2017-11-15T13:53:03-06:00 2016-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2016-01-01 161533232 KALEIDA HEALTH % REBECCA HASLINGER KALE 7168598528 726 EXCHANGE STREET Suite 200 BUFFALO NY 14210 JON SWIATKOWSKI CFO/TREASURER 7168598528 2017-11-15 true MARILYN E FARLEY P01231880 5184274600 2017-11-15 167.68.102.5 14012520173195000007 2017-11-15 P C69C12BFB41E5F2DBF989315BF73D8AC917A0741 9495D134D490A6B84E3CD7F5ECF2B12979C5F68F 2016 2017-02-10 21:41:12Z JODY LOMEO 100 HIGH STREET BUFFALO NY 14203 1399460625 false X WWW.KALEIDAHEALTH.ORG X 1998 NY 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. 15 10 9565 1758 4919671 -1320875 21313490 39715656 1161013584 1218391196 7497945 9121642 30359860 18538520 1220184879 1285767014 191300 464634 0 0 663521603 687042053 0 0 0 520408012 535475509 1184120915 1222982196 36063964 62784818 1138382417 1202747678 948334948 1009880563 190047469 192867115 X SEE SCHEDULE O. false false 1099192356 464634 1219881229 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. 1099192356 true true false true false false false false false true true false false true true true false true false false true false false false false false true true true false true true false false false false false false false false true true true false false false true true true true false false true 600 0 true 9565 true true true false false false false false false false false false X 15 10 false false false false false false false true true false false true true true true true true true true true true NY X X REBECCA HASLINGER 7168598528 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 JODY LOMEO PRES/CEO EX-OFFICIO W/VOTE 40.0 1.0 X X 1385574 0 511484 EVAN EVANS MD DIRECTOR 1.0 0.0 X 64419 0 276 JOHN R KOELMEL FORMER CHAIRMAN (THRU 4/27/16) 1.0 0.0 X 0 0 0 DAVID A MILLING MD SECRETARY 1.0 0.0 X 0 0 0 FRANCISCO VASQUEZ PHD DIRECTOR 1.0 0.0 X 0 0 0 AMY L CLIFTON DIRECTOR 1.0 0.0 X 0 0 0 CHRISTOPHER T GREENE ESQ DIRECTOR 1.0 0.0 X 0 0 0 DARREN J KING DIRECTOR 1.0 0.0 X 0 0 0 FRANK CURCI CHAIRMAN 1.0 0.0 X 0 0 0 KEVIN GIBBONS MD DIRECTOR 1.0 0.0 X 0 0 0 GEORGE MATTHEWS DIRECTOR 1.0 0.0 X 0 0 0 NICHOLAS J AQUINO MD DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM I MAGGIO VICE CHAIR 1.0 0.0 X 0 0 0 CHRISTOPHER C ROSS TREASURER 1.0 0.0 X 0 0 0 MARY LOU RUSIN EDD RN DIRECTOR 1.0 0.0 X 0 0 0 ALYSON SPAULDING GENERAL COUNSEL 40.0 0.0 X 456679 0 255681 DAVID HUGHES MD EVP, CMO 40.0 0.5 X 582882 0 225249 TONI BOOKER EVP, CHIEF HUMAN RESOURCES OFC 40.0 0.0 X 565935 0 52521 JONATHAN SWIATKOWSKI EVP, CFO 40.0 0.5 X 600904 0 204595 JAMAL GHANI FORMER EVP, COO 40.0 0.0 X 765388 0 15950 DONALD BOYD EVP BUSINESS DEVELOPMENT 40.0 1.0 X 720411 0 75077 CHRISTOPHER LANE VP PRESIDENT BGMC 40.0 0.0 X 516243 0 69558 CHERYL KLASS EVP, CHIEF NURSE EXECUTIVE 40.0 0.0 X 656776 0 57498 ALLEGRA JAROS SVP OPERATIONS WCHOB 40.0 0.0 X 423719 0 66719 MICHAEL HUGHES SVP, PUBLIC AFFAIRS MARKETING 40.0 0.0 X 353581 0 114218 AARON HOFFMAN MD EMPLOYED PHYSICIAN 40.0 0.0 X 830325 0 49624 CHRISTOPHER MALLAVARAPU MD EMPLOYED PHYSICIAN 40.0 0.0 X 901132 0 47987 CARROLL HARMON MD EMPLOYED PHYSICIAN 40.0 0.0 X 639019 0 10242 KATHRYN BASS MD EMPLOYED PHYSICIAN 40.0 0.0 X 586856 0 40774 LAN ADAMS MD EMPLOYED PHYSICIAN 40.0 0.0 X 601518 0 40118 JAMES KASKIE FORMER CEO 0.0 0.0 X 192017 0 0 10843378 0 1837571 640 true true false SODEXO MANAGEMENT INC PO BOX 81049 WOBURN MA 018131049 CLEANING & DIETARY 5234925 WNY RADIOLOGY LLC PO BOX 4029 BUFFALO NY 14240 RADIOLOGY SVCS 5203248 P2P STAFFING INC PO BOX 4729 WINTER PARK FL 327934729 CLINICAL DOCUMENTING 2077985 MACRO HELIX INC PO BOX 742256 ATLANTA GA 303742256 340B SOFTWARE FEES 1719220 WE CARE TRANSPORTATION 401 EAST AMHERST ST BUFFALO NY 14215 PATIENT TRANSPORT 1206360 71 26490261 12313942 911453 3764608 39715656 NET PATIENT SERVICE REVENUE 623990 1212542689 1212542689 MANAGEMENT FEES 561000 72900 72900 LAB SERVICES 621500 5775607 5775607 1218391196 7977167 -1159658 9136825 0 0 2374861 2374861 0 2374861 73363 2301498 114754788 83298 113659437 34174 1095351 49124 1144475 1144475 0 0 0 0 0 0 0 0 0 REBATE REVENUE 900099 10388942 10388942 UNIVERSITY LEASE INCOME 531120 1234980 1234980 MANAGEMENT & CONSULTING FEES 541610 980891 976416 4475 3558846 513617 152984 2892245 16163659 1285767014 1214032722 4919671 27098965 464634 464634 0 0 0 7161170 7161170 94559 94559 502266131 468050420 34215711 32289571 28692513 3597058 108519661 98619175 9900486 36710961 34146172 2564789 0 1756022 827405 928617 517761 72765 444996 247505 247505 0 0 135092966 124809177 10283789 3481269 2964877 516392 2410316 1987923 422393 0 0 16928052 4966273 11961779 1020416 748591 271825 0 0 13339740 10671792 2667948 0 61449993 45405019 16044974 7355934 4994309 2361625 HEALTH CARE SUPPLIES 209184629 209621824 -437195 EQPT RENTAL & MAINTENANCE 29678019 13022180 16655839 OTHER 26531307 27677845 -1146538 SERVICE CONTRACTS 11776819 9971280 1805539 14704761 11478182 3226579 1222982196 1099192356 123789840 0 41396112 23733732 44682583 10080703 0 0 159866006 164283239 0 0 0 0 0 0 25724911 27764208 10908230 15364653 1697240957 1136335001 481932950 560905956 74551845 118829598 66484188 49738308 0 0 0 0 232835592 232047281 1138382417 1202747678 149661885 155402146 0 0 0 0 0 9843323 0 0 0 0 313990121 349965673 0 0 484682942 494669421 948334948 1009880563 X 67087683 86795710 103226405 85831208 19733381 20240197 190047469 192867115 1138382417 1202747678 X 62784818 -207690 -59757482 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false false false true 89156 true 158349 false false 247505 false false GRANTS TO OTHER ORGANIZATIONS & DIRECT CONTACT WITH LEGISLATIVE BODY 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. 29821659 1770884 -6512169 -2358931 27439305 30738989 1435796 -1046152 1306974 29821659 30087437 1656821 850732 1856001 30738989 28644541 1589183 1819135 1965422 30087437 46995623 3133756 2880650 24365488 28644541 0.74670 0.25330 false true true 6713867 6713867 509115193 358135110 150980083 1165959196 768173500 397785696 15452701 10026391 5426310 560905956 DEFERRED FINANCING 11069506 INTEREST IN NET ASSETS OF FDNS 136548290 OTHER RECEIVABLES 39724716 OTHER ASSETS 27668244 ESTIMATED 3RD PARTY PAYOR REC 14451655 GRANT RECEIVABLE - LT 2584870 232047281 0 DUE TO THIRD PARTY PAYORS 18883081 SELF INSURANCE LIABILITY 146611429 OTHER LIABILITIES 20359841 PENSION LIABILITY 288441474 ASSET RETIREMENT OBLIGATIONS 13600635 CAPITAL LEASE OBLIGATIONS 6772961 494669421 X 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. 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X X X true true X X X true X WWW.KALEIDAHEALTH.ORG X WWW.KALEIDAHEALTH.ORG X WWW.KALEIDAHEALTH.ORG X X X X X X X true X false X true X false false 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. 29 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 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 true UNIVERSITY ORTHOPEDIC SERVICE 5500 MAIN STREET SUITE 107 BUFFALO NY 14221 161406947 N/A 50000 FMV CONTRIBUTION CONTRIBUTION CONTRIBUTION SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP SPONSORSHIP JACOBS INSTITUTION INC 875 ELLICOTT STREET 5TH FLOOR BUFFALO NY 14203 263085485 N/A 200000 FMV SPONSORSHIP CONTRIBUTION UPSTATE NY TRANSPLANT INC 110 BROADWAY BUFFALO NY 14203 161172453 501(C)(3) 25000 FMV Uncompensated Care SPONSORSHIP CONTRIBUTION UB FOUNDATION 3435 MAIN STREET SUITE 107 BUFFALO NY 14231 160865182 501(C)(3) 58500 FMV CONTRIBUTION SPONSORSHIP SPONSORSHIP MERCY FLIGHT 455 DELAWARE AVE BUFFALO NY 14202 161573408 N/A 20000 FMV GALA SPONSORSHIP MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVE SUITE 125 WHITE PLAINS NY 10605 131846366 501(C)(3) 10000 FMV SPONSORSHIP SPONSORSHIP SUSAN G KOMEN FOR THE CURE ELM CARLTON STREETS BUFFALO NY 14263 751835298 501(C)(3) 6000 FMV SPONSORSHIP ECMC LIFELINE FOUNDATION 462 GRIDER STREET BUFFALO NY 14215 160371125 501(C)(3) 13434 FMV SPONSORSHIP HOSPICE BUFFALO INC 225 COMO PARK BLVD BUFFALO NY 14227 510202066 501(C)(3) 12200 FMV SPONSORSHIP 43NORTH BPC INC 640 ELLICOTT ST SUITE 108 BUFFALO NY 14203 472878159 501(C)(3) 12000 FMV SPONSORSHIP ST JOSEPH COLLEGIATE INSTITUTE 845 KENMORE AVENUE BUFFALO NY 14223 160743159 N/A 10000 FMV SPONSORSHIP CYSTIC FIBROSIS FDN 6931 ARLINGTON RD SUITE T 200 BETHESDA MD 20814 131930701 501(C)(3) 10000 FMV SPONSORSHIP DEAF ACCESS SERVICES INC 2495 MAIN STREET SUITE 446 BUFFALO NY 14214 161433932 N/A 10000 FMV SPONSORSHIP WECK CULVER COMMUNICATIONS COR 2900 GENESEE STREET CHEEKTOWAGA NY 14225 261247618 N/A 8000 FMV SPONSORSHIP KEVIN GUEST HOUSE 782 ELLICOTT STREET BUFFALO NY 14203 237218160 501(C)(3) 7250 FMV SPONSORSHIP AMERICAN CANCER SOCIETY 101 JOHN JAMES AUDUBON PKWY AMHERST NY 14228 160743902 501(C)(3) 6500 FMV SPONSORSHIP AMERICAN DIABETES ASSOCIATION 569 HIGHLAND AVE TONAWANDA NY 14223 131623888 501(C)(3) 5750 FMV SPONSORSHIP 11 6 FORM 990, SCHEDULE I: 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. X true true X X X X X X true true false false false false false false false JODY LOMEO PRES/CEO EX-OFFICIO W/VOTE 995974 0 354600 0 35000 0 494299 0 17185 0 1897058 0 0 0 ALYSON SPAULDING GENERAL COUNSEL 347679 0 84000 0 25000 0 241499 0 14182 0 712360 0 0 0 DAVID HUGHES MD EVP, CMO 474757 0 83125 0 25000 0 210902 0 14347 0 808131 0 0 0 TONI BOOKER EVP, CHIEF HUMAN RESOURCES OFC 331080 0 54450 0 180405 0 46187 0 6334 0 618456 0 149905 0 JONATHAN SWIATKOWSKI EVP, CFO 449904 0 126000 0 25000 0 190281 0 14314 0 805499 0 0 0 JAMAL GHANI FORMER EVP, COO 86253 0 113750 0 565385 0 13520 0 2430 0 781338 0 0 0 DONALD BOYD EVP BUSINESS DEVELOPMENT 507339 0 85000 0 128072 0 60796 0 14281 0 795488 0 103072 0 CHRISTOPHER LANE VP PRESIDENT BGMC 443743 0 52500 0 20000 0 55343 0 14215 0 585801 0 0 0 CHERYL KLASS EVP, CHIEF NURSE EXECUTIVE 566776 0 65000 0 25000 0 50940 0 6558 0 714274 0 0 0 ALLEGRA JAROS SVP OPERATIONS WCHOB 351219 0 52500 0 20000 0 52537 0 14182 0 490438 0 0 0 MICHAEL HUGHES SVP, PUBLIC AFFAIRS MARKETING 274581 0 54000 0 25000 0 113585 0 633 0 467799 0 0 0 AARON HOFFMAN MD EMPLOYED PHYSICIAN 830325 0 0 0 0 0 34985 0 14639 0 879949 0 0 0 CHRISTOPHER MALLAVARAPU MD EMPLOYED PHYSICIAN 901132 33508 14479 949119 CARROLL HARMON MD EMPLOYED PHYSICIAN 639019 0 0 0 0 0 9127 0 1115 0 649261 0 0 0 KATHRYN BASS MD EMPLOYED PHYSICIAN 586856 0 0 0 0 0 39737 0 1037 0 627630 0 0 0 LAN ADAMS MD EMPLOYED PHYSICIAN 601518 0 0 0 0 0 39050 0 1068 0 641636 0 0 0 JAMES KASKIE FORMER CEO 0 0 0 0 192017 0 0 0 0 0 192017 0 0 0 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 A DORMITORY AUTHORITY - STATE OF NEW YORK (SCH 1) 146000293 2016-09-30 7650258 LEASE OF EQUIPMENT false false false B DORMITORY AUTHORITY - STATE OF NEW YORK (SCH 2) 146000293 2016-09-30 7349742 LEASE OF EQUIPMENT false false false A 168499 0 7650258 0 0 0 104266 0 0 7348433 0 197559 false false false true B 161880 0 7349742 0 0 0 0 0 0 2825269 0 4524473 false false false true A false false true true false 0 false false false false B false false true true false 0 false false false false A false true false false false false 0 false 0 false false B false true false false false false 0 false 0 false false A false B false SCHEDULE K, PART III, LINE 8, PART IV, LINE 7 AND PART V 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. SUSAN EVANS SEE PART V 94559 SEE PART V false WALSH INSURANCE SEE PART V 16215 SEE PART V false TOPS MARKETS LLC SEE PART V 2663004 SEE PART V false QUAKER BROOKBRIDGE REAL ESTATE SEE PART V 1800469 SEE PART V false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS 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. X VARIOUS MEDICAL EQUIPMENT 2 3764608 REPLACEMENT COST false true false 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 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 -402601 4340148 KH KALEIDA SERVICES LLC 2100 WEHRLE DRIVE WILLIAMSVILLE NY 14221 000000000 ADULT DAYCARE NY 197196 808195 KH MILLARD FILLMORE AMBULATORY SURGER CTR 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161307129 SUPPORT ORG NY 501(C)(3) 12A KH true VNA HOME CARE SERVICES 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161491203 HOME HLTHCARE NY 501(C)(3) 10 KH true VNA OF WESTERN NEW YORK 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 160743214 HOME HLTHCARE NY 501(C)(3) 10 KH true VISK 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738425 SUPPORT ORG NY 501(C)(3) 10 KH true KALEIDA HEALTH FOUNDATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161579143 FUNDRAISING NY 501(C)(3) 7 KH 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 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 true HARLEM ROAD LEASING LLC 3435 MAIN STREET BUFFALO NY 14214 205588135 EQUIPMENT LEASING NY KALEIDA HEALTH UNRELATED 95520 138196 false 0 true 0.50000 AMTON IMAGING LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE NY 14221 262925470 HEALTH CARE NY KALEIDA WNYI RELATED -51165 1675196 false 0 true 0.50000 SITE E LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 272124795 REAL ESTATE MGMT NY KPI EXCLUDED 111986 1642671 false 0 false 0.50160 MSFC LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 261582864 HEALTH CARE NY KALEIDA HEALTH EXCLUDED 439259 1843351 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 -257653 2457029 false 0 true 0.70000 COLLABORATIVE CARE VENTURES LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 HEALTH CARE NY KALEIDA HEALTH EXCLUDED -73651 17675054 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 -93783 207923 false 0 false 0.50000 ALTUS MANAGEMENT LLC 840 AERO DRIVE SUITE 150 BUFFALO NY 14225 GROUP PURCHAS NY KALEIDA HEALTH EXCLUDED 183048 1976625 false 0 false 0.52167 SOUTHTOWNS SURGERY CENTER LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 464742028 HEALTH CARE NY KALEIDA HEALTH EXCLUDED -1801005 3122497 false 0 true 0.63171 KALEIDA PROPERTIES INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738483 PROP MGMT SVCS NY KALEIDA HEALTH C Corp 1351355 17223458 1.00000 true WESTLINK CORPORATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161354421 MED & DIAGN SVCS NY KALEIDA HEALTH C Corp -290 100916 1.00000 true KALEIDA HEALTHNOW INC 257 WEST GENESEE STREET BUFFALO NY 14202 462164089 HEALTH CARE NY KALEIDA HEALTH C Corp 0.50000 false false true true true true false false false false true true true false false true true true false true VNA HOME CARE SERVICES O 121793 ACTUAL COST VNA HOME CARE SERVICES Q 1745194 ACTUAL COST VNA OF WESTERN NEW YORK O 279271 ACTUAL COST VNA OF WESTERN NEW YORK L 358004 ACTUAL COST VNA OF WESTERN NEW YORK Q 14041243 ACTUAL COST MFSC LLC J 637534 ACTUAL COST MFSC LLC D 55033 ACTUAL COST KALEIDA PROPERTIES INC q 110973 ACTUAL COST KALEIDA PROPERTIES INC d 4696287 ACTUAL COST SITE E LLC k 233450 ACTUAL COST WCHOB FOUNDATION c 1516781 ACTUAL COST WCHOB FOUNDATION s 21661975 ACTUAL COST WCHOB FOUNDATION P 90351 ACTUAL COST KALEIDA HEALTH FOUNDATION c 2247827 ACTUAL COST KALEIDA HEALTH FOUNDATION s 1332699 ACTUAL COST KALEIDA HEALTH FOUNDATION P 296081 ACTUAL COST SOUTHTOWNS IMAGING LLC D 402071 ACTUAL COST SOUTHTOWNS IMAGING LLC J 219997 ACTUAL COST SOUTHTOWNS IMAGING LLC Q 148903 ACTUAL COST SOUTHTOWNS SURGERY CENTER LLC L 172189 ACTUAL COST SOUTHTOWNS SURGERY CENTER LLC J 328947 ACTUAL COST SOUTHTOWNS SURGERY CENTER LLC D 298431 ACTUAL COST COLLABORATIVE CARE VENTURES LLC D 251104 ACTUAL COST