2016-10-27T13:25:50-07:00 2015-12-31 990 2015-01-01 222325405 CAYUGA MEDICAL CENTER AT ITHACA CAYU 6072744441 101 Dates Drive Ithaca NY 14850 John Collett VP/CFO 6072744441 2016-09-01 2015 2017-02-10 21:41:12Z John Rudd 101 Dates Drive Ithaca NY 14850 222251702 0 X www.cayugamed.org X 1981 NY TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 13 9 1586 147 1081929 338015 464475 491259 165211198 180651855 8835206 3997251 1241298 1366844 175752177 186507209 6750 4500 0 0 89539701 91451751 0 0 0 88926772 90219582 178473223 181675833 -2721046 4831376 275899511 259344620 106052369 113056707 169847142 146287913 TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. 0 0 135130135 3500 181221112 PATIENT SERVICE - GENERAL INPATIENT AND OUTPATIENT HOSPITAL CARE. SERVICES ARE PROVIDED TO THOSE IN NEED REGARDLESS OF THE PATIENTS ABILITY TO PAY, RACE, CREED, NATIONAL ORIGIN, LIFE CIRCUMSTANCES, OR DISEASE. CAYUGA MEDICAL CENTER WORKS CLOSELY WITH THE COMMUNITY TO DETERMINE HEALTH NEEDS AND TO SUPPORT THE DEVELOPMENT OF PROGRAMS AND SERVICES THAT IMPROVE THE HEALTH STATUS OF THE COMMUNITY. 1000 1000 0 A HEALTH CAREER SCHOLARSHIP AWARDED TO STUDENTS PURSUGING A HEALTHCARE DEGREE. TWO PARTICIPANTS IN 2015. 0 0 0 135131135 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 265 0 1 1586 1 1 1 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JOHN COLLETT 6072744441 101 DATES DRIVE ITHACA NY 14850 LARRY BAUM CHAIR 1 X X 0 0 0 BRIAN MCAREE VICE CHAIR 1 X X 0 0 0 SAMI HUSSEINI MD SECRETARY 1 X X 0 0 0 GREG HARTZ TREASURER 1 X X 0 0 0 HENRY D GERSON MD DIRECTOR 40 X 319689 0 10579 TONY EISENHUT DIRECTOR 1 X 0 0 0 KENNETH CLARKE DIRECTOR 1 X 0 0 0 PAULA E F YOUNGER DIRECTOR 1 X 0 0 0 JOANNE DESTEFANO DIRECTOR 1 X 0 0 0 STEVE ROGERS MD DIRECTOR 1 X 0 0 0 JOHN LAMBERT MD DIRECTOR 1 X 0 0 0 JOHN NEUMAN DIRECTOR 1 X 0 0 0 JOHN RUDD PRESIDENT/CEO 40 X X 450697 0 13079 JOHN COLLETT VP/CFO 40 X 214200 0 4284 TIMOTHY BAEL MD ONCOLOGIST 40 X 654547 0 10867 CHARLES GARBO MD ONCOLOGIST 40 X 555983 0 10579 JULIE CAMBELL MD ONCOLOGIST 40 X 480907 0 9626 SRISATISH DEVAPATLA MD NEONATOLOGIST 40 X 398811 0 11359 RAMESH VIDAVALUR NEONATOLOGIST 40 X 327754 0 14481 3402588 0 84854 58 0 1 0 LPCiminelli 2421 Main Street Buffalo NY 14214 Construction Contractor 2724755 Cayuga Anesthesia Associates PLLC PO Box 366 Ithaca NY 14850 Anesthesiology Services 2152217 Navigant Consulting 2875 Michelle Drive Suite 250 Irvine CA 92606 Reveue Cycle Services 2269120 Mayo Collaborative Services Inc PO Box 9146 Minneapolis MN 55480 Laboratory Services 1596052 Lechase Contruction Services 205 Indigo Creek Drive Rochester NY 14626 Construction Services 1283920 38 0 0 0 0 246428 244831 0 491259 NET PATIENT REVENUE 622000 178307256 178307256 0 0 CAFETERIA 722212 1536043 1536043 0 0 808556 808556 0 0 180651855 1418383 -5756 290098 1134041 0 0 0 0 0 0 0 0 0 0 38338621 -15260 35744493 0 2594128 -15260 2578868 0 0 2578868 0 OTHER OPERATING REVENUE 621990 710397 575013 135384 0 656447 0 656447 0 1366844 186507209 181221112 1081929 3712909 4500 4500 680642 680642 66600060 50804024 15796036 6772140 5113680 1658460 12789015 9657055 3131960 4609894 3484257 1125637 1261957 443863 818094 363937 272953 90984 174926 174926 31118 31118 70000 70000 14831519 5965128 8866391 857427 857427 42319303 38779761 3539542 353389 265042 88347 4275454 2886463 1388991 247695 113623 134072 1111103 1111103 13978492 7747100 6231392 1647449 1400332 247117 PHYSICIAN ADVANCE FORGIVENESS PROGRAM 111315 0 111315 0 LICENSE/CERTIFICATES/PERMIT FEES 128231 104516 23715 0 PURCHASED SERVICES 8456267 8088838 367429 0 0 181675833 135131135 46544698 0 6634 6864 7401730 9032457 0 0 31993873 31956321 0 0 0 0 227544 183949 7120805 7587128 11224685 8997789 241363306 127220830 117793135 114142476 82786909 69150468 0 0 0 0 1564717 1564717 15779479 16722451 275899511 259344620 56887967 68791630 0 0 0 0 38542601 35219870 0 0 0 0 0 0 0 0 10621801 9045207 106052369 113056707 X 165311435 141523091 3142172 3371287 1393535 1393535 169847142 146287913 275899511 259344620 X 4831376 -5916987 0 0 0 -22473618 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 1 31118 0 31118 0 Schedule C, Part II-B, Line 1 Cayuga Medical Center pays membership dues to the following organizations who take part in lobbying activities on behalf of their members: AHA and HANYS 1674520 43088 136 0 6091 0 1711653 1647374 41237 105 0 14196 0 1674520 1734183 261328 97 0 348234 0 1647374 1393535 0 0 0 0 0 1393535 1393535 0 0 0 0 0 1393535 0 0.814 0.186 0 0 2829462 0 2829462 139735500 0 57478793 82256707 2438269 0 1515329 922940 88039963 0 64513686 23526277 8320112 0 3713022 4607090 114142476 Beneficial Interest in Assets of Foundation 5516385 Insurance Receivable 2310120 Equity in Related Parties 4276078 Unamortized Bond Costs 796096 Other Assets 3823772 16722451 0 DUE TO THIRD PARTY PAYERS 6492341 FAIR VALUE OF INTEREST RATE SWAP 242746 ACCRUED INSURANCE CLAIMS 2310120 9045207 158116604 -5916987 0 0 -22473618 -28390605 186507209 0 0 0 186507209 181675833 0 0 0 0 0 181675833 0 0 0 181675833 Schedule D, Part V, Line 4 THE INTENDED USE FOR THE ENDOWMNET FUND OF THE CAYUGA MEDICAL CENTER AT ITHACA IS TO SUPPORT THE HOSPITAL'S ONGOING MISSION TO DELIVER THE HIGHEST QUALITY HEALTHCARE IN PARTNERSHIP WITH OUR COMMUNITY, ONE PERSON AT A TIME. Schedule D, Part XI, Line 2d Unrealized loss on interest rate swap $ 229,545 Pension and post retirement related changes ($8,719,809) Transfers to related parties ($13,983,354) 1 1 1 X 1 X 1 1 0 1 1 20396 0 20396 0.0001 23974580 19959733 4014846 0.0221 0 0 0 0 0 0 23994976 19959733 4035242 0.0222 16968170 633002 16335168 0.0899 691184 0 691184 0.0038 10061106 5697208 4363898 0.024 0 0 0 0 58325 0 58325 0.0003 0 0 27778785 6330210 21448575 0.1180 0 0 51773761 26289943 25483817 0.1402 1 6683127 4544526 32690181 53975105 -21284924 X 1 0 1 1 CAYUGA MEDICAL CENTER AT ITHACA 101 DATES DRIVE ITHACA NY 14850 www.cayugamed.org 5401001H X X X CAYUGA MEDICAL CENTER AT ITHACA 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X www.cayugamed.org/docs/CHNA_Final.pdf X 1 15 1 www.cayugamed.org/docs/2014CommBenefitsReport.pdf 0 0 1 X 100 300 1 1 X X X 1 X www.cayugamed.org X www.cayugamed.org X www.cayugamed.org X X X X X 1 X 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-CAYUGA MEDICAL CENTER AT ITHACA 5) The qualitative process provided crucial community input into this assessment. Information for this assessment was collected through four means. First, CMC conducted a meta-review of the qualitative information gathered from the six local health departments. Second, CMC participated in and used the information gathered through the Tompkins County Health Planning Council's Community Health Survey. The survey was released in May 2013 to an online listserv to solicit input from numerous community organizations to determine priority health focus areas. Third, Cayuga Medical Center conducted several focus groups during the summer of 2013 with members of our primary service area. The focus groups that Cayuga Medical Center held served to target harder to reach populations in order to understand some of the key needs associated with their local environment. Finally, across our organization many of our 35 directors and all of our Senior Leadership structure participate in local community boards. As such, this level of involvement and participation provides CMC with an understanding of community concerns and health needs through differing community lenses. The next CHNA will be completed in 2016. Schedule H, Part V, Section B, Line 11-CAYUGA MEDICAL CENTER AT ITHACA 11) CMC has formed a Community Health Needs Assessment Council to address the six needs identified through the health needs assessment process. Health needs not addressed by the document include: % of population (all ages) living in Poverty, % of population (under age 18) living in poverty, % of single parent-households with children under the age of 18 living in the home, Percent of individuals uninsured and the Housing affordability rate. CMC is not directly addressing these health conditions. CMC is however aligned with and supports the United Way in Tompkins County which helps address housing and poverty needs. CMC additionally is aligned with the Health Planning Council which assists in enrolling individuals into Medicaid and other affordable insurance programs and CMC provides space at the hospital for enrollment of individuals into these programs. Schedule H, Part V, Section B, Line 22d-CAYUGA MEDICAL CENTER AT ITHACA The hospital used the rates negotiated with its highest volume commercial payor. 7 CAYUGA MEDICAL CENTER 10 ARROWWOOD DRIVE ITHACA NY 14850 URGENT CARE CLINIC, DIAGNOSTIC IMAGING, HEMATOLOGY/ONCOLOGY SERVICES CAYUGA MEDICAL CENTER 1129 COMMONS AVE CORTLAND NY 13045 URGENT CARE CLINIC, DIAGNOSTIC IMAGING, LAB SERVICES, OUTPATIENT PHYSICAL THERAPY CAYUGA MEDICAL CENTER 310 TAUGHANNOCK BLVD ITHACA NY 14850 CARDIAC REHAB, SPORTS MEDICINE, OUTPATIENT REHAB, DIAGNOSTIC, NUTRITIONAL CAYUGA MEDICAL CENTER 201 DATES DRIVE ITHACA NY 14850 HEMATOLOGY AND ONCOLOGY SERVICES CAYUGA MEDICAL CENTER 10 ARROWWOOD DRIVE ITHACA NY 14850 OUTPATIENT SURGICAL SERVICES CAYUGA MEDICAL CENTER 10 BRENTWOOD DRIVE ITHACA NY 14850 OUTPATIENT REHAB SERVICE CAYUGA MEDICAL CENTER 16 BRENTWOOD DRIVE ITHACA NY 14850 DIAGNOSTIC IMAGING Schedule H, Part I, Line 7 Cayuga Medical System utilized its cost accounting system to obtain the cost of services related to financial assistance and subsidized health services, lines 7a and 7g. All other costs were derived from actual expenses incurred in the period that were directly related to the provision of the service or program. Schedule H, Part III, Section A, Line 4 Line 2: THE MEDICAL CENTER PROVIDES SERVICES THAT ARE PAID FOR BY THIRD-PARTY PAYERS AND INDIVIDUALS. THE MEDICAL CENTER DOES NOT ACCRUE INTEREST ON THESE RECEIVABLES. THE MEDICAL CENTER ESTIMATES THE AMOUNT TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS FOR DOUBTFUL ACCOUNTS BY ANALYZING PATIENT ACCOUNTS FOR COLLECTIBILITY AND APPLYING HISTORICALLY ESTABLISHED PERCENTAGES FOR SELF-PAY AND VARIOUS THIRD-PARTY PAYERS TO THE AGING CATEGORIES IN THE ACCOUNTS RECEIVABLE AGING. ACCOUNTS FOR WHICH NO PAYMENTS HAVE BEEN RECEIVED FOR A SIGNIFICANT AMOUNT OF TIME ARE CONSIDERED DELINQUENT AND THE ACCOUNT IS WRITTEN-OFF WHEN CUSTOMARY COLLECTION EFFORTS ARE EXHAUSTED. Line 3: FOR CALCULATING THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY OF THE MEDICAL CENTER, THE DENIAL RATE WAS APPLIED TO THE REPORTED BAD DEBT EXPENSE. THIS ALLOWS THE MEDICAL CENTER TO BE CONSERVATIVE IN THE ESTIMATE OF WHAT AMOUNT THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS. Line 4: THE PAGE NUMBER IN THE ATTACHED FINANCIAL STATEMENTS ON WHICH THE FOOTNOTE IS CONTAINED THAT DESCRIBES BAD DEBT IS PAGE 5, FOOTNOTE # 2 - SUMMARY SIGNIFICANT ACCOUNTING POLICIES - NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE. Schedule H, Part III, Section B, Line 8 Line 8: THE COST TO CHARGE RATIO OF 54% WAS CALCULATED FROM OUR FACILITIES COST ACCOUNTING SYSTEM BASED ON THE TOTAL COST TO TOTAL CHARGES ON MEDICARE ACCOUNT ONLY WAS APPLIED TO THE MEDICARE GROSS PATIENT REVENUE OF $108,569,850. THE RESULT WAS THEN REDUCED BY THE WORKSHEET 6 MEDICARE COSTS OF $4,924,039 FOR THE FY 2015. Schedule H, Part III, Section C, Line 9b ITEM 1 Part III, Section C, Ln 9b - CAYUGA MEDICAL CENTER'S STANDARD OPERATING PRACTICE IS TO STOP ALL COLLECTION EFFORTS AND HOLD ACCOUNTS BACK FROM BAD DEBT UNTIL THE PATIENT IS GIVEN SUFFICIENT TIME TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. REVIEW OF THE APPLICATION WILL BE MADE BY THE HOSPITAL AND PATIENTS ARE NOTIFIED OF DETERMINATION WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. IF A PATIENT DOES NOT QUALIFY FOR EITHER PARTIAL OR FULL ASSISTANCE, THEN A MONTHLY PAYMENT PLAN IS OFFERED TO THE PATIENT FOR ANY REMAINING BALANCES DUE. IF THE PATIENT QUALIFIES FOR ANY FINANCIAL ASSISTANCE, AN ADJUSTMENT IS IMMEDIATELY POSTED TO THE PATIENTS ACCOUNT UPON DETERMINATION OF QUALIFICATION. Schedule H, Part VI, Line 2 To determine the health needs of our community, a comprehensive analysis was conducted through quantitative and qualitative methods. In the quantitative analysis, multiple sources provided the reportable statistics including the New York State Community Health Indicators, the County Health Rankings Report, as well as internal data from Cayuga Medical Center. The data collected for the quantitative assessment was then sorted into the following health categories: * Demographics and socioeconomic status * Access to health care * Health Status of overall population and priority populations * Risk factor behaviors and conditions related to top 5 causes of death * Child health * Infectious diseases * Natural environment * Social and Mental Health environment * Resources/Assets For every indicator, comparisons were made utilizing the mean value for each individual county, the aggregate value for the total community, the New York State w/o New York City (NYC) state value, and the U.S. value where applicable to generate context for interpretation. The qualitative process provided crucial community input into this assessment. Information for this assessment was collected through four means. First, CMC conducted a meta-review of the qualitative information gathered from the six local health departments. Second, CMC participated in and used the information gathered through the Tompkins County Health Planning Council's Community Health Survey. Third, Cayuga Medical Center conducted several focus groups during the summer of 2013 with members of our primary service area. Finally, feedback from directors and senior level executives with Community Board involvement about community concerns and health needs through differing community lenses. Schedule H, Part VI, Line 3 Patients who request a financial assistance application are provided with the organization's policy and are connected with a financial counselor. Patients receive billing statements that provide information on financial policies and contact information for help with their bills. Patients are called and financial assistance is offered if the bills are unpaid. The organization has facilitated enrollers from Medicaid Managed Care plan on-site and refers patients to them for determination of Medicaid eligibility. In addition, information on the organizations financial assistance policy, Medicare and Medicaid enrollment is available on www.cayugamed.org. Schedule H, Part VI, Line 4 Located in the Finger Lakes region, CMC serves populations from six counties, Cayuga, Cortland, Schuyler, Seneca, Tioga and Tompkins Counties. Many of these areas are designated rural counties and Tompkins County is NYS's smallest Metropolitan Statistical Area. The total service area spans approximately 1,000 square miles in the middle of the state with an average population density of fewer than 125 persons per square mile. There are several distinct health and health-related factors affecting residents of this area: A)The Region is home to an older community. According to 2012 Census estimates, 14% of adults are 55-59 years of age (compared to 7% of adults in NYS and 6% of adults nationally). Since the 2000 Census, growth in the 65+ age cohort has ranged from 15% to 32% across the region and is projected to increase between 14% and 19% over the next five years. From 2000 - 2013 there has been astounding growth - from 45% to 78% - of adults aged 55 - 64; this population is projected to increase another 4% by 2018. Issues with chronic disease and psychological distress are well documented for this demographic. Overall, 22.9% of adults aged 55 and over are likely to be in fair or poor health, ranging from 19.6% of those aged 55-64 to 32.1% of those aged 85 and over (National Health Statistics Reports, Health Characteristics of Adults Aged 55 Years and Over: United States, 2004-2007, CDC, 2009). B)Access to health care professionals within the Region is problematic. Many of the counties have zip codes within that county with Health Professional Shortage Areas (HPSAs) designations for physician, dental, and mental health care for Medicaid beneficiaries. Even when a provider is available, the rural environment, defined by hilly terrains and lakes as geographic barriers, creates transportation challenges that can limit access. C)In aggregate, residents of the service area are fiscally challenged. The median salary within the Region is $48,424, which is $9,000 below the state average. The median household income for nearly 75% of CMC's service area is below the self-sufficiency standard. Of note, agriculture and seasonal tourism are significant industries within this Region. Schedule H, Part VI, Line 5 * The majority of Cayuga Medical Center's board of directors are all residents of Tompkins County - CMC's primary service area. * Any qualified health care professional that meets the high quality standards of our credentialing process may apply and secure medical staff privileges within an identified department or specialty. * As a 501c(3) organization, CMC reinvests any surplus in funds to improvements in medical care, including patient-side and technology improvements, facility structure and infrastructure, and improvements in care delivery. Schedule H, Part VI, Line 6 As of October 2014, CMC is now a subsidiary member of Cayuga Health System. All subsidiary organizations have their own separately identified primary and secondary service areas and are responsible for improving the health of those communities. Each subsidiary organization maintains its own board of directors and separate medical staffs. Fiduciary responsibilities are additionally separate and distinct. In the strategic plan of each organization, there is alignment with the identified community health needs of each organization's primary service area. Schedule H, Part VI, Line 7 New York State X 1 1 X X X 0 0 0 0 0 0 0 0 0 HENRY D GERSON MD DIRECTOR 319689 0 0 0 0 0 5300 0 5279 0 330268 0 0 0 JOHN RUDD PRESIDENT/CEO 450697 0 0 0 0 0 5300 0 7780 0 463777 0 0 0 JOHN COLLETT VP/CFO 214200 0 0 0 0 0 4284 0 0 0 218484 0 0 0 TIMOTHY BAEL MD ONCOLOGIST 533530 0 121017 0 0 0 5300 0 5567 0 665414 0 0 0 CHARLES GARBO MD ONCOLOGIST 527323 0 28660 0 0 0 5300 0 5279 0 566562 0 0 0 JULIE CAMBELL MD ONCOLOGIST 416576 0 64331 0 0 0 5300 0 4326 0 490533 0 0 0 SRISATISH DEVAPATLA MD NEONATOLOGIST 398811 0 0 0 0 0 5300 0 6059 0 410170 0 0 0 RAMESH VIDAVALUR NEONATOLOGIST 327754 0 0 0 0 0 3612 0 10869 0 342235 0 0 0 Schedule J, Part I, Line 1a ALL CAYUGA MEDICAL CENTER EMPLOYEES ARE ELIGIBLE FOR A HEALTH CLUB MEMEBERSHIP SUBSIDY. CAYUGA MEDICAL CENTER WILL REIMBURSE EMPLOYEES 50% OF THE COST OF A SINGLE MEMEERSHIP WHEN THEY ATTEND THE HEALTH CLUB AT LEAST 24 TIMES A QUARTER. IF AN INDIVIDUAL DOES NOT MEET THE CRITERIA, THEY WILL NOT RECEIVE THE SUBSIDY. A TOMPKINS COUNTY AREA DEVELOPMENT INC 166058339 2003-10-09 15000000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 B TOMPKINS COUNTY DEVELOPMENT CORP 272290745 890096AA8 2010-08-31 14275000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 C TOMPKINS COUNTY DEVELOPMENT CORP 272290745 2013-04-09 25000000 FINANCE CONSTRUCTION & PURCHASE OF EQUIPMENT 0 0 0 A 0 0 15000000 0 0 0 205375 0 369000 14525625 0 0 2003 0 0 1 1 B 0 0 14275000 0 0 0 285500 0 142750 13846750 0 0 2010 0 0 1 1 C 0 0 25000000 0 0 0 613238 0 0 24386762 0 0 2013 0 0 1 1 A 1 1 0 0 0 0.0082 0.0082 1 0 1 B 0 0 0 0 0 0 0 1 0 1 C 0 0 0 0 0 0 0 1 0 1 A 1 1 1 JP MORGAN 15 0 0 0 0 0 B 1 1 1 DEUTSCHE BANK 12 0 0 0 0 0 C 1 0 0 0 0 0 A 1 B 1 C 1 Larry Baum Board Chair and CEO of The Computing Center 418461 Payments to The Computing Center for certain computer products, consumables, and services. Transactions entered into were fair, reasonable and in the best interest of the organization based on ongoing analysis of value, local services, and history of quality service. The organization's conflict-of-interest policy was followed related to these transactions. 0 Steven Rogers MD Board Member and Owner of Triphammer Medical Realty 139341 Payment to Triphammer Medical Realty for rental of space. Transactions entered into were fair, reasonable and in the best interest of the orgainization based on third party analysis of property to establish fair market value. The organization's conflict-of-interest policy was followed related to these transactions. 0 Form 990, Part VI, Section B, Line 11b THE FORM IS REVIEWED WITH THE FINANCE, AUDIT AND PERSONNEL COMMITTEE AND IS MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part VI, Section B, Line 12c CAYUGA MEDICAL CENTER AT ITHACA MAINTAINS A CONFLICT OF INTEREST POLICY WHICH BOARD MEMBERS ARE REQUIRED TO SIGN ANNUALLY. THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATMEENTS ANNUALLY FOR CONFLICTS, IDENTIFYING DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDINGS RELATED TO A CONFLICT OF INTEREST TRANSACTION. Form 990, Part VI, Section B, Line 15 CAYUGA MEDICAL CENTER AT ITHACA DETERMINES COMPENSATION OF THE CEO AND OTHER OFFICERS BY UTILIZING INDEPENDENT COMPENSATION CONSULTANTS AND/OR COMPENSATION SURVEYS. A FORMAL WRITTEN CONTRACT FOR CEO IS REVEIWED AND APPROVED BY THE EXECUTIVE COMMITTTEE OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section C, Line 19 CAYUGA MEDICAL CENTER AT ITHACA FOLLOWS THE IRS DISCLOSURE REQUIREMENTS AND ALL REQUIRED DOCUMENTS ARE AVAILABLE UPON REQUEST. Form 990, Part XI, Line 9 Changes in Net Assets: Pension and Post Retirement Related Changes - ($8,719,809) Unrealized Gain on Interest Rate Swap - $229,545 Reserve for CMA Loan - ($13,983,354) CAYUGA MEDICAL CENTER FOUNDATION 101 DATES DRIVE ITHACA NY 14850 161072414 SUPPORT NY 501(C)(3) 11 CAYUGA MEDICAL CENTER AT ITHACA 0 CAYUGA MEDICAL ASSOCIATES 1301 TRUMANSBURG ROAD ITHACA NY 14850 204356115 MEDICAL PRACTICE NY 501(C)(3) 9 N/A 0 SCHUYLER HOSPITAL 220 STEUBEN STREET MONTOUR FALLS NY 14865 150533564 HOSPITAL NY 501(C)(3) 3 N/A 0 CAYUGA MEDICAL OFFICE BUILDING 101 DATES DRIVE ITHACA NY 14850 161261492 BUILDING MANAGEMENT NY N/A Related 324003 1252926 0 946 1 0.58 TOMPKINS OFFICE MANAGEMENT SYSTEM 101 DATES DRIVE ITHACA NY 14850 161437217 OFFICE MANAGEMENT NY CAYUGA MEDICAL CENTER AT ITHACA C 237609 1051461 1 1 CAYUGA AREA PLAN INC 101 DATES DRIVE ITHACA NY 14850 161298390 HEALTHCARE NY N/A C 0 0 0.5 0 CAYUGA AREA PREFERRED INC 101 DATES DRIVE ITHACA NY 14850 161542122 HEALTHCARE NY N/A C 8875 625768 0.5 0 ISLAND HEALTH & FITNESS 310 TAUGHANNOCK BLVD ITHACA NY 14850 203036206 FITNESS NY TOMPKINS OFFICE MANAGMENT SYSTEM C 0 0 0 0 RASA SPA 310 TAUGHANNOCK BLVD ITHACA NY 14850 204467386 HOLISTIC HEALTH NY ISLAND HEALTH & FITNESS C 0 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 1 0 0 TOMPKINS OFFICE MANAGEMENT SYSTEM a-i 6147 CONTRACT TOMPKINS OFFICE MANAGEMENT SYSTEM l 55848 CONTRACT CAYUGA AREA PREFERRED INC l 966682 CONTRACT CAYUGA MEDICAL OFFICE BUILDING k 508142 CONTRACT CAYUGA MEDICAL OFFICE BUILDING l 90237 CONTRACT SCHUYLER HOSPITAL q 347559 COST SCHUYLER HOSPITAL l 114259 CONTRACT CAYUGA MEDICAL CENTER FOUNDATION c 505731 CASH TRANSFER CAYUGA MEDICAL CENTER FOUNDATION l 265203 CONTRACT CAYUGA MEDICAL ASSOCIATES b 13983354 ACKNOWLEDGEMENT LETTER CAYUGA MEDICAL ASSOCIATES j 81257 CONTRACT CAYUGA MEDICAL ASSOCIATES l 585113 CONTRACT CAYUGA MEDICAL ASSOCIATES m 2471753 CONTRACT