2015-11-13T17:25:13-06:00 2014-12-31 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2014-01-01 161523353 Mount St Mary's Hospital of Niagara Falls MOUN 7162974800 5300 Military Road Lewiston NY 140921997 Judith A Maness President/CEO 7162974800 2015-11-13 1 Meghann Ackley P01399136 5137847100 2014 2016-03-07 17:11:31Z Mount St Mary's Hospital & Health Center Gary Tucker 5300 Military Road Lewiston NY 140921997 96322097 0 0928 X www.msmh.org X 1907 NY We are called to continue the healing ministry of Jesus by providing compassionate person-centered care. We will respect the dignity of all, with special concern for those who are poor and vulnerable. 15 14 871 256 0 0 560729 803382 84720975 92112823 90916 159586 5001634 3246306 90374254 96322097 0 0 0 0 53851928 56997901 0 0 0 36081187 36099229 89933115 93097130 441139 3224967 45669047 51071072 39813649 41142119 5855398 9928953 X We are called to continue the healing ministry of Jesus by providing compassionate person-centered care. We will respect the dignity of all, with special concern for those who are poor and vulnerable. 0 0 30063378 49840565 Mount St. Mary's Hospital provides in-patient medical and surgical services to the community, including acute care, cardiac and medical intensive care, telemetry, maternity, pediatrics, palliative care, stroke care and inpatient alcohol & substance abuse rehab. During the calendar year ending December 31, 2014, our Hospital treated 5,331 inpatient adults and children in the community for a total of 27,140 patient days of service. A substantial portion of services are provided to the elderly and poor. During the calendar year ending December 31, 2014, approximately 49% of the value of services rendered was to elderly patients under the Medicare program,and approximately 18% of the services were provided to patients who were deemed indigent under state, county, or Hospital guidelines. In the spirit of principles adopted by Ascension Health and our Mount St. Mary's Hospital Board of Trustees, Mount St. Mary's Hospital has taken proactive steps to address those issues that affect accessibility, financing, and delivery of healthcare to all persons, especially those who are uninsured, underinsured, and underserved. All services are designed to provide healing without harm to those we serve. 27196623 45087914 Mount St. Mary's provides the following outpatient medical services to the community: cardiac services, emergency services, laboratory services, neurology services including EEG and EMG, orthopedic services, pain management, primary care clinic services, radiology services, rehabilitation services, surgical services, physical therapy, occupational therapy, speech therapy, wound care, ENT, urology, hyperbaric medicine, respiratory therapy and pulmonary function studies. Some of the services listed, such as the primary care clinic services, operate at a deficit but are supported and maintained in order to ensure that all services are available to meet community health care needs. During the calendar year ending December 31, 2014, our Hospital provided 167,471 services to outpatients, including 8,294 outpatient surgery patients, 20,657 emergency room visits, 87,165 referred ambulatory patients, and 51,355 clinic visits. 5969177 During the calendar year ending December 31, 2014, the estimated unreimbursed cost of services provided to the elderly, uninsured, and underinsured totaled $5,969,177, including $291,000 cost for charity care, $923,000 in programs for the poor, $663,000 in services to the general community, and $4,093,000 in unpaid cost of public programs. Community benefit programs or activities are those that provide treatment and/or promote health and healing as a response to identified community needs. In efforts to promote healthy living, Mount St. Mary's Hospital has made available the following programs to the community: physical fitness activities, community health programs, medical education, cancer screening programs, heart disease screening programs, support groups and educational classes, CPR and first aid classes, flu shot clinics, nutrition and weight loss management, and smoking cessation, among others. 63229178 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 184 0 1 871 1 0 0 0 0 0 0 0 0 0 0 0 X 15 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Stephen Franko 7162982010 5300 Military Road Lewiston NY 140921997 Carmen A Granto Chairperson 2.00 2.00 X 0 0 0 Robert J Travis Vice-Chair/Treasurer 2.00 2.00 X 0 0 0 Dena Armstrong Secretary/Trustee 2.00 2.00 X 0 0 0 Patrick J Berrigan Trustee 2.00 2.00 X 0 0 0 William Bradberry Trustee 2.00 2.00 X 0 0 0 Lloyd W Brown MD Trustee 2.00 2.00 X 0 0 0 Donald J Largo Jr MD Trustee 2.00 2.00 X 0 0 0 Joseph D McDonald Trustee (end 6/4/14) 2.00 2.00 X 0 0 0 Robert A Minicucci Sr Trustee 2.00 2.00 X 0 0 0 Sister Kathleen Natwin DC Trustee 2.00 2.00 X 0 0 0 Sister Marilyn Perkins DC Trustee 2.00 2.00 X 0 0 0 Deborah J Winslow-Schaber Trustee 2.00 2.00 X 0 0 0 Michael L Vitch Trustee 2.00 2.00 X 0 0 0 Christopher H Brown Trustee 2.00 2.00 X 0 0 0 Antony L Eugeni Trustee 2.00 2.00 X 0 0 0 Judith A Maness President/CEO (end 6/30/15) 40.00 2.40 X X 951520 0 26027 Stephen H Franko III VP Finance/CFO (end 6/30/15) 40.00 2.00 X 348067 0 30546 Gary Tucker Sr. VP/COO 40.00 0.00 X 325125 0 29148 Deborah Serafin VP Human Resources 40.00 4.00 X 280615 0 12008 Barbara Bucci VP Patient Care Services 40.00 0.00 X 211575 0 13365 Benjamin G Rueda MD Cardiologist 40.00 0.00 X 461537 0 27342 Arif S Syed MD Cardiologist 40.00 0.00 X 412758 0 29959 Edmund A Juncewicz Anesthesiologist 40.00 0.00 X 336835 0 32627 Mikhail Choubmesser Anesthesiologist 40.00 0.00 X 331262 0 11537 Chelsie A Bax Anesthesiologist 40.00 0.00 X 330552 0 31251 3989846 0 243810 58 0 1 0 Morrison Management Specialist PO Box 102289 Atlanta GA 303682289 Dietary/Environmental 1828421 TriMedx LLC PO Box 636129 Cincinnati OH 452636129 Maintenance 1629024 Precision Health Care NY LLC 1160 Southwest 21st Avenue Boca Raton FL 334860000 Hyperbaric/Wound Care 857500 Exigence Hospitalist Medical 3 John James Audubon Pkwy Amherst NY 142281145 Physicians 657701 Atlas Health Care Linen 60 Grider St Buffalo NY 142154030 Laundry 643398 21 681748 22840 98794 803382 Net Inpatient Svcs 621990 48362253 48362253 Net Outpatient Svcs 621990 43750570 43750570 92112823 159586 159586 86626 0 86626 86626 86626 EHR Reimbursement 900099 1430998 1430998 Phys. Incentives Pymts 621110 638815 638815 Cafeteria 722210 344024 344024 745843 745843 3159680 96322097 94928479 0 590236 2116902 2116902 43660605 32151815 11508790 251686 176772 74914 7957253 5588774 2368479 3011455 2115094 896361 294763 294763 123166 123166 15014 15014 319199 319199 1133993 55950 1078043 937595 937595 2613340 2613340 436338 436338 Supplies 10786185 10185876 600309 0 Contracted Services 9465717 2045557 7420160 0 Equipment Rental 4542055 2242968 2299087 0 Professional Fees 2190222 2084876 105346 0 3241642 2275024 966618 93097130 63229178 29867952 0 1017612 3695187 8391242 8302523 329170 435749 1454344 1502512 616964 548222 56537907 32761374 24417639 23776533 9442076 12810346 45669047 51071072 8173417 10802635 31640232 30339484 39813649 41142119 X 199499 3136211 5655899 6792742 0 5855398 9928953 45669047 51071072 X 3224967 28946 819642 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15014 15014 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state associations that is specifically allocable to lobbying. Mount St. Mary's Hospital of Niagara Falls does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or opposition to) any candidate for public office. 377517 377517 29337728 17403230 11934498 21398404 12797164 8601240 5424258 2560980 2863278 23776533 Due from Affiliates 719687 Beneficial Interest in Net Assets of Foundation 6792742 Interest in Investments Held by Ascension Health Alliance 3618413 Executive Deferred Compensation 605925 Pension Asset 1073579 12810346 Third Party Liabilities 398068 Self-Insurance Liability 475351 Intercompany Debt to Ascension Health Alliance 29466065 30339484 1 1 X 1 X 1 X 1 1 1 0 1 1 792505 501811 290694 0.00310 17044775 13091720 3953055 0.04250 248348 108210 140138 0.00150 18085628 13701741 4383887 0.04710 809719 0 809719 0.00870 125464 0 125464 0.00130 1138219 669887 468332 0.00500 884 0 884 0.00000 180891 0 180891 0.00190 2255177 669887 1585290 0.01690 20340805 14371628 5969177 0.06400 4913 4913 0.00010 56829 56829 0.00060 61742 61742 0.00070 0 1960949 148083 18095376 15912374 2183002 X 1 1 1 1 Mount St Mary's Hospital 5300 Military Rd Lewiston NY 140921997 www.msmh.org 3121001H X X X Mount St Mary's Hospital 1 0 0 1 X X X X X X X X X 13 1 0 1 1 X Included in Section C, Line 5d X X 1 13 1 http://www.msmh.org 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X X X X X X X X X 1 X 0 X X X X 1 X 0 0 Mount St. Mary's Hospital Part V, Section B, Line 5: MSMH conducted a survey with respect to the community's health needs. As noted below, MSMH surveyed community members and visitors to the hospital, community organizations and churches and personally interviewed hospital volunteers. MSMH also conducted focus groups to discuss survey and interview results. In addition, MSMH compiled and reviewed health data from surveys conducted by the Niagara County Department of Health and data from the New York State Department of Health.Analytical MethodsTo identify and prioritize the MSMH community's health needs, this CHNAconsidered multiple data sources, including written surveys, interviews,focus groups, demographic data, health status indicators, and diseaseprevalence data. MSMH compiled the data from these sources to arrive atpotential priority health needs in the community. MSMH convened meetingswith MSMH staff and external healthcare experts to share the surveyresults, to discuss the potential priority health needs and to elicitconsiderations regarding secondary health needs. These groups included local area hospitals and the Niagara County Department of Health. Mount St. Mary's Hospital Part V, Section B, Line 7d: http://www.msmh.org/files/8213/8020/1831/2013-15_MSMH_Community_Health_Needs_Assessment_CHNA_Final.pdf Mount St. Mary's Hospital Part V, Section B, Line 11: The two priority initiatives identified by the County Health Department and all local hospitals were:1) Reduce Risk of Falls Among Vulnerable Populations, and 2) Increase access to high quality chronic disease preventative care and management in both clinical and community settingsWe are working with our hospital Rehabilitation Department and Patient Centered Medical Homes to track both of these priorities and to provide education and assistance in the community. There is extensive surveying of patients to identify their needs and outreach programs to community groups and organizations for education.Other priorities identified in the hospital Community Health Needs Assessment and Community Service Plan include addressing chronic diseases relative to cardiology/cancer/stroke and diabetes; healthy mothers and healthy babies; and obesity. To address these priorities, through Patient Care Services in hospital departments and our Patient Centered Medical Homes, we survey and track progress on such things through Blood Pressure Screenings, ACE/ARB Tracking, AMI: STEMI/TNK Tracking, vaccination information and conducting community screenings, among others.Not all of the needs identified are being addressed by the hospital. Items identified which are not being addressed in a comprehensive manner are:* Increase Need for Healthcare for Veterans - With the Buffalo Veteran's Affairs Hospital 20 miles away and the availability of local not-for-profit agencies to assist veterans, this need is handled by other providers.* Decrease the Rate of Binge Drinking - There are not-for-profit groups in the community (United Way Services, Fellowship House, Northpointe Council and Horizon, among others) better suited to handle this issue. * Decrease Use of Tobacco - There are numerous programs and agencies in New York State, most prominently being the NYS Tobacco Control Program, Smoking and Health Action Coalition, and Tobacco Free New York as examples, aggressively addressing the issue. Mount St. Mary's Hospital will continue to provide smoking cessation programs for area residents.* Dental Care - Niagara Cerebral Palsy of Niagara offers a dental program for low-income residents. Mount St. Mary's Hospital will support that initiative. Mount St. Mary's Hospital Part V, Section B, Line 16i: Brochures describing the Financial Assistance Policy and a sign indicating where to call or go to talk to the Financial Counselor, are located at every entry point of the hospital, including all off campus locations. The brochure and application are also posted on the hospital's website. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Mount St. Mary's Hospital Part V, Section B, line 16a website: www.msmh.org/files/9014/1337/3358/Financial_Assistance_Policy_2014.pdf Mount St. Mary's Hospital Part V, Section B, line 16b website: www.msmh.org/files/9513/7389/6469/Financial_Assistance_2013.pdf Mount St. Mary's Hospital Part V, Section B, line 16c website: www.msmh.org/files/1314/2434/9642/Financial_Aid_2015.pdf Part I, Line 7: A cost to charge ratio was used for costing various amounts in the table, using a calculation based on Worksheet 2. Part I, Line 7g: A loss of $468,332 from the Neighborhood Health Center, a hospital-based clinic located in a low income, economically depressed and health shortage area of the City of Niagara Falls, is included in Part I, Line 7. It is located in a census tract which has the largest segment of people who are poor and underserved in Niagara County. Part II, Community Building Activities: Among the Community Building activities the Hospital participates in are physicians recruitment and the Mayor's Task Group on Health, amoung others. Physicians recruitment brings necessry primary care to the community. The Mayor's Task Group on Health has targeted an underserved area of the city with specialized services. Hospital representatives also sit on boards for the Lower River Region Chamber of Commerce, Meals on Wheels, Opportunities Unlimited and the Niagara County Workforce Investment Board. Part III, Line 4: The provision for doubtful accounts is based upon management's assessment of historical and expected net collections considering economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for uncollectable accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Hospital may place past due patient balances with collection agencies,subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Hospital's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. The Hospital has not experienced material changes in write-off trends and has not materially changed its charity care policy in 2014.The organization's share of bad debt expense in 2014 was $1,960,949 at charges. Part III, Line 8: Ascension Health and related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. Part III, Line 9b: The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance, certain collection practices do not apply. Part VI, Line 2: MSMH conducted a survey with respect to the community's health needs. MSMH surveyed community members and visitors to the hospital, community organizations and churches and personally interviewed hospital volunteers. MSMH also conducted focus groups to discuss survey and interview results. In addition, MSMH compiled and reviewed health data from surveys conducted by the Niagra Country Department of Health and data from the New York State Department of Health.Analytical Methods:To identify and prioritize the MSMH community's health needs, this CHNA considered multiple data sources, including written surveys, interviews, focus groups, demographic data, health status indicators, and disease prevalence data. MSMH compiled the data from these sources to arrive at potential priority health needs in the community. MSMH convened meetings with MSMH staff and external healthcare experts to share the survey results, to discuss the potential priorty health needs and to elicit considerations regarding secondary health needs. These groups included local area hospitals and the Niagara County Department of Health. Part VI, Line 3: Patients are personally informed of the financial assistance and charity care policies at each inpatient and outpatient entry point of the Hospital by Patient Access representatives, who also direct those individuals requiring further information to the Financial Assistance Counselors. Each entry point of the Hospital and all of its offsite locations have both signs and brochures explaining the Financial Assistance Policy in place. In addition, a summary brochure of the Financial Assistance Policy and application have been placed on the homepage of the Hospital's website. Part VI, Line 4: Mount St. Mary's Primary Service Area includes the City of Niagara Falls (Zip Codes 14301, 14302, 14303, 14304 and 14305), a city of about 49,000 where 60% of the population is on some form of public assistance. The towns of Lewiston (14092, 14107, 14109, and 14132), Niagara (portions of 14304 and 14305), Wheatfield (portions of 14305 and 14120), Grand Island (14072) and Porter (14174) are more suburban and rural areas with slightly higher income levels. Secondary Service Area includes the towns of Wilson (14172) a small agricultural community and Lockport (14094) a nearby city with similar characteristics to Niagara Falls. In general, the primary service area is described as Western Niagara County. Part VI, Line 5: Other ways that the Hospital furthers its exempt purpose by promoting the health of the community include free health screenings and health fairs as described further in our community benefit report in Schedule O. Also, a majority of the organization's governing body is comprised of persons who reside in the Hospital's primary service area who are neither employees nor contractors of the Hospital, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in its community for many of its departments. The organization applies funding to improvements in patient care, such as the expanded cardiology services, Women's Center for Breast Health, and the Center for Women. Part VI, Line 6: Mount St. Mary's Hospital of Niagara Falls d/b/a Mount St. Mary's Hospital and Health Center (the Hospital) is a member of Ascension Health. Ascension Health Alliance, doing business as Ascension, is the sole corporate member and parent organization of Ascension Health, aCatholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and Health Ministries are referred collectively from time to time hereafter as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. TheParticipating Entities of Ascension Sponsor are the Daughters of Charityof St. Vincent de Paul, St. Louise Province; the Congregation of St.Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; theCongregation of Alexian Brothers of the Immaculate Conception Province,Inc. - American Province; and the Sisters of the Sorrowful Mother of theThird Order of St. Francis of Assisi - US/Caribbean Province. The Hospital, located in Lewiston, New York, is a nonprofit acute care hospital. The Hospital provides inpatient, outpatient and emergency care, and chemical dependency services for patients who reside primarily in the local geographic region. Admitting physicians are primarily practitioners in the local area. The Hospital is related to Ascension Health's other sponsored organizations through common control. The consolidated financial statements also include the financial results of Our Lady of Peace, Inc. (OLP) and Mount St. Mary's Child Care Center, Inc. (CCC), of which the Hospital is the sole corporate member (through October 9, 2014 for OLP). Effective October 10, 2014, Ascension Health Senior Care, a separate member corporation of Ascension, formally became the sole corporate member of OLP. Because the substance of combined operations and governance has not changed, OLP is included in the consolidated financial statements for all periods presented. Unless indicated otherwise, the three entities are collectively referred to as the Hospital for purposes of these consolidated financial statements. OLP is a nonprofit organization established to operate a freestanding 250-bed skilled nursing and rehabilitation facility. CCC is a nonprofit organization that provides daytime child-care services, primarily for employees of the Hospital. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.MissionThe System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources used for the care of persons living in poverty and community benefit programs:-Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.-Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.-Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.-Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for persons living in poverty, including health promotion and education, health clinics and screenings.Discounts are provided to all uninsured patients in the acute care facility, including those with the means to pay. Discounts provided to these patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and community benefit programs. The cost of providing care to persons living in poverty and community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care.The amount of traditional charity care provided, determined on the basis of cost, was approximately $291,000 and $877,000 for the years ended December 31, 2014 and 2013, respectively. The unpaid cost of public programs was approximately $4,093,000 and $3,100,000, the cost of other programs for persons living in poverty and other vulnerable persons was $923,000 and $917,000, and the cost of community benefit programs was $663,000 and $839,000 for the years ended December 31, 2014 and 2013, respectively. Part VI, Line 7, Reports Filed With States NY X X X X 0 1 0 0 0 0 0 0 0 Judith A Maness President/CEO (end 6/30/15) 339845 0 558407 0 53268 0 7800 0 18227 0 977547 0 0 0 Stephen H Franko III VP Finance/CFO (end 6/30/15) 227764 0 0 0 120303 0 6500 0 24046 0 378613 0 0 0 Gary Tucker Sr. VP/COO 219266 0 0 0 105859 0 7500 0 21648 0 354273 0 0 0 Deborah Serafin VP Human Resources 176196 0 0 0 104419 0 2637 0 9371 0 292623 0 0 0 Barbara Bucci VP Patient Care Services 143410 0 0 0 68165 0 4829 0 8536 0 224940 0 0 0 Benjamin G Rueda MD Cardiologist 447608 0 11529 0 2400 0 1200 0 26142 0 488879 0 0 0 Arif S Syed MD Cardiologist 357504 0 37754 0 17500 0 5913 0 24046 0 442717 0 0 0 Edmund A Juncewicz Anesthesiologist 311154 0 8183 0 17498 0 7800 0 24827 0 369462 0 0 0 Mikhail Choubmesser Anesthesiologist 302566 0 5696 0 23000 0 3000 0 8537 0 342799 0 0 0 Chelsie A Bax Anesthesiologist 307502 0 5552 0 17498 0 7800 0 23451 0 361803 0 0 0 Part I, Line 4b Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year paid. Form 990, Part III, Line 4 Mount St. Mary's Hospital and Health Center Community Benefit Report For the year ended December 31, 2014. This report illustrates the significant ongoing degree to which Mount St. Mary's Hospital and Health Center contributes to the positive health status of the communities we serve. As a member of Ascension Health, the nation's largest Catholic and non-profit health system, Mount St. Mary's continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it services. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Community Outreach Activities: Mount St. Mary's Hospital (MSMH) seeks to improve the physical, mental, social and spiritual health status of its surrounding community in addition to providing health care services to all individuals who require medical attention. Senior leadership sets the tone for all associates at MSMH by engaging with and in the community. By visibly volunteering their time, talent and financial resources, senior leaders are committed to living up to the saying that "for those to whom much is given, much is expected" and the greater community of the hospital is the beneficiary of this effort. Expanding Awareness, Health Education and Healthcare Promotion: Mount St. Mary's believes that it is essential to educate people regarding the types of behaviors that improve their chances of living a healthy life. Mount St. Mary's Hospital has invested to provide quality health education and materials to accomplish its goals. Mount St. Mary's has a positive impact on the surrounding neighborhoods as it contributes to civic and cultural programs, makes space available to support groups, community groups, and improves the overall healthcare environment. Through our "Health for All Seasons" educational programs, we reach out to the community with unique health education offerings. In 2013 these programs occurred throughout the year and covered a wide-array of topics from "Healthy Heart" to "Warning Signs of Stroke." To promote attendance and conduct the programs, Mount St. Mary's invests more than $25,000 on services and promotion. Throughout the year Mount St. Mary's conducts a series of community events including: February: Heart Month * Free Community Lipid Panel Screening * Heart Month Education Events, free blood pressure screening, and more April: Prescription Drop Off Site May: Stroke Awareness Month * Stroke Awareness Day * Free Community Education events June: Men's Health Month * Free Community PSA Prostate Screening in June October: Breast Health Awareness Month * Free Community Education events * Prescription Drop Off Site November: Diabetes Awareness Month * Free A1C Testing * Free Community Education Events Year Round: * Staff at Mount St. Mary's attends numerous community health fairs and programs, offering screenings as requested for blood pressure and diabetes. Such events attended include those held at the Tuscarora Nation School, Niagara Falls Neighborhood Block Clubs, Niagara County Community College and Niagara University, Wheatfield Family Picnic, local elementary schools, among others. To address specific health issues and needs, Mount St. Mary's has launched targeted programs, and participates and collaborates in others including: Niagara Falls Mayor's Task Group on Health The CEO serves as an active member of this Task Group and its steering committee. The Task Group is a community-based effort (including public and private agencies) to have a demonstrated impact on the social determinants of health, (personal health issues, housing and safety, transportation, lack of jobs and lack of access to healthy food). The area's largest private foundation has invested in the program that is working in a designated area of the city with a high proportion of uninsured and underserved. The overall project goal: "Create a Healthier Niagara Falls by developing Sustainable Neighborhoods." A strategic planning effort for the City of Niagara Falls has recently been initiated and will continue into 2015. Niagara County Community Health Assessment Mount St. Mary's participates in a county led effort that involves other hospitals. A community survey was conducted to identify priority health needs. The two priorities identified include reducing the risk of falls among vulnerable populations and increasing access to high quality, chronic disease preventative care and management in both clinical and community settings. Mount St. Mary's has been tracking progress and action on these initiatives in coordination with the Niagara County Department of Health, and others. HANCI/PACE Program - Complete Senior Care MSMH and Our Lady of Peace Nursing Care Residence have partnered with the Health Association of Niagara County (HANCI) to implement the "Program of All-Inclusive Care for the Elderly." This program, titled "Complete Senior Care" is designed to assist frail elderly persons to remain in their home and out of institutional care as long as possible. MSMH is the medical provider for this initiative and supports and staffs the healthcare component with a clinic located in the center of the facility. This is a provider-based Medicare/Medicaid managed care program that follows with stated strategies for reforming healthcare in New York State advanced by the Governor. The Senior Vice President of Operations is a member of the Board of HANCI and serves them as an unpaid volunteer. Opportunities Unlimited Artshow This program provides a venue for and highlights the work of artists who are clients of a community organization that provides an array of services to those citizens who are developmentally disabled. In addition, the SVP of Operations serves on the organizations Foundation Board of Directors. Pathways to Careers Program The "Pathways to Careers" Program was initiated by MSMH in collaboration with Niagara Catholic High School and Niagara University, as an adjunct to the hospital's HERO (Health Education Raises Opportunities) Program, to provide unique opportunities for high school students planning for careers in healthcare and healthcare-related fields. The program was initiated in 2010 and continues each year offering shadowing opportunities in several hospital departments, including information technology, rehabilitation, nursing, food service, surgical services, and more. Niagara University provides an academic moderator for the program. This program was developed with an eye toward future recruitment as well as for the purpose of providing high school students with enriched educational options to assist them in the selection of college courses of study. The program is designed to move students along a chosen local, educational pathway to potential local employment while affording education and visibility for traditional and non-traditional healthcare occupations. Form 990, Part III, Line 4 continued: HERO (Health Education Raises Opportunities) Health Literacy for Faith-Based Schools The Health Education Raises Opportunities (HERO) Program, initiated by Mount St. Mary's Hospital and Health Center in 2009, focuses on improving health literacy for local school children. It is currently offered in different menu formats for students in Grades K through 12 in five schools with expansion to seven schools planned for the future. The Program brings experts in the health field into classrooms to teach children on important and current health issues. HERO's ultimate goal is to help students and their families to become better consumers of healthcare. HERO's Collaborative Partners include the following: The Niagara County Health Department * Niagara University Department of Nursing * Niagara University Department of Biology * Catholic Charities of Western New York * The Buffalo Diocesan Catholic Schools * Fidelis Care New York * Catholic Academy of Niagara Falls * St. Peter's Roman Catholic School, Lewiston * St. Peter's Evangelical Lutheran School, Lockport * St. Peter's Lutheran School, Sanborn * The Niagara Charter School * DeSales Catholic School * Niagara Catholic High School * Mount St. Mary's Hospital and Health Center, Departments of: Education and Organizational Development, Mission Integration, Parish Nursing, Employee Health Services, Rehabilitation and Sports Medicine, and Community Relations * Northpointe Council Mount St. Mary's Hospital Student Affiliate Agreements MSMH has fully executed Affiliate Agreements for clinical rotations and internships within its hospital departments with more than 70 institutions of higher learning, including three medical schools. These facilities include not only local schools, but colleges and universities throughout the country. Community Service Education The Department of Education and Organizational Development provides instruction in the following areas for community health providers: * Basic Lifesaving Skills (BLS): Certification and Re-certification * Heartsaver The Department also coordinates and facilitates education for community health providers for the following: * Neonatal Lifesaving Skills (NALS): Re-certification * Pediatric Lifesaving Skills (PALS): Re-certification * Advanced Lifesaving Skills (ACLS): Certification and Re-certification As an American Diabetes Association Certified Center, the Department of Education and Organizational Development coordinates with the Hospital's Certified Diabetes Educator to provide to the community through both the organization's HERO and CHEERS (Choosing Healthy Eating and Exercise Routines) programs. In addition, as a Designated Stroke Center, Stroke Prevention Education is provided through focused programs both on the hospital campus, in local schools and throughout the community. Employee Health Services Mount St. Mary's provides Medical Case Management to employees who are ill or injured in an effort to return them to full pay and benefits as soon as possible. Mount St. Mary's Hospital offers individual health coaching to each employee annually and on an as needed basis to improve the quality of life through healthy lifestyles and disease management. EAP referrals are made for employees (or employee's families) in crisis. Free onsite exercise classes, wellness seminars, recipes and self-guided fitness options are available to all employees, physicians and volunteers. New York State Designated Stroke Center Application was re-approved in 2014 by the New York State Department of Health as a "Designated Stroke Center. MSMH works cooperatively with Catholic Health of Buffalo on components of this service. Echocardiography Accreditation Accreditation received from the Intersocietal Commission for the Accreditation of Echocardiography (ICAEL). Chest Pain Center Designation Accreditation Approved. Support of Niagara County Diabetes Coalition: The rate of diabetes in Niagara County is 11.9% with 10.6% in males and 13.2% in females. These statistics are higher than the NYS rates of 9.7% overall, 7.6% in males overall and 11.6% overall in females. An estimate of recent hospitalizations at MSMH indicates that one-sixth of admissions had a diagnosis or co-morbidity of diabetes. To address these issues, cooperative strategies were developed for all Niagara County hospitals including: * The Niagara Diabetes Coalition which consists of area hospitals, the Department of Aging, and Niagara County Department of Health (NCDOH) meet regularly. We have worked co-operatively to develop and promote diabetes programs. The NCDOH has a web based resource guide of all area offerings. * Press releases and TV appearances by hospital representatives and Local Health Department staff to update the community on hospital collaboration. * At MSMH, Medical and nursing staff may make referrals for diabetes education supplied by a Certified Diabetes Educator. * Diabetes education supplies are kept on each floor for use by all staff. * The Diabetes Educator interacts with insurance companies to discuss reimbursement of diabetes management services and education. * Interact with area physicians and endocrinologists . * Developing community education lectures that emphasize good nutrition, physical activity, mental health, and lowering risks for chronic diseases. * Maintain accreditation by the American Association of Diabetes Educators for the diabetes programs provided. Form 990, Part III, Line 4 continued: Financial Counselors Mount St. Mary's Hospital has two full-time Financial Counselors positions to aid in identifying and assisting with charity care as well as facilitating the Medicaid enrollment process. The Financial Counselors are well-versed in the organization's charity/financial assistance care policy which provides discounts up to 100%. Establishing a Full Continuum of Care in the Niagara Community Expansion of Mount St. Mary's Neighborhood Health Center Mount St. Mary's Hospital invested more than $1.7 million from donations, public support and private grants to construct a new and expanded Mount St. Mary's Neighborhood Health Center (NHC). The new 6,500 square foot facility opened in April 2010. The facility doubles the current treatment space from six to twelve exam rooms. This primary care center includes adult and pediatric medicine as well as OB/GYN (Obstetrics/Gynecology) services and serves as a medical home for the patients. It is located in the inner-city of Niagara Falls in the poorest census tract in the County. In addition, new low-income apartments for 250 families and other subsidized housing have been constructed in the surrounding neighborhood. The community served is predominantly minority (African-American), is of low income, and minimally insured, if at all. If the clinic did not exist they would have no readily available health care options. The clinic currently operates at a financial loss, requiring an annual subsidy from MSMH in the hundreds of thousands of dollars. The organization remains committed to operating this clinic knowing its importance in the community, and has hired a full-time Medical Director to coordinate care. The NHC continues to work to improve efficiency and services, facilitate enrollment in insurance plans as much as possible, and to minimize losses. Patient visits have significantly increased. In addition, staff is looking to add new services to help in the treatment of chronic diseases such as diabetes and adding other specialists as needed. An on-site social worker helps patients of the NHC navigate the social service and governmental and non-government assistance system. Care Coordinators are now on site. A full time Physician Assistant (PA) was added in 2011 to provide additional capacity to see adults. Pediatrician coverage is being monitored to assure productivity as volumes have softened in this area as the population ages. Additional staffing for Obstetrics/Gynecology has also been added and Dermatology service is available. A major initiative added in 2013 was a Dental Program in conjunction with Niagara Cerebral Palsy. This service reached more than 100 patients in 2013. A passenger van was also secured and transportation is provided. Heart, Love and Soul Food Pantry Mount St. Mary's Hospital continues to collaborate with the Heart and Soul Food Pantry located in Niagara Falls to provide referral navigation and education services to those in need of healthcare and those who are uninsured and/or unable to obtain healthcare service. The Parish Nurse is on duty in the Heart and Soul location three days a week and is actively working at Heart and Soul Soup Kitchen identifying health needs and referring to other social services agencies. Health referrals are made to Neighborhood Health Center as needed. Transportation to health services and Social Services is arranged and provided when necessary. Several local agencies have agreed to collaborate by offering services at Heart and Soul. MSMH will continue to work with Heart and Soul and continue support for the Parish Nurse Program. VanGo VanGo provides transportation services for patients from all over the western part of Niagara County, assisting them to get to the hospital campus and to off-site services such as rehab and the Neighborhood Health Center. The charge is $1 each way unless patients cannot afford it. Volunteers drive the vans and scheduling is coordinated by hospital staff. As a rural county with an elderly population, the van provides reliable convenient service which fills a gaping hole in the public transportation system. The two mini-vans were purchased through the generous donation of a local businessman who also provides funds annually for the upkeep of the vans. New vans were purchased in October 2014 at a cost of more than $50,000. Women's Health Conference One major event initiated by Mount St. Mary's that has become a significant community event is the annual "Women's Healthcare Conference." The event now attracts more than 300 persons in a day-long program to emphasize holistic health and wellness concepts in downtown Niagara Falls. Support Groups Community information support groups hosted by Mount St. Mary's each year include Alzheimer's, Breast Cancer, Diabetes, Fibromyalgia, Lupus, Parent Grief, Multiple Sclerosis, Sleep Apnea, and Prostate Cancer. Summary In summary, Mount St. Mary's furthers its charitable purposes by providing a broad array of services specifically designed to meet the healthcare needs of patients and organizations in the community. The organization provides essential medical services to the community, trains and recruits healthcare professionals to serve the needs of the broader community, provides appropriate charity services to those patients unable to pay, and provides services to others. Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related Mount St. Mary's Hospital of Niagara Falls entity boards. Form 990, Part VI, Section A, line 6 Mount St. Mary's Hospital has a single corporate member, Ascension Health. Form 990, Part VI, Section A, line 7a Mount St. Mary's Hospital of Niagara Falls has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Mount St. Mary's Hospital of Niagara Falls. Form 990, Part VI, Section A, line 7b Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the System. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Form 990, Part VI, Section B, line 11 Management, including certain Officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to a designated committee of the Board, to review and answer any questions. Prior to filing the return, all Board Members are provided a copy the Form 990. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Board Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other hospitals in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when her compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review of comparability data. In the review of the compensation, the other officers or key employees of the organization were compared to individuals at other hospitals in the area who hold the same title. Form 990, Part VI, Section C, line 19 Mount St. Mary's Hospital will provide any documents open to public inspection upon request. Form 990, Part XI, line 9: Pension Liability Adjustment -316,276. Transfer to Affiliates -143,887. Change in Interest in Foundation 1,279,805. Ascension Health Alliance 4600 Edmundson Road St Louis MO 63134 453358926 National Health System MO 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 63145 311662309 National Health System MO 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Our Lady of Peace Inc 5285 Lewiston Road Lewiston NY 140921997 161608735 Nursing Home NY 501(c)(3) Schedule A, Line 3 Mount St Mary's Hospital of Niagara Falls 1 Mount St Mary's Hospital Child Care Center 5310 Military Road Lewiston NY 140921997 161523352 Child Care Center NY 501(c)(3) Schedule A, Line 9 Mount St Mary's Hospital of Niagara Falls 1 Mount St Mary's Hospital Foundation 5300 Military Road Lewiston NY 140921997 161360884 Foundation NY 501(c)(3) Schedule A, Line 11a Mount St Mary's Hospital of Niagara Falls 1 Board of Associates of Mount St Mary's Hospital Inc 5300 Military Road Lewiston NY 140921997 161582926 Fund Raising NY 501(c)(3) Schedule A, Line 11a Mount St Mary's Hospital of Niagara Falls 1 The St Francis Guild of Mount St Mary's Hospital of Niagara Falls Inc 5300 Military Road Lewiston NY 140921997 510217790 Fund Raising NY 501(c)(3) Schedule A, Line 11a Mount St Mary's Hospital of Niagara Falls 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 Mount St Mary's Hospital Foundation C 681748 Actual Amount Paid Our Lady of Peace Inc O 533234 Actual Amount Paid Ascension Health P 7390044 Actual Amount Paid Our Lady of Peace Inc Q 1661235 Actual Amount Paid Ascension Health R 437293 Actual Amount Paid