TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) Steve Goldstein...................................................................... Board Member	1 ................. 71.00	X			0	1,232,162	505,762
(2) Michael Kamali MD...................................................................... Board Member	1 ................. 55	X			0	642,978	66,738
(3) John Robshaw...................................................................... Physician	40 ................. 0			X	475,634	0	24,121
(4) Ismail Mehr MD...................................................................... Board Member	1 ................. 0	X			472,640	0	0
(5) M Tariq Randhawa...................................................................... Physician	40 ................. 0			X	422,201	0	5,907
(6) Aileen Shinaman...................................................................... Board Member	1 ................. 55	X			0	310,262	100,525
(7) Kevin Wentworth...................................................................... Physician Assistant	40 ................. 0			X	290,402	0	24,914
(8) Giacomo Floria...................................................................... Chief Advanced Practice Provider	40 ................. 0			X	231,441	0	14,347
(9) Bryan O'Donovan...................................................................... President/CEO	55 ................. 1		X		217,257	0	8,550
(10) Kevin Briceland...................................................................... Physician Assistant	40 ................. 0			X	191,994	0	7,412
(11) James Helms...................................................................... CFP/ VP of Finance	30 ................. 30		X		0	147,984	10,751
(12) Spencer Annabel MD...................................................................... Board Member	1 ................. 0	X			138,000	0	0
(13) Sue Gray PhD...................................................................... Chair	1 ................. 0	X	X		0	0	0
(14) Shawn Hogan...................................................................... Vice Chair	1 ................. 0	X	X		0	0	0
(15) Brian Schu...................................................................... Treasurer	1 ................. 0	X	X		0	0	0
(16) Pete Wall...................................................................... Secretary	1 ................. 0	X	X		0	0	0
(17) Matt Shick...................................................................... Board Member	1 ................. 0	X			0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Le Chase Construction 205 Indigo Creek Dr Rochester,NY14626	Construct Proj New Hosp	27,337,412
FSI Acoustical Systems LLC 90 Goodway Dr Rochester,NY14623	Construct Project MOB	1,521,662
Univ of Rochester 135 Corporate Woods Suite 100 Rochester,NY14623	Physician/Radiology Staffing	1,189,177
Strong Memorial Hospital Strong Mem Hosp 601 Elmwood Ave PO Box 608 Rochester,NY14642	Pathology/ Lab Services	1,169,969
Razak Assoc Architecture Eng and Land Survey PLLC 2060 Fairport Nine Mile Road Suite 300 Penfield,NY14526	Architect	778,914
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 16

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization ST JAMES HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization ST JAMES HOSPITAL		Employer identification number 16-0743310

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization ST JAMES HOSPITAL			Employer identification number 16-0743310
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	26,366	27,732	27,732	27,732	26,332
b	Contributions ...	0	0	0	0	0
c	Net investment earnings, gains, and losses	0	-1,366	0	0	1,400
d	Grants or scholarships ...	0	0	0	0	0
e	Other expenditures for facilities and programs ...	0	0	0	0	0
f	Administrative expenses ....	0	0	0	0	0
g	End of year balance ......	26,366	26,366	27,732	27,732	27,732

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	0	935,597		935,597
b	Buildings ....	0	0	0	0
c	Leasehold improvements	0	136,057	136,057	0
d	Equipment ....	0	4,954,313	1,059,864	3,894,449
e	Other .....	0	47,233,982	0	47,233,982
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					52,064,028

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Due from Third Parties				3,777,383
(2)Right to Use Asset				11,211,677
(3)Other Misc Assets				2,335,616
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				17,324,676

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	14,325,620
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part V, Line 4

With the help of nearly 350 community members, business partners, employees, providers, and friends and donors like you, SJ Foundation raises charitable gifts to make possible a range of facilities improvements, capital equipment and program initiatives.

Schedule D, Part X, Line 2

Income Taxes The Hospital and the Foundation are not-for-profit corporations described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal, state and local income taxes on related income pursuant to Section 501(a) of the Code. The Hospital and the Foundation have also been classified by the Internal Revenue Service as a corporation that is not a private foundation. HMV is considered a for-profit entity and subject to New York State and Federal Income taxes. As of December 31, 2019 and 2018, the Hospital does not have a liability for unrecognized tax positions. The Hospital files informational tax returns in the U.S. federal jurisdiction and New York State.

Schedule D (Form 990) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			1,117,496	1,084,037	33,459	0.09 %
b	Medicaid (from Worksheet 3, column a) . . . . .			8,319,128	5,181,388	3,137,740	8.17 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	9,436,624	6,265,425	3,171,199	8.26 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			54,279		54,279	0.14 %
f	Health professions education (from Worksheet 5) . . .			24,852		24,852	0.06 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			49,269		49,269	0.13 %
j	Total. Other Benefits . .	0	0	128,400	0	128,400	0.33 %
k	Total. Add lines 7d and 7j .	0	0	9,565,024	6,265,425	3,299,599	8.59 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

764,774

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

124

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

6,163,255

Enter Medicare allowable costs of care relating to payments on line 5.....

6,729,554

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-566,299

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	St James Hospital 411 Canisteo Street Hornell,NY14843 www.urmc.rochester.edu/st-james 5002001H	X	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	St James Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Supplemental Information

Other website (list url): See Supplemental Information

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Supplemental Information

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	St James Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200%
and FPG family income limit for eligibility for discounted care of 300%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Supplemental Information

The FAP application form was widely available on a website (list url):

See Supplemental Information

A plain language summary of the FAP was widely available on a website (list url):
See Supplemental Information

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	St James Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	St James Hospital
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5-St James Hospital	THE COMMUNITY NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN 2018 IN COLLABORATION WITH STEUBEN COUNTY PUBLIC HEALTH. THIS INCLUDED THE THREE HOSPITALS LOCATED WITHIN THE COUNTY. A VARIETY OF PARTNERS WERE ENGAGED THROUGHOUT THE PROCESS INCLUDING REPRESENTATIVES FROMLOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS), COMMUNITY BASED ORGANIZATIONS(CBOS), THE COUNTY LEGISLATURE, COUNTY GOVERNMENT EMPLOYEES, SCHOOL DISTRICT REPRESENTATIVES, OFFICE FOR THE AGING, AND MORE. THE COMMUNITY AT LARGE WAS ENGAGED THROUGHOUT THE ASSESSMENT PERIOD VIA A REGIONAL HEATH SURVEY IN 2018 (MY HEALTH STORY 2019) AND FOCUS GROUPS. A FULL LIST OF PARTICIPANTS CAN BE FOUND IN THE COMMUNITY SERVICE PLAN LOCATED ON THE ST JAMES HOSPITAL WEBSITE.
Schedule H, Part V, Section B, Line 6a-St James Hospital	Arnot Health - Ira Davenport Memorial Hospital, Guthrie Corning Hospital, St. James Hospital
Schedule H, Part V, Section B, Line 6b-St James Hospital	CENTER FOR COMMUNITY HEALTH AND PREVENTION, CENTER FOR TOBACCO FREE FINGER LAKES, FINGER LAKES COMMUNITY HEALTH, OAK ARCHARD HEALTH, PREGNANCY RESOURCE CENTER OF THE VALLEY, PROACTION, STEUBEN COUNTY ALCOHOL AND SUSTANCE ABUSE SERVICES/MENTAL HEALTH, STEUBEN COUNTY PUBLIC HEALTH, STEUBEN RURAL HEALTH NETWORK, STTAC
Schedule H, Part V, Section B, Line 7a-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/st-james/images/Steuben-CHA-and-CHIP-2019-2021.pdf
Schedule H, Part V, Section B, Line 7b-St James Hospital	https://www.steubencony.org/Files/Documents/publichealth/Steuben%20CHA%20and%20CHIP%2012-2-19.pdf
Schedule H, Part V, Section B, Line 10a-St James Hospital	https://www.urmc.rochester.edu/st-james/patients-visitors.aspx
Schedule H, Part V, Section B, Line 11-St James Hospital	PRIORITY: PREVENT CHRONIC DISEASES - FOCUS AREA - TOBACCO PREVENTION - INTERVENTION - ASSIST MEDICAL AND BEHAVIORAL HEALTH CARE ORGANIZATIONS AND PROVIDER GROUPS IN ESTABLISHING POLICIES, PROCEDURES, AND WORKFLOWS TO FACILITATE THE DELIVERY OF TOBACCO DEPENDENCE TREATMENT, CONSISTENT WITH THE PUBLIC HEALTH SERVICE CLINICAL PRACTICE GUIDELINES, COMMUNITY HEALTH CENTERS AND BEHAVIORAL HEALTH PROVIDERS: ST. JAMES HOSPITAL AND ST JAMES PRIMARY CARE ASSESS PATIENTS FOR TOBACCO USE AND PROVIDE TOBACCO CESSATION EDUCATION AND ALSO REFER PATIENTS TO NY QUITS IF PATIENT IS AGREEABLE. TREATMENT OPTIONS ARE DISCUSSED AND OFFERED TO PATIENT. FOCUS AREA 2 - PREVENT MENTAL & SUBSTANCE USE DISORDERS - INTERVENTION - BUILD SUPPORT SYSTEMS TO CARE FOR OPIOD USERS OR AT RISK OF AN OVERDOES. ST. JAMES HOSPITAL IS LINKING ED PROVIDERS WITH I-STOP. SJH IS WORKING WITH CASA TRINITY TO IDENTIFY PATIENTS WITH SUSBSTANCE ABUSE CONCERNS WHETHER NEW OR CHRONIC. SJH REACHES OUT TO CASA'S CASE WORKER WHO COMES DIRECTLY ON-SITE AT THE HOSPITAL TO GET THEM LINKED WITH THEIR PROGRAM (EITHER INPATIENT OR OUTPATIENT). IF THE PATIENT IS IN WITHDRAWAL AT THE TIME OF ARRIVAL TO SJH, THEY ARE ADMITTED AND PROVIDED CARE TO SAFELY GET THROUGH THE ACTUE DETOX/WITHDRWAWL PHASE. THEY ARE LINKED WITH CASA FROM THE TIME THEY ARRIVE. ALSO PROVIDE EDUCATION AND TRAINING TO ED PROVIDERS FOR PIOATE PRESCRIBING. INTERVENTION - PREVENT SUICIDES - IDENTIFY AND SUPPORT PEOPLE AT RISK: GATEKEEPER TRAINING, CRISIS INTERVENTION, TREATMENT FOR PEOPLE AT RISK OF SUICIDE, TREATMENT TO PREVENT RE-ATTEMPTS, POSTVENTION, SAFE REPORTING AND MESSAGING ABOUT SUICIDE. SJH'S PSYCHIATRIC ASSESSMENT OFFICER (PAO) IS LOCATED IN THE EMERGENCY DEPARTMENT. THE PAO CONNECTS MENTAL HEALTH PATIENTS AND SUBSTANCE ABUSE PATIENTS WITH COMMUNITY RESOURCES. THE PAO WORKS WITH A TELEPSCYH PSCYHIATRIST TO IDENTIFY THE NEED FOR INPATIENT TREATMENT AS WELL. THIS HELPS TO KEEP PATIENTS WITHIN THEIR OWN COMMUNITY AND NOT TO TRAVEL OUTSIDE THE COMMUNITY UNLESS THE NEED FOR FURTHER SERVICES IS AVAILABLE.
Schedule H, Part V, Section B, Line 16a-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/st-james/images/SJMH-Charity-Care-Summary.pdf
Schedule H, Part V, Section B, Line 16b-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/st-james/images/2020-FSP-app_1.pdf
Schedule H, Part V, Section B, Line 16c-St James Hospital	https://www.urmc.rochester.edu/st-james/patients-visitors/financial.aspx#finasst

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part I, Line 7	The cost-to-charge ratio is used for Lines 7A and 7B, computed by taking total expenses divided by total gross patient revenue.
Schedule H, Part I, Line 7, Column f	Due to the adoption of new accounting pronouncement ASC 606, current year implicit price concessions are treated as a contra-revenue item on the statement of revenue.
Schedule H, Part III, Section A, Line 4	Line 2 - The costing methodology used in determining the amounts reported on lines 2 and 3 are based on actual charges written off (amounts that are deemed to be uncollectible and recorded as implicit price concessions under new accounting pronouncement ASC 606). The test of the implicit price concession (Bad Debt Expense) footnote can be found on page 8 of the electronically attached audited financial statements.
Schedule H, Part III, Section B, Line 8	To determine Medicare allowable costs reportable in the Medicare cost report, the cost-to-charge ratio is applied to gross patient revenue associated with services performed for patients who are eligible for Medicare
Schedule H, Part III, Section C, Line 9b	A bad debt results from a patient account balance from which payment was anticipated from the patient, credit extended and the account later deemed to be uncollectible. A bad debt does not meet the criteria for charity care, that is, bad debt patients are considered to have the financial capability and ability to pay, but are unwilling to pay. Collection activities are only pursued with respect to amounts that patients are able to pay as determined by the Hospital's charity care policy. NO collection activities take place with respect to amounts that patients are not expected to pay under this policy. A separate charity care policy is in place and would be exhausted before a patient balance would be deemed Self=pay. Under the charity care policy, charity care/financial assistance is provided to a patient with a demonstrated inability to pay. A patient is eligible for charity care/financial assistance consideration based upon meeting certain income eligibility criteria as established by the federal poverty income guideline sliding scale. Per NYS PHL 2807K, this considers patients whose household income in up to 300% of the most recent federal poverty guidelines. All uninsured, low-income patients within St. James Hospital's primary service area who can demonstrate an inability to pay charge may apply for charity care/financial assistance for adjustments to their balances for all medically necessary healthcare services, provided that a member, in good standing of St. James hospital's medical staff determines the need for such medical care.
Schedule H, Part VI, Line 2	In conjunction with the community needs assessment that is done every three years in conjunction with Steuben County Public Health, the organization uses the following to determine the health needs of the community: community town hall meetings, surveying participants at public health education programs, local case management meetings, and physician/medical office information shared. In addition, regional data and information from DSRIP projects is used to assess community need. St. James Hospital conducts a community needs assessment every three years in conjunction with Steuben County Public Health. Based on resident's feedback the county's health care priorities, strategies, and programs are determined. St. James Hospital creates an annual plan based on this assessment, and the progress of these initiatives is reported annually to the NYS Department of Health. Local Health Care Priorities are also identified through surveying participants at public health education programs.
Schedule H, Part VI, Line 3	At the time of registration, all self-pay individuals receive an information sheet describing the types of Federal, State and Local government programs available including St. James Hospital's charity care policy. The eligibility process is coordinated by a financial counselor, who contacts the patient or patient family member by phone and/or letter. Patients who qualify for Medicaid are also directed to an in-house facilitated enroller, who coordinates the Medicaid application process on behalf of the patient.
Schedule H, Part VI, Line 4	The primary service area for St. James Hospital is the 15-mile radius extending from Hornell, (Steuben County), New York, and includes the towns of Wayland to the northeast and Troupsburg to the southeast (just outside of the 15-miles radius). The secondary service area is the 30-mile radius extending from Hornell, per the 2010 census, the population for the primary service area (Steuben County) remained relatively flat, increasing 0.3% from 2000 to 2010 to 90,990 and is projected to remain flat throughout 2014. The population aged 65 and over comprises 16% of the primary service area compared to 13% for New York State. The population is racially and ethnically homogenous with 95.3% white, 1.6% black, 1.4% Hispanic/Latino, and 1.2% Asian. Persons over the age of 65 represent 15.6% of the county, 2percentage points higher than the state. Median household income is $42,764 compared to $54,554 for the state. Approximately 20% of the county population have a bachelor's degree or higher compared to 32% of the state.
Schedule H, Part VI, Line 5	St. James Hospital is the lead agency for the cancer services program (CSP) of Steuben County. A community-based, grant-funded program of New York State Department of Health (NYSDOH), the SCP Serves uninsured men and women with comprehensive, age-appropriate, no-cost screenings for breast, cervical and colorectal cancer. In addition, St. James Hospital received the NYSDOH Breast and Prostate peer education program in 2016 and began implementation of a community education based program. St. James Hospital participates in coordinating the annual healthy kid's day at the Maple City kid's quarter miler. This event is directed to parents and community youth and includes a pediatric health fair and a longstanding community kids "fun run" to promote exercise and healthy lifestyles. The organization participates in local health fairs and works with local businesses to promote workplace wellness via the CSP program mentioned above. In addition, St. James Hospital operates a cardiac rehab program and a Coumadin clinic that provide outpatient based services to the community. A collaboration with Noyes Memorial Hospital supports a diabetes education program available to the community. St. James Hospital staff members throughout the organization participate in community initiatives and hold seats on boards, including the Steuben Rural Health Network, YMCA, United Way of the Southern Tier, Smart Steuben, Steuben prevention coalition and other non-profit organizations whose primary mission is to assess and address community needs. St. James Hospital welcomes community organizations to utilize space for meetings, programs and activities that are deem supportive to the health of the community, this includes support groups, drier safety programs and blood drives.
Schedule H, Part VI, Line 6	THE UNIVERSITY OF ROCHESTER MEDICAL CENTER IS AN INTEGRATED ACADEMIC HEALTH CENTER THAT COMPRISES THE SCHOOL OF MEDICINE AND DENTISTRY, INCLUDING ITS FACULTY PRACTICE-UNIVERSITY OF ROCHESTER MEDICAL FACULTY GROUP; STRONG MEMORIAL HOSPITAL; HIGHLAND HOSPITAL; GOLISANO CHILDREN'S HOSPITAL; JAMES P. WILMOT CANCER CENTER; STRONG WEST; SCHOOL OF NURSING; EASTMAN INSTITUTE FOR ORAL HEALTH; VISITING NURSE SERVICE; HIGHLANDS AT PITTSFORD; THE HIGHLANDS LIVING CENTER, INC.; HIGHLANDS AT BRIGHTON, FF THOMPSON HEALTH SYSTEM, INC., JONES MEMORIAL HOSPITAL, NOYES HEALTH, ST. JAMES HOSPITAL AND ACCOUNTABLE HEALTH PARTNERS, LLC. URMC AND THE AFFILIATED HEALTH CARE ENTITIES HAVE EMBRACED A COMPREHENSIVE APPROACH TO COMMUNITY HEALTH, WHICH EMPLOYS THE MULTIDISCIPLINARY SKILLS FOUND IN AN ACADEMIC MEDICAL CENTER TO BOTH PROVIDE IMPORTANT COMMUNITY SERVICES AND CONDUCT COMMUNITY-BASED RESEARCH. THESE ACTIVITIES HELP INFORM POLICYMAKERS AND THE COMMUNITY ABOUT LOCAL HEALTH CHALLENGES, EVALUATE THE EFFECTIVENESS OF INTERVENTIONS, AND SERVE AS A FOUNDATION FOR EVIDENCE-BASED PRACTICES TO IMPROVE HEALTH AND OVERALL QUALITY OF LIFE. - THE UNIVERSITY'S HEALTH CARE DELIVERY NETWORK IS ANCHORED BY STRONG MEMORIAL HOSPITAL, AN 838 BED TEACHING HOSPITAL, WHICH INCLUDES A CHILDREN'S HOSPITAL-GOLISANO CHILDREN'S HOSPITAL. PATIENTS BENEFIT FROM THE MEDICAL CENTER'S ROBUST TEACHING AND BIOMEDICAL RESEARCH PROGRAMS. STUDENT ROSTERS INCLUDE APPROXIMATELY 400 MEDICAL STUDENTS, 500 GRADUATE STUDENTS, AND 890 RESIDENTS AND FELLOWS WHO ARE ENGAGED IN COMMUNITY SERVICE THROUGHOUT THEIR EDUCATION. - EASTMAN INSTITUTE FOR ORAL HEALTH PROVIDES COMMUNITY DENTAL CARE IN A NUMBER OF CLINICS, AS WELL AS CLINICAL EDUCATION TO DENTAL STUDENTS ENROLLED AT THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY. IT OFFERS GENERAL DENTISTRY, PEDIATRIC AND ORTHODONTIC CLINICS, AND AN URGENT CARE DENTAL CLINIC THAT SEES 10 - 50 PATIENTS PER DAY. IT OPERATES LOW-INCOME CLINICS AT SCHOOLS AND A DOWNTOWN LOCATION. ADDITIONALLY, FOUR SMILEMOBILES PROVIDE A DENTAL OFFICE ON WHEELS, ALLOWING THE CITY'S CHILDREN INCREASED ACCESS TO MUCH NEEDED DENTAL CARE. - THE JAMES P. WILMOT CANCER CENTER IS ORGANIZED AROUND A MULTIDISCIPLINARY CARE MODEL, WHICH LEADING CANCER EXPERTS BELIEVE IS THE GOLD STANDARD IN CANCER CARE IN THE 21ST CENTURY. ITS MODEL UNDERSCORES A COMMITMENT TO PROVIDE PATIENTS IN THE ROCHESTER AREA WITH THE MOST UP-TO-DATE INFORMATION AND AVAILABLE TREATMENTS, BASING OUR RECOMMENDATIONS ON THE BEST EVIDENCE. IT IS THE ONLY CENTER IN THE ROCHESTER AND FINGER LAKES REGION OFFERING THIS TEAM APPROACH TO CARE. A VARIETY OF FREE PREVENTIVE EDUCATION EVENTS ARE HELD THROUGHOUT THE YEAR, INCLUDING MEN'S HEALTH DAY, WHICH INCLUDES NUMEROUS FREE HEALTH SCREENINGS; FREE SKIN CANCER SCREENINGS; AND BREAST CANCER SCREENINGS FOR THE UNINSURED AND UNDERINSURED. - GOLISANO CHILDREN'S HOSPITAL, HOUSED IN STRONG MEMORIAL HOSPITAL, IS A 124-BED CHILDREN'S HOSPITAL THAT SERVES AS THE REFERRAL CENTER FOR ALL SERIOUSLY ILL OR INJURED CHILDREN FROM THE 17-COUNTY FINGER LAKES REGION. IT COMBINES AWARD-WINNING RESEARCH, INTERNATIONALLY ACCLAIMED EDUCATION AND COMPASSIONATE CARE TO SERVE CHILDREN AND FAMILIES. PEDIATRIC SPECIALTIES INCLUDE ORTHOPAEDICS, NEUROLOGY/NEUROSURGERY, CANCER AND NEONATAL CARE. IN ADDITION TO THESE TRADITIONAL MEDICAL SERVICES, GOLISANO CHILDREN'S HOSPITAL IS THE NATION'S MODEL FOR "COMMUNITY PEDIATRICS", A PHILOSOPHY THAT EMBRACES THE IDEA THAT A CHILD'S COMMUNITY AND ENVIRONMENT AFFECT HIS HEALTH AND, THEREFORE, HE CANNOT BE TREATED SOLELY IN AN EXAM ROOM. THE HOSPITAL ENCOURAGES PHYSICIANS AND STAFF TO PARTNER WITH COMMUNTIY ORGANIZAITONS TO IMPROVE VACCINATION RATES, EDUCATIONAL OPPORTUNITIES, SAFETY AT HOME AND ON PLAYGROUNDS, AND HEALTH INSURANCE AND HEALTH CARE ACCESS. - THE STRONG WEST CAMPUS, WHICH IS LOCATED APPROXIMATELY 20 MILES WEST OF ROCHESTER IN BROCKPORT, NY WAS ACQUIRED BY THE UNIVERSITY IN 2013. IT IS THE SITE OF THE FORMER 61 BED LAKESIDE MEMORIAL HOSPITAL, WHICH ANNOUNCED IT WAS CLOSING IN APRIL, 2013, LEAVING THE COMMUNITY WITHOUT AN EMERGENCY ROOM AND LOCAL ACCESS TO OTHER HEALTH CARE SERVICES. STRONG MEMORIAL HOSPITAL NOW OPERATES A FREE-STANDING EMERGENCY ROOM ON THE STRONG WEST CAMPUS, IN ADDITION TO OFFERING AMBULATORY SURGERY, HEALTH IMAGING, LABORATORY SERVICES, PRIMARY CARE, ORTHOPAEDICS, CARDIAC CARE, ONCOLOGY AND HEMATOLOGY, SLEEP MEDICINE, NEUROLOGY, AND UROLOGY SERVICES. THE UNIVERSITY'S WHOLLY OWNED HEALTH CARE AFFILIATES ARE: STRONG PARTNERS HEALTH SYSTEM, INC. AND AFFILIATES IN JUNE 1997, HIGHLAND HOSPITAL AND ITS AFFILIATES AND THE UNIVERSITY BECAME AFFILIATED THROUGH THE RESTRUCTURING OF A CORPORATION NOW KNOWN AS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"), OF WHICH THE UNIVERSITY IS THE SOLE MEMBER. SPHS, A NOT-FOR-PROFIT CORPORATION, NOW SERVES AS THE CORPORATE PARENT OF HIGHLAND HOSPITAL AND THE UNIVERSITY'S LONG TERM CARE AFFILIATES. A BRIEF DESCRIPTION OF THE SPHS AFFILIATES FOLLOWS: HIGHLAND HOSPITAL OF ROCHESTER IS A 261-BED NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN ROCHESTER, NEW YORK. THE HOSPITAL'S SERVICES INCLUDE MEDICAL/SURGICAL CARE, INTENSIVE CARE, MATERNITY AND EMERGENCY CARE. IN ADDITION, THE HOSPITAL OWNS AND OPERATES 21 OUTPATIENT EXTENSION CLINICS, PROVIDING PRIMARY CARE, PRENATAL CARE, RADIOLOGY, AND/OR THERAPEUTIC RADIOLOGY SERVICES. HIGHLAND COMMUNITY DEVELOPMENT CORPORATION HIGHLAND COMMUNITY DEVELOPMENT CORPORATION ("HCDC") IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES THE HIGHLANDS AT PITTSFORD, A RETIREMENT COMMUNITY LOCATED IN PITTSFORD, MONROE COUNTY, NEW YORK. THE RETIREMENT COMMUNITY INCLUDES 130 INDEPENDENT LIVING APARTMENTS, 36 INDEPENDENT LIVING COTTAGES, 60 ENRICHED HOUSING UNITS, A COMMUNITY COMMON AREA, A DINING ROOM, SITTING AREAS, RECREATIONAL AREAS, A WELLNESS CENTER, AND A COMMUNITY CENTER. HCDC ALSO OWNS AND OPERATES LAURELWOOD AT THE HIGHLANDS, AN ASSISTED LIVING FACILITY INCLUDING 68 APARTMENTS LOCATED ON THE SAME CAMPUS AS THE HIGHLANDS AT PITTSFORD. THE HIGHLANDS LIVING CENTER, INC. THE HIGHLANDS LIVING CENTER, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A 122-BED SKILLED NURSING FACILITY AND AN ADULT DAY CARE HEALTH PROGRAM FOR SENIORS IN PITTSFORD, MONROE COUNTY, NEW YORK. THE SKILLED NURSING FACILITY IS ADJACENT TO THE HIGHLANDS AT PITTSFORD. THE HIGHLANDS AT BRIGHT ONTHE MEADOWS AT WESTFALL, INC. D/B/A/ THE HIGHLANDS AT BRIGHTON ("HAB") IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A 145-BED SKILLED NURSING FACILITY IN BRIGHTON, MONROE COUNTY, NEW YORK. HIGHLAND FACILITIES DEVELOPMENT CORPORATION HIGHLAND FACILITIES DEVELOPMENT CORPORATION ("HFDC") IS A NOT-FOR-PROFIT CORPORATION WHOSE PRIMARY PURPOSE IS TO PROVIDE SERVICES THAT ARE SUBSTANTIALLY RELATED TO THE CHARITABLE PURPOSES OF HIGHLAND HOSPITAL BUT DO NOT INVOLVE THE PROVISION OF HEALTH CARE SERVICES. HFDC OWNS AND OPERATES A MEDICAL OFFICE BUILDING AND A PARKING GARAGE ON THE HOSPITAL CAMPUS. MEDICAL ADMINISTRATIVE ASSOCIATES, INC. HIGHLAND HOSPITAL IS THE SOLE SHAREHOLDER OF MEDICAL ADMINISTRATIVE ASSOCIATES, INC., D/B/A HIGHLAND SOUTH WEDGE PHARMACY, WHICH IS A FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A RETAIL PHARMACY IN ROCHESTER, NEW YORK. THE HIGHLAND FOUNDATION, INC. THE HIGHLAND FOUNDATION, INC. IS A NOT-FOR-PROFIT CORPORATION CONTROLLED BY HIGHLAND HOSPITAL WHICH SOLICITS, RECEIVES AND MAINTAINS FUNDS FOR THE SUPPORT OF HIGHLAND HOSPITAL AND THE LONG TERM CARE AFFILIATES. STRONG HOME CARE GROUP AND AFFILIATES THE UNIVERSITY AFFILIATED WITH VISITING NURSE FOUNDATION, INC. IN APRIL 1999, WHICH IS A NOT-FOR-PROFIT CORPORATION NOW KNOWN AS STRONG HOME CARE GROUP ("SHCG"). THE UNIVERSITY IS THE SOLE CORPORATE MEMBER OF SHCG. SHCG SERVES AS THE CORPORATE PARENT OF THE UNIVERSITY'S HOME HEALTH CARE AFFILIATES. SHCG IS THE CORPORATE PARENT OF TWO NOT-FOR-PROFIT HOME HEALTH CARE PROVIDERS, UR MEDICINE HOME CARE, CERTIFIED SERVICES, INC. ("CERTIFIED SERVICES") (FORMERLY NAMED VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC.), WHICH OPERATES A LICENSED HOME CARE SERVICES AGENCY.
Schedule H, Part VI, Line 7	New York -- Schedule H Part VI - Line 6 Continued:IN OCTOBER 2014, FINGER LAKES VISITING NURSE SERVICE, INC., WHICH OPERATES A NOT-FOR-PROFIT CERTIFIED HOME HEALTH AGENCY AND A HOSPICE, AND FINGERLAKES HOME CARE, INC., WHICH OPERATES A NOT-FOR-PROFIT LICENSED HOME CARE SERVICES AGENCY, BECAME UNIVERSITY AFFILIATES. CERTIFIED SERVICES IS THE SOLE CORPORATE MEMBER OF THE FINGER LAKES HOME HEALTH AFFILIATES. CERTIFIED SERVICES AND FINGER LAKES VISITING NURSE SERVICE, INC. ARE IN THE FINAL STAGES OF A CORPORATE MERGER. IN 2018, SHCG FORMED TWO NEW WHOLLY CONTROLLED, NOT-FOR-PROFIT SUBSIDIARIES: UR MEDICINE HOME CARE, COMMUNITY SERVICES, INC., WHICH OPERATES CERTAIN COMMUNITY-BASED PROGRAMS THAT PROVIDE HOME-BASED SERVICES THAT ARE NOT REGULATED BY THE DEPARTMENT OF HEALTH OR SUBJECT TO THE MEDICARE CONDITIONS OF PARTICIPATION, INCLUDING PROGRAMS SUCH AS MEALS ON WHEELS, WHICH WAS FORMERLY OPERATED BY CERTIFIED SERVICES; AND UR MEDICINE HOME CARE FOUNDATION, INC., WHICH SOLICITS, RECEIVES AND MAINTAINS FUNDS FOR THE SUPPORT AND BENEFIT OF THE HOME CARE AFFILIATES. F.F. THOMPSON HEALTH SYSTEM, INC. AND AFFILIATES IN SEPTEMBER 2012, THE UNIVERSITY AFFILIATED WITH F.F. THOMPSON HEALTH SYSTEM, INC. ("FFTHS"), WHICH IS THE CORPORATE PARENT OF A HOSPITAL ANDOTHER AFFILIATES LOCATED IN CANANDAIGUA, ONTARIO COUNTY, NEW YORK. THE UNIVERSITY IS THE SOLE MEMBER OF FFTHS. A BRIEF DESCRIPTION OF THE FFTHS AFFILIATES FOLLOWS: THE FREDERICK FERRIS THOMPSON HOSPITAL THE FREDERICK FERRIS THOMPSON HOSPITAL IS A 113-BED NOT-FOR-PROFIT ACUTE CARE HOSPITAL. ITS SERVICES INCLUDE MEDICAL/SURGICAL CARE, INTENSIVE CARE, MATERNITY AND EMERGENCY CARE. IN ADDITION, THE HOSPITAL OWNS AND OPERATES 10 EXTENSION CLINICS, 9 OF WHICH PROVIDE PRIMARY HEALTH CARE SERVICE AND 1 OF WHICH PROVIDES OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY. M.M. EWING CONTINUING CARE CENTER M.M. EWING CONTINUING CARE CENTER INC. IS A NOT-FOR-PROFIT CORPORATION THAT OPERATES A 188-BED SKILLED NURSING FACILITY AND ADULT DAY CARE PROGRAM ADJACENT TO F.F. THOMPSON HOSPITAL. F.F.T. SENIOR COMMUNITIES, INC. F.F.T. SENIOR COMMUNITIES, INC. IS A NOT-FOR-PROFIT CORPORATION THAT OPERATES FERRIS HILLS AT WESTLAKE, A RESIDENTIAL COMMUNITY CONSISTING OF 84 INDEPENDENT LIVING UNITS AND CLARK MEADOWS, CONSISTING OF 48 ENRICHED LIVING UNITS. THE F.F. THOMPSON FOUNDATION, INC. THE F.F. THOMPSON FOUNDATION, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH SOLICITS, RECEIVES AND MAINTAINS FUNDS FOR THE SUPPORT AND BENEFIT OF FFTHS AND ITS AFFILIATES. FFTH PROPERTIES AND SERVICES, INC. (PROPERTIES) FFTH PROPERTIES AND SERVICES, INC. IS A FOR-PROFIT NEW YORK STATE BUSINESS CORPORATION ORGANIZED FOR THE PURPOSE OF OWNING, DEVELOPING AND OPERATING UNREGULATED REAL PROPERTY FOR THE BENEFIT OF FFTHS AND ITS AFFILIATES. PROPERTIES OWNS AND OPERATES A MEDICAL OFFICE BUILDING IN CANANDAIGUA, NEW YORK AND A MEDICAL OFFICE BUILDING IN THE TOWN OF FARMINGTON, NEW YORK. FINGER LAKES COMMUNITY CARE NETWORK, INC. (FLCCN) FINGER LAKES COMMUNITY CARE NETWORK, INC. IS A FOR-PROFIT NEW YORK STATE BUSINESS CORPORATION ORIGINALLY ORGANIZED FOR THE PURPOSE OF COORDINATING SERVICES AMONG THE HOSPITAL, PARTICIPATING PHYSICIANS AND INSURANCE INDUSTRY REPRESENTATIVES. FLCCN IS CURRENTLY INACTIVE. FFTHS MANAGEMENT IS REVIEWING THE CORPORATE STRUCTURE, FUNCTION AND FUTURE OF THE CORPORATION. ACCOUNTABLE HEALTH PARTNERS, LLC ("AHP") AND ACCOUNTABLE HEALTH PARTNERS - IPA, LLC ACCOUNTABLE HEALTH PARTNERS, LLC ("AHP") AND ACCOUNTABLE HEALTH PARTNERS - IPA, LLC IS A NETWORK OF PHYSICIANS EMPLOYED BY THE UNIVERSITY AND ITS AFFILIATED HOSPITALS, COMMUNITY BASED PHYSICIANS, AND OTHER AFFILIATED HOSPITALS THAT ARE CLINICALLY INTEGRATED AND NEGOTIATE REIMBURSEMENT CONTRACTS WITH LOCAL PAYERS AND SELF-INSURED BUSINESSES. THE UNIVERSITY, THROUGH STRONG MEMORIAL HOSPITAL, OWNS 25% OF AHP, WITH THE BALANCE OWNED BY OTHER HOSPITALS, UNIVERSITY-EMPLOYED PHYSICIANS, AFFILIATED HOSPITAL-EMPLOYED PHYSICIANS, AND COMMUNITY PHYSICIANS. AHP INSURANCE COMPANY AHP INSURANCE COMPANY IS A VERMONT BUSINESS CORPORATION THAT WAS FORMED BY AHP IN NOVEMBER 2016 TO ENGAGE IN THE BUSINESS OF INSURING AND REINSURING VARIOUS TYPES OF RISK AND IN PARTICULAR TO SERVE AS A CAPTIVE INSURANCE COMPANY FOR AHP, BY ESTABLISHING A RESERVE FUND TO PROTECT THE ORGANIZATION AGAINST POTENTIAL FUTURE LOSSES FROM DOWNSIDE RISK TAKEN ON ITS VALUE BASED CONTRACTS. AHP INSURANCE COMPANY IS WHOLLY OWNED BY AHP. LIVINGSTON HEALTH CARE SYSTEM, INC. ON JANUARY 1, 2016, THE UNIVERSITY BECAME THE SOLE CORPORATE MEMBER OF LIVINGSTON HEALTH CARE SYSTEM, INC. ("LHCS"), WHICH IS THE CORPORATE PARENT OF A HOSPITAL AND OTHER AFFILIATES LOCATED IN DANSVILLE, LIVINGSTON COUNTY, NEW YORK. A BRIEF DESCRIPTION OF THE LHCS AFFILIATES FOLLOWS: NOYES H. NOYES MEMORIAL HOSPITAL, INC. ("NOYES MEMORIAL HOSPITAL") NOYES MEMORIAL HOSPITAL IS A 67-BED NOT-FOR-PROFIT ACUTE CARE HOSPITALLOCATED IN DANSVILLE, NEW YORK. ITS SERVICES INCLUDE MEDICAL/SURGICAL CARE, INTENSIVE CARE, MATERNITY, AND EMERGENCY CARE. IN ADDITION, NOYES MEMORIAL HOSPITAL OPERATES AN AMBULATORY SURGERY AND MULTISPECIALTY EXTENSION CLINIC, AND 3 OTHER EXTENSION CLINICS PROVIDING MENTAL HEALTH, DIALYSIS AND PRIMARY CARE SERVICES, RESPECTIVELY. RED JACKET CENTER, INC. RED JACKET CENTER, INC. IS A NEW YORK STATE NOT-FOR-PROFIT CORPORATION ORGANIZED FOR THE PURPOSE OF OWNING, OPERATING AND MAINTAINING OFFICE BUILDINGS TO ATTRACT DOCTORS TO THE RURAL AREA OF DANSVILLE NEW YORK AND THE COUNTIES OF LIVINGSTON, STEUBEN AND ALLEGANY. RED JACKET CENTER, INC. OWNS AND OPERATES A MEDICAL OFFICE BUILDING IN GENESEO, NEW YORK THAT LEASES SPACE TO NOYES MEMORIAL HOSPITAL AND PRIVATE PHYSICIANS. THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM, INC. THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH SOLICITS, RECEIVES, AND MAINTAINS FUNDS FOR THE SUPPORT AND BENEFIT OF LCHS AND ITS NOT-FOR-PROFIT, TAX EXEMPT AFFILIATES. THE MEMORIAL HOSPITAL OF WILLIAM F. AND GERTRUDE F. JONES, INC. ON JANUARY 1, 2016, THE UNIVERSITY BECAME THE SOLE CORPORATE MEMBER OF THE MEMORIAL HOSPITAL OF WILLIAM F. AND GERTRUDE F. JONES, INC. (JONES MEMORIAL HOSPITAL), WHICH IS LOCATED IN WELLSVILLE, ALLEGANY COUNTY, NEW YORK. JONES MEMORIAL HOSPITAL IS A 70-BED NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN WELLSVILLE, NY. THE HOSPITAL'S SERVICES INCLUDE MEDICAL/SURGICAL CARE, INTENSIVE CARE, MATERNITY AND PEDIATRIC CARE. IN ADDITION, JONES MEMORIAL HOSPITAL OPERATES SIX EXTENSION CLINICS, PROVIDING PRIMARY CARE, PRENATAL CARE, AND/OR PEDIATRIC CARE. JONES MEDICAL SERVICES, P.C. IS A CAPTIVE PROFESSIONAL CORPORATION OF JONES MEMORIAL HOSPITAL THAT EMPLOYS PHYSICIANS AND ADVANCED PRACTICE PROVIDERS WHO ARE CONTRACTED TO THE HOSPITAL TO PROVIDE MEDICAL SERVICES IN THE WELLSVILLE, NEW YORK COMMUNITY. JONES MEMORIAL HOSPITAL IS THE SOLE MEMBER OF JONES MEMORIAL HOSPITAL FOUNDATION, A NOT-FOR-PROFIT CORPORATION THAT WAS FORMED IN AUGUST 2016AND SOLICITS, RECEIVES, AND MAINTAINS FUNDS FOR THE SUPPORT AND BENEFIT OF JONES MEMORIAL HOSPITAL AND ITS NOT-FOR-PROFIT, TAX EXEMPT AFFILIATES.

Schedule H (Form 990) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Aileen Shinaman Board Member	(i) (ii)	0 ------------- 291,012	0 ------------- 0	0 ------------- 19,250	0 ------------- 26,067	0 ------------- 74,458	0 ------------- 410,787	0 ------------- 0
2Steve Goldstein Board Member	(i) (ii)	0 ------------- 1,143,063	0 ------------- 5,000	0 ------------- 84,099	0 ------------- 486,254	0 ------------- 19,508	0 ------------- 1,737,924	0 ------------- 0
3Bryan O'Donovan President/CEO	(i) (ii)	217,257 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	8,550 ------------- 0	225,807 ------------- 0	0 ------------- 0
4John Robshaw Physician	(i) (ii)	427,557 ------------- 0	0 ------------- 0	48,077 ------------- 0	0 ------------- 0	24,121 ------------- 0	499,755 ------------- 0	0 ------------- 0
5M Tariq Randhawa Physician	(i) (ii)	308,925 ------------- 0	0 ------------- 0	113,276 ------------- 0	0 ------------- 0	5,907 ------------- 0	428,108 ------------- 0	0 ------------- 0
6Kevin Wentworth Physician Assistant	(i) (ii)	287,402 ------------- 0	0 ------------- 0	3,000 ------------- 0	0 ------------- 0	24,914 ------------- 0	315,316 ------------- 0	0 ------------- 0
7Giacomo Floria Chief Advanced Practice Provider	(i) (ii)	214,768 ------------- 0	0 ------------- 0	16,673 ------------- 0	0 ------------- 0	14,347 ------------- 0	245,788 ------------- 0	0 ------------- 0
8Kevin Briceland Physician Assistant	(i) (ii)	173,448 ------------- 0	18,333 ------------- 0	213 ------------- 0	0 ------------- 0	7,412 ------------- 0	199,406 ------------- 0	0 ------------- 0
9James Helms CFP/ VP of Finance	(i) (ii)	0 ------------- 147,984	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 10,751	0 ------------- 158,735	0 ------------- 0
10Michael Kamali MD Board Member	(i) (ii)	0 ------------- 621,632	0 ------------- 18,819	0 ------------- 2,527	0 ------------- 39,754	0 ------------- 26,984	0 ------------- 709,716	0 ------------- 0
11Ismail Mehr MD Board Member	(i) (ii)	472,640 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	472,640 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 4	THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED EMPLOYER PAID AMOUNTS THAT ARE INCLUDED IN DEFERRED COMPENSATION STEVEN GOLDSTEIN SERP PLAN 159,400 STEVEN GOLDSTEIN 457(f) PLAN 300,000 MICHAEL KAMALI, MD SERP PLAN 12,900

Schedule J (Form 990) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Return Reference	Explanation
Form 990, Part I, Line 1	Description of organization mission: St. James Hospital, governed by a self-perpetuating community based board, is a community of persons committed to being a transforming, healing presence within the rural communities we serve, particularly addressing the needs of the poor, underserved and disadvantaged.
Form 990, Part III (Cont. 1)	See the mission description above for Part I, line 1
Form 990, Part VI, Section A, Line 6	The sole member of St. James Hospital is the University of Rochester (UR). As such, UR has the authority to elect the governing body of St. James Hospital, and certain decisions of St. James Hospital are subject to the approval of UR. Such decisions include amendment of the certificate of incorporation and bylaws and approval of extraordinary corporate actions such as merger or dissolution.
Form 990, Part VI, Section A, Line 7a	Refer to Schedule O, Membership Information Form 990 Part VI, Section A, Line 6
Form 990, Part VI, Section A, Line 7b	Refer to Schedule O, Membership Information Form 990 Part VI, Section A, Line 6
Form 990, Part VI, Section B, Line 11b	A copy of the Form 990 was made available to each board member before it was filed. St. James Hospital has designed the audit and compliance committee as the group to be educated and to review the return.
Form 990, Part VI, Section B, Line 12c	Board members, officers and key employees (determined by the President & CEO) complete conflict of interest forms annually to identify actual and potential conflicts of interest that may exist relative to their duties with the organization and the organization's COI policy. The CEO shall disclose to the Board or appropriate committee thereof any employee disclosure made relevant to the matter and the evaluation thereof. Copies are provided to the Corporate Compliance Office and maintained by the executive assistant to the Board of Directors and CEO. IF a conflict is disclosed, that person shall leave the Board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The Chairperson of the Board of committee will determine if a conflict of interest exists. To help ensure compliance with the COI policy, among the provisions the person with an actual or potential conflict of interest will not be allowed to participate in an y discussion or decision in any are of the convict identified, and leave the room during discussion and vote. The Corporate Responsibility and Compliance Committee review these procedures every two (2) years to assess their effectiveness and recommend (or make) appropriate changes as needed to ensure the conflict of interest policy is consistently and effectively enforced. This was done with Board members on December 4, 2018.
Form 990, Part VI, Section B, Line 15	The board has an independent committee review and approval all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee reviews market data, comparative market compensation data, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations . All of these discussions and decisions are documented through the provision of meeting minutes.
Form 990, Part VI, Section C, Line 19	St. James Hospital's Form 1023 and Form 990 are available on request. St. James Hospital's governing documents, conflict of interest policy and audited financial statements are not routinely made available to the public.
Form 990, Part IX, Line 7	St. James Hospital contracts with an outside company to employee it's staff. The hospital reimburses all payroll and benefits to the contracted company, but reports the salaries and benefits as such on it's financial statements and in the functional expenses. The contracted company actually pays the employees directly and issues their W-2s and pays employment taxes. The Salaries reported on this line are the salary cost for these employees. The company is ER Select LLC - Tax ID 27-3654825 - the W-2s and payroll taxes would be submitted under their ID number.
Form 990, Part IX, Line 9	St. James Hospital contracts with an outside company to employee it's staff. The hospital reimburses all payroll and benefits to the contracted company, but reports the salaries and benefits as such on it's financial statements and in the functional expenses. The contracted company actually pays the employees directly and issues their W-2s and pays employment taxes. The other employee benefits reported on this line are all of the expenses for benefits and taxes paid to the contracted company.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JAMES HOSPITAL

Employer identification number

16-0743310

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)UNIVERSITY OF ROCHESTER 910 GENESEE STREET STE 200 ROCHESTER,NY14611 16-0743209	SCHOOL	NY	501 C (3)	2	N/A		No
(2)HIGHLAND HOSPITAL OF ROCHESTER 1000 SOUTH AVENUE ROCHESTER,NY14620 16-0743037	HOSPITAL	NY	501 C (3)	3	SPHS		No
(3)THE HIGHLAND FOUNDATION INC 1000 SOUTH AVENUE ROCHESTER,NY14620 23-7310662	FUNDRAISING	NY	501 C (3)	12A 1	HIGHLD HOSP		No
(4)HIGHLAND FACILITIES DEVELOPMENT CORP 1000 SOUTH AVENUE ROCHESTER,NY14620 22-3039077	MEDICAL BLDG	NY	501 C (3)	10	HIGHLD HOSP		No
(5)HIGHLAND COMMUNITY DEVELOPMENT CORP 100 HAHNEMANN TRAIL PITTSFORD,NY14534 22-3154715	ELDER CARE	NY	501 C (3)	10	SPHS		No
(6)THE HIGHLANDS LIVING CENTER INC 500 HAHNEMANN TRAIL PITTSFORD,NY14534 22-3240227	HEALTHCARE	NY	501 C (3)	10	SPHS		No
(7)THE MEADOWS AT WESTFALL INC 5901 LAC DE VILLE BLVD ROCHESTER,NY14618 16-1502303	HEALTHCARE	NY	501 C (3)	10	SPHS		No
(8)STRONG PARTNERS HEALTH SYSTEM INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER,NY14642 16-1499099	SUPPORT ORG	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(9)STRONG HOME CARE GROUP 2180 EMPIRE BOULEVARD WEBSTER,NY14580 22-2577664	FUNDRAISING	NY	501 C (3)	7	UNIV OF ROCH		No
(10)UR MEDICINE HOME CARE CERTIFIED SERVICES INC 2180 EMPIRE BOULEVARD WEBSTER,NY14580 16-0743215	HEALTHCARE	NY	501 C (3)	10	SHCG		No
(11)COMMUNITY CARE OF ROCHESTER 2180 EMPIRE BOULEVARD WEBSTER,NY14580 16-1561691	HEALTHCARE	NY	501 C (3)	10	SHCG		No
(12)EXCELL PARTNERS INC 343 STATE STREET KODAK TOWER 2nd Floor ROCHESTER,NY14650 20-1862628	ECONOMIC DEV	NY	501 C (4)	N/A	UNIV OF ROCH		No
(13)ROCHESTER BIOVENTURE CENTER INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER,NY14642 20-2485999	BIOTECH INCUB	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(14)NEXTCORPS INC 260 EAST MAIN STREET SUITE 6000 ROCHESTER,NY14604 16-1195028	BUSINESS INCU	NY	501 C (3)	7	UNIV OF ROCH		No
(15)UNIVERSITY OF ROCHESTER EMPLOYEE BENEFIT TRUST 910 GENESEE STREET SUITE 200 ROCHESTER,NY14611 16-1600112	EMPL BEN TRST	NY	501 C (9)	N/A	UNIV OF ROCH		No
(16)U OF R BROADCASTING CORPORATION 201 WILSON COMMONS ROCHESTER,NY14627 16-0743209	BROADCAST LIC	NY	501 C (4)	N/A	UNIV OF ROCH		No
(17)UR REAL ESTATE CORPORATION 263 WALLIS HALL ROCHESTER,NY14627 27-1140014	SUPPORT ORG	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(18)MELIORA REAL ESTATE CORPORATION 263 WALLIS HALL ROCHESTER,NY14627 45-2464788	SUPPORT ORG	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(19)F F THOMPSON HEALTH SYSTEM INC 350 PARRISH STREET CANANDAIGUA,NY14424 22-2959987	SUPPORT ORG	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(20)THE FREDERICK FERRIS THOMPSON HOSPITAL 350 PARRISH STREET CANANDAIGUA,NY14424 16-0743024	HOSPITAL	NY	501 C (3)	3	THS		No
(21)M M EWING CONTINUING CARE CENTER 350 PARRISH STREET CANANDAIGUA,NY14424 23-7046583	HEALTHCARE	NY	501 C (3)	3	THS		No
(22)F F T SENIOR COMMUNITIES INC 1 FERRIS HILLS CANANDAIGUA,NY14424 16-1557494	ELDER CARE	NY	501 C (3)	10	THS		No
(23)THE F F THOMPSON FOUNDATION INC 350 PARRISH STREET CANANDAIGUA,NY14424 22-2959984	FUNDRAISING	NY	501 C (3)	7	THS		No
(24)FINGER LAKES HOME CARE INC 756 PRE EMPTION ROAD GENEVA,NY14456 16-1489133	HEALTHCARE	NY	501 C (3)	10	URM HOME CARE		No
(25)FINGER LAKES VISITING NURSE SERVICE INC 756 PRE EMPTION ROAD GENEVA,NY14456 22-3067627	HEALTHCARE	NY	501 C (3)	10	URM HOME CARE		No
(26)THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC 191 NORTH MAIN STREET WELLSVILLE,NY14895 22-2807681	HOSPITAL	NY	501 C (3)	3	UNIV OF ROCH		No
(27)LIVINGSTON HEALTH CARE SYSTEM INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1455240	SUPPORT ORG	NY	501 C (3)	12A 1	UNIV OF ROCH		No
(28)NICHOLAS H NOYES MEMORIAL HOSPITAL INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-0743979	HOSPITAL	NY	501 C (3)	3	LHCS		No
(29)RED JACKET CENTER INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1037658	MEDICAL BLDG	NY	501 C (3)	12A 1	LHCS		No
(30)THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1584778	FUNDRAISING	NY	501 C (3)	7	LHCS		No
(31)JONES MEMORIAL HOSPITAL FOUNDATION 191 NORTH MAIN STREET WELLSVILLE,NY14895 47-3763374	SUPPORT ORG	NY	501 C (3)	7	JONES HOSP		No
(32)JONES MEDICAL SERVICES PC 191 NORTH MAIN STREET WELLSVILLE,NY14895 46-5210222	MEDICAL CLINIC	NY	501 C (3)	3	JONES HOSP		No
(33)ST JAMES FOUNDATION INC 411 CANISTEO STREET HORNELL,NY14843 16-1486437	FUNDRAISING	NY	501 C (3)	7	STJAMES HOSP		No
(34)UR MEDICINE HOME CARE COMMUNITY SERVICES INC 2180 EMPIRE BOULEVARD WEBSTER,NY14580 82-5091873	HEALTHCARE	NY	501 C (3)	10	SHCG		No
(35)UR MEDICINE HOME CARE FOUNDATION INC 2180 EMPIRE BOULEVARD WEBSTER,NY14580 83-1912967	SUPPORT ORG	NY	501 C (3)	12A 1	SHCG		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Excell Innovate NY Fund LP 343 State St Kodak Tower 2nd Fl Rochester,NY14650 46-2405519	Investment Fund	NY	ETV Inc
(2) Excell Minority and Women Owned Investment Fund LP 343 State St Kodak Tower 2nd Fl Rochester,NY14650 81-0723223	Investment Fund	NY	ETV Inc
(3) Excell Partners Innovative TC Fund LP 343 State St Kodak Tower 2nd Fl Rochester,NY14650 81-0711015	Investment Fund	NY	ETV Inc

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) MEDICAL ADMINISTRATIVE ASSOCIATES INC 777 SOUTH CLINTON AVENUE ROCHESTER,NY14620 16-1354319	RETAIL PHARMACY	NY	HIGHLD HOSP	C					No
(2) UR EQUITY HOLDINGS INC 110 OFFICE PARK WAY PITTSFORD,NY14534 27-3040889	HOLDING CO	DE	UNIV OF ROCH	C					No
(3) F F T H PROPERTIES AND SERVICES INC 350 PARRISH STREET CANANDAIGUA,NY14424 16-1286518	HOLDING CO	NY	THS	C					No
(4) FINGER LAKES COMMUNITY CARE NETWORK INC 350 PARRISH STREET CANANDAIGUA,NY14424 16-1423442	INACTIVE	NY	THS	C					No
(5) EXCELL TECHNOLOGY VENTURES INC 343 STATE STREET KODAK TOWER 2ND Floor ROCHESTER,NY14650 80-0909149	BIOTECH INCUBATOR	NY	ROCH BIOVENTURE	C					No
(6) ACCOUNTABLE HEALTH PARTNERS LLC 135 CORPORATE WOODS STE 320 ROCHESTER,NY14623 30-0787967	ACCT CARE NETWORK	NY	UNIV OF ROCH	C					No
(7) ACCOUNTABLE HEALTH PARTNERS IPA LLC 135 CORPORATE WOODS STE 320 ROCHESTER,NY14623 37-1746016	INDEP PRACTICE ASSOC	NY	AHP LLC	C					No
(8) AHP INSURANCE COMPANY 76 ST PAUL STREET SUITE 500 BURLINGTON,VT05401 81-4644839	CAPTIVE INSURANCE CO	VT	AHP LLC	C					No
(9) LUMINATE VENTURE CHALLENGE CORP 260 EAST MAIN STREET SUITE 6000 ROCHESTER,NY14604 82-3954131	BUSINESS INCU	NY	NEXTCORPS INC	C					No
(10) HORNELL MEDICAL VILLAGE LLC 7100 ROUTE 70A HORNELL,NY14843 61-1886763	HOLD REAL ESTATE	NY	ST JAMES HOSP	C	900,628	13,890,053	100 %		No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ST JAMES FOUNDATION INC	o	66,864	Actual Salary Expense
(2) HORNELL MEDICAL VILLAGE LLC	j	614,443	Lease of medical office space

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:	19009572
Software Version:	v1.00

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,401,665	31,839,048
9	Program service revenue (Part VIII, line 2g) .........	25,136,390	32,307,998
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	100,000	88,580
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	796,685	1,685,747
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	30,434,740	65,921,373
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	16,840,401	17,780,867
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	16,147,812	20,629,811
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	32,988,213	38,410,678
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,553,473	27,510,695
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	50,200,664	87,431,040
21	Total liabilities (Part X, line 26).............	25,669,644	35,389,325
22	Net assets or fund balances. Subtract line 21 from line 20.....	24,531,020	52,041,715

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 28,508,072 including grants of $ ) (Revenue $ 34,082,325 )
	ST. JAMES HOSPITAL IS AN ACUTE HEALTHCARE FACILITY PROVIDING ROUTINE, AMBULATORY AND ANCILLARY SERVICES. MAJOR SERVICES INCLUDE MEDICAL, SURGICAL, RADIOLOGY, AND LABORATORY. TOTAL ACUTE DISCHARGES FOR THE HOSPITAL WERE 835. OUTPATIENT REGISTRATIONS FOR THE HOSPITAL WERE 162,915. ST. JAMES HOSPITAL OPERATES SEVERAL PHYSICIAN PRACTICES. TOTAL OFFICE VISITS WERE 30,659, INCLUDING URGENT CARE.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses28,508,072

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,439,569	2,333,386	769,027

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	30,559,270

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,279,778

g	Noncash contributions included in lines 1a - 1f:$		1g	0

h Total. Add lines 1a-1f.......		31,839,048

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	443
6	Total number of volunteers (estimate if necessary) .............	6	22
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) John Weyand DC........................................................................ Board Member	1 .......................0	X	0	0	0
(19) John Eagleton........................................................................ Board Member	1 .......................0	X	0	0	0
(20) Skip Sullivan........................................................................ Board Member	1 .......................0	X	0	0	0

		Business Code
2a	Net Patient Service Revenue	621990	32,307,998	32,307,998	0	0
b
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		32,307,998

3 Investment income (including dividends, interest, and othersimilar amounts) ......			88,580	0	0	88,580
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents	0	123,203	6a
b	Less: rental expenses	0	0	6b
c	Rental income or (loss)	0	123,203	6c
d	Net rental income or (loss).......			123,203	123,203	0	0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	0	0	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ 0of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	URMC Revenue		900099	978,489	978,489	0	0
b	Lifeline Revenue		900099	252,736	252,736	0	0
c
d	All other revenue ....			331,319	331,319	0	0
e	Total. Add lines 11a–11d ......			1,562,544
12	Total revenue. See instructions.....			65,921,373	33,993,745	0	88,580

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0	0
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	334,551	117,070	217,481	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0	0	0	0
7	Other salaries and wages........	13,775,541	10,036,069	3,739,472	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	241,698	173,831	67,867	0
9	Other employee benefits .......	2,365,383	1,701,205	664,178	0
10	Payroll taxes ...........	1,063,694	765,018	298,676	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	148,908	39,679	109,229	0
c	Accounting ...........	80,000	0	80,000	0
d	Lobbying ...........	0	0	0	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0	0	0	0
12	Advertising and promotion ....	215,971	0	215,971	0
13	Office expenses .......	390,124	78,735	311,389	0
14	Information technology ......	0	0	0	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	853,314	273,705	579,609	0
17	Travel ............	0	0	0	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	0	0	0	0
20	Interest ...........	307,050	100,072	206,978	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	525,137	171,150	353,987	0
23	Insurance ...	376,398	122,674	253,724	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Physician Fees	6,276,741	6,276,741	0	0
b	Purchased Services	4,521,834	2,718,411	1,803,423	0
c	Medical Supplies	3,826,249	3,826,249	0	0
d	Equipment Rental/Leases	1,988,921	1,728,920	260,001	0
e	All other expenses	1,119,164	378,543	740,621	0
25	Total functional expenses. Add lines 1 through 24e	38,410,678	28,508,072	9,902,606	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,184,607	1	2,297,627
2	Savings and temporary cash investments .........			17,030	2	17,042
3	Pledges and grants receivable, net ......			12,254,049	3	6,184,345
4	Accounts receivable, net .............			3,307,803	4	3,125,489
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........			5,441,600	7	5,441,600
8	Inventories for sale or use ............			705,405	8	823,750
9	Prepaid expenses and deferred charges ......			245,365	9	152,483
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	53,259,949
b	Less: accumulated depreciation	10b	1,195,921	25,189,938	10c	52,064,028
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,854,867	15	17,324,676
16	Total assets. Add lines 1 through 15 (must equal line 33)...			50,200,664	16	87,431,040

17	Accounts payable and accrued expenses .....	16,658,653	17	14,500,251
18	Grants payable ...		18
19	Deferred revenue .........	0	19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	7,486,980	23	6,563,454
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	1,524,011	25	14,325,620
26	Total liabilities. Add lines 17 through 25..	25,669,644	26	35,389,325

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	24,531,020	27	50,430,179
28	Net assets with donor restrictions ...........	0	28	1,611,536
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	24,531,020	32	52,041,715
33	Total liabilities and net assets/fund balances ........	50,200,664	33	87,431,040