NY	KALEIDA WNYI	UNRELATED	-$257,653	$2,457,029	false	$0	Yes (true)	0.70000
COLLABORATIVE CARE VENTURES LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210		HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	-$73,651	$17,675,054	false	$0	false	0.60000
GREAT LAKES MEDICAL BILLING SVCS LLC
199 PARK CLUB LANE SUITE 300	WILLIAMSVILLE	NY	14221		MEDICAL BILLING	NY	KALEIDA WNYI	UNRELATED	-$93,783	$207,923	false	$0	false	0.50000
ALTUS MANAGEMENT LLC
840 AERO DRIVE SUITE 150	BUFFALO	NY	14225		GROUP PURCHAS	NY	KALEIDA HEALTH	EXCLUDED	$183,048	$1,976,625	false	$0	false	0.52167
SOUTHTOWNS SURGERY CENTER LLC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	464742028	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	-$1,801,005	$3,122,497	false	$0	Yes (true)	0.63171

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
KALEIDA PROPERTIES INC
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	222738483	PROP MGMT SVCS	NY	KALEIDA HEALTH	C Corp	$1,351,355	$17,223,458	1.00000	Yes (true)
WESTLINK CORPORATION
726 EXCHANGE STREET SUITE 200	BUFFALO	NY	14210	161354421	MED & DIAGN SVCS	NY	KALEIDA HEALTH	C Corp	-$290	$100,916	1.00000	Yes (true)
KALEIDA HEALTHNOW INC
257 WEST GENESEE STREET	BUFFALO	NY	14202	462164089	HEALTH CARE	NY	KALEIDA HEALTH	C Corp			0.50000	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (23 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
VNA HOME CARE SERVICES
O	$121,793	ACTUAL COST
VNA HOME CARE SERVICES
Q	$1,745,194	ACTUAL COST
VNA OF WESTERN NEW YORK
O	$279,271	ACTUAL COST
VNA OF WESTERN NEW YORK
L	$358,004	ACTUAL COST
VNA OF WESTERN NEW YORK
Q	$14,041,243	ACTUAL COST
MFSC LLC
J	$637,534	ACTUAL COST
MFSC LLC
D	$55,033	ACTUAL COST
KALEIDA PROPERTIES INC
q	$110,973	ACTUAL COST
KALEIDA PROPERTIES INC
d	$4,696,287	ACTUAL COST
SITE E LLC
k	$233,450	ACTUAL COST
WCHOB FOUNDATION
c	$1,516,781	ACTUAL COST
WCHOB FOUNDATION
s	$21,661,975	ACTUAL COST
WCHOB FOUNDATION
P	$90,351	ACTUAL COST
KALEIDA HEALTH FOUNDATION
c	$2,247,827	ACTUAL COST
KALEIDA HEALTH FOUNDATION
s	$1,332,699	ACTUAL COST
KALEIDA HEALTH FOUNDATION
P	$296,081	ACTUAL COST
SOUTHTOWNS IMAGING LLC
D	$402,071	ACTUAL COST
SOUTHTOWNS IMAGING LLC
J	$219,997	ACTUAL COST
SOUTHTOWNS IMAGING LLC
Q	$148,903	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
L	$172,189	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
J	$328,947	ACTUAL COST
SOUTHTOWNS SURGERY CENTER LLC
D	$298,431	ACTUAL COST
COLLABORATIVE CARE VENTURES LLC
D	$251,104	ACTUAL COST