2015-11-10T14:08:21-07:00 2014-12-31 990 2014-01-01 160743905 ARNOT OGDEN MEDICAL CENTER ARNO 6077374235 600 ROE AVENUE ELMIRA NY 14905 Robert Lambert President & CEO 6077374235 2016-11-10 2014 2016-04-25 22:37:26Z Ronald J Kintz Arnot Ogden Medical Center 600 Roe Avenue Elmira NY 14905 292874109 0 X www.aomc.org X 1889 NY Arnot Ogden Medical Center is a community based hospital with an open emergency room and selected highly specialized services that are part of a high quality health care delivery system that serves Chemung County, NY and the Twin Tier Regions of New York and Pennslyvania. 21 20 2748 486 -361879 -361879 1542728 1188532 260826432 270538688 3041400 9031350 4828667 1609679 270239227 282368249 0 0 0 0 171187900 183155636 0 0 0 91369565 94601166 262557465 277756802 7681762 4611447 283599860 277712820 95490586 100718728 188109274 176994092 Arnot Ogden Medical Center is an independent, not-for-profit, 201-bed tertiary medical facility with more than 120 physicians from over 50 specialties. Arnot Ogden Medical Center offers specialty services at the Falck Cancer Center, Heart and Vascular Institute, Stroke Care, Maternity, Surgery. 0 0 234372239 0 270047399 The Arnot Ogden Medical Center continues to provide of health care related services since it opened in 1889, serving Chemung County and the Twin Tier Regions of New York and Pennsylvania. The Medical Center specialzied in the fields of Cardiology, Oncology, Renal, Neonatology, Bariatrics and Emergency Care. Other sub specialized services include but are not limited to Anesthesiology, Surgery, Laboratory, Imaging, Physical Therapy, Obstetrics, and Gynecology. In 2014 the Medical Center's 2,107 Full-time equivalent of employees cared for 12,778 inpatient admissions in its 201 staffed beds. The Medical Center provided Outpatient Services to approximately 337,782 Outpatient Visits in its subspecialty services. The approximately 123 Full-time equivalent of physicans provided for 363,287 office visits in the areas of primary care and specialty services. 1133491 0 491289 The Arnot Ogden Medical Center School of Nursing began in 1889 and continues to offer a three year diploma program accredited by the National League for Nursing with approximately 81 students enrolled. The Arnot Ogden School of Radiologic Sciences began in 1953 continues to offer a two year certificate program which is accredited by the Joint Review Commission on Education in Radiologic Technology with approximatedly 21 students enrolled. Upon completion of their program of study, students are eligible to take the NYS licensing examinations for Registered Nurse or Radiologic Technologist. 0 0 0 235505730 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 1 280 0 1 2748 1 1 1 0 0 0 0 0 0 0 0 0 X 21 20 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X X X Ronald J Kintz 6077374235 Accounting Department 600 Roe Avenue Elmira NY 14905 Michael Hosey Chairman of the Board 1 3 X 0 0 0 Joseph P Manning Vice Chairman 0.3 0.9 X 0 0 0 Daniel J Burke Board Member 0.3 0.9 X 0 0 0 Kenneth Herzl Betz Board Member 0.3 0.9 X 0 0 0 David Dalrymple Board Member 0.3 0.9 X 0 0 0 Christine M Deschamps Board Member 0.2 0.7 X 0 0 0 S Jan Eberhard Board Member 0.7 2.2 X 0 0 0 John T Gough Board Member 0.1 0.4 X 0 0 0 Mark J Hagan Board Member 0.7 2 X 0 0 0 Roy A Kyles Board Member 0.1 0.4 X 0 0 0 Ben E Lynch Board Member 0.7 2.2 X 0 0 0 Robert McNamara Board Member 0.1 0.4 X 0 0 0 Mary Louise Mitchell Board Member 0.2 0.7 X 0 0 0 John F OMara Board Member 0.3 0.9 X 0 0 0 Donald Quick Board Member 0.5 1.4 X 0 0 0 Patrick J Rogers Board Member 0.1 0.4 X 0 0 0 Melinda Sartori Board Member 0.2 0.7 X 0 0 0 Roger Schenone Board Member 0.5 1.4 X 0 0 0 Kevin OConnor Board Member 0.1 0.4 X 0 0 0 Margaret Streeter Board Member 0.1 0.4 X 0 0 0 Robert Lambert MD President Arnot Health 50.00 10.00 X X 586846 0 36639 John R Alexander Secretary 0.1 0.4 X 0 0 0 Ronald J Kintz DHA Senior VP/CFO 42 11 X 361864 0 36639 H Fred Farley PhD Hospital President COO 43.00 8.00 X 374508 0 36639 Kevin Deluca MD VP Medical Affairs 20 3 X X 173650 0 20669 James Watson President IDMH 7.5 40 X 222666 0 9496 Wes Blauvelt VP Planning 20 10 X X 194566 0 9414 Vidyasagar Mokureddy MD Pain Mgmt Physician 45 0 X 1408579 0 32557 Timothy Minton MD ENT Physician 45 0 X 939706 0 29533 Nishith Amin MD Cardiologist 45 0 X 750832 0 30324 William DeLuccia MD Cardiologist 45 0 X 754714 0 32557 Paul Tinsley MD ENT Physician 45 0 X 895901 0 30324 6663832 0 304791 215 1 1 0 Streeter Associates PO Box 118 Elmira NY 14902 Construction Services 5869332 Siemens Medical Solutions 51 Valley Stream Parkway Malvern PA 19355 Maintenance Contracts Services 3449439 Quadramed PO Box 347188 Pittsburgh PA 15251 Software Support Services 3045859 Navigant Consulting Inc 4511 Paysphere Circle Chicago IL 60674 Consulting Services 2288142 Associated Anesthesiologists of The Finger Lakes PO Box 1253 Elmira NY 14902 Anesthesiology Medical Director Services 2071267 79 0 0 0 395658 792874 0 0 1188532 Net Patient Service Hosptial Revenue 622110 212394301 212394301 0 0 Net Patient Service Physician Revenue 621110 57653098 57653098 0 0 School of Nursing 611600 412962 412962 0 0 School of Radiologic Technology 611600 78327 78327 0 0 0 0 0 0 270538688 2550172 0 0 2550172 0 0 0 0 0 0 0 0 307653 0 663216 0 -355563 0 -355563 0 -355563 0 14424184 0 7946641 -3635 6477543 3635 6481178 0 0 6481178 119583 0 26924 92659 0 92659 0 0 0 0 0 0 732608 1872714 -1140106 0 0 -1140106 Education/Seminars/Workshops 611699 85130 0 0 85130 2927559 2933875 -6316 0 3012689 282368249 273472563 -361879 8069033 0 0 0 0 0 0 0 0 2062659 0 2062659 0 0 0 0 0 136002574 124930779 11071795 0 5350510 0 5350510 0 30948823 0 30948823 0 8791070 7343310 1447760 0 2287100 1065379 1221721 0 565492 97721 467771 0 104783 10365 94418 0 27911 0 27911 0 0 0 478427 0 478427 0 8528909 7822542 706367 0 1249852 111124 1138728 0 4401353 2663039 1738314 0 5403618 737923 4665695 0 0 0 0 0 3562635 667660 2894975 0 529618 416596 113022 0 0 0 0 0 175562 146773 28789 0 1593430 0 1593430 0 0 0 0 0 10872334 6005366 4866968 0 2120671 1702333 418338 0 Medical/Surgical/Pharmaceuticals Supplies 39335190 39334153 1037 0 Maintenance Contracts/Purchased Services 9759252 7466827 2292425 0 Benefit Allocation 0 31366290 -31366290 0 Leases 2156836 2667161 -510325 0 1448193 950389 497804 0 277756802 235505730 42251072 0 14323 13159 7023831 2665564 64804 117827 40683845 37484672 0 0 0 0 18367318 18197728 1186774 1351031 2107972 2042646 261869817 169547407 86674140 92322410 64952684 66578874 0 0 0 0 768677 726661 61755492 56212248 283599860 277712820 23530265 21482622 0 0 17943 3855 26582855 25469532 0 0 0 0 9987521 8621386 0 0 35372002 45141333 95490586 100718728 X 177222846 163059272 7938674 10840886 2947754 3093934 188109274 176994092 283599860 277712820 X 4611447 -2118680 0 0 0 -13607949 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 0 0 0 1 27911 27911 0 Schedule C, Part II-B, Line 1 Arnot Ogden Medical Center pays annual dues to the American Hospital Association, AHA and the Hospital Association of New York State, HANYS, of which a percentage is for lobbying fees. The total lobbying fees paid to both in 2014 was $27,911. 2947754 3326 142854 0 0 0 3093934 2827204 0 120550 0 0 0 2947754 2827204 0 0 0 0 0 2827204 2431346 0 395858 0 0 0 2827204 2430246 1100 0 0 0 0 2431346 0 1 0 0 1 1 4558886 0 4558886 100008978 0 55003262 45005716 1338592 0 1002229 336363 142120588 0 111920580 30200008 13842773 0 1621336 12221437 92322410 Interest in Net Assets of Foundation 17909569 Bond Payment & Debt Service Reserve Funds 3492841 Self Insurance & Depreciation Investment Funds 25904827 457 Plan Assets 4582457 Investment in Subsidiary 4192874 Prepaid Pension Asset 129680 56212248 0 Self Insurance Reserve 9050627 Note Payable AOMC Foundation/Auxiliary Investmnt 11890570 457 Plan Liability 4569121 Minimum Pension Liability 15300485 Third Party Reserves 3662672 Note Payable Physician Practice/Related Parties 667858 45141333 X 283937438 0 0 0 -488317 -488317 284425755 478424 -2535930 -2057506 282368249 279814308 0 0 0 0 0 279814308 478424 -2535930 -2057506 277756802 Schedule D, Part V, Line 4 The organization has interpreted the NYS Prudent Management of Institutional Funds Act Law, NYPMIFA as requiring the preservation of the historical dollar value of the corpus of the permanent restricted endowment funds absent of donor stipulations to the contrary. The net appreciation of the permanent restricted endowment funds absent of the donor stipulations to the contrary. The net appreciation of the permanently restricted net assets is considered temporarily restricted net assets until those amounts are appropriated for expenditure by the Organization in a manner consistent with the standard of prudence prescribed by NYPMIFA. If the fair value of the investments assets falls below the level of the donor, NYSMIFA requires the Center to retain the fund in perpetual duration. There were no such deficiencies as of December 31, 2013. To ensure the preservation of the corpus of the permanently restricted endowment funds, the total fair value of all commingled investment assets are classified first to the level of the permanently restricted endowment funds corpus, an endowment fund deficiency receivable from the unrestricted net assets would be recognized until the deficiency is recovered. Schedule D, Part X, Line 2 NOTE 1. ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) During the year ended December 31, 2014 AMS applied for not-for-profit status, they had previous been treated as a Corporation for tax purposes. Ivy Street files corporate tax returns. The Organization accounts for uncertain tax positions in accordance with US GAAP, which requires the recognition and measurement of uncertain tax positions that the Organization has taken or expects to take in the Organization's tax returns. Management believes there are no significant uncertain tax positions not reflected in the accompanying consolidated financial statements. The Organization is no longer subject to Federal and NYS income tax examination for years prior to 2011. Schedule D, Part XI, Line 2d Childrens Miracle Network, CMN Fundraiser Income Net of Expenses from Fund Balance of $92,659 and CMN Donations of $395,658 from Fund Balance. Schedule D, Part XI, Line 4b Rental Expenses moved to offset Rental Income in the amount of $663,216. Nutritional Services expenses moved to offset Nutritional Services Income in the amount of $1,872,714. Schedule D, Part XII, Line 4b Rental Expenses moved to offset Rental Income in the amount of $663,216. Nutritional Services expenses moved to offset Nutritional Services Income in the amount of $1,872,714. CMN Golf Tournament 48617 0 48617 200 0 8411 5541 0 3056 CMN Healthcare Heroes Gala 38647 0 38647 0 0 295 6590 800 410 1 32319 0 32319 0 0 0 0 0 1621 119583 0 119583 200 0 8706 12131 800 5087 26924 92659 1 1 X 1 X 1 X 1 1 0 1 1 432 949153 18721 930432 0.0033 7616 25194399 14990037 10204362 0.0367 38231 37986046 25583161 12402885 0.0447 0 46279 64129598 40591919 23537679 0.0847 24 19965 385718 20000 365718 0.0013 2 323 1004569 889942 114627 0.0004 65 87396026 72767528 14628498 0.0527 0 0 0 0 0 2 1108 28387 0 28387 0.0001 93 21396 88814700 73677470 15137230 0.0545 93 67675 152944298 114269389 38674909 0.1392 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 13900 13900 0 0 1 18 8884 0 8884 0 2 0 336196 118823 217373 0.0008 6 0 0 0 0 0 13 18 358980 132723 226257 0.0008 0 22828515 0 13933943 18711054 -4777111 X 1 1 Ivy Street Development Corp Collection of Services & Rentals 1 0 0 1 1 Arnot Ogden Medical Center 600 Roe Avenue Elmira NY 14905 www.arnothealth.org 0701000H X X X X A 2 Arnot Ogden Medical Center Health Center for Women 600 Fitch Street Elmira NY 14905 www.arnothealth.org X Hospital Extension Clinic - Diagnostic Radiology A 3 Arnot Ogden Medical Center Horseheads Campus 100 John Rommelt Drive Horseheads NY 14845 www.arnothealth.org X Clinical Laboratory Service & Radiology Diagnostic Outpatient. A A 0 0 1 X X X X X X X X 13 1 1 1 1 X www.arnothealth.org X X 1 13 1 www.arnothealth.org 0 0 1 X 150 400 X X X 1 1 X X X 1 X X X X X X X X 1 X 0 X X X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-Group A Arnot Health is a partner in the Community Health Improvement Plan HP2 with the following Chemung County organizations committed to improving the health of Chemung County residents. Members include, Chemung County Health Department, Arnot Health, Guthrie Health, EMSTAR, Creating Healthy Places, Health On Demand, Comprehensive Interdisciplinary Developmental Services, Inc, Family Services, Chemung ARC, Health Ministries of the Southern Tier, YWCA, Chemung County Dept of Social Services, Cornell Cooperative Extension, Eat Smart NY, Chemung County Dept. of Aging, Elmira College, Chemung County Mental Health, WIC, Cancer Services Program of Chemung & Schuyler counties, Arnot Tobacco Cessation Center, Southern Tier Tobacco Awareness Community Partnership (STTAC), Southern Tier Pediatrics, Chemung County Medical Reserve Corps., Community Mental Health Program at Family Services, Chemung County School Readiness Project, Economic Opportunity Program, Elmira City Council, Chemung County Poverty Reduction Coalition and community members. Schedule H, Part V, Section B, Line 5-Group A Arnot Ogden Medical Center Arnot Health in collaboration with partners from HP2 and SHPT, developed broad based five-year Community Health Improvement Plans in 2013 to address chronic disease as a public health priority. Arnot Health and its partners continued to implement the plans in 2014, and plan to conduct another Comprehensive Community Health Needs Assessment in 2016. However, the Finger Lakes Health Association conducted a Comprehensive Needs Assessment for the Finger Lakes Region in 2014 as part of the DSRIP initiative. The Community Health Improvement Plans (CHIP) plans in both Chemung and Steuben Counties focus on reducing obesity and tobacco use. The CHIP from both counties place emphasis on three key areas 1 health promotion activities to encourage healthy living and limit the onset of chronic diseases 2 early detection opportunities that include screening populations at risk and successful management strategies for existing diseases and related complications. These strategies recommended by the NYSDOH Prevention Agenda and Health Impact Pyramid are based on the evidenced based potential to address health inequities the ability to measure success and potential reach potential for broad partner support and collaboration and political feasibility. This method is based on findings from such organizations as the Institute of Medicine of the National Academies and their report Accelerating Progress in Obesity Prevention Solving the Weight of the Nation or the CDCs Recommended Community Strategies and Measurements to Prevent Obesity in the United States. For each focus area under the selected Prevention Agenda Prevent Chronic Disease priority Chemung and Steuben County Partnerships identified objectives and goals that include improvement strategies and performance measures with measurable and time framed targets over the next five years. The proposed chronic disease prevention strategies are evidence based or promising practices. They include activities currently underway by partners and new strategies to be implemented. All proposed strategies in Chemung and Steuben Counties are supported by the HP2 and SHPT partnerships. Chronic disease prevention strategies will be implemented in multiple sectors, including at local schools, worksites, businesses, community organizations, and with providers, to make it easier for residents to make healthy choices. By planning and implementing strategies from many levels of the Health Impact Pyramid, and through our network of diverse partnerships, we can create an environment that is conducive to physical activity, good nutrition and tobacco cessation. The Chemung and Steuben County partnerships have included many suggested activities from the States Prevent Chronic Disease Plan that will encourage increased physical activity, better nutrition and tobacco cessation strategies that aim toward reducing and preventing the incidence of chronic disease in Chemung and Steuben Counties. Some of these interventions include environmental, policy and systems changes to create communities that support physical activity, improved nutrition and breastfeeding, and tobacco cessation. Chemung County will continue its work through the Creating Healthy Places to Live, Work and Play grant and improve parks and playgrounds, establish community gardens to improve access to fresh fruits and vegetables, and work with local restaurant partners to make eating out healthier. Steuben County will continue to work with the cross county Southern Tier Tobacco Awareness Community Partnership, STTAC to establish tobacco free policies and urge members of the Regional Economic Development Council to consider health in their projects. Both counties plan to pursue joint use agreements with local school districts. Promote breast feeding policies at worksites, and create resource guides that promote the counties many opportunities for physical activity and healthy foods, including local farmers markets, parks and hiking trails. Other strategies include the clinical and community solutions such as provider 51 referrals to Diabetes Prevention Programs, Chronic Disease Self Management Programs and Tobacco Cessation Education. One exciting aspect of the CHIP is the unlimited possibilities offered by technological advances. Arnot Health and other local providers are beginning to implement Electronic Health Records, EHR. When fully functional, the benefits of EHRs will include improved quality and convenience of patient care, accuracy of diagnoses, enhanced care coordination, increased patient participation in their care, improved health outcomes and increased practice efficiencies and cost savings. EHRs will give providers decision support tools and available resources to better prevent and manage chronic disease. Arnot Health is currently working towards consolidating existing technologies within the healthcare system, with the objective of getting everyone on the same system organization wide. Consolidating technology within the healthcare system will improve communication among care providers, and between patients with their providers, enhance patient care coordination, improve chronic disease management and health outcomes. Arnot Health is increasing its focus on population health management and working towards increasing the systems abilities and competencies related to population health management. Areas of focus include realigning our health care delivery system to be more patient and ambulatory centric, increasing patient engagement with primary care providers using PCMH as a model, improving care coordination, and improving the management of chronic disease. Successful consolidation of IT systems will, contribute towards the integration and interoperability of data, and data exchange among care providers. Create robust and functional analytics which can identify higher risk patients to better manage chronic disease and improve health outcomes. Equip providers with the competencies needed to manage health care in a more predictive and less reactive way. Reduce preventable utilization of higher cost health care services such as emergency room or inpatient settings. Chemung and Steuben Counties Community Health Improvement Plans propose training primary care providers to talk to their patients about their weight, physical activity, diet and tobacco use and offering professional training opportunities which include programs on prevention, screening, diagnosis and treatment of overweight, obesity and diabetes. Residents and medical students will benefit from this training through the healthcare systems graduate medical education program. Arnot Healths graduate medical education program is offered in partnership with Lake Erie College of Osteopathic Medicine, LECOM. Another CHIP strategy is to investigate the possibility of incorporating referrals to community resources to prevent or manage chronic disease through a link in EHR. Through the use of new technology, follow up calls can be made to check on patient compliance, and provide the opportunity to document and measure the effectiveness of healthcare interventions. 52 Arnot Healths service area includes two Medically Underserved Areas, MUA. Elmiras Census Tract 0007.00 in Chemung County and Troupsburg and Tuscarora Town Service Area in Steuben County. Poor access to care is associated with a higher incidence of chronic disease, poorly managed chronic disease and an increased incidence of preventable hospitalizations. In both counties, the ratio of residents to primary care providers exceeds the NYS average. Arnot Health, through its Arnot Medical Services provider practice group, continues to aggressively recruit providers for the counties most underserved areas, and expand its graduate medical program to help meet identified needs within the MUAs. As Arnot Health works in partnership with Chemung County's HP2 and Steuben County's SHPT to implement the CHIPs, we will continue to identify emerging best practices to reduce obesity and tobacco use. Data measures will be developed to assess the effectiveness of our plans in impacting the community's health, and set mid-course corrections where needed. Promising cases for return on investment will be shared with policymakers. The specifics of Chemung and Steuben Counties Community Health Improvement Plans are outlined in the following CHIP charts. Strategies, goals, objectives, improvement strategies, performance measures with measurable time-framed targets over a three year period are included in the CHIP charts. Schedule H, Part V, Section B, Line 6a-Group A Arnot Health filed the Community Service Plan and included Arnot Ogden Medical Center, Ira Davenport Memorial Hospital, and St Josephs Hospital in Elmira. Schedule H, Part V, Section B, Line 6a-Group A Arnot Ogden Medical Center Arnot Health is a regional healthcare system that serves five counties within the Southern Tier Region of New York State and the Northern Tier of Pennsylvania. Arnot Health's three hospitals are located in two counties: Arnot Ogden Medical Center and St. Joseph's Hospitals are located in Chemung County, and Ira Davenport Memorial Hospital is situated in Steuben County. With hospital facilities in two counties, Arnot Health followed guidance from the New York State Department of Health (NYSDOH) and the 2013-2017 Prevention Agenda to answer the question of health priorities impacting the wellness of our communities. Schedule H, Part V, Section B, Line 6b-Group A Community Health Improvement Plan HP2 is made up of Chemung County organizations committed to improving the health of Chemung County residents. Members include: Chemung County Health Department, Arnot Health, Guthrie Health, EMSTAR, Creating Healthy Places, Health On Demand, Comprehensive Interdisciplinary Developmental Services, Inc (CIDS), Family Services, Chemung ARC, Health Ministries of the Southern Tier, YWCA Chemung County DSS, Cornell Cooperative Extension, Eat Smart NY, Chemung County Dept. of Aging, Elmira College, Chemung County Mental Health, WIC, Cancer Services Program of Chemung & Schuyler counties, Arnot Tobacco Cessation Center, Southern Tier Tobacco Awareness Community Partnership (STTAC), Southern Tier Pediatrics, Chemung County Medical Reserve Corps., Community Mental Health Program at Family Services, Chemung County School Readiness Project, Economic Opportunity Program, Elmira City Council, Chemung County Poverty Reduction Coalition and community members. Schedule H, Part V, Section B, Line 6b-Group A Arnot Ogden Medical Center Arnot Health participated in a comprehensive year-long process to assess community needs across county lines with partners such as: The Chemung County Health Department; Steuben County Public Health; other hospitals and healthcare agencies in Chemung, Steuben, and Schuyler Counties; a diverse collaborative of community partners and community residents. The year-long process of Assessing Community Health Needs was facilitated by a consultant contracted by Chemung County Health Department and technical assistance from the S2AY Rural Health Network in Steuben County. Arnot Health, in partnership with the dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership), to collect and analyze data from a variety of sources. Valuable input was gained from surveying Chemung and Steuben County residents about their current health, and opinions on county-wide health challenges. Areas of disparity were also assessed within each county. Schedule H, Part V, Section B, Line 7d-Group A Arnot Health will use a variety of methods to disseminate the Community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospitals, and the CHIPs for Chemung and Steuben Counties: Web site Documents will be posted on the healthcare system's Web site at the following URL: http://www.arnothealth.org/aboutus. Arnot Health's CSP and CHIP can also be found by entering the words "Community Service Plan" in the general search tool on the system's Web site, and typing "Arnot Health "Community Service Plan" in Google's Search Engine. Arnot Health plans to develop a section of the system's Web site dedicated to community outreach in 2014, budget permitting, to bring community service work to a more prominent place within the site. Partner Web sites Chemung and Steuben Counties will post links to their CHA and CHIP on their Web sites. HP2 and SHPT partners have also agreed to investigate the possibility of posting links to the plans on their Web sites and in their agencies' publications. Presentations Arnot Health's Community Health Department provides education about the healthcare systems' CSP and community outreach strategies to address public health priorities through presentations at community events, regional and state conferences, to Arnot Health's department managers and the healthcare system's Board of Directors. Local Media Outlets Arnot Health works with a variety of local media outlets to disseminate information about the Community Service Plan and community outreach programs and services. The health system continually assesses the effectiveness of each of those outlets. Historically, regional newspapers have proven an effective way to provide timely information to the public, based on consumer feedback at programs and events. Other methods include website, social media, television, radio, phone banking, direct mail, and other community publications. Health on Demand Call Center The public may call the healthcare system's Health on Demand Regional Medical Call Center at 607.737.4499 to receive a copy of the Community Service Plan and plan of action for improving the health of the community. Insight Newsletter Information about accessing Arnot Health's Community Service Plan and request for community input will be published annually in Insight, a monthly publication for employees, retirees and volunteers of the Arnot Health System. Former Insight Newsletters featured articles that illustrate the healthcare system's mission to provide quality preventative healthcare through community outreach and ongoing assessment of public health needs. Schedule H, Part V, Section B, Line 7d-Group A Arnot Ogden Medical Center Dissemination of the Plan to the Public Arnot Health will use a variety of methods to disseminate the Community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospitals, and the CHIPs for Chemung and Steuben Counties: Web site Documents will be posted on the healthcare system's Web site at the following URL: http://www.arnothealth.org/aboutus. Arnot Health's CSP and CHIP can also be found by entering the words "Community Service Plan" in the general search tool on the system's Web site, and typing "Arnot Health "Community Service Plan" in Google's Search Engine. Arnot Health plans to develop a section of the system's Web site dedicated to community outreach in 2014, budget permitting, to bring community service work to a more prominent place within the site. Partner Web sites Chemung and Steuben Counties will post links to their CHA and CHIP on their Web sites. HP2 and SHPT partners have also agreed to investigate the possibility of posting links to the plans on their Web sites and in their agencies' publications. Presentations Arnot Health's Community Health Department provides education about the healthcare systems' CSP and community outreach strategies to address public health priorities through presentations at community events, regional and state conferences, to Arnot Health's department managers and the healthcare system's Board of Directors. Local Media Outlets Arnot Health works with a variety of local media outlets to disseminate information about the Community Service Plan and community outreach programs and services. The health system continually assesses the effectiveness of each of those outlets. Historically, regional newspapers have proven an effective way to provide timely information to the public, based on consumer feedback at programs and events. Other methods include website, social media, television, radio, phone banking, direct mail, and other community publications. Health on Demand Call Center The public may call the healthcare system's Health on Demand Regional Medical Call Center at 607.737.4499 to receive a copy of the Community Service Plan and plan of action for improving the health of the community. Insight Newsletter Information about accessing Arnot Health's Community Service Plan and request for community input will be published annually in Insight, a monthly publication for employees, retirees and volunteers of the Arnot Health System. Former Insight Newsletters featured articles that illustrate the healthcare system's mission to provide quality preventative healthcare through community outreach and ongoing assessment of public health needs. Provider Offices The CSP will also be found in Arnot Health's providers' offices for the public to access during visits. Moving forward, Arnot Health will continue to identify ways to effectively communicate with residents in the service area to solicit input and provide an update to the plan of action. Schedule H, Part V, Section B, Line 11-Group A Four assessments inform the entire MAPP process. The assessment phase provides a comprehensive picture of the community in its current state using both qualitative and quantitative methods. The use of four different assessments is a unique feature of the MAPP process. Most planning processes look only at quantitative statistics and anecdotal data. MAPP provides tools to help communities analyze health issues through multiple lenses. Arnot Health, in cross-county collaborations with local health departments and community partners, participated in all four MAPP assessments in both Chemung and Steuben Counties. The first assessment examined local, regional and state Community Health Status Indicators. Two methods were used to examine indicators. The first method was to collect relevant statistical data using the NYSDOH Community Health Indicator Reports, Census data, BRFSS reports, CDC Healthy People 2020 and a wide variety of other data sources. Chemung County data collection and analysis was facilitated by a consultant contracted by the Chemung County Health Department. Data collection and analysis in Steuben County was facilitated by S2AY Rural Health Network staff. Data that was available in the fall of 2012 and early winter of 2013 was used for analysis to complete work in a timely fashion; allow time for partnerships to review and discuss the data, identify priorities, establish and refine goals and objectives, and prepare the CHA, CHIP and CSP.The second method was to collect primary data by conducting a comprehensive community health survey among a random sample of residents to determine their opinions, health-related behaviors and health needs. The surveys were designed to encompass questions in the five Prevention Agenda areas that NYSDOH has identified as high priority issues on a statewide basis, Prevent chronic diseases, Promote healthy and safe environments, Promote healthy women, infants and children, Promote mental health and prevent substance abuse, and Prevent HIV, sexually transmitted diseases, vaccine preventable diseases and healthcare associated Infections. This was completed in both counties by the fall of 2012 and early spring of 2013. Surveys were conducted electronically through a Survey Monkey link, along with paper copies which were distributed to the public through hospitals, employers, health educational and human services agencies, and through other community groups. Links to the surveys were posted on Rural Health Networks' Web sites, hospitals and health departments' Web sites and in signature lines of partners' communications. Press releases, TV ads, flyers, postcards were distributed, and partners promoted the completion of surveys at community presentations and health events. Arnot Health's community health nurses facilitated the completion of electronic and paper surveys for residents with limited ability to self complete, such as persons with low educational attainment, disability, or low level of literacy. In Chemung County, a total of 564 surveys were completed, which represents 63 percent of the county's population. In Steuben County, a total of 747 surveys, representing 77 percent of population, were completed. Once all the statistics and the results from the four assessments were tallied, a finalized list of the top issues from all components of the assessment process was compiled. Arnot Health attended a series of meetings to present data and pick public health priorities with the Health Priority Partnership (HP2) in Chemung County and the Steuben Health Priorities Team (SHPT) in Steuben County. The partnerships in both counties were charged with ranking the priorities based on their knowledge of health needs and available services, along with the data presented, to select two priorities and one disparity. In order to accomplish this, the Hanlon Method was used. This method of ranking health priorities focuses most heavily on how effective any interventions might be. The Hanlon Method utilizes the following formula to rank priorities. (A & 2B) X C Where A= the size of the problem, B= the severity of the problem and C=the effectiveness of the solution. The effectiveness of the solution is given a lot more weight than the size or seriousness of the problem, with the hope of making wise use of limited resources by targeting solutions that are known to be effective. Participants also considered the weight of the propriety, economic feasibility, acceptability, resources and legality (PEARL) of issues in this ranking system. PEARL Factors Propriety Is the problem one that falls within the overall scope of operation? Is it consistent with our mission statement? Economic Feasibility Does it make economic sense to address the problem? Are these economic consequences as a result of the problem NOT being addressed? Acceptability Will the community/or target population accept a program to address the problem? Resources Are, or should, resources be available to address the problem? Schedule H, Part V, Section B, Line 11-Group A Arnot Ogden Medical Center Reduce illness, disability and death related to heart disease and hypertension. Promote tobacco cessation, especially among low socioeconomic populations and those with mental health illness. Hypertension and tobacco use are two major contributing factors to cardiovascular diseases. Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery. Cigarette smoking is widespread and significant as a risk factor that the Surgeon General has called it the leading preventable cause of disease and deaths in the United States. Both Chemung and Steuben Counties CHAs priority rankings through the Hanlon Method identified obesity and tobacco use as major focus areas to prevent chronic disease. According to the CDC, growing evidence indicates that a comprehensive approach to prevention can save tremendous costs and enhance the quality of life. The four common modifiable behaviors that contribute to chronic illness, disability, and premature death related to chronic disease. These include tobacco use, insufficient physical activity, poor eating habits, and excessive alcohol use. With hospital facilities in Chemung and Steuben Counties, and ongoing efforts to expand partnerships in both counties, Arnot Health is uniquely positioned to work more regionally across county lines to develop and implement prevention strategies that will improve the health of the community. The Health Impact Pyramid developed by Thomas R. Frieden, MD, MPH was extensively utilized. This is a pyramid approach to describe the impact of different types of public health interventions and provides a framework to improve health. The base of the pyramid indicates interventions with the greatest potential impact and in ascending order are interventions that change the context to make individuals default decisions healthy, clinical interventions that require limited contact but confer long term protection, on going direct clinical care, and health education and counseling. Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort. Community Health Improvement Plans from both counties place emphasis on three key areas, health promotion activities to encourage healthy living and limit the onset of chronic diseases, early detection opportunities that include screening populations at risk and successful management strategies for existing diseases and related complications. These strategies, recommended by the Health Impact Pyramid, are based on the interventions evidenced base potential to address health inequities the ability to measure success and potential reach potential for broad partner support and collaboration and political feasibility. Chemung and Steuben County Partnerships identified objectives and goals that include improvement strategies and performance measures with measurable and time framed targets over the next five years. The proposed chronic disease prevention strategies are evidence based or promising practices. They include activities currently underway by partners and new strategies to be implemented. Chronic disease prevention strategies will be implemented in multiple sectors, including at local schools, worksites, businesses, community organizations, and with providers, to make it easier for residents to make healthy choices. By planning and implementing strategies from many levels of the Health Impact Pyramid, and through our network of diverse partnerships, we can create an environment that is conducive to physical activity, good nutrition and tobacco cessation. The Chemung and Steuben County partnerships have included many suggested activities from the States Prevent Chronic Disease Plan that will encourage increased physical activity, better nutrition and tobacco cessation strategies that aim toward reducing and preventing the incidence of chronic disease in Chemung and Steuben Counties. Some of these interventions include environmental, policy and systems changes to create communities that support physical activity, improved nutrition and breastfeeding, and tobacco cessation. Chemung County will continue its work through the Creating Healthy Places to Live, Work and Play grant and improve parks and playgrounds, establish community gardens to improve access to fresh fruits and vegetables, and work with local restaurant partners to make eating out healthier. Steuben County will continue to work with the cross county Southern Tier Tobacco Awareness Community Partnership, STTAC to establish tobacco free policies and urge members of the Regional Economic Development Council to consider health in their projects. Both counties plan to pursue joint use agreements with local school districts, promote breast feeding policies at worksites, and create resource guides that promote the counties many opportunities for physical activity and healthy foods, including local farmers markets, parks and hiking trails. Other strategies include the clinical and community solutions such as provider referrals to Diabetes Prevention Programs, Chronic Disease Self Management Programs and Tobacco Cessation Education. One exciting aspect of the CHIP is the unlimited possibilities offered by technological advances. Arnot Health and other local providers are beginning to implement Electronic Health Records, EHR. When fully functional, the benefits of EHRs will include improved quality and convenience of patient care, accuracy of diagnoses, enhanced care coordination, increased patient participation in their care, improved health outcomes and increased practice efficiencies and cost savings. EHRs will give providers decision support tools and available resources to better prevent and manage chronic disease. Arnot Health is currently working towards consolidating existing technologies within the healthcare system, with the objective of getting everyone on the same system organization wide. Consolidating technology within the healthcare system will improve communication among care providers, and between patients with their providers, enhance patient care coordination, improve chronic disease management and health outcomes. Arnot Health is increasing its focus on population health management and working towards increasing the systems abilities and competencies related to population health management. Areas of focus include realigning our health care delivery system to be more patient and ambulatory centric increasing patient engagement with primary care providers using PCMH as a model, improving care coordination, and improving the management of chronic disease. Successful consolidation of IT systems will, contribute towards the integration and interoperability of data, and data exchange among care providers. Create robust and functional analytics which can identify higher risk patients to better manage chronic disease and improve health outcomes. Equip providers with the competencies needed to manage health care in a more predictive and less reactive way. Reduce preventable utilization of higher cost health care services such as emergency room or inpatient settings. Chemung and Steuben Counties Community Health Improvement Plans propose training primary care providers to talk to their patients about their weight, physical activity, diet and tobacco use and offering professional training opportunities which include programs on prevention, screening, diagnosis and treatment of overweight, obesity and diabetes. Residents and medical students will benefit from this training through the healthcare systems graduate medical education program. Arnot Healths graduate medical education program is offered in partnership with Lake Erie College of Osteopathic Medicine LECOM. Another CHIP strategy is to investigate the possibility of incorporating referrals to community resources to prevent or manage chronic disease through a link in EHR. Through the use of new technology, follow up calls can be made to check on patient compliance, and provide the opportunity to document and measure the effectiveness of healthcare interventions. Poor access to care is associated with a higher incidence of chronic disease, poorly managed chronic disease and an increased incidence of preventable hospitalizations. Arnot Health, through its Arnot Medical Services provider practice group, continues to aggressively recruit providers for the counties most underserved areas, and expand its graduate medical program to help meet identified needs within the MUAs. Schedule H, Part V, Section B, Line 16a-Group A www.arnothealth.org Schedule H, Part V, Section B, Line 16b-Group A www.arnothealth.org Schedule H, Part V, Section B, Line 16b-Group A Arnot Ogden Medical Center www.arnothealth.org Schedule H, Part V, Section B, Line 16c-Group A www.arnothealth.org Schedule H, Part V, Section B, Line 16c-Group A Arnot Ogden Medical Center www.arnothealth.org Schedule H, Part V, Section B, Line 20e-Group A Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, self pay collector must verify eligibility for the date of service. The Self pay staff will change the health plan to the correct one for all covered dates of service and ARNOT Billing will submit claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing process. Self Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self pay staff will attempt to make payment arrangements and to notify patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The Self Pay Collectors documents all activity in Soarian, and enters any necessary hold to support resolution. Self pay collections staff enters the payment plan and documents comments in Soarian. Payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. Schedule H, Part V, Section B, Line 20e-Group A Arnot Ogden Medical Center Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, self pay collector must verify eligibility for the date of service. The Self pay staff will change the health plan to the correct one for all covered dates of service and ARNOT Billing will submit claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing process. Self Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self pay staff will attempt to make payment arrangements and to notify patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The Self Pay Collectors documents all activity in Soarian, and enters any necessary hold to support resolution. Self pay collections staff enters the payment plan and documents comments in Soarian. Payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections. Schedule H, Part V, Section B, Line 22d-Group A Arnot Ogden Medical Center FAP eligible patients receive a percentage discount of either charges for the uninsured or patient responsibility for the insured patient. Schedule H, Part V, Section B, Line 22d-Group A Arnot Ogden Medical Center FAP eligible patients receive a percentage discount of either charges for the uninsured or patient responsiblity for the insured. Schedule H, Part V, Section B, Line 22d-Group A Arnot Ogden Medical Center FAP eligible patients receive a percentage discount of either charges for the uninsured for the uninsured patient for patients responsibility for the uninsured patient. Schedule H, Part V, Section B, Line 24-Group A Participants in the Medicare System are required to charge all patients the same amount for services regardless of insurance per the Medicare Participation Guidelines. Schedule H, Part V, Section B, Line 24-Group A Arnot Ogden Medical Center Participants in the Medicare System are required to charge all patients the same amount for services regardless of insurance per the Medicare Participation Guidelines. Schedule H, Part I, Line 6a The Community Beneift Report for 2014 was prepared by Arnot Health for Arnot Ogden Medical Center, Ira Davenport Memorial Hospital, St. Joseph's Hospital and Arnot Medical Services. Schedule H, Part I, Line 7 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services Schedule H, Part II Dr. Lambert and Rosemary Anthony are both on Chemung County Board of Health, Dr. Fred Farley is on the CNY Health Health Careers Board, Adult Immunization Coalition (AIC), Chemung Steuben, and Schuyler County Health Departments, Cancer Services Chemung & Schuyler Counties, Chemung Co. Health Priorities Partnership, Housing Coalition - Catholic Charities, Hunger Coalition, and Poverty Coalition. Arnot Ogden Medical Center also operates the School of Nursing and the School of Radiologic Technology at a loss each year to educate and train members of the community to become Registered Nurses or Licensed Radiologic Technologists. Schedule H, Part III, Section A, Line 4 The Organization's allowance for doubtful accounts decreased from 11.4% of gross accounts receivable at December 31, 2013 to 11.1% of gross accounts receivable at December 31, 2014. In addition, the Organization's bad debt write-offs increased approximately $1,200,000 from approximately $26,900,000 for fiscal year end 2013 to approximately $28,100,000 for fiscal year end 2014. The increase in write-offs was to account for negative trends experienced in the collection of amounts from self-pay patients in fiscal year 2014. The Organization has not changed its charity care or uninsured discount policies during the fiscal year 2014 and 2013. The Organization does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third-party payors. Schedule H, Part III, Section B, Line 8 Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. Schedule H, Part III, Section C, Line 9b Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, self pay collector must verify eligibility for the date of service. The Self pay staff will change the health plan to the correct one for all covered dates of service and ARNOT Billing will submit claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing process. Self Pay Collections Staff attempts to collect full balance due by check or credit card. If they are unable to make the full payment, Self pay staff will attempt to make payment arrangements and to notify patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patient will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The Self Pay Collectors documents all activity in Soarian, and enters any necessary hold to support resolution. Self pay collections staff enters the payment plan and documents comments in Soarian. Payment plan statement is demanded and sent to the patient. If patient does not enter into a payment plan agreement, or fails to pay as agreed, account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections. Schedule H, Part VI, Line 2 Arnot Health participated in a comprehensive year long process to assess community needs across county lines with partners such as: The Chemung County Health Department; Steuben County Public Health; other hospitals and healthcare agencies in Chemung, Steuben, and Schuyler Counties; a diverse collaborative of community partners and community residents. The year-long process of Assessing Community Health Needs was facilitated by a consultant contracted by Chemung County Health Department and technical assistance from the S2AY Rural Health Network in Steuben County. Arnot Health, in partnership with the dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership), to collect and analyze data from a variety of sources. Valuable input was gained from surveying Chemung and Steuben County residents about their current health, and opinions on county-wide health challenges. Areas of disparity were also assessed within each county. Findings from the Community Health Assessment (CHA) identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties: Chemung County Priority: Prevent Chronic Disease.Arnot Health works collaboratively with the Chemung County Health Department, Chemung Valley Rural Health Network, Cornell Cooperative Extension, other area hospitals, faith based organizations, and community partners to assess public health needs within the community. Programs to prevent obesity and diabetes, such as a free 6 week community walking program called Step It Up, are planned, implemented and evaluated in partnership. Pre and post program health screening data is shared between agencies, and outreach efforts are coordinated to maximize reach and community health impact. Arnot Health has a leadership role in the NYSDOH grant funded Creating Healthy Places to Live, Work, and Play partnership. This diverse collaborative of over 30 community partners across public, private, and non profit sectors is working together to plan, implement and evaluate environmental, policy and systems changes to promote physical activity and nutrition. The Creating Healthy Places partnerships goal is to prevent obesity and diabetes through rehabilitating Elmira parks and playgrounds, increasing safe access to open public places for physical activity, building community gardens to increase access to fresh fruits and vegetables and working with local restaurants to offer healthier options on their menus. Schedule H, Part VI, Line 3 The Arnot Ogden Medical Center communicates our Community Care Program in the following ways: Signage in waiting rooms, Brochures in waiting rooms and Admission packages, Notations on billing notices, Staff education so they can share availability of program and contact information with patients. Communication and education of shared County Dept of Social Services staff so they are informed of the program details and contact information. Communication of programs with Collection Agencies and collection attorneys so they can share the availability of the program and contact information with prospective enrollees. The information is also posted on our website, www.arnothealth.org. Schedule H, Part VI, Line 4 Arnot Health is comprised of three hospitals, Arnot Ogden Medical Center and St. Joseph's Hospitals in Elmira, and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative and wellness services to meet the needs of residents in Chemung, Steuben and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. The distribution of patients from this service area, as measured by total discharges from system's hospitals, is as follows: Chemung (60.3%), Steuben (17.2%), Schuyler (8.3%), Bradford, PA (3.1%), Tioga, PA (3.1%) and all other (8%). Zip Codes within closest proximity to Arnot Health's hospital facilities include: Chemung County Steuben County Schuyler County 14814 Big Flats 14801 Addison 14805 Alpine 14816 Breesport 14809 Avoca 14812 Beaver Dams 14825 Chemung 14810 Bath 14815 Bradford 14901 Elmira (MUA) 14819 Cameron 14818 Burdett 14902 Elmira Schedule H, Part VI, Line 5 Health Indicators Chronic diseases such as heart disease, diabetes, stroke, and some cancers are the most common and costly of all health problems, but they are also the most preventable. Growing evidence indicates that a comprehensive approach to prevention can save tremendous costs and enhance the quality of life. There are four common modifiable behaviors that contribute to chronic illness, disability, and premature death related to chronic disease. These include tobacco use, insufficient physical activity, poor eating habits, and excessive alcohol use (http://www.cdc.gov/chronicdisease/resources/publications/aag/chronic.htm). According to the 2013 University of Wisconsin Population Health Institute's County Health Rankings, Chemung and Steuben County residents are among the unhealthiest in NYS, ranking 60th and 44th respectively, out of 62 counties for poor health outcomes. Two major contributors to the poor health outcomes in Chemung and Steuben Counties are the high percentage of residents using tobacco and who are overweight or obese. Obesity is a significant risk factor for many chronic diseases and conditions which reduce the quality of life, including type-2 diabetes, asthma, high blood pressure, and high cholesterol. Increasingly, these conditions are being seen in children and adolescents (http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/docs/prevent_chronic_diseases.pdf). Tobacco use is the leading preventable cause of morbidity and mortality in NYS and is associated with illnesses such as lung and oral cancers, heart disease, stroke, chronic obstructive pulmonary disease, and other lung diseases (http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/indicators/2013/chemung.htm). The incidence of obesity in children and adolescents in Chemung and Steuben Counties exceeds the NYS average of 16.7%. The percentage of adults who are obese with a BMI of 30 or higher in Chemung (30.1%) and Steuben (27.6%) Counties also exceed the NYS average (23.1%). Additionally, more Chemung and Steuben County residents use tobacco than the NYS average (16.8%). Although there have been substantial reductions in the percentage of adults who smoke in NYS, tobacco use disparities have become more pronounced over the past decade. Smoking rates have not declined among adults of low-socioeconomic status and adults with poor mental health. Lower socioeconomic status is associated with an increased risk of smoking initiation and progression to regular smoking, and a decreased likelihood of successful smoking cessation ("Who's Quitting in New York: A Decade of Progress Reducing Smoking and Promoting Cessation", February 2011, Final Report"). According to NYS Tobacco Control Program in 2008-2009, the incidence of smoking among adults who reported poor mental health (32.5%), was twice the incidence of smoking among adults who reported good mental health (15.7%) (http://www.health.ny.gov/prevention/tobacco_control/reports/statshots/volume5/n2_mental_health_and_s moking_prevalence.pdf). Chemung and Steuben Counties have a high incidence of residents with low-socioeconomic status and poor mental health. Chemung County residents reporting poor mental health for 14 days or more is 12.8%, which exceeds the NYS average of 10.2%. Recent Census Data indicates the percentage of Chemung (16.5%) and Steuben County (15%) residents living below poverty level exceeds the NYS average of 14.5%. The incidence of children living below poverty level is reflected in one of X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 Michael Hosey Chairman of the Board 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Joseph P Manning Vice Chairman 0 0 0 0 0 0 0 0 0 0 0 0 0 0 John R Alexander Secretary 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Daniel J Burke Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kenneth Herzl Betz Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 David Dalrymple Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Christine M Deschamps Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 S Jan Eberhard Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 John T Gough Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mark J Hagan Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Roy A Kyles Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Ben E Lynch Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Robert McNamara Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mary Louise Mitchell Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 John F OMara Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Donald Quick Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Patrick J Rogers Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Melinda Sartori Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Roger Schenone Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Kevin OConnor Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Margaret Streeter Board Member 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Ronald J Kintz DHA Senior VP/CFO 323362 0 38502 0 0 0 13000 0 23639 0 398503 0 0 0 Robert Lambert MD President Arnot Health 524738 0 62108 0 0 0 13000 0 23639 0 623485 0 0 0 H Fred Farley PhD Hospital President COO 344660 0 29848 0 0 0 13000 0 23639 0 411147 0 0 0 Kevin Deluca MD VP Medical Affairs 173650 0 0 0 0 0 3925 0 16744 0 194319 0 0 0 James Watson President IDMH 221154 0 1512 0 0 0 7637 0 1859 0 232162 0 0 0 Wes Blauvelt VP Planning 167826 0 26740 0 0 0 8142 0 1272 0 203980 0 0 0 Vidyasagar Mokureddy MD Pain Mgmt Physician 1106625 0 301954 0 0 0 8918 0 23639 0 1441136 0 0 0 Timothy Minton MD ENT Physician 731714 0 207992 0 0 0 8918 0 20615 0 969239 0 0 0 Nishith Amin MD Cardiologist 750832 0 0 0 0 0 8918 0 21406 0 781156 0 0 0 William DeLuccia MD Cardiologist 754714 0 0 0 0 0 8918 0 23639 0 787271 0 0 0 Paul Tinsley MD ENT Physician 856701 0 39200 0 0 0 8918 0 21406 0 926225 0 0 0 Schedule J, Part I, Line 1a The CEO and COO have their dues paid at the Elmira Country Club. The personal use portion is reported under taxable income. Schedule J, Part I, Line 3 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Directors. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Schedule J, Part I, Line 7 Physician compensation has a variable component based upon volume quality and patient satisfaction scores. Officer compensation has a variable component based upon patient experience quality and efficiency. A Chemung County Industrial Developmental Agency 166209017 000164019 2004-03-10 19912203 Series A Construction Bond 0 0 0 B Chemung County Industrial Developmental Agency 166209017 000164019 2004-03-10 16959701 Series B Facility Renovation 0 0 0 A 3500000 0 19912203 1317663 0 0 419500 0 1802477 16377225 0 0 2006 0 0 1 1 B 7990169 0 16959701 1042483 4561742 0 328213 0 0 10287552 0 0 2005 0 1 1 1 A 0 0 0 0 0 1 0 1 B 0 0 0 0 0 1 0 1 A 1 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 David Dalrymple Chairman of Board Chemung Canal Trust Company 5822033 Competitively bid loans and custodian of investments. 0 John Alexander Lawyer with Sayles Evans Legal Firm 816586 Legal Services provided to Arnot Ogden Medical Center 0 Form 990, Part VI, Section B, Line 11b Upon completion of the Form 990 it is reviewed by the Medical Center's Senior Vice President of Finance and then made available to the Audit and Finance Committees of the Board of Directors. The return sent to all Board Members for review and questions. Form 990, Part VI, Section B, Line 12c All members of the Board of Directors, Officers and Management employees are required annually to file a Disclosure Statement setting forth any respect in which such a person, or any person associated with such person, has or may have any interest in a transaction in which there may be, or appear to be, a conflict between the interests of such person and the Arnot Ogden Medical Center. An Associate included (1) a spouse, a descendant or an ancestor, or a spouse of a descendant or ancestor; (2) an organization in which the person or an associate is a partner or employee, or such person or an associate owns a more that 10% beneficial interest; (3) a trust in which such a person is a trustee, or such person or an associate holds a more than 10% beneficial interest; and (4) a corporation in which such person or an associate is an officer or director or employee, or such person or an associate is an owner of more that 10% of any class of securities. The responses to the Conflict of Interest are reviewed by the Audit Committee and shared with the Board annually so conflicts are avoided. Form 990, Part VI, Section B, Line 15 Compensation for the President and Vice Presidents are set pursuant to a policy and compensation philosophy adopted by the Board of Directors. The Board has a Compensation Committee consisting of outside directors. The Compensation Committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports compensation on similar positions in similar nonprofit hospitals from upstate New York and Western Pennsylvania. The Compensation Committee recommends adjustments to the Executive Committee of the Board which reviews the recommendations and approves or disapproves without employees in the room. This action then is reviewed with the entire Board also in executive session. Form 990, Part VI, Section C, Line 18 Upon request the 990 Form is made available to the public and also via www.guidestar.com. Financial Statements are posted to the Electronic Municipal Market Access website. Form 990, Part VI, Section C, Line 19 Arnot Ogden Medical Center's Governing and Conflict of Interest Policies are available to the public upon request. The Financial Statements are available on Guide Star's website and also EMMA Bond Disclosure website and the 990 is available upon request. Form 990, Part XI, Line 9 Pension Charge to Equity $(18,778,098). Donations for Capital Assets $241,398. Transfer in of St. Joseph's Hospital Foundation Net Assets in combining company with AOMC Foundation $2,799,602. Interest Income and Gain/Loss on Temp Restricted Investments posted to Fund Balance $393,167. Restricted Funds expensed to Fund Balance for restricted purposes $(129,650). AOMC Foundation change in Net Assets $1,865,632. Arnot Ogden Medical Center Foundation Accounting Dept 600 Roe Avenue Elmira NY 14905 161109472 Contribution Management NY 501(c)(3) 11B N/A 0 Arnot Ogden Medical Center Auxiliary 600 Roe Avenue Elmira NY 14905 510192902 Fund Raising NY 501(c)(3) 11B N/A 0 Ira Davenport Memorial Hospital Inc Accounting Dept 7571 State Route 54 Bath NY 14810 160835446 Affiliate NY 501(c)(3) 3 N/A 0 Keuka Health Care Foundation Accounting Dept 7571 State Route 54 Bath NY 14810 161461215 Affiliate NY 501(c)(3) 11B N/A 0 St Josephs Hospital Accounting Dept 555 St Josephs Blvd Elmira NY 14901 160743163 Affiliate NY 501(c)(3) 3 N/A 0 St Josephs Hospital Foundation Accounting Dept 571 St Josephs Blvd Elmira NY 14901 161265182 Affiliate NY 501(c)3 11B N/A 0 Arnot Health 600 Roe Avenue Elmira NY 14845 453049405 Parent Organization NY 501(c)(3) 11B Arnot Ogden Medical Center St Josephs Hospital 0 Ivy Street Development Corporation 600 Ivy Street Elmira NY 14905 161009245 Real Estate NY N/A C 100 100 1 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 Arnot Ogden Medical Center Foundation o 157349 Arnot Ogden Medical Center provided paid employees to Arnot Ogden Medical Center Foundation to perform Accounting, Administrative and Materials Management functions. The method of determining the amount involved was cost. Ivy Street Development Corporation o 24820 Arnot Ogden Medical Center provided paid employees to Ivy Street Development Corporation to perform Accounting and Property Management services. The method of determining the amount involved was cost. Ivy Street Development Corporation q 162435 Arnot Ogden Medical Center was reimbursed by Ivy Street Development Corporation for Utilities, Maintenance, and Insurance expenses. The method of determining the amount involved was cost. Ivy Street Development Corporation k -640768 Arnot Ogden Medical Center leased facilities from Ivy Street Development Corporation. The method of determining the amount involved was a lease agreement. Ira Davenport Memorial Hospital Inc o 2701081 Arnot Ogden Medical Center provided paid employees to Ira Davenport Memorial Hospital to perform Accounting, Administrative, Management Information and various Medical Services. The method of determining the amount involved was cost. Keuka Health Care Foundation o -36825 Arnot Ogden Medical Center provided paid employees to Keuka Health Care Foundation to perform Accounting and Administrative functions. The method of determining the amount involved was cost. St Josephs Hospital o 7616062 Arnot Ogden Medical Center provided paid employees to St. Joseph's Hospital to perform Accounting, Administrative, Management Information and various Medical functions. The method of determining the amount involved was cost. St Josephs Hospital o -98356 St. Joseph's Hospital provided paid employees to Arnot Ogden Medical Center to perform Environmental and Pastoral services. The method of determining the amount involved was cost. St Josephs Hospital Foundation o 106494 Arnot Ogden Medical Center provided paid employees to St. Joseph's Hospital Foundation to perform Accounting, Administrative and Materials Management functions. The method of determining the amount involved was cost.