2017-05-12T08:27:13-05:00 2016-06-30 990 2015-07-01 141348692 ST PETER'S HOSPITAL STPE 5185251550 315 SOUTH MANNING BLVD ALBANY NY 12208 LORI SANTOS VP, ACUTE CARE FINANCE 5185251550 2017-05-12 2015 2021-01-29 14:40:06Z VIRGINIA GOLDEN 315 SOUTH MANNING BLVD ALBANY NY 12208 594985088 0 0928 X WWW.SPHP.COM X 1871 NY TO PROVIDE HEALTHCARE AND HOSPITAL SERVICES 23 16 4557 478 5889920 340465 2069226 3028420 534428444 575464362 2652876 304514 15810630 14703670 554961176 593500966 0 0 0 0 207434122 221512721 0 0 0 294842101 330619504 502276223 552132225 52684953 41368741 624683064 627668457 358142284 361931488 266540780 265736969 X WE, ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. FOUNDED IN COMMUNITY-BASED LEGACIES OF COMPASSIONATE HEALING, WE PROVIDE THE HIGHEST QUALITY COMPREHENSIVE CONTINUUM OF INTEGRATED HEALTH CARE, SUPPORTIVE HOUSING AND COMMUNITY SERVICES, ESPECIALLY FOR THE NEEDY AND VULNERABLE. ST. PETER'S HOSPITAL IS A MEMBER OF ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH. 0 0 521952204 0 580755241 AT ST. PETER'S HOSPITAL, CARING FOR THE COMMUNITY DATES BACK TO 1869 WHEN FOUR SISTERS OF MERCY FOUNDED ST. PETER'S HOSPITAL IN DOWNTOWN ALBANY, NY. TODAY, ST. PETER'S HOSPITAL PROVIDES KEY SERVICES TO THE COMMUNITY INCLUDING CARDIAC & VASCULAR CARE, CANCER CARE, WOMEN'S & CHILDREN'S SERVICES, ORTHOPEDIC CARE, GASTROENTEROLOGY, AND BARIATRIC CARE.ST. PETER'S HOSPITAL STRIVES TO INCREASE QUALITY OUTCOMES THROUGH CUTTING EDGE TECHNOLOGIES AND THE IMPLEMENTATION OF EVIDENCE-BASED PRACTICES. ST. PETER'S HOSPITAL IS COMMITTED TO PROVIDING SAFE, EFFECTIVE, COMPASSIONATE CARE TO PATIENTS BY OFFERING THE MOST ADVANCED TREATMENT OPTIONS IN A UNIQUE, CARING ENVIRONMENT AND HAS BEEN RECOGNIZED BY NATIONAL AND STATE HEALTH CARE QUALITY ORGANIZATIONS FOR EXCELLENCE IN CARE. ST. PETER'S HOSPITAL SERVES PATIENTS WITH COMPREHENSIVE MEDICAL CARE, FREE EDUCATIONAL PROGRAMS, AND A HOST OF COMMUNITY HEALTH SCREENINGS THROUGHOUT THE REGION. PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.SPHCS.ORG/ 521952204 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 364 0 1 4557 1 1 1 0 0 0 0 0 0 0 0 0 X 23 16 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 NY X LORI SANTOS 5185255537 315 S MANNING BLVD ALBANY NY 12208 X JAMES K REED MD DIRECTOR; PRESIDENT & CEO 1.00 54.00 X X 0 1076350 46443 HAROLD D GORDON ESQ DIRECTOR; CHAIR 1.00 14.00 X X 0 0 0 ANN DISARRO DIRECTOR; VICE CHAIR 1.00 14.00 X X 0 0 0 MICHAEL KEEGAN DIRECTOR; TREASURER 1.00 14.00 X X 0 0 0 ROBERT J BYLANCIK DIRECTOR; CONSULTANT 1.00 15.00 X 0 1539 1000 BARBARA COTTRELL DIRECTOR 1.00 14.00 X 0 0 0 GARY DAKE DIRECTOR 1.00 14.00 X 0 0 0 SR CATHERINE DECLERCQ SCH O DIR AS OF 1/16; TRINITY HEALTH EVP 1.00 54.00 X 0 0 6573 REV KENNETH DOYLE DIRECTOR THROUGH 1/16 1.00 14.00 X 0 0 0 JOHN D FILIPPONE MD DIRECTOR; PHYSICIAN 1.00 49.00 X 0 587979 35316 RONALD L GUZIOR DIRECTOR 1.00 14.00 X 0 0 0 GEORGE HEARST III DIRECTOR 1.00 14.00 X 0 0 0 SR PHYLLIS HERBERT DIRECTOR 1.00 14.00 X 0 0 0 ROBERT W JOHNSON III ESQ DIRECTOR 1.00 14.00 X 0 0 0 BEVERLY KARPIAK DIRECTOR 1.00 14.00 X 0 0 0 JOHN M LANG DIRECTOR 1.00 14.00 X 0 0 0 SR MARY ANN LOGIUDICE DIRECTOR AS OF 1/16 1.00 14.00 X 0 0 0 NORMAN MASSRY DIRECTOR 1.00 14.00 X 0 0 0 ROBERT J MCCORMICK DIRECTOR 1.00 14.00 X 0 0 0 SR KATHLEEN NATWIN DIRECTOR 1.00 14.00 X 0 0 0 J RICHARD O'CONNELL DIR THR 12/15; TRINITY HEALTH EVP 1.00 54.00 X 0 1558150 47546 CURTIS POWELL DIRECTOR 1.00 14.00 X 0 0 0 ALAN SANDERS MD DIRECTOR; PHYSICIAN 26.00 14.00 X 191894 0 16504 JAMES SLAVIN MD DIRECTOR 1.00 14.00 X 0 0 0 ANTHONY P TARTAGLIA MD DIRECTOR THROUGH 3/16 1.00 14.00 X 0 0 0 LISA THORN MD DIRECTOR 1.00 19.00 X 0 53387 0 SR KATHLEEN TURLEY DIRECTOR THROUGH 12/15 1.00 14.00 X 0 0 0 THOMAS SCHUHLE SPHP VP, CFO & TREASURER 1.00 49.00 X 0 529709 45348 ROBERT SWIDLER SECRETARY; VP LEGAL SERVICES 1.00 49.00 X 0 292592 23636 ANN ERRICHETTI MD VP & CEO, ACUTE CARE ALB THR 4/16 25.00 25.00 X 641908 0 24380 VIRGINIA GOLDEN VP & CEO, ACUTE CARE ALB AS OF 4/16 25.00 25.00 X 0 392369 44822 LORI SANTOS CFO ALBANY 25.00 25.00 X 0 293669 24912 ROBERT CELLA VP & CHIEF MEDICAL OFFICER, ALBANY 20.00 20.00 X 398713 0 26001 DARROCH MOORES PHYSICIAN 40.00 0.00 X 750054 0 25161 DENNIS RASSIAS PHYSICIAN 40.00 0.00 X 597196 0 35395 ROBERT OKSENHOLT PHYSICIAN 40.00 0.00 X 557695 0 40580 KENNETH BAKER PHYSICIAN 40.00 0.00 X 486129 0 39556 MEHUL TRIVEDI PHYSICIAN 40.00 0.00 X 456993 0 20032 ROSARIO PEREZ FMR OFFICER; VP OF MISSION SERVICES 20.00 20.00 X 0 208181 27629 JUDITH GRAY FORMER KEY EMPLOYEE; VP HR 20.00 20.00 X 0 259443 41131 JANE O'ROURKE FMR KEY EMP; VP OPS & CNO THR 5/16 40.00 0.00 X 316031 0 24036 MICHAEL F WHELAN FMR KEY EMP; VP FAC MGMT THR 1/16 20.00 20.00 X 0 270428 36671 JONATHAN GOLDBERG FMR KEY EMPLOYEE; VP & CIO THR 11/15 20.00 20.00 X 0 282195 49671 4396613 5805991 682343 209 1 1 0 ALBANY CARDIOTHORACIC SURGEONS 319 S MANNING BLVD SUITE 110 ALBANY NY 12208 PHYSICIAN SERVICES 4152435 ALL ABOUT STAFFING 1000 SAWGRASS CORP PARKWAY 5TH FLO SUNRISE FL 33323 STAFFING SERVICES 3301744 COMPHEALTH PO BOX 972651 DALLAS TX 75397 PHYSICIAN SERVICES 3135842 SODEXO INC 50 ROSS STREET PITTSBURGH PA 15262 FOOD SERVICES 2529057 BBL LLC 302 WASHINGTON AVE ALBANY NY 12203 CONSTRUCTION SERVICES 2254419 85 2935765 45469 47186 3028420 NET PATIENT SERVICE REVENUE 622110 571166172 571166172 LAB SERVICES & OTHER 621500 4298190 4298190 575464362 1283504 1283504 642248 496132 146116 146116 146116 9000 980734 7256 -980734 1744 -978990 -978990 CAFETERIA REVENUE 722514 2590481 2590481 MEDICARE/MEDICAID HIT REV 622110 844202 844202 PARKING REVENUE 812930 786274 786274 10336597 8744867 1591730 14557554 593500966 580755241 5889920 3827385 X 1299400 208398 1091002 398106 58039 340067 187567943 174187680 13380263 1816828 1721231 95597 17088921 15778847 1310074 13341523 12302189 1039334 65427 65427 27500 27500 93106 93106 83952084 78368029 5584055 42180 38894 3286 12873515 11870640 1002875 483398 445740 37658 14615639 13477048 1138591 328180 302614 25566 110403 101802 8601 9831855 9831855 33649497 31028126 2621371 7161046 6603185 557861 MEDICAL SUPPLIES 122754558 122754558 BAD DEBT 16651727 16651727 CONTRACT LABOR 14711837 13565752 1146085 UBI TAXES 70130 70130 13197422 12585720 611702 552132225 521952204 30180021 0 24977529 28477557 284144 284144 63097469 67744143 76056738 93639747 4578110 6779918 2500876 1680548 769579035 453990494 330669159 315588541 53353460 51121851 38345635 35337984 30819944 27014024 624683064 627668457 58255732 58651535 3815114 3877853 296071438 299402100 358142284 361931488 X 254120652 253976644 4863336 4380298 7556792 7380027 266540780 265736969 624683064 627668457 X 41368741 -2330238 -39842314 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 46718 0 0 0 46718 0 PART II-B, LINE 1: ST. PETER'S HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED ST. PETER'S HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 7556792 -176765 7380027 7640000 98 -83306 7556792 7721554 66789 75405 223748 7640000 7135109 242533 378942 35030 7721554 6659608 698803 675886 899188 7135109 1.00000 0 0 14140193 14140193 416641351 183306997 233334354 325562646 270683497 54879149 13234845 13234845 315588541 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 14423667 F HEDGE FUNDS 8654200 F EQUITY METHOD INVESTMENTS 12260117 C 35337984 INTERCOMPANY ACCOUNTS PAYABLE 3577349 INTERCOMPANY NOTES PAYABLE 286095944 OTHER CURRENT LIABILITIES 580272 OTHER LONG-TERM LIABILITIES 4538590 DEFERRED COMPENSATION LIABILITY 4609945 299402100 PART V, LINE 4: ENDOWMENT FUNDS ARE USED FOR CANCER TREATMENT, THE STUDY OF CANCER TREATMENTS, AND NURSING SCHOLARSHIPS FOR EMPLOYEES 1 1 X 1 X 1 X 1 1 0 1 1 2560 541885 496064 45821 0.00010 176399 77639591 65897152 11742439 0.02190 178959 78181476 66393216 11788260 0.02200 19 48659 999652 37291 962361 0.00180 6 662 825270 10980 814290 0.00150 10 65060 9561924 8511911 1050013 0.00200 1 0 25245 25245 0.00000 1 15410 828 828 0.00000 37 129791 11412919 8560182 2852737 0.00530 37 308750 89594395 74953398 14640997 0.02730 1 7030 5324 5324 0.00000 1 15 4460 4460 0.00000 2 6693 6693 0.00000 4 7045 16477 16477 1 16651727 158042 108610133 121399711 -12789578 X 1 1 1 ST PETER'S AMBULATORY SURGERY CENTER LLC SURGERY CENTER 0.31360 0.68640 1 1 ST PETER'S HOSPITAL 315 SOUTH MANNING BLVD ALBANY NY 12208 WWW.SPHP.COM 0101004H X X X X ST PETER'S HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X WWW.SPHCS.ORG/BODY.CFM?ID=1388&FR=TRUE X 1 15 1 WWW.SPHCS.ORG/BODY.CFM?ID=1388&FR=TRUE 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X WWW.SPHP.COM/FINANCIAL-ASSISTANCE X WWW.SPHP.COM/FINANCIAL-ASSISTANCE X WWW.SPHP.COM/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X X X X 1 X 0 0 ST. PETER'S HOSPITAL PART V, SECTION B, LINE 5: THE ST. PETER'S HOSPITAL COMMUNITY BENEFITS PROGRAM IS BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY THE HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI). HCDI IS A CONSORTIUM OF ORGANIZATIONS JOINED TOGETHER TO PRIORITIZE AND ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. ST. PETER'S HOSPITAL HAS BEEN A MEMBER OF HCDI SINCE 1997. THE CHNA BENEFITED FROM THE REVIEW AND INPUT OF THE MEMBERS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WORKGROUP OF THE HEALTHY CAPITAL DISTRICT INITIATIVE. THESE INDIVIDUALS ARE SUBJECT MATTER EXPERTS FROM THE COUNTY PUBLIC HEALTH DEPARTMENTS OF ALBANY, RENSSELAER, AND SCHENECTADY; AND OF EACH OF THE CAPITAL REGION HOSPITALS: ALBANY MEDICAL CENTER, ALBANY MEMORIAL HOSPITAL, SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, ST. MARY'S HOSPITAL, SAMARITAN HOSPITAL, AND ELLIS HOSPITAL. THEY WERE JOINED BY REPRESENTATIVES FROM COMMUNITY BASED ORGANIZATIONS, BUSINESSES, CONSUMERS, SCHOOLS, ACADEMICS, AND THOSE WHO HAVE CONTACT AND CARE FOR PEOPLE WITH CERTAIN CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA, COPD, AND CANCER. A TOTAL OF 34 DIFFERENT ORGANIZATIONS IN OUR CAPITAL REGION SUCH AS CATHOLIC CHARITIES, WHITNEY M. YOUNG, JR. FEDERALLY QUALIFIED HEALTH CENTER (FQHC), CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, FIDELIS CARE HEALTH PLAN, UNIVERSITY OF ALBANY SCHOOL OF PUBLIC HEALTH, YMCA, COMMUNITY GARDENS, AND SENIOR HOUSING ORGANIZATIONS PARTICIPATED. ALMOST ALL OF THESE ORGANIZATIONS SERVE MEDICALLY UNDERSERVED, LOW INCOME OR MINORITY POPULATIONS, AND MANY OFFER SPECIFIC PROGRAMS TARGETED TOWARDS THESE GROUPS. REPRESENTATIVES OF THE HCDI DETERMINED THE PROCESS FOR COMPLETING THE NEEDS ASSESSMENT AND REVIEWED THE COLLECTED DATA. THE CHNA IS THE RESULT OF OVER A YEAR OF MEETINGS WITH MEMBER ORGANIZATIONS AND COMMUNITY INPUT THROUGH OUR SURVEY OF OVER 3,000 RESIDENTS OF THE CAPITAL DISTRICT. DRAFTS OF THE SECTIONS WERE SENT TO LOCAL SUBJECT MATTER EXPERTS FOR REVIEW IN THE HEALTH DEPARTMENTS OF ALBANY, RENSSELAER, AND SCHENECTADY COUNTIES AND IN ST. PETER'S HEALTH PARTNERS, ALBANY MEDICAL CENTER, ELLIS HOSPITAL, AND INTERFAITH PARTNERSHIP FOR THE HOMELESS. COMMENTS WERE ADDRESSED AND CHANGES WERE INCORPORATED INTO THE FINAL DOCUMENT. THE COMMUNITY HEALTHNEEDS ASSESSMENT WAS COMPLETED AND APPROVED IN JUNE 2016. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 6A: ST. PETER'S HOSPITAL CONDUCTED ITS CHNA IN COLLABORATION WITH THE FOLLOWING HOSPITAL FACILITIES: ALBANY MEDICAL CENTER, ALBANY MEMORIAL HOSPITAL, ELLIS HOSPITAL, ST. MARY'S HOSPITAL, SAMARITAN HOSPITAL, SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, AND BURDETT CARE CENTER. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 6B: ST. PETER'S HOSPITAL WAS JOINED BY REPRESENTATIVES FROM COMMUNITY BASED ORGANIZATIONS, BUSINESSES, CONSUMERS, SCHOOLS, ACADEMICS, AND THOSE WHO HAVE CONTACT AND CARE FOR PEOPLE WITH CERTAIN CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA, COPD, AND CANCER. A TOTAL OF 34 DIFFERENT ORGANIZATIONS IN OUR CAPITAL REGION SUCH AS CATHOLIC CHARITIES, WHITNEY M. YOUNG, JR. FEDERALLY QUALIFIED HEALTH CENTER (FQHC), CENTRO CIVICO, CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, FIDELIS CARE HEALTH PLAN, UNIVERSITY OF ALBANY SCHOOL OF PUBLIC HEALTH, YMCA, COMMUNITY GARDENS, AND SEVERAL SENIOR HOUSING ORGANIZATIONS PARTICIPATED. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 11: DURING FY 16, NEEDS FROM THE 2013 CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WERE ADDRESSED, WITH A FOCUS ON CHRONIC DISEASE PREVENTION AND MANAGEMENT AND MENTAL HEALTH WITH SMOKING CESSATION. OTHER HEALTH CARE FACILITIES SERVING OUR COMMUNITY CONTINUED TO ADDRESS THE OTHER AREAS IDENTIFIED AS WELL.ST. PETER'S HOSPITAL TOOK THE LEAD ON SEVERAL OF THE HEALTH PRIORITIES FROM THE CHNA AND CHIP. ST. PETER'S HEALTH PARTNERS (SPHP), THROUGH ST. PETER'S HOSPITAL, PROVIDED FUNDING TO INITIATE THE ASTHMA EDUCATION PROJECT UTILIZING COMMUNITY HEALTH WORKERS (CHW) TO PROVIDE SERVICES FOR LOW-INCOME AND UNDERSERVED INDIVIDUALS FOR FY 2016. THIS PROJECT FOCUSES ON CHILDREN REFERRED FROM OUR CLINICS AND EMERGENCY DEPARTMENTS WITHIN THE ACUITY AREAS WITH HIGH INCIDENTS OF UNCONTROLLED ASTHMA. THROUGHOUT 2016, CHW CONDUCTED HOME VISITS, FAMILIARIZED FAMILIES WITH ASTHMA TERMINOLOGY, AND OFFERED TRAINING FOR MANAGEMENT OF THE DISEASE. ALSO, CHW ASSESSED PATIENT HOMES FOR ENVIRONMENTAL FACTORS, SUCH AS MOLD AND DUST, WHICH MAY TRIGGER ASTHMA SYMPTOMS, AND PROVIDED HOUSEHOLDS WITH "GREEN" CLEANING SUPPLIES AND VACUUMS WITH HEPA FILTERS. ST. PETER'S ALSO PROVIDED ASTHMA ACTION PLANS TO DISTRIBUTE TO PATIENT'S HOMES AND COMMUNITY PARTNERS. THIS YEAR, ST. PETER'S CONTINUED TO OFFER THE ASTHMA EDUCATOR PROGRAM. THE GOAL OF THE PROGRAM IS TO PROVIDE CLINICIANS AS WELL AS COMMUNITY MEMBERS WITH THE MOST CURRENT AND COMPREHENSIVE INFORMATION CONCERNING ASTHMA, WHICH INCLUDED TEACHING SELF-MANAGEMENT SKILLS, THE ROLE OF MEDICATIONS, THEIR DELIVERY DEVICES, AND CONTROLLING ENVIRONMENTAL FACTORS.FURTHERMORE, PATIENTS IDENTIFYING AS SMOKERS ARE GIVEN INFORMATION AND REFERRALS TO THE NYS SMOKERS QUIT LINE, "OPT TO QUIT" PROGRAM, WHICH IS A SYSTEM-WIDE SOLUTION FOR ENSURING THAT CESSATION SUPPORT IS OFFERED AND ACCESSIBLE TO ALL INPATIENTS SO THAT ONCE THEY LEAVE THE HEALTH CARE SETTING, THEY WILL HAVE A NICOTINE REPLACEMENT THERAPY AT HOME TO UTILIZE IF THEY OPT TO QUIT. IN ADDITION, ST. PETER'S HOSPITAL HAS A LONG TRADITION OF PROVIDING MEETING SPACE FOR THE BUTT STOPS HERE, A 7 WEEK SMOKING CESSATION PROGRAM THAT IS TAUGHT ON SITE WHENEVER THERE ARE INTERESTED COMMUNITY MEMBERS AND/OR STAFF. TO ASSIST IN THE IDENTIFICATION OF PRE-DIABETICS AND TO MONITOR A1C'S OF LOW-INCOME COMMUNITY MEMBERS (WORKING POOR), WE CONDUCT QUARTERLY CARDIOVASCULAR AND DIABETES SCREENING. THIS YEAR, THE ACTIVITY REACHED MORE THAN 5,000 INDIVIDUALS, WHO ALSO RECEIVED ONE-ON-ONE HEALTH EDUCATION, REFERRALS FOR CARE AND TREATMENT, AS WELL AS A COPY OF THE DIABETES GUIDE WITH INFORMATION ON MANAGEMENT CLASSES. ST. PETER'S HOSPITAL HAS A DIABETES EDUCATOR ON SITE TO ADVISE AND EDUCATE NURSING STAFF AND INDIVIDUALS WITH DIABETES TO PREVENT COMPLICATIONS FROM DIABETES.ON JUNE 22, 2016, ST. PETER'S HOSPITAL ADOPTED THEIR FISCAL YEAR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. FOCUS AREAS FOR THE 2016 CHNA ARE AS FOLLOWS: (I) THE PREVENTION OF CHRONIC DISEASE WITH AN EMPHASIS ON REDUCING OBESITY IN CHILDREN AND ADULTS (INCLUSIVE OF RISK FACTORS AND PROMOTION OF EVIDENCE-BASED INTERVENTION PROGRAMS), REDUCING ASTHMA TRIGGERS, AND DECREASING THE PREVALENCE OF CIGARETTE SMOKING BY ADULTS 18 AND OLDER WHO HAVE LOW SOCIOECONOMIC STATUS AND/OR POOR MENTAL HEALTH AND (II) BEHAVIORAL HEALTH - PREVENTION OF SUBSTANCE ABUSE (PARTICULARLY OPIOID ABUSE) AND STRENGTHENING MENTAL HEALTH INFRASTRUCTURE ACROSS SYSTEMS.WHILE THE ORGANIZATION WILL CONTINUE TO OFFER SERVICES ADDRESSING OTHER PRESSING HEALTH NEEDS, IT FELT THAT THE INCREASED FOCUS ON THE SELECTED AREAS REPRESENTS THE BEST USE OF RESOURCES AND EXPERTISE.ST. PETER'S HOSPITAL ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, AND DETERMINED IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND WITHIN ITS ABILITY TO INFLUENCE. THUS, ADVERSE BIRTH OUTCOMES, STD'S AND LYME DISEASE WILL NOT DIRECTLY BE ADDRESSED BY ST. PETER'S HOPSITAL. AS MENTIONED ABOVE, OTHER HEALTH CARE FACILITIES SERVING OUR COMMUNITY WILL CONTINUE TO ADDRESS THE OTHER AREAS AS WELL AND ARE BEING WORKED ON AT BOTH THE COUNTY LEVEL AND AT THE STATE LEVEL. THE TWO FOCUS AREAS WERE CHOSEN ACCORDING TO THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT - WE LOOKED AT DISEASE PREVALENCE RATES, WHICH CONDITIONS AFFECTED DISPARATE POPULATIONS MOST, AND THE AVAILABILITY OF EVIDENCE BASED INTERVENTIONS TO ADDRESS THE PROBLEM, AS DIRECTED BY THE NY STATE PREVENTION AGENDA. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 15E: ALTHOUGH NOT IN OUR POLICY, OUR PROCESS DOES PROVIDE THE CONTACT INFORMATION OF NONPROFIT ORGANIZATIONS OR GOVERNMENT AGENCIES THAT MAY BE SOURCES OF ASSISTANCE WITH FAP APPLICATIONS. ST. PETER'S HOSPITAL PART V, SECTION B, LINE 22D: PATIENTS WITH INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. ACUTE CARE PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE ACUTE CARE CONTRACTUAL ADJUSTMENT FOR MEDICARE. AMBULATORY PATIENTS WITH INCOME BETWEEN 201% AND 400% OF THE FPG RECEIVE A DISCOUNT OFF TOTAL CHARGES FOR MEDICALLY NECESSARY SERVICES EQUAL TO THE HOSPITAL'S AVERAGE PHYSICIAN CONTRACTUAL ADJUSTMENT FOR MEDICARE. THE ACUTE AND PHYSICIAN AVERAGE CONTRACTUAL ADJUSTMENT AMOUNTS FOR MEDICARE ARE CALCULATED UTILIZING THE LOOK BACK METHODOLOGY OF CALCULATING THE SUM OF PAID CLAIMS DIVIDED BY THE TOTAL GROSS CHARGES FOR THOSE CLAIMS ANNUALLY USING TWELVE MONTHS OF PAID CLAIMS WITH A 30 DAY LAG FROM REPORT DATE TO THE MOST RECENT DISCHARGE DATE. ST. PETER'S HOSPITAL - PART V, SECTION B, LINE 9: AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. 10 1 - CANCER CARE - RADIATION ONCOLOGY 317 SOUTH MANNING BLVD ALBANY NY 12208 CANCER TREATMENT AND ONCOLOGY 2 - ST PETER'S SURGERY AND ENDOSCOPY CENTER 1375 WASHINGTON AVE SUITE 201 ALBANY NY 12206 AMBULATORY SURGERY CENTER 3 - OP MEDICAL IMAGING 319 SOUTH MANNING BLVD ALBANY NY 12208 MEDICAL IMAGING, BREAST CENTER, LABS, ADVANCED HEART AND CONG. HEART FAILURE 4 - FAMILY HEALTH CENTER 126 SOUTH PEARL ST ALBANY NY 12208 ADULT MEDICINE, PEDIATRICS, OB/GYN SERVICES 5 - SIENA STUDENT CENTER 515 LOUDON ROAD LOUDONVILLE NY 12211 COLLEGE STUDENT HEALTH SERVICES 6 - PATIENT SERVICE CENTER 1365 WASHINGTON AVE ALBANY NY 12205 LABS 7 - PATIENT SERVICE CENTER 62 HACKETT BLVD ALBANY NY 12208 LABS 8 - ST PETER'S SERVICE CENTER 6 EXECUTIVE PARK DRIVE ALBANY NY 12203 LABS 9 - ST PETER'S SERVICE CENTER 1814 CENTRAL AVENUE ALBANY NY 12205 LABS 10 - NUCLEAR MEDICINE 7 PALISADES DRIVE ALBANY NY 12205 NUCLEAR MEDICINE AND ECHOCARDIOGRAMS PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: ST. PETER'S HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF NEW YORK. IN ADDITION, ST. PETER'S HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.ST. PETER'S HOSPITAL ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $16,651,727, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: ST. PETER'S HOSPITAL STAFF IS VERY ACTIVE ON A NUMBER OF LOCAL NONPROFIT COMMUNITY BOARDS, INCLUDING THE HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI) BOARD, BY ASSISTING TO DEVELOP THE COMMUNITY HEALTH AGENDA AS WELL AS ADVANCING A UNIFIED REPORTING SYSTEM FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). IN AN EFFORT TO SUPPORT COALITION BUILDING, THE STAFF PARTICIPATES AND, IN SOME CASES, LEADS THE VARIOUS TASK FORCE MEETINGS THAT HAVE ARISEN FROM THE CHIP: THE ASTHMA TASK FORCE, THE DIABETES TASK FORCE, THE MENTAL/BEHAVIORAL HEALTH TASK FORCE, SMOKING CESSATION INITIATIVE AND THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PLANNING PROCESS, ESPECIALLY PROJECT 11. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: A PERCENTAGE OF THE HOSPITAL'S BAD DEBT EXPENSE IS REPORTED ON LINE 3. THIS PERCENTAGE IS BASED ON THE SELF-PAY ACCOUNTS WITH NO PAYMENTS THAT WERE TRANSFERRED TO BAD DEBT AS COMPARED TO ALL OTHER PAYORS. THE RATIONALE IS THAT THESE SELF-PAY PATIENTS WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THEY APPLIED. PART III, LINE 4: ST. PETER'S HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 15 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: ST. PETER'S HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - ST. PETER'S HOSPITAL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT ELIGIBILITY FOR ASSISTANCE - ST. PETER'S HOSPITAL IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, ST. PETER'S HOSPITAL HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSST. PETER'S HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT.ST. PETER'S HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. PAPER COPIES OF THE APPLICATION, PLAIN LANGUAGE SUMMARY, AND COMPLETE POLICY ARE AVAILABLE IN SPANISH, BURMESE AND ARABIC, REFLECTING OTHER LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. ST. PETER'S HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. ST. PETER'S HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - ST. PETER'S HOSPITAL IS LOCATED IN ALBANY, NY, ALBANY COUNTY AND IS ALSO THE CAPITAL OF NEW YORK STATE. THE MEDIAN HOUSEHOLD INCOME IS $59,965. THE COMMUNITIES SERVED BY ST. PETER'S HOSPITAL INCLUDE THE COUNTIES OF ALBANY, RENSSELAER, AND SCHENECTADY. THE THREE COUNTIES PROVIDE A RANGE OF GEOGRAPHY THAT INCLUDES URBAN, SUBURBAN AND RURAL SETTINGS IN ADDITION TO REPRESENTING THE HOME ZIP CODES OF 65.5% OF ITS PATIENTS. THE COMBINED POPULATION IN ALBANY, RENSSELAER, AND SCHENECTADY COUNTIES WAS 78.8% WHITE, 9.6% BLACK, 4.8% HISPANIC, 3.7% ASIAN/PACIFIC ISLANDER, AND 3.0% OTHER RACES/ETHNICITIES IN 2010. OVER TIME, THE CAPITAL DISTRICT POPULATION HAS GROWN MORE ETHNICALLY DIVERSE, WITH FEWER INDIVIDUALS IDENTIFIED AS WHITE NON-HISPANIC.IN GENERAL, PERSONS IN THE COMMUNITY SERVED BY ST. PETER'S HOSPITAL TEND TO BE BETTER EDUCATED AND HAVE A HIGHER INCOME THAN THOSE IN THE U.S. AS A WHOLE AND THE STATE OF NY. THERE IS A LOWER RATE OF UNEMPLOYMENT AND FEWER PERSONS WITHOUT HEALTH INSURANCE THAN THE STATE OR NATIONAL COMPARISONS. THE POPULATION FOR THE THREE COUNTY SERVICE AREAS IS 620,414. THERE ARE276,563 HOUSING UNITS IN THE SERVICE AREA WITH AN AVERAGE OF 64% OWNER OCCUPIED. ON AVERAGE 12.3% OF PERSONS LIVE BELOW THE POVERTY LEVEL. THE MEDIAN HOUSEHOLD INCOME IS $58,254.HEALTH CARE ACCESS INDICATORS SHOW THE CAPITAL DISTRICT HAVING FEWER BARRIERS TO CARE THAN THE REST OF THE STATE. CAPITAL DISTRICT RESIDENTS, BOTH CHILDREN AND ADULTS, HAD HIGHER HEALTH INSURANCE COVERAGE RATES COMPARED TO THE REST OF THE STATE. WHILE THE CAPITAL DISTRICT HAD GOOD HEALTH INSURANCE COVERAGE, STILL SLIGHTLY LESS THAN 10% OF RESIDENTS WERE NOT COVERED BY ANY FORM OF HEALTH INSURANCE. PART VI, LINE 5: OTHER INFORMATION - ST. PETER'S PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE IN THE COMMUNITY IT SERVES, INCLUDING A 24-HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL IN NEED REGARDLESS OF ABILITY TO PAY, A CANCER CENTER, CARDIAC CARE THAT IS RECOGNIZED FOR EXCELLENCE BY HEALTH AND HEART CARE ORGANIZATIONS, COMPLETE OBSTETRICAL AND NEWBORN SERVICES, DENTAL AND HEALTH CENTERS FOR UNINSURED AND UNDERINSURED MEMBERS OF OUR COMMUNITY, AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. ST. PETER'S CONDUCTS ITS ACTIVITIES AND ITS HEALTH CARE PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, SEXUAL ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN UPSTATE NEW YORK, ST. PETER'S HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY, NOT ONLY AS A CARING COMMUNITY MEMBER, BUT ALSO AS A CATALYST FOR CHANGE. AS SUCH, WE PARTICIPATE IN MANY COMMUNITY PARTNERSHIPS AIMED AT ASSESSING THE CURRENT HEALTH STATUS OF OUR COMMUNITY AND IDENTIFYING OPPORTUNITIES TO MAKE A DIFFERENCE IN THE HEALTH OF OUR CITIZENS WITH PARTICULAR ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. AS WE HAVE DONE FOR MANY YEARS, WE CONTINUE TO PLAY A MAJOR ROLE IN THE HEALTHY CAPITAL DISTRICT INITIATIVE, AN ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF THE RESIDENTS OF ALBANY, RENSSELAER AND SCHENECTADY COUNTIES. OUR PARTNERS IN THIS ENDEAVOR ARE THE LOCAL COUNTY HEALTH DEPARTMENTS, OTHER HEALTH CARE PROVIDERS, INSURERS AND COMMUNITY MEMBERS. ST. PETER'S SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, CHURCHES AND OTHER HEALTH CARE ORGANIZATIONS TO PROVIDE COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES AND PROACTIVE HEALTH CARE PROGRAMS. THIS INCLUDES SITTING ON COMMUNITY BOARDS, COMMITTEES, AND ADVISORY GROUPS. ST. PETER'S ALSO PROVIDES SERVICES FOR THE BROADER COMMUNITY AS A PART OF ITS OVERALL COMMUNITY BENEFIT. THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NONPROFIT HEALTH CARE. THIS EDUCATION INCLUDES STUDENT INTERNSHIPS, CLINIC EXPERIENCE AND OTHER EDUCATION FOR PHYSICIANS, NURSES, PHYSICAL THERAPISTS AND OTHER HEALTH CARE STUDENTS. AS A NONPROFIT ORGANIZATION THAT IS PART OF ST. PETER'S HEALTH PARTNERS (SPHP), ST. PETER'S HOSPITAL IS GUIDED BY A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE. ST. PETER'S HOSPITAL HAS AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK TO PROVIDE CARE TO OUR COMMUNITIES. ALL MEDICAL STAFF MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. NO PART OF THE INCOME OF ST. PETER'S HOSPITAL BENEFITS ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED. ALL SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT OR PROGRAMS OF THE HOSPITAL TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND OUR FACILITIES AND ADVANCE OUR MEDICAL TRAINING, EDUCATION AND RESEARCH PROGRAMS.IN FY 16, THE SMOKE FREE ENVIRONMENT POLICY WAS UPDATED FOR SPHP, INCLUDING ST. PETER'S HOSPITAL, TO BAN THE USE OF ELECTRONIC CIGARETTES (E-CIGARETTES) ON SPHP OWNED, LEASED OR CONTROLLED PROPERTY AND AREAS WITHIN FIFTEEN FEET OF A BUILDING ENTRANCE OR EXIT OF THE GENERAL HOSPITAL OR RESIDENTIAL HEALTH FACILITY. IN ADDITION, THROUGH THE ADVOCACY WORK OF OUR CENTER FOR HEALTH PROGRAMS AND PROMOTIONS, TOBACCO 21 LEGISLATION WAS PASSED IN ALBANY COUNTY. TOBACCO 21 ADVOCATES INCREASING THE LEGAL AGE TO PURCHASE TOBACCO FROM 18 TO 21. DURING FY 16, OUR CHILD BIRTH CENTER CONTINUED ON THE PATH OF ACHIEVING BABY FRIENDLY DESIGNATION. BABY FRIENDLY HOSPITALS ARE HOSPITALS THAT ARE RECOGNIZED FOR ENCOURAGING BREASTFEEDING AND MOTHER/BABY BONDING, WHICH IS KNOWN TO PROVIDE HEALTH BENEFITS FOR INFANTS, CHILDREN, AND MOTHERS.ST. PETER'S HOSPITAL, ALONG WITH ITS SPHP SISTER HOSPITALS, COLLABORATED WITH OTHER LOCAL HEALTH SYSTEMS, COUNTY HEALTH DEPARTMENTS AND COMMUNITY BASED AGENCIES TO COMPLETE A SIX COUNTY (ALBANY, RENSSELAER, SCHENECTADY, SARATOGA, COLUMBIA AND GREEN) COMMUNITY HEALTH NEEDS ASSESSMENT, LED BY HEALTHY CAPITAL DISTRICT INITIATIVE (HCDI). HCDI IS AN INCORPORATED NOT-FOR-PROFIT WHICH WORKS WITH OTHERS IN THE COMMUNITY TO DETERMINE WAYS IN WHICH THE CAPITAL REGION COULD BE MORE EFFECTIVE IN IDENTIFYING AND ADDRESSING PUBLIC HEALTH ISSUES. PART VI, LINE 6: ST. PETER'S HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2016, GOALS INCLUDED 1) PARTNERING WITH COMMUNITY ORGANIZATIONS IN INSURANCE ENROLLMENT ACTIVITIES TARGETED AT UNINSURED INDIVIDUALS TO IMPROVE ACCESS TO HEALTHCARE, 2) PARTICIPATING IN LOCAL ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, AND 3) DEVELOPING A STRATEGY WITH MULTI-DISCIPLINARY TEAMS TO OPTIMIZE CARE FOR VULNERABLE PERSONS, WITH PARTICULAR FOCUS ON THOSE WHO ARE DUALLY ENROLLED IN MEDICAID AND MEDICARE. TRINITY HEALTH APPRECIATES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED PROGRAMS FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED AREAS OF NEED AND THAT WILL REDUCE OBESITY AND TOBACCO USE.AS A SYSTEM, TRINITY HEALTH SUPPORTED PROGRAMS AND ORGANIZATIONS WHO ADDRESS THESE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE GRANTING SEVEN DACA "DREAMERS" LOW INTEREST LOANS, ENABLING RECIPIENTS TO ATTEND MEDICAL SCHOOL AT STRITCH SCHOOL OF MEDICINE, AND PROVIDING A GRANT TO THE U.S. SOCCER FOUNDATION TO FUND ITS SOCCER FOR SUCCESS PROGRAM IN NINE COMMUNITIES, OFFERING STUDENTS IN UNDERSERVED AREAS THE OPPORTUNITY TO SAFELY AND COST-EFFECTIVELY ENGAGE IN A HEALTHY AND ACTIVE LIFESTYLE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND UNINSURED, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND REACHING OUT TO UNDERSERVED POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS NEARLY $1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES NY 0 1 0 0 0 0 0 0 0 JAMES K REED MD DIRECTOR; PRESIDENT & CEO 0 609179 0 217448 0 249723 0 21100 0 25343 0 1122793 0 0 JOHN D FILIPPONE MD DIRECTOR; PHYSICIAN 0 489873 0 97562 0 544 0 17125 0 18191 0 623295 0 0 J RICHARD O'CONNELL DIR THR 12/15; TRINITY HEALTH EVP 0 859386 0 383634 0 315130 0 11925 0 35621 0 1605696 0 39142 ALAN SANDERS MD DIRECTOR; PHYSICIAN 191254 0 0 0 640 0 15925 0 579 0 208398 0 0 0 THOMAS SCHUHLE SPHP VP, CFO & TREASURER 0 412977 0 73734 0 42998 0 25075 0 20273 0 575057 0 0 ROBERT SWIDLER SECRETARY; VP LEGAL SERVICES 0 246186 0 44446 0 1960 0 22576 0 1060 0 316228 0 0 ANN ERRICHETTI MD VP & CEO, ACUTE CARE ALB THR 4/16 488245 0 137690 0 15973 0 17125 0 7255 0 666288 0 0 0 VIRGINIA GOLDEN VP & CEO, ACUTE CARE ALB AS OF 4/16 0 329956 0 60188 0 2225 0 25075 0 19747 0 437191 0 0 LORI SANTOS CFO ALBANY 0 289421 0 0 0 4248 0 22434 0 2478 0 318581 0 0 ROBERT CELLA VP & CHIEF MEDICAL OFFICER, ALBANY 333300 0 63059 0 2354 0 17125 0 8876 0 424714 0 0 0 DARROCH MOORES PHYSICIAN 744414 0 0 0 5640 0 17712 0 7449 0 775215 0 0 0 DENNIS RASSIAS PHYSICIAN 512409 0 78514 0 6273 0 17125 0 18270 0 632591 0 0 0 ROBERT OKSENHOLT PHYSICIAN 555827 0 0 0 1868 0 19929 0 20651 0 598275 0 0 0 KENNETH BAKER PHYSICIAN 455459 0 0 0 30670 0 21100 0 18456 0 525685 0 0 0 MEHUL TRIVEDI PHYSICIAN 378459 0 61049 0 17485 0 13150 0 6882 0 477025 0 0 0 ROSARIO PEREZ FMR OFFICER; VP OF MISSION SERVICES 0 174492 0 33442 0 247 0 12151 0 15478 0 235810 0 0 JUDITH GRAY FORMER KEY EMPLOYEE; VP HR 0 216025 0 41836 0 1582 0 24511 0 16620 0 300574 0 0 JANE O'ROURKE FMR KEY EMP; VP OPS & CNO THR 5/16 313853 0 0 0 2178 0 17125 0 6911 0 340067 0 0 0 MICHAEL F WHELAN FMR KEY EMP; VP FAC MGMT THR 1/16 0 224959 0 43948 0 1521 0 17601 0 19070 0 307099 0 0 JONATHAN GOLDBERG FMR KEY EMPLOYEE; VP & CIO THR 11/15 0 233588 0 28504 0 20103 0 26350 0 23321 0 331866 0 0 PART I, LINE 3 ST. PETER'S HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. ST. PETER'S HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF ST. PETER'S HOSPITAL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2015, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2015. THE FOLLOWING PAYOUTS FOR 2015 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: J. RICHARD O'CONNELL - $207,673 JAMES K. REED - $169,884 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2015). THE FOLLOWING PAYOUTS FOR 2015 FOR THESE PLANS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: J. RICHARD O'CONNELL - $39,142 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. LEIZBETH VALLEJO-SANDERS FAMILY MEMBER OF ALAN SANDERS, MD, BOARD DIRECTOR 58039 EMPLOYMENT ARRANGEMENT 0 FORM 990, PART VI, SECTION A, LINE 4 AT THE BEGINNING OF THE TAX YEAR, THE SOLE MEMBER OF ST. PETER'S HOSPITAL WAS ST. PETER'S HEALTH CARE SERVICES. EFFECTIVE DECEMBER 31, 2015, ST. PETER'S HEALTH CARE SERVICES MERGED INTO ITS PARENT, ST. PETER'S HEALTH PARTNERS. THEREFORE, EFFECTIVE DECEMBER 31, 2015, ST. PETER'S HEALTH PARTNERS BECAME THE SOLE MEMBER OF ST. PETER'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF ST. PETER'S HOSPITAL IS ST. PETER'S HEALTH HEALTH PARTNERS. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A ST. PETER'S HEALTH PARTNERS IS THE SOLE MEMBER OF ST. PETER'S HOSPITAL. ST. PETER'S HEALTH PARTNERS HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF ST. PETER'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, ST. PETER'S HEALTH PARTNERS MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. ST. PETER'S HEALTH PARTNERS MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR ST. PETER'S HOSPITAL IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE EXECUTIVE COMMITTEE AS WELL AS THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ST. PETER'S HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF ST. PETER'S HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF ST. PETER'S HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF ST. PETER'S HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO ST. PETER'S HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF ST. PETER'S HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF ST. PETER'S HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B QUESTION 15A IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR ST. PETER'S HOSPITAL'S SYSTEM CEO IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING ST. PETER'S HOSPITAL'S SYSTEM CEO AND SYSTEM CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF BOTH THE SYSTEM CEO AND SYSTEM CFO OF ST. PETER'S HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES, ST. PETER'S HOSPITAL HAS A PROCESS FOR DETERMINING COMPENSATION WHICH INCLUDES THE FOLLOWING: COMPENSATION IS REVIEWED BY AN INDEPENDENT COMPENSATION CONSULTANT WHO REVIEWS THE SALARIES TO ENSURE THEY ARE WITHIN MARKET AND MARKET COMPETITIVE. THIS IS DONE ON AN ANNUAL BASIS, REVIEWED BY EITHER THE ORGANIZATION'S OR A RELATED ORGANIZATION'S COMPENSATION COMMITTEE AND COMMUNICATED TO THE OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 ST. PETER'S HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, ST. PETER'S HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. ST. PETER'S HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: SR. CATHERINE DECLERCQ IS A MEMBER OF THE ORDER OF ADRIAN DOMINICAN SISTERS. HAVING TAKEN A VOW OF POVERTY, SR. CATHERINE DECLERCQ DID NOT RECEIVE COMPENSATION FOR THE SERVICES PROVIDED TO TRINITY HEALTH, A RELATED ORGANIZATION, EXCEPT FOR INSURANCE BENEFITS OF $6,573. INSTEAD, A TOTAL OF $613,798 WAS PAID BY TRINITY HEALTH DIRECTLY TO THE ORDER OF ADRIAN DOMINICAN SISTERS FOR SR. CATHERINE DECLERCQ'S SERVICES. FORM 990, PART IX, LINE 11G MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 12,271,799. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,271,799. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 645,416. MANAGEMENT AND GENERAL EXPENSES 54,527. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 699,943. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 1,399,933. MANAGEMENT AND GENERAL EXPENSES 118,272. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,518,205. MISC. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 63,989,561. MANAGEMENT AND GENERAL EXPENSES 5,406,076. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,395,637. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 61,320. MANAGEMENT AND GENERAL EXPENSES 5,180. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,500. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO/FROM AFFILIATES -40,483,809. EQUITY GAIN/LOSS IN UNCONSOL. AFFILIATES 1,147,969. OTHER TRANSACTIONS -506,474. FORM 990, PART XII, LINE 2: ST. PETER'S HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY16 CONSOLIDATED FINANCIAL STATEMENTS OF ST. PETER'S HEALTH PARTNERS AND TRINITY HEALTH, WHICH WERE BOTH AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 ALBANY MEMORIAL HOSPITAL 600 NORTHERN BLVD ALBANY NY 12204 141338457 HEALTHCARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT FL 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 AMICARE HOSPICE SERVICES INC 20555 VICTOR PARKWAY LIVONIA MI 48152 382949053 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTHCARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH - NEW ENGLAND INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTHCARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 11A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 BRIGHTSIDE INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042182395 HEALTHCARE SERVICES MA 501(C)(3) LINE 9 SISTERS OF PROVIDENCE HEALTH SYSTEM INC 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA ST COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP PO BOX 995 ANN ARBOR MI 48106 382507173 HEALTHCARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 COLUMBUS ACQUISITION CORP 111 CENTRAL AVENUE NEWARK NJ 07102 262616342 INACTIVE ENTITY NJ 501(C)(3) LINE 9 SAINT MICHAEL'S MEDICAL CENTER 1 COMMUNITY HEALTH PARTNERS OF SOUTH BEND PO BOX 3998 SOUTH BEND IN 46619 263051440 HEALTHCARE SERVICES IN 501(C)(3) LINE 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC 1 CRANBROOK HOSPICE CARE 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320699 HOSPICE SERVICES MI 501(C)(3) LINE 9 TRINITY HOME HEALTH SERVICES 1 DILEY RIDGE MEDICAL CENTER 6150 EAST BROAD STREET COLUMBUS OH 43213 342032340 HEALTHCARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION INC 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 EAST NORRITON PHYSICIANS SERVICES ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 232515999 HEALTHCARE SERVICES PA 501(C)(3) LINE 3 MERCY PHYSICIAN NETWORK 1 EDDY LICENSED HOME CARE AGENCY INC 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE SUITE 100 DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 9 ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 FARREN CARE CENTER INC C/O SPHS 1221 MAIN STREET SUITE 213 HOLYOKE MA 01040 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 SISTERS OF PROVIDENCE HEALTH SYSTEM INC 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 9 ST FRANCIS HOSPITAL 1 GLEN EDDY INC ONE GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTHCARE SERVICES MI 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTHCARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 COMMUNITY OUTREACH IL 501(C)(3) LINE 9 GOTTLIEB MEMORIAL HOSPITAL 1 GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 11C, III-FI N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTHCARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC 945 OTTAWA AVE NW GRAND RAPIDS MI 49503 237270669 MEDICAL EDUCATION TRAINING PROGRAMS MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN 1 HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST PO BOX 3302 MUSKEGON MI 49443 382299878 SELF INSURANCE MI 501(C)(3) LINE 11B, II MERCY HEALTH PARTNERS 1 HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON MI 49442 381386362 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 MERCY HEALTH PARTNERS 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 9 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 520738041 HEALTHCARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 590791028 HEALTHCARE AND HOSPITAL SERVICES FL 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS MEDICAL PROPERTIES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 650666283 BUILDING MANAGEMENT SERVICES FL 501(C)(2) N/A HOLY CROSS HOSPITAL INC 1 HOLY CROSS OUTPATIENT SERVICES INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 465421068 HEALTHCARE SERVICES FL 501(C)(3) LINE 9 HOLY CROSS HOSPITAL INC 1 HOLY CROSS PRIMARY CARE INC 4725 NORTH FEDERAL HIGHWAY FT LAUDERDALE FL 33308 812531495 HEALTHCARE SERVICES FL 501(C)(3) LINE 9 HOLY CROSS HOSPITAL INC 1 HOME & COMMUNITY HEALTH SERVICES INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS CT 06076 810723591 HOME HEALTH SERVICES CT 501(C)(3) LINE 9 TRINITY HEALTH - NEW ENGLAND INC 1 HOME AIDE SERVICE OF EASTERN NEW YORK INC 433 RIVER ST SUITE 3000 TROY NY 12180 141514867 HOME HEALTH SERVICES NY 501(C)(3) LINE 9 LTC (EDDY) INC 1 HOSPICE OF NORTH IOWA 232 SECOND STREET SE MASON CITY IA 50401 421173708 HOSPICE SERVICES IA 501(C)(3) LINE 9 MERCY HEALTH SERVICES-IOWA CORP 1 HOSPICE OF SIOUXLAND 4300 HAMILTON BLVD SIOUX CITY IA 51104 383320710 HOSPICE SERVICES IA 501(C)(3) LINE 11A, I N/A 0 HOSPICE OF WASHTENAW II 806 AIRPORT BLVD ANN ARBOR MI 48108 383320707 HOSPICE SERVICES (INACTIVE) MI 501(C)(3) LINE 11A, I TRINITY HEALTH-MICHIGAN 1 IHA HEALTH SERVICES CORPORATION 24 FRANK LLOYD WRIGHT DR LOBBY J ANN ARBOR MI 48106 383316559 HEALTHCARE SERVICES MI 501(C)(3) LINE 9 TRINITY HEALTH-MICHIGAN 1 JOHNSON HEALTH CARE INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS CT 06076 810709903 HEALTHCARE SERVICES CT 501(C)(3) LINE 9 TRINITY HEALTH - NEW ENGLAND INC 1 JOHNSON MEMORIAL HOSPITAL INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS CT 06076 475676956 HEALTHCARE AND HOSPITAL SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH - NEW ENGLAND INC 1 JOHNSON MEMORIAL MEDICAL CENTER INC 201 CHESTNUT HILL ROAD STAFFORD SPRINGS CT 06076 810696923 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT CT 501(C)(3) LINE 11B, II TRINITY HEALTH - NEW ENGLAND INC 1 LANGHORNE MRI INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232519529 HEALTHCARE SERVICES (INACTIVE) PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LANGHORNE PHYSICIAN SERVICES INC 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 232571699 HEALTHCARE SERVICES PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LIFE AT LOURDES INC 2475 MCCLELLAN AVENUE PENNSAUKEN NJ 08109 261854750 PACE PROGRAM NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LIFE AT ST FRANCIS HEALTHCARE INC 7TH CLAYTON STREETS WILMINGTON DE 19805 452569214 PACE PROGRAM DE 501(C)(3) LINE 9 ST FRANCIS HOSPITAL 1 LIFE ST FRANCIS CORPORATION 1435 LIBERTY STREET HAMILTON NJ 08629 222797282 PACE PROGRAM NJ 501(C)(3) LINE 9 ST FRANCIS MEDICAL CENTER TRENTON NJ 1 LIFE ST JOSEPH OF THE PINES INC 100 GOSSMAN DRIVE SOUTHERN PINES NC 28387 272159847 PACE PROGRAM NC 501(C)(3) LINE 3 ST JOSEPH OF THE PINES INC 1 LIFE ST MARY 1201 LANGHORNE-NEWTOWN ROAD LANGHORNE PA 19047 262976184 PACE PROGRAM PA 501(C)(3) LINE 9 ST MARY MEDICAL CENTER 1 LOURDES ANCILLARY SERVICES 1600 HADDON AVENUE CAMDEN NJ 08103 222568525 VOLUNTEER SERVICE AUXILIARY NJ 501(C)(3) LINE 11B, II OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES CARDIOLOGY SERVICES PC 1600 HADDON AVENUE CAMDEN NJ 08103 274357794 HEALTHCARE SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 218 SUNSET ROAD WILLINGBORO NJ 08046 223612265 HEALTHCARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 OUR LADY OF LOURDES HEALTH CARE SERVICES 1 LOYOLA MEDICINE TRANSPORT LLC 905 W NORTH AVE MELROSE PARK IL 60160 474147171 TRANSPORATION SERVICES IL 501(C)(3) LINE 9 LOYOLA UNIVERSITY MEDICAL CENTER 1 LOYOLA UNIVERSITY HEALTH SYSTEM 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 363342448 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) LINE 11B, II TRINITY HEALTH CORPORATION 1 LOYOLA UNIVERSITY MEDICAL CENTER 2160 SOUTH FIRST AVENUE MAYWOOD IL 60153 364015560 HEALTHCARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 LTC (EDDY) INC 2212 BURDETT AVE TROY NY 12180 222564710 MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 11B, II ST PETER'S HEALTH PARTNERS 1 MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 240711230 HEALTHCARE SERVICES (INACTIVE) PA 501(C)(3) LINE 9 MAXIS HEALTH SYSTEM 1 MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY IA 51101 383320705 HOME HEALTH SERVICES (INACTIVE) IA 501(C)(3) LINE 11A, I MERCY HEALTH SERVICES-IOWA CORP 1 MARYCREST HEIGHTS PO BOX 9184 FARMINGTON HILLS MI 48333 270291722 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 9 TRINITY CONTINUING CARE SERVICES 1 MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 911940902 HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) PA 501(C)(3) LINE 11A, I TRINITY HEALTH CORPORATION 1 MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD CT 06117 061058086 SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 9 MERCY COMMUNITY HEALTH INC 1 MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTHCARE SERVICES 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