TY 2022 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/1099-NEC)
(1) JOHN M CARRIGG...................................................................... BOARD MEMBER 2ND V CHAIR	2.00 ................. 55.00	X	X	0	1,579,359	94,357
(2) ELIZABETH K BOLAND...................................................................... BOARD MEMBER	2.00 ................. 55.00	X		0	724,570	99,761
(3) DRAKE LAMEN MD...................................................................... BOARD MEMBER/PRES/CEO/CMO	57.00 .................	X	X	352,377	0	23,663
(4) CATHERINE M SCARLETT...................................................................... BOARD MEMBER/CHAIR TO 5/31/22	2.00 .................	X	X	0	0	0
(5) JOSEPH R STAGLIANO...................................................................... BOARD MEMBER/CHAIR	2.00 .................	X	X	0	0	0
(6) HEATHER FERRARESE...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(7) RIC FESTARINI...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(8) ERIC G LARSEN...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(9) DENISE REPPERT...................................................................... BOARD MEMBER/PRES OF AUX	2.00 .................	X	X	0	0	0
(10) ROBERT W NASSAR...................................................................... BOARD MEMBER SECRETARY	2.00 .................	X	X	0	0	0
(11) JULIE OEHLBECK...................................................................... BOARD MEMBER TREASURER	2.00 .................	X	X	0	0	0
(12) BRUCE S ERATH...................................................................... BOARD MEMBER 1ST VICE CHAIR	2.00 .................	X	X	0	0	0
(13) JAY SMITH...................................................................... BOARD MEMBER	2.00 ................. 55.00	X		0	391,900	26,852
(14) CARLOS SANTA INES JR MD...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(15) DOMINIC SHEA...................................................................... BOARD MEMBER	2.00 .................	X		0	0	0
(16) MARTIN MASARECH MD...................................................................... BOARD MEMBER	2.00 ................. 55.00	X		0	193,271	43,280
(17) KATHLEEN MIRATBITO VOSS...................................................................... BOARD MEMBER TO 5/31/22	2.00 .................	X		0	0	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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SHAUNA HYLE........................................................................ BOARD MEMBER	2.00 .......................	X					0	0	0
(19) KRISTINA K HUMMER........................................................................ VP OF MEDICAL	1.00 .......................55.00		X				175,894	0	30,162
(20) DESIREE AXLEY........................................................................ VP FINANCE AND CFO	55.00 .......................		X				208,710	0	5,445
(21) DAVID FINNEY........................................................................ VP, NURSING	55.00 .......................		X				0	161,481	38,852
(22) CHRISTINA KISACKY........................................................................ VP OF OPERATIONS	55.00 .......................		X				173,540	0	23,652
(23) WENDY SURDOVAL........................................................................ VP OF QUALITY MGMT	55.00 .......................		X				135,189	0	4,347
(24) PHYLLIS SHERIFF-WHITE........................................................................ PRES OF MED STAFF	55.00 .......................			X			325,977	0	24,674
(25) MARGARET SWARTWOOD........................................................................ CONTROLLER	55.00 .......................			X			162,675	0	16,070
(26) RICHARD STONE........................................................................ DIRECTOR OF SUPP SERV-FAC	55.00 .......................				X		118,107	0	30,909
(27) BRAXTON TOMSIC........................................................................ CARDIAC CARE MGR	55.00 .......................				X		104,374	0	14,591
(28) MELISSA STAGNARO........................................................................ EXEC DIR FOUNDATION	55.00 .......................				X		102,551	0	30,529
(29) LEIA TRACY........................................................................ STAFF NURSE	55.00 .......................				X		128,479	0	11,769
(30) PATRICIA ADAMS........................................................................ NURSING SUPERVISOR	55.00 .......................				X		129,528	0	3,010
(31) MATTHEW SALANGER TO 53118........................................................................ FORMER 2ND VICE CHAIR	0.00 .......................20.00					X	0	253,227	80
(32) ROHAN JAYASENA........................................................................ FORMER PRES OF MED STAFF TO 12/31/17	0.00 .......................55.00					X	387,239	0	51,623

(A) Name and business address	(B) Description of services	(C) Compensation
AMN HEALTHCARE PO BOX 56157 LOS ANGELES,CA90074	TEMPORARY SVCS	4,732,130
SUSQUEHANNA ANESTHESIA 156 CORLISS AVE JOHNSON CITY,NY13790	ANESTHESIA SVCS	2,139,615
CROTHALL HEALTHCARE 13028 COLLECTIONS CENTER DR CHICAGO,IL60693	HOUSEKEEPING SVCS	1,807,614
PARK AVE ASSOC IN RADIOLOGY 32-36 HARRISON ST JOHNSON CITY,NY13790	RADIOLOGY SVCS	1,448,439
SECO PHYSICAL AND OCC THERAPY PO BOX 1046 NORWICH,NY13815	THERAPY SVCS	1,279,837
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 31

- TIN:

SCHEDULE A
(Form 990)

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 5 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 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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 5 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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2022

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2022

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 0.015 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 0.035	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) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2022

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization CHENANGO MEMORIAL HOSPITAL INC

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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization CHENANGO MEMORIAL HOSPITAL INC		Employer identification number 15-0532180

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization CHENANGO MEMORIAL HOSPITAL INC			Employer identification number 15-0532180
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) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

12,431

Total. Add lines 1c through 1i ....................................................................................................

12,431

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	AMOUNT DISCLOSED IS THE LOBBYING PORTION OF DUES PAID TO THE HEALTHCARE ASSOCIATION OF NY, IROQUOIS HEALTHCARE ASSOCIATION AND LEADING AGE NY.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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

2021

Open to Public Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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) 2021

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 ....	22,706,421	17,098,616	11,463,530	6,800,829	7,611,346
b	Contributions ...	1,099,442	5,919,643	6,062,602	2,008,119	664,482
c	Net investment earnings, gains, and losses	-1,645,284	-12,986	-352,916	3,286,342	-844,488
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	14,412,551	298,852	74,600	631,760	630,511
f	Administrative expenses ....
g	End of year balance ......	7,748,028	22,706,421	17,098,616	11,463,530	6,800,829

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

78.980 %

Term endowment SchDMd Bullet

21.020 %

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 .....	195,653		195,653
b	Buildings ....	69,001,976	27,035,510	41,966,466
c	Leasehold improvements	2,812,584	1,847,202	965,382
d	Equipment ....	44,740,684	38,052,903	6,687,781
e	Other .....	273,459		273,459
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				50,088,741

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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)BENEFICIAL INTEREST IN CMH FOUNDATION				6,886,598
(2)ASSETS LIMITED TO USE- RESTRICTED CASH FOR EQUIPMENT				142,056
(3)OPERATING LEASE FOR RIGHT OF USE ASSETS				3,714,154
(4)OTHER ASSETS				703,596
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				11,446,404

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	18,520,677
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) 2021

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	89,823,833
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-22,428
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	1,396,723
e	Add lines 2a through 2d .....................			2e	1,374,295
3	Subtract line 2e from line 1..................			3	88,449,538
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	2,349,170
c	Add lines 4a and 4b....................			4c	2,349,170
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	90,798,708

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	85,375,283
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	0
3	Subtract line 2e from line 1...................			3	85,375,283
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	2,311,348
c	Add lines 4a and 4b.....................			4c	2,311,348
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	87,686,631

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
PART V, LINE 4:	THE INTENDED USE OF ENDOWMENT FUNDS IS A COMBINATION OF DESIGNATED SPECIAL PURPOSES AND GENERAL USE BY THE HOSPITAL.
PART X, LINE 2:	THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2022 AND 2021, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN FOR EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN INTEREST IN CHENANGO FOUNDATION -953,613. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT 3,668,418. CHANGE IN VALUE OF FUNDS HELD IN TRUST -1,321,351. CHANGE IN ACCOUNTING PRINCIPLE 3,269.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	AUXILIARY INCOME 44,933. BAD DEBT 2,304,237.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	AUXILIARY EXPENSES 7,361. BAD DEBT EXPENSE 2,304,237. RENTAL EXPENSE -250.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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: . . . . . . . .

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? . . . . . .

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? . . . . . . . . .

Yes

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

Yes

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		(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) . . .	694,000		694,000	0.790 %
b	Medicaid (from Worksheet 3, column a) . . . . .	16,542,573	12,448,582	4,093,991	4.670 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	17,236,573	12,448,582	4,787,991	5.460 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	835,542		835,542	0.950 %
f	Health professions education (from Worksheet 5) . . .	171,880	350	171,530	0.200 %
g	Subsidized health services (from Worksheet 6) . . . .	821,731	570,610	251,121	0.290 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,000		1,000	0 %
j	Total. Other Benefits . .	1,830,153	570,960	1,259,193	1.440 %
k	Total. Add lines 7d and 7j .	19,066,726	13,019,542	6,047,184	6.900 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	140,903	140,903	0.160 %
2	Economic development	9,671	9,671	0.010 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	6,173	6,173	0.010 %
7	Community health improvement advocacy	9,371	9,371	0.010 %
8	Workforce development	770,296	770,296	0.880 %
9	Other	2,881	2,881	0 %
10	Total	939,295	939,295	1.070 %

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. ......

2,304,237

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. ......

321,403

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).....

8,262,365

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

11,340,953

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

-3,078,588

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) 2022

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)					Other (describe)
1	CHENANGO MEMORIAL HOSPITAL INC 179 NORTH BROAD STREET NORWICH,NY13815 HTTPS://WWW.NYUHS.ORG	X	X	X	SOLE COMMUNITY

Schedule H (Form 990) 2022

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)

	CHENANGO MEMORIAL HOSPITAL INC
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 22

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): HTTPS://WWW.NYUHS.ORG

Other website (list url):

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 22

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

Yes

If "Yes" (list url): HTTPS://WWW.NYUHS.ORG

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CHENANGO MEMORIAL HOSPITAL INC
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 200.000000000000%
and FPG family income limit for eligibility for discounted care of %

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):

HTTPS://WWW.NYUHS.ORG

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

HTTPS://WWW.NYUHS.ORG

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.NYUHS.ORG

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	CHENANGO MEMORIAL HOSPITAL INC
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) 2022

Page 7

Part VFacility Information (continued)

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

	CHENANGO MEMORIAL HOSPITAL INC
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) 2022

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
CHENANGO MEMORIAL HOSPITAL, INC.	PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE.
PART V, SECTION B, LINE 5:	CHENANGO COUNTY DEPARTMENT OF PUBLIC HEALTH (CCPH) AND UHS CHENANGO MEMORIAL HOSPITAL (CMH) COLLABORATED TO CONDUCT THE 2022-2024 COMMUNITY HEALTH ASSESSMENT (CHA) AND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A NEEDS ASSESSMENT COMMITTEE WAS CREATED AND COMPRISED OF REPRESENTATIVES FROM CCPH, CMH, AND THE CHENANGO HEALTH NETWORK (CHN). THE COMMITTEE PROVIDED OVERSIGHT AND GUIDANCE TO THE ASSESSMENT PROCESS.PRIORITY SELECTION PROCESS CHENANGO COUNTY ENGAGED IN A PROCESS TO SELECT PRIORITIES AND ACTIVITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP)/COMMUNITY SERVICE PLAN (CSP). THE PROCESS ALLOWED SIGNIFICANT INPUT FROM STAKEHOLDERS AND INTEGRATED FEEDBACK FROM THE COMMUNITY. HEALTHCARE AND SOCIAL DETERMINANTS OF HEALTH DATA WERE COLLECTED FROM A VARIETY OF SOURCES INCLUDING, BUT NOT LIMITED TO, THE NYS DEPARTMENT OF HEALTH (NYSDOH), THE US CENSUS, THE NYS DEPARTMENT OF EDUCATION (NYSED), THE NYS OFFICE OF FAMILY AND CHILDREN (NYSOCFS), AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS). ADDITIONAL DATARESOURCES UTILIZED INCLUDED THE COUNTY HEALTH RANKINGS AND OTHER LOCAL NEEDS ASSESSMENT REPORTS. QUALITATIVE DATA WAS GATHERED FROM 781 CHENANGO COUNTY RESIDENTS THROUGH A COMMUNITY SURVEY. PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE MOST PRESSING HEALTH ISSUES FACING THE COUNTY, AS WELL AS THE BARRIERS AND CHALLENGES THEY FACE IN THEIR EFFORT TO LEAD HEALTHY LIVES. IN ADDITION, 10 KEY STAKEHOLDERS REPRESENTING A RANGE OF NON-PROFIT ORGANIZATIONS, GOVERNMENT AGENCIES AND PROVIDERS, WERE INTERVIEWED TO GAIN FURTHER INSIGHT INTO THE COUNTY'S HEALTH CARE STRENGTHS AND BARRIERS. BASED ON ALL QUALITATIVE DATA COLLECTED AND STAKEHOLDER INSIGHT, THE NEEDS ASSESSMENT COMMITTEE SELECTED INTERVENTIONS WITH THE GREATEST OPPORTUNITY TO OPTIMIZE ON CURRENT RESOURCES AND THOSE THAT WOULD HAVE THE GREATEST IMPACT ON THE FOCUS AREAS RELATED TO THE COUNTY'S MOST SIGNIFICANT HEALTH ISSUES.SELECTED PRIORITIES AND INTERVENTIONSPROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN HEALTH DISPARITY: CHENANGO COUNTY IS A RURAL UPSTATE COMMUNITY WITH A HIGH POVERTY RATE. STAKEHOLDERS REGULARLY SITE ACCESS AS A PRIMARY BARRIER TO CARE.INTERVENTION:GOAL 2.1: REDUCE INFANT MORTALITY AND MORBIDITY - CHENANGO COUNTY WILL UTILIZE A PROGRAM CALLED PROJECT SAFE SLEEP TO FOCUS ON SHARING INFORMATION ABOUT ACTIONS NEW PARENTS AND OTHERS CAN TAKE TO HELP BABIES SLEEP SAFELY, WITH THE GOAL OF REDUCING INFANT'S RISK OF SUDDEN INFANT DEATH SYNDROME (SIDS) AND OTHER SLEEP-RELATED CAUSES OF INFANT DEATH.CHENANGO COUNTY PUBLIC HEALTH WILL PROVIDE LOGISTICAL SUPPORT, TRAINING MATERIALS, TRAINERS, AND EVENT PROMOTION. MULTIPLE HEALTH SERVICE ORGANIZATIONS THROUGHOUT THE COUNTY WILL SERVE TO HOST, REFER, AND PROMOTE EVENTS, INCLUDING UHS CHENANGO MEMORIAL HOSPITAL.UHS CHENANGO MEMORIAL HOSPITAL WILL REDOUBLE EFFORTS TO PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN BY ENSURING EASY ACCESS TO THE PATIENT AND FAMILY EDUCATION IT OFFERS INCLUDING REGULARLY SCHEDULING TWO-PART BIRTHING CLASSES TAUGHT BY REGISTERED NURSES. FOR THOSE WHO ARE UNABLE TO ATTEND THESE CLASSES IN PERSON, A VIRTUAL OPTION WHICH CAN BE ACCESSED ON A SMARTPHONE BY SCANNING A QR CODE IS BEING MADE AVAILABLE. IN ADDITION, PRENATAL NUTRITIONAL INFORMATION AND EDUCATION WILL BE MADE MORE READILY AVAILABLE. THERE WILL ALSO BE AN INCREASED FOCUS ON REFERRALS TO COMMUNITY PARTNERS SUCH AS MOTHERS AND BABIES PERINATAL NETWORK, AS WELL AS TO SOCIAL WORKERS WHO CAN WORK WITH THE EXPECTANT MOTHERS AND THEIR PARTNERS IF NEEDED. BIRTH CONTROL FOLLOW-UPS WILL ALSO BE ENCOURAGED.GOAL 2.2: INCREASE BREASTFEEDING - CHENANGO COUNTY WILL PARTNER WITH THE LOCAL BREASTFEEDING COALITION TO INCREASE THE NUMBER OF CERTIFIED LACTATION CONSULTANTS AND INCREASE LOCAL BREASTFEEDING SUPPORTS.UHS CHENANGO MEMORIAL HOSPITAL WILL LEVERAGE ITS SUCCESS IN INCREASING BREASTFEEDING RATES FOR NEW MOTHERS OVER THE LAST TEN YEARS. TO THAT END, THE UHS WOMEN'S HEALTH CENTER IN NORWICH WILL DISTRIBUTE PRENATAL EDUCATION PACKETS DURING VISITS TO INFORM AND PREPARE EXPECTANT MOTHERS. LACTATION CONSULTANTS WILL CONTINUE TO BE STAFFED ON THE LABOR DELIVERY FLOOR, TO PROVIDE IMMEDIATE SUPPORT AND COACHING TO NEW MOTHERS. IN ADDITION, LACTATION CONSULTANTS ON STAFF IN THE OFFICE SETTING WILL OFFER A NEEDED POINT OF EDUCATION TO MOTHERS DEALING WITH FIRST TIME BREAST FEEDING CHALLENGES OR ISSUES THAT ARISE AFTER BIRTH. IN ADDITION, UHS CHENANGO MEMORIAL WILL SERVE AS A REFERRAL SOURCE TO PARTNERS WITHIN THE BREASTFEEDING COALITION.GOAL 3.3: REDUCE DENTAL CARIES AMONG CHILDREN - CHENANGO COUNTY PUBLIC HEALTH WILL CREATE AND PUBLISH DENTAL HEALTH EDUCATION MATERIALS WHILE MULTIPLE PARTNERS IN DENTAL TASK FORCE WILL WORK TO DISTRIBUTE THE HEALTH INFORMATION. UHS CHENANGO MEMORIAL HOSPITAL, AND PARTICULARLY ITS PEDIATRIC PRACTICES, WILL PROVIDE PATIENTS WITH DENTAL HEALTH EDUCATION MATERIALS AND INFORM PATIENTS IN NEED OF DENTAL SERVICES OF LOCAL DENTAL HEALTH OFFERINGS. WHILE IN APPOINTMENTS WITH CMH PROVIDERS, PATIENTS WILL BE MADE AWARE OF SPECIFIC SERVICES OFFERED BY PUBLIC HEALTH, LIKE WIC. WHEN DENTAL HEALTH EVENTS ARE SCHEDULED, CMH WILL HELP TO PROMOTETHESE EVENTS TO ITS STAFF AND PATIENTS.PROMOTE A HEALTHY AND SAFE ENVIRONMENTHEALTH DISPARITY:CHENANGO COUNTY IS AN AGING, LOW-INCOME COMMUNITY. STAKEHOLDERS REGULARLY SITE ACCESS AS A PRIMARY BARRIER TO CARE.INTERVENTION:UTILIZING THE PROGRAM BINGOCIZE, WHICH IS AN EVIDENCED BASED SENIOR MOVEMENT THAT COMBINES EXERCISE AND HEALTH INFORMATION WITH THE FAMILIAR GAME OF BINGO, HAS BEEN SHOWN TO BE A GREAT WAY TO GET SENIORS MOVING WHILE SOCIALIZING. THE GOAL OF PARTICIPATION IS IMPROVED AND/OR MAINTAINED MOBILITY AND INDEPENDENCE AS IT IS ADAPTABLE AND BENEFICIAL FOR ALL RANGES OF PHYSICAL AND MENTAL ABILITY. THE OVERALL GOALS OF THE PROGRAM ARE TO HELP OLDER ADULTS IMPROVE AND/OR MAINTAIN MOBILITY AND INDEPENDENCE, LEARN AND USE HEALTH INFORMATION FOCUSED ON FALLS REDUCTION TO PROMOTE WELLNESS, SOCIALIZATION AND CONNECTEDNESS. CHENANGO COUNTY PUBLIC HEALTH WILL COLLABORATE WITH CHENANGO COUNTY'S AREA AGENCY OF THE AGING TO PROVIDE THE CERTIFIED TRAINER, LOGISTICS, PROMOTION, REFERRAL, AND IMPLEMENTATION OF PROGRAM. UHS CHENANGO MEMORIAL HOSPITAL PROVIDERS WILL WORK WITH PATIENTS DURING APPOINTMENTS TO PROMOTE HEALTHY AND SAFE ENVIRONMENTS AT WORK AND HOME. PROVIDERS WORK CLOSELY WITH EACH PATIENT PERSONALLYTO SOLVE ISSUES THEY MAY BE DEALING WITH OR CONCERNED ABOUT. PROVIDERS WILL BE INFORMED ABOUT THE BINGOCIZE PROGRAM, AS WELL AS OTHER COMMUNITY-BASED OFFERINGS, TO FACILITATE REFERRALS TO THESE PROGRAMS. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSHEALTH DISPARITY:CHENANGO COUNTY IS A LOW-INCOME, RURAL COMMUNITY CONSISTENTLY HINDERED BY LIMITED ACCESS TO CARE.INTERVENTION:MENTAL HEALTH FIRST AID - WHILE INCREASING THE NUMBER OF MENTAL HEALTH CARE PROVIDERS WOULD BENEFIT THE COUNTY, A MORE IMMEDIATE AND EFFECTIVE COMMUNITY-BASED INTERVENTION WOULD BE TO EXPAND THE NUMBER OF PEOPLE TRAINED TO IDENTIFY MENTAL HEALTH ISSUES IN THEIR PROFESSIONAL SPHERE AND TO PROVIDE APPROPRIATE SUPPORT. EARLY DETECTION AND INTERVENTION COULD HAVE A SIGNIFICANT IMPACT ON THE TRAJECTORY OF YOUNG PEOPLE IN THE COUNTY. CHENANGO COUNTY PROPOSES TO EXPAND THE MENTAL HEALTH FIRST AID PROGRAM BY MAKING HOSPITAL STAFF, HEALTH DEPARTMENT STAFF, AND PROVIDERS AVAILABLE FOR TRAINING. EFFORTS WILL BE MADE TO PROMOTE THE PROGRAM AND ORGANIZE TRAININGS FOR OTHER STAKEHOLDERS WITH A PARTICULAR EMPHASIS ON TRAINING INDIVIDUALS WHO WORK WITH YOUNG PEOPLE SUCH AS SCHOOL STAFF, EDUCATORS, AND ORGANIZATIONS SERVING YOUTH.PARTNERS:BRINGING PARTNERS TO THE TABLE AND MAINTAINING THEIR ENGAGEMENT WILL BE VITAL TO THE SUCCESS OF THEINTERVENTIONS WITHIN THE CHOSEN PRIORITY AREAS. THE NEEDS ASSESSMENT COMMITTEE WILL CREATE ANDMAINTAIN PLANNING COMMITTEES FOR EACH OF THE IDENTIFIED PRIORITY AREAS. THESE COMMITTEES, AND SUB-COMMITTEES, WILL BRING TOGETHER COMMUNITY STAKEHOLDERS REPRESENTING VARIOUS CONSTITUENCIES INCLUDING COMMUNITY-BASED ORGANIZATIONS, GOVERNMENTAL ENTITIES, FUNDERS, FAITH COMMUNITIES, AND EMPLOYERS.IMPACT AND PROCESS MEASURES:THOSE COMMITTEES AND SUB-COMMITTEES FORMED FOR EACH PRIORITY AREA WILL BE CHARGED WITH ACTIVITY PLANNING, MEASURING PROGRESS TOWARD GOALS, AND REPORTING ON EACH PRIORITY AREA. THE NEEDS ASSESSMENT COMMITTEE WILL PROVIDE SUPPORT AS NEEDED TO THESE COMMITTEES TO ENSURE IMPACT AND PROCESS MEASURES ARE DEVELOPED AND THAT PROGRESS IS MADE TOWARDS MEETING THESE MEASURES.
PART V, SECTION B, LINE 5, CONTINUED:	THE FOLLOWING AGENCIES WERE, AT SOME POINT IN TIME, INVOLVED WITH INFORMATION GATHERING DURING THIS PROCESS: CARE COMPASS NETWORK CHENANGO COUNTY AREA AGENCY ON AGING CHENANGO COUNTY CATHOLIC CHARITIES CHENANGO COUNTY DEPARTMENT OF PUBLIC HEALTH CHENANGO COUNTY DEPARTMENT OF SOCIAL SERVICES CHENANGO COUNTY MENTAL HYGIENE & BEHAVIORAL HEALTH SERVICES CHENANGO HEALTH NETWORK CHENANGO UNITED WAY COMMUNITY FOUNDATION OF SOUTH CENTRAL NEW YORK CORNELL COOPERATIVE EXTENSION CROUSE HOSPITAL DCMO BOCES DELAWARE COUNTY DEPARTMENT OF HEALTH HANYS HOSPICE & PALLIATIVE CARE OF CHENANGO COUNTY LIBERTY PARTNERSHIP LOCAL BUSINESSES LOCAL SCHOOL DISTRICTS MOTHERS & BABIES PERINATAL NETWORK NEW YORK CONNECTS NORWICH FAMILY YMCA OPPORTUNITIES FOR CHENANGO AND HEADSTART POPULATION HEALTH IMPROVEMENT PROGRAM PUBLIC LIBRARIES THE PLACE UHS CHENANGO MEMORIAL HOSPITAL UNITED HEALTH SERVICES (UHS) VARIOUS COMMUNITY FOUNDATIONS WOMEN, INFANTS & CHILDREN (WIC)
PART V, SECTION B, LINE 11:	HOW THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.THE MAJORITY OF 2022 WAS SPENT RESEARCHING THE NEEDS OF THE COMMUNITY, IDENTIFYING THE INITIATIVES THAT WOULD HAVE THE GREATEST IMPACT WITH AVAILABLE RESOURCES, AUTHORING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2022-2024, AND BEGINNING WORK ON THE IDENTIFIED INITIATIVES IN COLLABORATION WITH THE LHD. SELECTED PRIORITY AREAS AND INTERVENTIONSPREVENT CHRONIC DISEASE: PREVENTIVE CARE AND MANAGEMENTWITH HIGH MORTALITY RATES FOR SEVERAL CHRONIC DISEASES, CHENANGO COUNTY FACES A SIGNIFICANT CHALLENGE IN ASSISTING COUNTY RESIDENTS IN EFFECTIVELY MANAGING THEIR CONDITIONS. HORN RESEARCH CONDUCTED AN ANALYSIS OF THE POTENTIAL HEALTH CARE COSTS AS WELL AS THE YEARS OF LIFE LOST AND POTENTIAL EARNINGS LOSS ASSOCIATED WITH THESE DISEASES IN THE COUNTY. THE RESULTS SHOW A NEED FOR INCREASED HEALTHY BEHAVIORS AND BETTER DISEASE MANAGEMENT AMONG CHENANGO COUNTY RESIDENTS. LOW-INCOME INDIVIDUALS AND FAMILIES ARE AT PARTICULAR RISK FOR CHRONIC DISEASE AND OFTEN LACK THE RESOURCES AND KNOWLEDGE TO MANAGE THEIR ILLNESSES.CHN HAS RECENTLY INCORPORATED THE EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM INTO THE SERVICES THEY OFFER. THE PROGRAM SUCCESSFULLY TAUGHT SELF-MANAGEMENT SKILLS TO 45 CHENANGO COUNTY RESIDENTS IN 2022 AND WILL CONTINUE CLASSES IN 2023. PROGRAM RESULTS SHOW A CLINICAL REDUCTION IN A1C LEVELS IN PARTICIPANTS AS WELL AS INCREASED KNOWLEDGE OF DISEASE SELF-MANAGEMENT AND A BETTER UNDERSTANDING OF THEIR HEALTH AND PHYSICAL ACTIVITY. THE PROGRAM'S EARLY SUCCESS COUPLED WITH THE HIGH NEED FOR INDIVIDUAL SELF-MANAGEMENT IMPROVEMENT CLEARLY SHOW THE SUITABILITY OF INVESTING IN THE PROGRAM MORE BROADLY.CHENANGO COUNTY PROPOSES TO EXPAND THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM BY ESTABLISHING A REFERRAL PROCESS OF NEWLY DIAGNOSED PATIENTS THROUGH THE HOSPITAL, INCORPORATING THE HOSPITAL'S HEAD DIETICIAN AND CHEF INTO THE PROGRAM'S CURRICULUM, CREATING A REFERRAL PROCESS THROUGH THE HEALTH DEPARTMENT'S PROGRAMS, AND EXPLORING HAVING HEALTH DEPARTMENT STAFF BECOME TRAINED AS PEER LEADERS. A SPECIAL EMPHASIS WILL BE PLACED ON PARTNERING WITH AND RECRUITING FROM COMMUNITY-BASED ORGANIZATIONS WHO WORK WITH LOW-INCOME INDIVIDUALS AND FAMILIES TO ADDRESS THE HEALTH DISPARITIES ASSOCIATED WITH INCOME AND HEALTH.PROMOTE WELL-BEINGCHENANGO COUNTY HAS HIGH RATES OF POOR SELF-REPORTED MENTAL HEALTH IN ADULTS, HAS HIGH RATES OF YOUTH DISCONNECTION, AND IS DESIGNATED AS A HEALTH PROVIDER SHORTAGE AREA FOR MENTAL HEALTH. WHILE INCREASING THE NUMBER OF MENTAL HEALTH CARE PROVIDERS WOULD BE OF BENEFIT TO THE COUNTY, A MORE IMMEDIATE AND EFFECTIVE COMMUNITY-BASED INTERVENTION WOULD BE TO EXPAND THE NUMBER OF PEOPLE TRAINED TO IDENTIFY MENTAL HEALTH ISSUES IN THEIR PROFESSIONAL SPHERE AND PROVIDE APPROPRIATE SUPPORT. IN PARTICULAR, NEGATIVE YOUTH MENTAL HEALTH OUTCOMES IN THE COUNTY HAVE BEEN INCREASING. EARLY INTERVENTION COULD HAVE A SIGNIFICANT IMPACT ON THE TRAJECTORY OF THE YOUNG PEOPLE IN THE COUNTY AND IMPROVE THOSE OUTCOMES.CHN HAS ADDED THE EVIDENCE-BASED TRAINING PROGRAM MENTAL HEALTH FIRST AID TO THEIR PROGRAMMING. THIS TRAINING CREATES MORE OPPORTUNITIES FOR EARLY DETECTION AND INTERVENTION, AND WITH THE INCREASING NEGATIVE YOUTH MENTAL HEALTH OUTCOMES IN THE COUNTY, EARLY INTERVENTION COULD HAVE A SIGNIFICANT IMPACT ON THE TRAJECTORY OF YOUNG PEOPLE IN THE COUNTY.CHENANGO COUNTY PROPOSES TO EXPAND THE MENTAL HEALTH FIRST AID PROGRAM BY MAKING HOSPITAL STAFF, HEALTH DEPARTMENT STAFF, AND PROVIDERS AVAILABLE FOR TRAINING. IN ADDITION, EFFORTS WILL BE MADE TO PROMOTE THE PROGRAM AND ORGANIZE TRAININGS FOR OTHER STAKEHOLDERS AND PROFESSIONALS FROM COMMUNITY BASED ORGANIZATIONS. A PARTICULAR EMPHASIS WILL BE PLACED ON TRAINING INDIVIDUALS WHO WORK WITH YOUNG PEOPLE SUCH AS SCHOOL STAFF, EDUCATORS, AND ORGANIZATIONS SERVING YOUTH.INITIATIVE 1PRIORITY: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSFOCUS AREA: PROMOTE WELL BEINGGOAL: FACILITATE SUPPORTIVE ENHANCEMENTS THAT PROMOTE RESPECT AND DIGNITY FOR PEOPLE OF ALL AGES.OBJECTIVE: INCREASE CHENANGO COUNTY COMMUNITY SCORES BY 7% TO 44.8%.DISPARITIES: LACK OF EDUCATION OF MENTAL HEALTH ISSUES IN COUNTY, LOW-INCOME, LOW PROVIDER AREA, LACK OF TRANSPORTATION AND SERVICES ACCESS.INTERVENTIONS MENTAL HEALTH FIRST AID COURSES MADE AVAILABLE/DELIVERED TO COMMUNITY AND PROFESSIONALS EDUCATE PROVIDERS VIA DETAILING VISITS TO PROMOTE POSTPARTUM DEPRESSION (PPD) SCREENING AT INFANT'S WELL CHILD VISITS (1WK, 2WK, 2, 4 AND 6 MONTHS) IN PEDIATRIC OFFICE WITH REFERRAL TO MOTHER'S PRIMARY HEALTH CARE PROVIDER (PCP) EDUCATE PEDIATRIC PROVIDERS IN THE COUNTY ON THE PROJECT TEACH REFERRAL AND MATERNAL HEALTH MENTAL HEALTH PROJECT THROUGH PROJECT TEACH INITIATIVE VIA DETAILING VISITS TO PROVIDERS MULTI-AGENCY LOBBYING EFFORTS TO NYS MEDICAID TRANSPORTATION PROGRAM TO IMPROVE ACCESS AND TIMELINESS OF TRANSPORTATION TO MEDICAL APPOINTMENTS FOR COUNTY RESIDENTS IMPROVE AWARENESS OF LOCAL AND REGIONAL SERVICES IN AN EFFORT TO IMPROVE OUTREACH EFFORTS EVALUATE AND IMPROVE OUTREACH EFFORTSFAMILY OF MEASURESMENTAL HEALTH FIRST AID NUMBER OF COURSES HELD NUMBER OF INDIVIDUALS TRAINEDPROVIDER DETAILING POSTPARTUM DEPRESSION NUMBER OF PROVIDERS EDUCATED ON PROJECT NUMBER OF PEDIATRIC PRACTICES WILLING TO SCREEN MOMSPROJECT TEACH DETAILING 100% OF HEALTH CARE PROVIDERS IN COUNTY EDUCATED ON BOTH PROJECTS 100% OF HEALTH CARE PROVIDERS IN COUNTY RECEIVE ANNUAL UPDATES AND EDUCATION NUMBER OF PROVIDERS PARTICIPATING IN KICK OFF DINNER/WEBINAR NUMBER OF PROVIDERS COMPLETING CORE TRAINING BY PROJECT TEACHMEDICAID TRANSPORTATION LOBBYING NUMBER OF AGENCIES JOINING LETTER WRITING CAMPAIGN AGENCY SELF-REPORTS IMPROVEMENT IN MEDICAID TRANSPORTATION FOR CLIENTSSERVICES AWARENESS AND IMPROVED OUTREACH NUMBER OF CHENANGO COUNTY CALLS TO 211 AGENCY SELF-REPORTS IMPROVEMENT FOR CLIENTSPROJECTED YEAR 1 INTERVENTIONSMENTAL HEALTH FIRST AID1. ORGANIZE RESOURCES 2. COALESCE PARTNERS 3. PRIORITIZE AND SCHEDULE FIRST TRAININGSPROVIDER DETAILING - POSTPARTUM DEPRESSION 1. BY END OF 2022, REACH OUT AND MEET WITH 100% OF HEALTH CARE PROVIDERS IN COUNTY WHO SEE NEWBORNS AND INFANTS TO PROVIDE EDUCATION REGARDING POSTPARTUM DEPRESSION SCREENING OF MOMS IN PEDIATRIC OFFICES 2. EDUCATE HEALTH CARE PROVIDERS ON THE EVIDENCE BASED PROGRAM PROJECT TEACH DETAILING PROJECT 1. BY END OF 2022, REACH OUT TO PROJECT TEACH FACILITATOR TO DISCUSS PLAN2. FORM SUBCOMMITTEE TO PLAN KICK OFF INFORMATIONAL DINNER3. SECURE FUNDING FOR DINNER PRESENTATIONTRANSPORTATION1. FORM WORKGROUP2. EXPLORE ISSUE IN DEPTH 3. INTERVIEW PARTNERS 4. DRAFT ADVOCACY LETTERACCESS TO SERVICES 1. FORM WORKGROUP 2. EXPLORE ISSUE IN DEPTH3. IDENTIFY AND TARGET SHORT COMINGS AND GAPSPROJECTED YEAR 2 INTERVENTIONSMENTAL HEALTH FIRST AID 1. EXECUTE FULL SLATE OF TRAINING COURSES PROVIDER DETAILING - POSTPARTUM DEPRESSION1. BEGIN DETAILING VISITS AT 2ND QUARTER WITH PLANNED REVISIT BY END OF THE YEAR 2020 TO REMIND AND RE-INFORCE THE PROJECT DETAILS2. HAVE AT LEAST ONE HEALTH CARE PROVIDER SUCCESSFULLY IMPLEMENT POSTPARTUM DEPRESSION SCREENING IN THEIR PEDIATRIC PRACTICEPROJECT TEACH DETAILING PROJECT 1. PLAN AND IMPLEMENT INFORMATIONAL DINNER FOR HEALTH CARE PROVIDERS TO EDUCATE THEM ON PROJECT TEACH IN FIRST QUARTER OF THE YEAR 20202. ENCOURAGE PARTICIPANTS TO SIGN UP FOR CORE TRAININGS FOR THEIR STAFF BY PROJECT TEACH FACILITATORS 3. BEGIN DETAILING VISITS IN 2ND QUARTER, WITH PLANNED REVISIT BY END OF THE YEAR 2020 TO REMIND AND RE-INFORCE TRANSPORTATION 1. INTRODUCE PARTNERS TO ADVOCACY LETTER2. EDIT DRAFT AS NEEDED3. COLLECT SIGNATURES 4. SEND LETTERSACCESS TO SERVICE 1. GATHER REFERRALS, CONTACTS AND PROGRAM INFORMATION TO FILL GAPS IN 211 SERVICESPROJECTED YEAR 3 INTERVENTIONSMENTAL HEALTH FIRST AID1. EXECUTE ADDITIONAL TRAININGS 2. EVALUATE PROGRESS AND FUTURE NEEDSPROVIDER DETAILING - POSTPARTUM DEPRESSION1. ANNUAL DETAILING TO HEALTH CARE PROVIDERS TO ENCOURAGE THOSE WHO ARE NOT SCREENING TO START DOING SO2. HAVE ONE ADDITIONAL HEALTH CARE PROVIDER AGREE TO AND IMPLEMENT POSTPARTUM DEPRESSION SCREENING IN THEIR PEDIATRIC PRACTICEPROJECT TEACH DETAILING PROJECT 1. VISIT EACH HEALTH CARE PROVIDER ANNUALLY TO REVIEW PROJECT TEACH AND ENCOURAGE ITS USETRANSPORTATION 1. CONTINUE CONVERSATION WITH PARTNERS AND TARGET PROGRAM STAFF 2. EVALUATE CHANGE AND ADDITIONAL NEEDS ACCESS TO SERVICES 1. CONTINUE TO IMPROVE PROGRAM DETAIL IN 211 SYSTEM 2. ENCOURAGE AGENCY UPDATES TO THE SYSTEM3. PROMOTE SYSTEM USE
PART V, SECTION B, LINE 11:	IMPLEMENTATION PARTNER, ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTMENTAL HEALTH FIRST AID1. HOST TRAINING FOR STAFF2. PROMOTE AND REFER PROVIDER DETAILING - POSTPARTUM DEPRESSION1. CARRY OUT DETAILING PROJECT WITH PROVIDERSPROJECT TEACH DETAILING1. FACILITATE TRAININGS & EVENTS2. FUNDINGMEDICAID TRANSPORTATION LOBBYING1. LEAD AGENCY LOBBYING EFFORTSSERVICES AWARENESS AND IMPROVED OUTREACH WORKGROUP PARTICIPANT1. ID RESOURCES2. ID GAPS IN RESOURCE AWARENESS3. CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONSHOSPITALMENTAL HEALTH FIRST AID1. HOST TRAINING FOR STAFF2. FACILITATE3. PROVIDE SPACE4. PROMOTE PROGRAM5. OBTAIN FUNDINGPROVIDER DETAILING - POSTPARTUM DEPRESSION UHS CHENANGO MEMORIAL HOSPITAL COMMUNITY HEALTH ADVOCATE - PROMOTE TO PROVIDERSMEDICAID TRANSPORTATION LOBBYINGASSIST IN FINALIZING LETTERSERVICES AWARENESS AND IMPROVED OUTREACH UHS CHENANGO MEMORIAL COMMUNITY HEALTH ADVOCATE - WORKGROUP PARTICIPANT1. ID RESOURCES 2. ID GAPS IN RESOURCE AWARENESS 3. CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONS PROVIDERSMENTAL HEALTH FIRST AIDBASSETT - STAFF TRAINING, PROMOTEPROVIDER DETAILING - POSTPARTUM DEPRESSION UHS CHENANGO MEMORIAL HOSPITAL - ADOPT PRACTICE CHANGEBASSETT - ADOPT PRACTICE CHANGE PROJECT TEACH DETAILINGUHS CHENANGO MEMORIAL HOSPITAL - PROMOTE & UTILIZEBASSETT - PROMOTE & UTILIZEPRIVATE - PROMOTE & UTILIZEMEDICAID TRANSPORTATION LOBBYING 1. ASSIST IN FINALIZING LETTER2. CONSIDER SUPPORT COMMUNITY BASED ORGANIZATIONSMENTAL HEALTH FIRST AIDCHENANGO HEALTH NETWORK (CHN) 1. FACILITATE2. PROVIDE SPACE3. PROMOTE PROGRAM4. OBTAIN FUNDINGCHENANGO COUNTY BEHAVIORAL HEALTH1. STAFF TRAINED AS PROGRAM FACILITATORSPROJECT TEACH DETAILING CHENANGO HEALTH NETWORK 1. VOLUNTEER2. OBTAIN FUNDING3. FACILITATE KICKOFF EVENTCHENANGO COUNTY BEHAVIORAL HEALTH1. SUPPORT2. KICKOFF EVENT PARTICIPANTMEDICAID TRANSPORTATION LOBBYINGCATHOLIC CHARITIES - LOBBYING EFFORTS CHENANGO COUNTY BEHAVIORAL HEALTH - LOBBYING EFFORTSSERVICES AWARENESS AND IMPROVED OUTREACH CATHOLIC CHARITIES WORKGROUP PARTICIPANT1. ID RESOURCES2. ID GAPS IN RESOURCE AWARENESS 3. CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONSCHENANGO COUNTY BEHAVIORAL HEALTH - WORKGROUP PARTICIPANT 1. ID RESOURCES2. ID GAPS IN RESOURCE AWARENESS 3. CULMINATE CORRECTIVE RESOURCES AND RECOMMENDATIONS OTHERMENTAL HEALTH FIRST AIDFIRST RESPONDERS HOST TRAININGS FOR STAFFLAW ENFORCEMENTMENTAL HEALTH FIRST AID HOST TRAININGS FOR STAFFK-12 SCHOOLMENTAL HEALTH FIRST AIDHOST TRAININGS FOR STAFF AND PROMOTEPROJECT TEACH DETAILINGUNADILLA VALLEY SCHOOL BASED CLINIC - PROMOTE AND UTILIZESHERBURNE SCHOOL BASED CLINIC PROMOTE AND UTILIZE2022 UPDATEMENTAL HEALTH FIRST AIDTHE CHENANGO HEALTH NETWORK AND CHENANGO MEMORIAL HOSPITAL WORKED TOGETHER ONCE AGAIN TO PROVIDE 10 DIFFERENT EVENTS WITHIN THE COMMUNITY TO BETTER PREPARE THE COMMUNITY AND EDUCATE THEM ABOUT MENTAL HEALTH FIRST AID. WITH MORE THAN 110 PARTICIPANTS AT ALL THE EVENTS COMBINED, THE AREA IS STARTING TO SEE A COMEBACK AFTER THE COVID SHUTDOWN. BUSINESSES, SCHOOL PROFESSIONALS AND OTHER HEALTH PROFESSIONALS TOOK ADVANTAGE OF THESE EVENTS. PROVIDER DETAILING - POSTPARTUM DEPRESSION CHENANGO MEMORIAL HOSPITAL'S MATERNITY AND WOMEN'S HEALTH CENTER WORKED WITH ALL NEW MOM'S AND EVEN AN OCCASIONAL CALL IN TO WORK THROUGH PERSONAL PATIENT NEEDS AND CONCERNS. DEPRESSION IS A SERIOUS SITUATION THAT ALL STAFF HERE AT THE HOSPITAL AND CLINICS TAKE SERIOUSLY. THE PARTNERSHIP WITH THE COUNTY HEALTH DEPARTMENT IS ALWAYS AN IMPORTANT PART OF SUCCESS WHEN DEALING WITH DEPRESSION. PROJECT TEACH DETAILING PROJECTPROJECT TEACH FACILITATOR IS SCHEDULED TO DISCUSS PROGRAM BENEFITS, PLAN AND HOW TO IMPLEMENT. FUNDING HAS BEEN SECURED FOR DINNER EVENT AND WILL BE ORGANIZED BY CHENANGO HEALTH NETWORK AND CHENANGO COUNTY DEPARTMENT OF HEALTH. ALL PROVIDERS WITHIN CHENANGO COUNTY WILL BE INVITED TO ATTEND. TRANSPORTATIONTRANSPORTATION CONTINUES TO BE A STICKING POINT FOR A HEALTHIER CHENANGO COUNTY. INTERVIEWS WITH OPTION PARTNERS WITHIN THE COMMUNITY WILL CONTINUE AND SOME PROGRESS HAS BEEN MADE. THERE IS STILL A NEED FOR A DEPENDABLE SERVICE WITH LITTLE TO NO COST FOR THOSE IN OUR COMMUNITY IN THE NEED FOR TRANSPORTATION TO AND FROM HEALTHCARE APPOINTMENTS. TALKS WILL CONTINUE AND A SOLUTION WILL BE FOUND. THE HEALTH DEPARTMENT AND CMH WILL CONTINUE TO WORK TOGETHER AS NEEDED.ACCESS TO SERVICES THE RESOURCE GUIDE WAS PRODUCED AND PRINTED FOR LOCAL USE AND HAS OFFERED OPTIONS FOR THOSE IN NEED OF RIDES TO AND FROM HEALTHCARE AND NEEDED SERVICES. PATIENTS HAVE FOUND THOSE RESOURCE USEFUL BUT MORE PROGRESS CAN BE MADE AND IS THE GOAL OF THE COMMITTEE IN 2023.
PART V, SECTION B, LINE 11:	INITIATIVE 2PRIORITY: PREVENT CHRONIC DISEASESFOCUS AREA: HEALTHY EATING AND FOOD SECURITYGOAL: INCREASE SKILLS AND KNOWLEDGE TO SUPPORT HEALTHY FOOD AND BEVERAGE CHOICES.OBJECTIVE: DECREASE THE PERCENTAGE OF ADULTS WHO CONSUME ONE OR MORE SUGARY DRINKS PER DAY BY 5%. DECREASE THE PERCENT OF CHILDREN WITH OBESITY BY 5%. DECREASE THE PERCENT OF ADULTS, AGES 18 YEARS AND OLDER WITH OBESITY BY 5%. REDUCE DENTAL CARRIES. DISPARITIES: LOW INCOME, GEOGRAPHYINTERVENTIONSPROJECT YEAR 1 "RETHINK YOUR DRINK: DRINK WATER" - CAMPAIGN ADOPT BEVERAGE STANDARDS AND PROMOTE MESSAGE THROUGH LITERATURE AND PROGRAMMING TO REDUCE OVER CONSUMPTION OF SUGARY SWEETENED BEVERAGES PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSPROJECT YEAR 2 EXPAND "RETHINK YOUR DRINK: DRINK WATER" CAMPAIGN FOCUS ON: SUGARY SWEETENED BEVERAGE PRACTICE CHANGE AMONG 1. SCHOOLS 2. COMMUNITY - BASED PARTNERS3. BUSINESS PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS ALONG WITH A DENTAL PRESENTATION ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSPROJECT YEAR 3 EXPAND "RETHINK YOUR DRINK: DRINK WATER" CAMPAIGN FOCUS ON: SUGARY SWEETENED BEVERAGE PRACTICE CHANGE FOR PROVIDERS 1. CHENANGO MEMORIAL HOSPITAL PROVIDERS 2. BASSETT AND PRIVATE PROVIDERS3. DENTAL PROVIDERS PROVIDE DENTAL SUPPLIES TO PRE K - 5TH GRADES IN ALL 9 COMMUNITY SCHOOLS ENCOURAGE CLASSROOM DENTAL CARE PRACTICE CHANGE IN THE SCHOOLSFAMILY OF MEASURESPROJECT YEAR 1 NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF EDUCATED NUMBER OF PROVIDERS' OFFICES AND THEIR STAFF EDUCATED NUMBER OF HOUSEHOLDS REACHED WITH DOOR TO DOOR MESSAGING NUMBER OF NEW FAMILIES OF NEWBORNS REACHED THROUGH MAILINGS NUMBER OF COMMUNITY EVENTS NUMBER OF PEOPLE REACHED DURING COMMUNITY EVENTS PHONE SURVEY (100 RANDOM CALLS THROUGHOUT THE TOWNSHIPS) TO ASSESS NUMBER OF PEOPLE REACHED VIA CAMPAIGN NUMBER OF PRE K - 5TH GRADE CLASSES PROVIDED WITH DENTAL SUPPLIES AND EDUCATIONAL PRESENTATIONS IN THE SPRING AND FALL NUMBER OF STUDENTS REACHED NUMBER OF SCHOOLS THAT AGREE TO ADOPT CLASSROOM DENTAL CARE PRACTICE CHANGE FOR PRE K- 5TH GRADEPROJECT YEAR 2 NUMBER POTENTIALLY REACHED IN 2020 WITH BILL BOARD MESSAGING CREATED ON 2019 NUMBER OF SCHOOLS THAT AGREE TO CLASS ROOM SUGARY SWEETENED BEVERAGES PRACTICE CHANGE (PLEDGE) NUMBER OF COMMUNITY PARTNERS AGREED TO SUGARY SWEETENED BEVERAGES PRACTICE CHANGE FOR MEETINGS AND EVENTS (PLEDGE) NUMBER OF BUSINESSES THAT AGREE TO SUGARY SWEETENED BEVERAGES PRACTICE CHANGE FOR MEETINGS AND EVENTS (PLEDGE) NUMBER OF PRE K - 5TH GRADE CLASSES PROVIDED WITH DENTAL SUPPLIES AND SUGARY SWEETENED BEVERAGES EDUCATIONAL PRESENTATIONS NUMBER OF STUDENTS REACHED INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE BY 1 SUGARY SWEETENED BEVERAGES CONSUMPTION AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM PREVALENCE OF OBESITY AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMPROJECT YEAR 3 PROVIDERS TO SCREEN AND COUNSEL PATIENTS REGARDING SUGARY SWEETENED BEVERAGES CONSUMPTION AS PART OF ROUTINE MEDICAL CARE NUMBER OF CHENANGO MEMORIAL HOSPITAL PROVIDERS CURRENTLY SCREENING AND COUNSELLING NUMBER OF CHENANGO MEMORIAL HOSPITAL PROVIDERS THAT AGREE TO PRACTICE CHANGE NUMBER OF BASSETT AND PRIVATE PROVIDERS CURRENTLY SCREENING AND COUNSELLING NUMBER OF BASSETT AND PRIVATE PROVIDERS THAT AGREE TO PRACTICE CHANGE NUMBER OF DENTISTS CURRENTLY SCREENING AND COUNSELLING NUMBER OF DENTISTS THAT AGREE TO PRACTICE CHANGE INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE BY 1 SUGARY SWEETENED BEVERAGES CONSUMPTION AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM PREVALENCE OF OBESITY AMONG NYS ADULTS BY COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEMPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONS1. CAMPAIGN CREATION (3 PRONGED APPROACH - PARTNERS, PROVIDERS AND COMMUNITY)2. CAMPAIGN PRESENTATIONS TO PARTNERS AND THEIR STAFF, PROVIDERS AND OFFICE STAFF, AND COMMUNITY AT LARGE3. CUPS WITH CAMPAIGN MESSAGING DEVELOPED AND DISTRIBUTED DURING EDUCATIONAL OPPORTUNITIES (5,000+)4. WORK WITH THE DENTAL TASK FORCE TO COMBINE MESSAGING PROJECTED YEAR 2 INTERVENTIONS1. WORK WITH COMMUNITY SCHOOLS TO PROVIDE PRESENTATIONS TO STUDENTS, MESSAGING IN SCHOOLS AND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE2. WORK WITH COMMUNITY PARTNERS AROUND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE3. WORK WITH BUSINESSES AROUND SUGARY SWEETENED BEVERAGES PRACTICE CHANGE4. INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE PROJECTED YEAR 3 INTERVENTIONS1. WORK WITH PROVIDERS (PHYSICIANS AND DENTISTS) TO SCREEN AND COUNSEL ABOUT SUGARY SWEETENED BEVERAGES CONSUMPTION AS PART OF ROUTINE MEDICAL CARE 2. INCREASE THE NUMBER OF SCHOOLS ADOPTING CLASSROOM DENTAL PRACTICE CHANGE (BRUSHING IN THE CLASSROOM)IMPLEMENTATION PARTNERS, ROLES(S) AND RESOURCESLOCAL HEALTH DEPARTMENTSUGARY SWEETENED BEVERAGESCREATE AND FACILITATE SUGARY SWEETENED BEVERAGE CAMPAIGNDENTALFUNDING, VOLUNTEERS, PRESENTATIONS IN SCHOOLSBUSINESSESSUGARY SWEETENED BEVERAGESADVOCATE FOR WORKSITE PRACTICE CHANGEDENTALFRONTIER VOLUNTEERNBT BANK VOLUNTEERBLUEOX VOLUNTEERCOMMUNITY-BASED ORGANIZATIONSSUGARY SWEETENED BEVERAGESADVOCATE FOR WORKSITE PRACTICE CHANGEDENTAL CHENANGO UNITED WAY - FORMATION OF DENTAL TASKFORCE, FUNDING, VOLUNTEER CHENANGO HEALTH NETWORK - FUNDING, VOLUNTEERNORWICH ROTARY - FUNDING, VOLUNTEERROGERS CENTER - HOST EVENTS/SPACE, VOLUNTEERHEALTH INSURANCE PLANSDENTALFIDELIS FUNDINGHOSPITALSUGARY SWEETENED BEVERAGESUHS CHENANGO MEMORIAL HOSPITAL COMMUNITY HEALTH ADVOCATE FACILITATE SUGARY SWEETENED BEVERAGES PRACTICE CHANGE AMONG THEIR PROVIDERSK-12 SCHOOLSUGARY SWEETENED BEVERAGESPLEDGE TO ADOPT CLASSROOM PRACTICE CHANGEPROMOTE MESSAGING IN SCHOOLSDENTALADOPT CLASSROOM PRACTICE CHANGE
PART V, SECTION B, LINE 11:	PROJECT YEAR 1 11 SCHOOLS PROVIDED WITH DENTAL SUPPLIES (ZIP BAGS, TOOTHBRUSHES, TOOTHBRUSH COVERS AND TOOTHPASTE) TWICE DURING THE SCHOOL YEAR (4000 CHILDREN IMPACTED) 11 SCHOOLS ACCEPTED THE INITIAL DENTAL PRESENTATION (4000 CHILDREN IMPACTED) UNADILLA VALLEY CENTRAL SCHOOL - ROLE MODEL FOR CLASSROOM PRACTICE CHANGE PERRY BROWN - ADOPTED CLASSROOM PRACTICE CHANGE STANFORD GIBSON - ADOPTED CLASSROOM PRACTICE CHANGE HOLY FAMILY - ADOPTED CLASSROOM PRACTICE CHANGEMEDIASUGARY SWEETENED BEVERAGESEVENING SUN - RUN PRESS RELEASESPARK OUTDOORS - ASSIST WITH BILLBOARD ADSLOCAL RADIO - ASSIST WITH ADSPROVIDERSSUGARY SWEETENED BEVERAGESADVOCATE FOR STAFF TRAINING, PRACTICE CHANGE AROUND SUGARY SWEETENED BEVERAGESPROVIDERS - SCREEN AND EDUCATE DURING MEDICAL VISITSOTHERDENTALCARE COMPASS NETWORK, DSRIP DONATION COLLECTIONOFFICE FOR THE AGINGSUGARY SWEETENED BEVERAGESADVOCATE FOR MESSAGING CAMPAIGN2022 UPDATE DENTAL INITIATIVE AND RETHINK YOUR DRINK INITIATIVETHIS INITIATIVE WAS STALLED DURING 2020/2021 BECAUSE OF THE INABILITY TO GET INTO THE SCHOOLS DURING THE PANDEMIC, BUT IN RECENT YEARS THE ENERGY AROUND THIS INITIATIVE HAS BEGUN TO REBUILD. OVER TIME WE HOPE TO GET BACK TO WHERE WE LEFT OFF AND THE HEALTH DEPARTMENT'S INVOLVEMENT IS IMPORTANT AND THE LEADING AGENCY.SUGARY DRINK EDUCATIONFOUR CHENANGO COUNTY SCHOOLS HAVE STUDENTS BRUSHING THEIR TEETH IN SCHOOL TO DEVELOP HEALTHY HABITS. ALONG WITH IN-SCHOOL TEETH BRUSHING THE CHENANGO DENTAL TASKFORCE HAS 2 DROP-OFFS A YEAR FOR DENTAL HYGIENE BAGS FOR ALL STUDENTS PRE-K THROUGH 5TH GRADE. CHENANGO COUNTY PUBLIC HEALTH HAS PARTNERS ON THIS INITIATIVE AND IS PLANNING THEIR NEXT DROP-OFF AND EDUCATION TO BE FOCUSED AROUND DRINKING WATER AND DENTAL HEALTH. BELOW ARE THE STATISTICS FROM OUTREACH FROM THE CHENANGO DENTAL TASKFORCE AND RETHINK YOUR DRINK INITIATIVE. THE RETHINK YOUR DRINK HAS ALSO BEEN OUTREACHING TO COMMUNITY BUSINESSES FOR PLEDGES TO ONLY SERVE WATER, COFFEE OR TEA AT STAFF MEETINGS AND GATHERINGS. COMMUNITY OUTREACHPUBLIC EDUCATION HAS CONTINUED THROUGH THE LAST CAN. ALONG WITH IN-SCHOOL TEETH BRUSHING THE CHENANGO DENTAL TASKFORCE HAS 2 DROP-OFFS A YEAR FOR DENTAL HYGIENE BAGS FOR ALL STUDENT'S PRE-K THROUGH 5TH GRADE. CHENANGO COUNTY PUBLIC HEALTH HAS PARTNERS ON THIS INITIATIVE AND IS PLANNING THEIR NEXT DROP-OFF AND EDUCATION TO BE FOCUSED AROUND DRINKING WATER AND DENTAL HEALTH. DENTAL EDUCATION ON DAMAGE FROM SUGARY DRINKSNUMBER OF COMMUNITY PARTNERS 25 AND THEIR STAFF EDUCATED 128NUMBER OF PROVIDERS' OFFICES 9 AND THEIR STAFF EDUCATED 89NUMBER OF PEOPLE REACHED DURING COMMUNITY EVENTS WERE MORE THAN 100PHONE SURVEY (APPROX. 100 RANDOM CALLS THROUGHOUT THE TOWNSHIPS) TO ASSESS NUMBER OF PEOPLE REACHED VIA CAMPAIGN, 28 HEARD OF IT, 72 NOT NUMBER OF STUDENTS REACHED WERE 2,850OTHER INITIATIVESPRIORITY: PREVENT CHRONIC DISEASES FOCUS AREA: PHYSICAL ACTIVITYGOAL: INCREASE ACCESS, FOR PEOPLE OF ALL AGES AND ABILITIES, TO INDOOR AND/OR OUTDOOR PLACES FOR PHYSICAL ACTIVITIES.OBJECTIVE: BY DECEMBER 31, 2024: DECREASE THE PERCENTAGE OF ADULTS AGES 18 YEARS AND OLDER WITH OBESITY (AMONG ALL ADULTS). OBJECTIVE 1.7 INCREASE THE PERCENTAGE OF ADULTS AGE 18 YEARS AND OLDER WHO PARTICIPATE IN LEISURE-TIME PHYSICAL ACTIVITY (AMONG ALL ADULTS).DISPARITIES: LOW-INCOME, GEOGRAPHYINTERVENTIONSCHENANGO HEALTHY CHALLENGE: A FREE RESOURCE FOR ALL COMMUNITY MEMBERS TO BECOME ENGAGED IN PHYSICAL ACTIVITY, HEALTHY EATING AND WHOLE HEALTH WELLNESS.FAMILY OF MEASURESPROJECT YEAR 1 NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVED NUMBER OF FAMILIES INVOLVED NUMBER OF PARTICIPANTS NUMBER OF ORGANIZATIONAL TEAMS NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITY NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECT YEAR 2 INCREASE NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVED INCREASE NUMBER OF FAMILIES INVOLVED INCREASE NUMBER OF PARTICIPANTS INCREASE NUMBER OF ORGANIZATIONAL TEAMS NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITY NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECT YEAR 3 NUMBER OF COMMUNITY PARTNERS AND THEIR STAFF INVOLVED NUMBER OF FAMILIES INVOLVED NUMBER OF PARTICIPANTS NUMBER OF ORGANIZATIONAL TEAMS NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ACTIVITY NUMBER OF SURVEYED PARTICIPANTS WHO IMPROVED THEIR OVERALL HEALTHPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONSLAUNCH THE CHENANGO HEALTHY CHALLENGEPROJECTED YEAR 2 INTERVENTIONSINCREASE THE NUMBER OF PARTICIPANTS WHO PARTICIPATE IN THE CHALLENGE AND COMPLETE ITPROJECTED YEAR 3 INTERVENTIONSTO HAVE THE SUPPORT OF COMMUNITY PARTNERS, BUSINESSES AND THE COMMUNITY AT LARGE TO EXTEND THE HEALTHY CHALLENGE BEYOND 2021IMPLEMENTATION PARTNERS, PARTNER ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTCHENANGO HEALTHY CHALLENGEVOLUNTEER, PROMOTE AND EDUCATE PARTICIPANTS AROUND SUGARY SWEETENED BEVERAGES MESSAGINGBUSINESSCHENANGO HEALTHY CHALLENGECHOBANI DONATIONSWILLOW PRIMITIVE & BOUTIQUE FACILITATE CLASSES AROUND CREATIVE THERAPY FOR EMOTIONAL AND SOCIAL HEALTHOTHER - PROMOTE TO STAFFHEADSTARTCHENANGO HEALTHY CHALLENGEVOLUNTEERHOSPITALCHENANGO HEALTHY CHALLENGEUHS CHENANGO MEMORIAL HOSPITAL, COMMUNITY HEALTH ADVOCATE - VOLUNTEER, PROMOTE TO HOSPITAL STAFF K-12 SCHOOLCHENANGO HEALTHY CHALLENGEPROMOTE TO FAMILIES AND STAFFOFFICE OF THE AGINGCHENANGO HEALTHY CHALLENGEPROMOTE TO STAFF AND SENIORS2022 UPDATEHEALTHY CHALLENGECHALLENGE ORGANIZERS ENGAGED PARTICIPANTS THROUGH SOCIAL MEDIA BY PROVIDING TIPS AND STRATEGIES TO HELP DURING THE QUARANTINE. POSTS INCLUDED TIPS ON HEALTHY LIVING, EATING, EXERCISE AND MENTAL HEALTH. THE FACEBOOK SITE HAS 100 ACTIVE PARTICIPANTS. IT IS HOPED A VIRTUAL CHALLENGE CAN BE HELD IN 2021. THE WALK/RUN IS NOW PART OF THE SUICIDE PREVENTION COALITION.LOCAL BIG BUSINESS COOPERATION AND INVOLVEMENTTHE EFFECTS OF COVID SEEM TO BE DISAPPEARING, AS SOME OF THE LOCAL BIG BUSINESSES HAVE BEGUN TO LET EVENTS LIKE THIS AND THE PURPOSE BACK INTO THE ORGANIZATION. WITH VISITS TO NBT BANK, UHS CHENANGO MEMORIAL, AND ALVOGEN, THE MESSAGE WILL CONTINUE TO SPREAD. THESE STOPS SAW THE FOLLOWING NUMBERS:NBT NUMBER OF GUESTS 71UHS CHENANGO MEMORIAL 75ALVOGEN 59WE EXPECT TO INTERACT WITH MORE BUSINESS IN THE COMING YEARS. COMMUNITY INVOLVEMENT IS IMPORTANT AND ALWAYS THE HARD PART ABOUT PREDICTING SUCCESS, BUT ALONG WITH PERSISTENCE AND COMMUNITY PARTNER INVOLVEMENT THE CHANCES OF SUCCESS IS MORE PROBABLE. PRIORITY: PREVENT CHRONIC DISEASESFOCUS AREA: PREVENTIVE CARE AND MANAGEMENTGOAL: IN THE COMMUNITY SETTING, IMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASES, INCLUDING ASTHMA, ARTHRITIS, CARDIOVASCULAR DISEASE, DIABETES AND PREDIABETES AND OBESITY.OBJECTIVE: BY DECEMBER 31, 2024 INCREASE THE PERCENTAGE OF ADULTS WITH CHRONIC CONDITIONS (ARTHRITIS, ASTHMA, CVD, DIABETES, CKD,) WHO HAVE TAKEN A COURSE OR CLASS TO LEARN HOW TO MANAGE THEIR CONDITION BY 5%. INCREASE HEALTH SYSTEM REFERRALS BY 5%. OVERALL, DECREASE A1CS BY 5% OF PARTICIPANTS THAT COMPLETED THE PROGRAM.DISPARITIES: LOW-INCOME, GEOGRAPHY, AGEINTERVENTIONS: CHN, UHS CHENANGO MEMORIAL HOSPITAL AND BASSETT HEALTH CARE: CHRONIC DISEASE SELF-MANAGEMENT PROGRAMEXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE BASSET HEALTH CARE: NATIONAL DIABETES PREVENTION PROGRAMEXPAND ACCESS TO THE NATIONAL DIABETES PREVENTION PROGRAM (NATIONAL DPP), A LIFESTYLE CHANGE FOR PREVENTING TYPE 2 DIABETES
PART V, SECTION B, LINE 11:	FAMILY OF MEASURES: NUMBER OF HEALTH SYSTEMS THAT HAVE POLICIES & PRACTICES FOR IDENTIFYING AND REFERRING PATIENTS TO EVIDENCE-BASED SELF- MANAGEMENT EDUCATION (EBSMP) (PROGRAMS OFFERED: CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP), DIABETES SELF-MANAGEMENT PROGRAM (DSMP), PAIN SELF-MANAGEMENT PROGRAM (PSMP) NUMBER AND TYPE OF EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMS IN COMMUNITY SETTINGS NUMBER OF PATIENTS WHO PARTICIPATE IN EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMS PERCENTAGE OF PATIENTS WHO COMPLETE EVIDENCE-BASED SELF-MANAGEMENT EDUCATION PROGRAMS A1C PRE/POST FOR DIABETES MANAGEMENT PROGRAM OTHER PRE/POST FOR PAIN MANAGEMENT PROGRAM NUMBER OF HEALTH SYSTEMS THAT HAVE POLICIES & PRACTICES FOR IDENTIFYING AND REFERRING PATIENTS TO NATIONAL DIABETES PREVENTION PROGRAMS (NDPP) NUMBER OF NATIONAL DIABETES PREVENTION PROGRAMS IN COMMUNITY SETTINGS NUMBER OF PATIENTS REFERRED TO NATIONAL DIABETES PREVENTION PROGRAMS NUMBER OF PATIENTS WHO PARTICIPATE IN NATIONAL DIABETES PREVENTION PROGRAMS PERCENTAGE OF PATIENTS WHO COMPLETE NATIONAL DIABETES PREVENTION PROGRAMSPROJECTED (OR COMPLETED) YEAR 1 INTERVENTIONS OFFER:O CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)O DIABETES SELF-MANAGEMENT PROGRAM (DSMP) 95% OF PARTICIPANTS REGISTERED COMPLETE THE PROGRAMPROJECTED YEAR 2 INTERVENTIONS OFFER: O CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)O DIABETES SELF-MANAGEMENT PROGRAM (DSMP)O PAIN SELF-MANAGEMENT PROGRAM (PSMP) UHS CHENANGO MEMORIAL HOSPITAL TO GENERATE REFERRALS VIA THEIR ELECTRONIC MEDICAL RECORDPROJECTED YEAR 3 INTERVENTIONS OFFER:O CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP)O DIABETES SELF-MANAGEMENT PROGRAM (DSMP)O PAIN SELF-MANAGEMENT PROGRAM (PSMP) INSTITUTE THE NATIONAL DIABETES PREVENTION PROGRAM (NDPP)IMPLEMENTATION PARTNERS, PARTNER ROLE(S) AND RESOURCESLOCAL HEALTH DEPARTMENTCHRONIC DISEASE SELF-MANAGEMENTREFERRALS, OUTREACH, AND CLASS PROMOTIONCOMMUNITY-BASED ORGANIZATIONCHRONIC DISEASE SELF-MANAGEMENT CHENANGO HEALTH NETWORK - FUNDING, PROGRAM FACILITATORS, SPACE, REFERRALS, OUTREACH AND EDUCATION ABOUT CLASSES, ADVERTISE THE CLASSES, COLLECTING AND TRACKING DATA IN GSI NORWICH FAMILY YMCA - SPACE, OUTREACH AND EDUCATION ABOUT CLASSES, AND ADVERTISE THE CLASSESHOSPITALCHRONIC DISEASE SELF-MANAGEMENT UHS CHENANGO MEMORIAL HOSPITAL - FUNDING, PROGRAM FACILITATORS, SPACE, REFERRALS VIA PROVIDERS AND EMR, OUTREACH AND PROMOTION BASSETT FACILITATE NATIONAL DIABETES PREVENTION PROGRAM, FUNDING, REFERRALS, OUTREACH AND PROMOTION.PROVIDERSCHRONIC DISEASE SELF-MANAGEMENTPROMOTE AND REFERRAL SOURCEOTHERCHRONIC DISEASE SELF-MANAGEMENT CARE COMPASS NETWORK, DSRIP OUTREACH AND PROMOTIONOFFICE OF THE AGINGCHRONIC DISEASE SELF-MANAGEMENTSPACE, REFERRAL, OUTREACH AND PROMOTION 2022 UPDATEIMPROVE SELF-MANAGEMENT SKILLS FOR INDIVIDUALS WITH CHRONIC DISEASESTHE CHRONIC DISEASE SELF-MANAGEMENT (CDSM) HAS ALWAYS BEEN OUR GO TO PROGRAM FOR SPREADING INFORMATION AND PERSONAL MANAGEMENT ADVICE. THIS PROGRAM ALWAYS SEEMS TO DRAW A CROWD AND INTEREST. SUCCESS IN THE TRANSFER OF KNOWLEDGE IS THIS PROGRAMS STRONG BLOODLINE AND WW SEE THAT CONTINUING IN THE YEARS TO COME.DIABETES AND PREDIABETES ARE ALWAYS IMPORTANT PROGRAMS FOR THE CHENANGO COMMUNITY. BOTH THE CHENANGO HEALTH NETWORK AND UHS CHENANGO MEMORIAL CONTINUE TO WORK TOGETHER IN SUPPORTING THE DIABETES SELF-MANAGEMENT PROGRAM (DSMP). THIS PROGRAM PLAYS AN IMPORTANT ROLE IN THE COMMUNITY AND WILL CONTINUED TO BE SCHEDULED THROUGHOUT THE NEXT SEVERAL YEARS. PAIN SELF-MANAGEMENT, CARDIOVASCULAR DISEASE AND OBESITY HAVE ALL TRANSITIONED TO A VIRTUAL FORMAT MAKING IT EASIER FOR PEOPLE TO ATTEND IN THIS RURAL ENVIRONMENT. AFTER THE PANDEMIC THIS PROGRAM WAS REDUCED IN PARTICIPANT SIZE BUT HAS STARTED TO GROW, INCLUDING THE VIRTUAL COMPONENT. THE CHENANGO HEALTH NETWORK CONTINUES TO LEAD ALL THESE INITIATIVES AND COMMUNITY EVENTS. THEY WILL CALL ON UHS CHENANGO MEMORIAL WHEN NEEDED AND WE WORK TOGETHER WITH GREAT SUCCESS. PREVENTING CHRONIC DISEASE TOUCHES A CORD WITH ALL ASPECTS OF HEALTHCARE IN CHENANGO COUNTY.

Schedule H (Form 990) 2022

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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?9
Name and address		Type of Facility (describe)
1	1 - UHS IMAGING 6 NEWTON AVENUE NORWICH,NY13815	IMAGING CARE CENTER
2	2 - UHS PHYSICAL THERAPY 26 CONKEY AVENUE NORWICH,NY13815	CENTER FOR PHYSICAL THERAPIES
3	3 - UHS PRIMARY CARE - SIDNEY 44 PEARL STREET SIDNEY,NY13838	PRIMARY CARE CENTER
4	4 - UHS PEDIATRICS 4 NEWTON AVENUE NORWICH,NY13815	PEDIATRIC CARE CENTER
5	5 - UHS ORTHOPEDICS 4 NEWTON AVENUE NORWICH,NY13815	ORTHOPEDIC CARE CENTER
6	6 - UHS GENERAL SURGERY 4 NEWTON AVENUE NORWICH,NY13815	GENERAL SURGERY CARE CENTER
7	7 - UHS PRIMARY CARE - SHERBURNE 38A CLASSIC STREET SHERBURNE,NY13460	PRIMARY CARE CENTER
8	8 - UHS PRIMARY CARE - OXFORD 21 NORTH CANAL STREET OXFORD,NY13830	PRIMARY CARE CENTER
9	9 - UHS WOMEN'S HEALTH 32 CONKEY AVENUE NORWICH,NY13815	WOMEN'S HEALTH
10

Schedule H (Form 990) 2022

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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
PART I, LINE 7:	A COMBINATION OF IRS PROVIDED WORKSHEETS AND THE RATIO OF PATIENT CARE COST TO CHARGES WAS USED.
PART I, LN 7 COL(F):	100% OF THE ANNUAL BAD DEBT EXPENSE OF $2,304,237 WAS NOT INCLUDED IN THE CALCULATION OF NET BENEFIT EXPENSE.
PART III, LINE 2:	THE COST OF BAD DEBTS IS TAKEN FROM THE 2022 AUDITED FINANCIAL STATEMENTS.
PART III, LINE 3:	THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2022 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2022 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2022, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 13.95% OF THE TOTAL BAD DEBT WRITE-OFFS.
PART III, LINE 4:	THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON A PERCENTAGE ALLOCATION APPLIED TO THE TOTAL BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. THE PERCENTAGE CALCULATION COMPARED THE 2022 ACTUAL BAD DEBT WRITE-OFFS RELATED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE TO THE TOTAL 2022 ACTUAL BAD DEBT WRITE-OFFS. THIS CALCULATION DID NOT INCLUDE ESTIMATES OR ACCRUALS. IN 2022, THE WRITE-OFFS RELATED TO PATIENTS ELIGIBE FOR FINANCIAL ASSISTANCE WAS APPROXIMATELY 13.95% OF THE TOTAL BAD DEBT WRITE-OFFS.
PART III, LINE 8:	CMH FEELS THAT ANY SERVICES PROVIDED TO MEDICARE BENIFICIARIES THAT RESULTS IN A SHORTFALL TO THE ORGANIZATION BASED ON A LESS THAN ADEQUATE MEDICARE REIMBURSEMENT SHOULD BE TREATED AS A COMMUNITY BENEFIT. CMH TREATS ANY AND ALL COMMUNITY MEMBERS REGARDLESS OF ABILITY TO PAY. CMH'S SERVICE REGION HAS A HIGHER PROPORTION OF ELDERLY THAN THE U.S. AVERAGE. THEREFORE, CMH IS SERVICING AT RISK MEDICARE BENEFICIARIES WITH ALL ITS PROGRAMS AND SERVICES.
PART III, LINE 9B:	THE ORGANIZATION'S COLLECTION POLICY PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE AS FOLLOWS:CHARITY CARE IS GIVEN FIRST, THE REMAINING BALANCE, IS THEN SUBJECT TO AN INTEREST FREE PAY PLAN. IF THE PATIENT GUARANTOR CHOOSES TO IGNORE ALL FURTHER ATTEMPTS TO MAKE ARRANGEMENTS FOR PAYMENTS, AFTER 180 DAYS THE ACCOUNT IS SENT TO A COLLECTION AGENCY AT THE DISCOUNTED LEVEL.CMH'S POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.CMH REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. CMH PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. CMH ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENCING LEGAL ACTION.
PART VI, LINE 2:	IN BETWEEN CHNA SUBMITTALS, UHS CHENANGO MEMORIAL HOSPITAL (CMH) USES INPATIENT AND OUTPATIENT SURVEYS ADMINISTERED THROUGH PRESS GANEY TO COLLECT PATIENT INPUT. ALL CMH PATIENTS, BOTH INPATIENT AND OUTPATIENT, RECEIVE EASY-TO-COMPLETE FORMS ASKING THEM QUESTIONS ABOUT THE CARE ISSUES THEY FEEL NEED TO BE ADDRESSED, AND SERVICES THAT NEED TO BE IMPROVED OR ADDED. PATIENTS PROVIDE VALUABLE INFORMATION IN THE "COMMENTS" SECTION OF THESE SURVEYS. EACH MONTH, THE SURVEY SCORES ARE COMPARED TO A ROLLING 12-MONTH AVERAGE AND TARGETS. THE TARGETS ARE BASED ON NATIONAL AVERAGES TO DETERMINE IF CMH IS AT OR ABOVE TARGET, WITHIN 10% OF APPROACHING TARGET, OR IS MORE THAN 10% BELOW TARGET. THE PROCESS FOR COMPILING AND REPORTING THIS DATA HAS BEEN CUMBERSOME AND TIME CONSUMING. IN 2022, CMH IDENTIFIED THREE OPPORTUNITIES TO IMPROVE THE PROCESS: 1) DEVELOP MORE PURPOSEFUL, CONSISTENT VISUALS (CHARTS) ACROSS SURVEY TYPES, 2) CREATE MORE USEFUL PATIENT COMMENT SHARING - FOR BOTH SUCCESSES AND REMINDERS OF AREAS FOR IMPROVEMENT, AND 3) INCREASE STAFF INVOLVEMENT WITH MORE TRANSPARENCY ON PERFORMANCE AND CREATE A PLATFORM FOR EDUCATION.DEPARTMENTAL SURVEY SCORES ARE NOW SHOWN IN A "SCORECARD" FORMAT THAT IS A CLEANER VISUAL AND IS EASY TO USE AND MODIFY. IT IS ALSO A BETTER REPRESENTATION OF ACTUAL PERFORMANCE ILLUSTRATING CAHPS AND HCAHPS SCORES AS WELL AS PATIENT COMMENTS. CMH'S PATIENT EXPERIENCE TEAM REVIEWS THE CHARTS MONTHLY AND DEPARTMENT LEADERS SHARE THE CHARTS WITH THEIR STAFF SO THEY CAN SEE PROGRESS AGAINST TARGETS AND READ PATIENT COMMENTS. PATIENT COMMENTS THAT REQUIRE MANAGEMENT CONSIDERATION ARE FORWARDED TO THE APPROPRIATE LEADERS FOR REVIEW AND DISCUSSION TO IMPROVE SERVICES.LIVING IN A SMALL COMMUNITY, WE ALSO GET SUGGESTIONS DIRECTLY FROM RESIDENTS ABOUT SERVICES THAT ARE NEEDED OR NEED IMPROVEMENT. HOSPITAL BOARD MEMBERS, AUXILIARY BOARD MEMBERS, AND FOUNDATION BOARD MEMBERS ARE VERY VOCAL ABOUT WHAT THEY ARE HEARING IN THE COMMUNITY OR EXPERIENCING THEMSELVES. EMPLOYEES ARE QUITE CRITICAL ABOUT THEIR OR THEIR FAMILY'S EXPERIENCES IN ALL FACETS OF PATIENT CARE PROVIDING VALUABLE FEEDBACK WITH A TRAINED EYE. BASED ON THIS FEEDBACK AND THOSE OF PATIENTS CALLING IN OR VISITING PROVIDERS, THE HOSPITAL HAS DEVELOPED THE FOLLOWING INITIATIVES.THE HOSPITAL HAS USED OTHER MEANS FOR COLLECTING COMMUNITY INPUT BETWEEN NEEDS ASSESSMENTS. FOCUS GROUPS HAVE BEEN USED TO DISCUSS A SPECIFIC NEED THAT HAS BEEN IDENTIFIED AND REQUIRES FURTHER RESEARCH. FOCUS GROUPS WERE HELD DURING OUR MOST RECENT NEEDS ASSESSMENT PROCESS AND MORE INFORMATION ABOUT THAT IS AVAILABLE IN PART V, SECTION C - SUPPLEMENTAL INFORMATION FOR PART V, SECTION B.CMH ALSO LOOKS AT DIAGNOSIS CODES AND MARKET DATA PERIODICALLY TO DETECT DEVELOPING TRENDS AND ADDRESS THEM AS NEEDED.LASTLY, THE HOSPITAL'S VP OF SERVICE COORDINATION & DEVELOPMENT IS CHAIRMAN OF THE CHENANGO HEALTH NETWORK (CHN). THE CHN IS CHENANGO COUNTY'S RURAL HEALTH NETWORK. THE BOARD CONSISTS OF 13 COMMUNITY LEADERS REPRESENTING A CROSS SECTION OF HEALTH CARE SERVICES IN THE AREA. THIS GROUP MEETS MONTHLY AND DISCUSSES HEALTH CARE CONCERNS AND OPPORTUNITIES IN THE COMMUNITY AND INITIATES SUBCOMMITTEES TO ADDRESS SPECIFIC ISSUES AS NEEDED.
PART VI, LINE 3:	OUR 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 OUR CHARITY CARE POLICY AS FOLLOWS:* EVERY CLINIC AND AREA OF PATIENT REGISTRATION HAS A NOTICE POSTED INFORMING THE PATIENT/S/PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE* BROCHURES DESCRIBING THE POLICY ARE AVAILABLE AT CLINICS, POINTS OF REGISTRATION, AND ARE MAILED TO SELF PAY PATIENTS ALONG WITH APPLICATIONS* INPATIENTS ARE VISITED BY THE PATIENT FINANCIAL ADVOCATE. THEY ARE MADE AWARE OF GOVERNMENT PROGRAMS AND IF NECESSARY, ARRANGEMENTS ARE MADE WITH THE DEPARTMENT OF SOCIAL SERVICES TO HAVE A WORKER COME IN AND TAKE THE APPLICATION FROM THE PATIENT. THE PATIENT IS GIVEN INFORMATION AND AN APPLICATION FOR FINANCIAL ASSISTANCE, WHICH CAN BE COMPLETED AT THE PATIENT'S BEDSIDE.* THE WOMAN'S HEALTH CENTER INFORMS ALL SELF PAY PREGNANT WOMEN OF THE "PRESUMPTIVE ELIGIBILITY" PROCESS AND PATIENTS ARE DIRECTED TO PATIENT FINANCIAL SERVICES FOR COMPLETION OF THE APPLICATION AND COMPLETION OF A WIC APPLICATION IF PATIENT SO DESIRES* EVERY CMH EMPLOYEE IS MADE AWARE OF THE CHARITY CARE PROGRAM AT ORIENTATION AND ENCOURAGED TO INFORM PATIENTS AND THE PUBLIC ABOUT THE PROGRAM. PERSONNEL WHO HAVE PATIENT CONTACT ARE ANNUALLY IN-SERVICED ON CHARITY CARE PROGRAM* EVERY BILL THAT IS SENT OUT IS MARKED "FOR INFORMATION REGARDING OUR "PATIENT FINANCIAL ASSISTANCE" PROGRAM" PLEASE CONTACT 607-337-4295
PART VI, LINE 4:	CHENANGO COUNTY IS A RURAL COUNTY IN THE SOUTH-CENTRAL AREA OF NEW YORK, FREQUENTLY REFERRED TO AS THE SOUTHERN TIER. CONTIGUOUS COUNTIES INCLUDE MADISON, OTSEGO, DELAWARE, BROOME, AND CORTLAND. NORWICH, THE COUNTY SEAT, IS APPROXIMATELY 112 MILES WEST OF ALBANY, 40 MILES NORTH OF BINGHAMTON, AND 60 MILES SOUTHEAST OF SYRACUSE. THERE ARE 21 TOWNSHIPS, 8 VILLAGES, AND 1 CITY IN THE COUNTY. THE COUNTY'S LAND AREA CONSTITUTES 899 SQUARE MILES AND IS COMPRISED MAINLY OF RURAL LANDSCAPES WITH AGRICULTURAL LAND (35%) AND FOREST (60%) BEING THE TWO MOST PREDOMINANT. APPROXIMATELY 112,000 ACRES, OR 20%, OF CHENANGO COUNTY'S LAND IS STATE OWNED. THE PRIMARY CONNECTOR FROM CHENANGO COUNTY TO THE REST OF NEW YORK STATE IS STATE ROUTE 12, WHICH PROVIDES LINKS TO THE NYS THRUWAY, AND INTERSTATES 81, 86, AND 88. THERE IS ACCESS TO AIR TRANSPORTATION THROUGH COMMERCIAL AIRPORTS IN BINGHAMTON, UTICA, SYRACUSE, AND ALBANY. BINGHAMTON AIRPORT IS THE CLOSEST AIRPORT AT 42 MILES FROM NORWICH. IN ADDITION, THE LT. WARREN EATON AIRPORT IN NORWICH PROVIDES ACCESS TO PRIVATE AIR TRAVEL. CMH HAS A HELIPORT WHICH ALLOWS PATIENTS IN NEED OF INTENSIVE CARE TO BE AIRLIFTED TO LARGER CARE CENTERS. THE COUNTY DOES NOT HAVE ACCESS TO COMMUTER RAIL TRANSPORTATION. COACH USA AND GREYHOUND LINES OFFER BUS TRANSPORTATION TO AND FROM THE AREA. CHENANGO FIRST TRANSIT PROVIDES BUS SERVICE VIA SIX FIXED ROUTES WITHIN THE COUNTY. THE TRAVEL TIME TO HOSPITALS OTHER THAN CMH FOR CHENANGO COUNTY RESIDENTS IS SUBSTANTIAL. AS NOTED BELOW, THE NEAREST LARGE HOSPITALS REQUIRE TRAVEL OF UP TO 45 MINUTES OR MORE.A.O. FOX HOSPITAL, ONEONTA, NY, IS 32 MILES OR 45 MINUTESM.I. BASSETT HEALTHCARE, COOPERSTOWN, NY, IS 44 MILES OR 1 HOURUHS BINGHAMTON GENERAL HOSPITAL, NY, IS 43 MILES OR 1 HOURCOMMUNITY MEMORIAL HOSPITAL, HAMILTON, NY, IS 22 MILES OR 30 MINUTESCORTLAND REGIONAL MEDICAL CENTER, NY, IS 43 MILES OR 1 HOURCROUSE HOSPITAL, SYRACUSE, NY, IS 58 MILES OR 1 HOUR, 15 MINUTESOUR LADY OF LOURDES HOSPITAL, BINGHAMTON, NY, IS 42 MILES OR 1 HOURSYRACUSE VA MEDICAL CENTER, NY, IS 58 MILES OR 1 HOUR, 15 MINUTESTRI TOWN REGIONAL HOSPITAL (ED ONLY), NY, 22 MILES OR 30 MINUTESUHS WILSON MEDICAL CENTER, JOHNSON CITY, NY, IS 44 MILES OR 1 HOURUPSTATE UNIVERSITY HOSPITAL, SYRACUSE, NY IS 58 MILES OR 1 HOUR, 15 MINUTESDEMOGRAPHICALLY, 95% OF THE COUNTY'S POPULATION (47,527) IS PREDOMINANTLY WHITE. THE REMAINING POPULATION INCLUDES HISPANIC/LATINO, BLACK, ASIAN AND AMERICAN INDIAN. CHENANGO COUNTY IS 50TH IN TOTAL POPULATION AMONG THE 62 COUNTIES IN NEW YORK STATE AND HAS BEEN EXPERIENCING A STEADY DECLINE IN ITS OVERALL POPULATION. AS WITH THE REST OF THE UNITED STATES, THE POPULATION OF CHENANGO COUNTY IS AGING. THE MEDIAN AGE OF THE POPULATION HAS CONTINUED TO INCREASE OVER TIME, RISING FROM AGE 43 IN 2010 TO AGE 44.9 IN 2017 AND HAS STAYED RELATIVELY CONSISTENT, AT 45.1% IN 2022. THE GROUP THAT HAS SEEN THE LARGEST INCREASE DURING THIS TIME IS ADULTS AGED 65 TO 79, WITH A POPULATION INCREASE FROM 14.6% IN 2016 TO 20.4% IN 2022.THE CHENANGO COUNTY UNEMPLOYMENT RATE IS TYPICALLY HIGHER THAN THAT OF NYS AS A WHOLE. AS OF 2022, THE CHENANGO COUNTY UNEMPLOYMENT RATE (NOT SEASONALLY ADJUSTED) WAS 6.5% WHILE THE NYS RATE WAS 5.7%. OF THE 29,071 PEOPLE AGED 16-64 IN THE COUNTY, 76.5% (22,232) WORKED AT LEAST PART-TIME FOR PART OF THE YEAR. THE NUMBER OF PEOPLE AGED 16-64 IN CHENANGO COUNTY WHO DID NOT WORK AT ALL INCREASED FROM 7,755 (23.8%) IN 2010 TO 8,548 (27.7%) IN 2016 AND THEN INCREASED TO 8,741 (28.5%) IN 2022. OF THOSE WORKERS WHO DID WORK, NEARLY TWO-THIRDS OR 65.2%, WORKED FULL-TIME, YEAR-ROUND, AND 77.9% OF WORKERS USUALLY WORKED 35 HOURS OR MORE IN 2022, SLIGHTLY DOWN FROM 78.9% IN 2016. IN 2022, 17.5% OF THE PEOPLE IN CHENANGO COUNTY AGED 18 TO 64 IDENTIFIED AS HAVING A DISABILITY, AN INCREASE FROM 16.4% IN 2016. 57.7% OF PEOPLE WITH DISABILITIES ARE NOT IN THE LABOR FORCE WHILE 33.3% ARE EMPLOYED.CHENANGO COUNTY HAS A SIGNIFICANTLY LOWER MEDIAN INCOME THAN NEW YORK STATE AS A WHOLE, BOTH FOR HOUSEHOLDS AND FAMILIES. THIS SUGGESTS THAT THE COUNTY POPULATION OVERALL HAS LESS "BUYING" POWER. THE MEDIAN HOUSEHOLD INCOME IN 2022 WAS $50,411 IN CHENANGO COUNTY WHILE NYS WAS $71,117. MEDIAN FAMILY INCOME IN 2022 WAS $65,743 FOR FAMILIES..CHENANGO COUNTY IS A POOR COUNTY WITH 27% OF ITS POPULATION AND 15.8% OF ITS CHILDREN LIVING BELOW THE FEDERAL POVERTY LEVEL. THE NUMBER OF CHILDREN AGED 0-17 LIVING IN POVERTY DECREASED FROM 18.9% IN 2016 TO 17.6% IN 2022. OF THOSE FAMILIES WITH FEMALE HEADS OF HOUSEHOLD AND CHILDREN PRESENT, 33.6% LIVE IN POVERTY. OF THE 29,071 PEOPLE AGED 16-64 IN THE COUNTY, 76.5% (22,232) WORKED AT LEAST A PART-TIME FOR PART OF THE YEAR. POOR ECONOMIC STATUS IS OFTEN ASSOCIATED WITH POOR HEALTH OUTCOMES AS THOSE WITHOUT MEANS ARE NOT IN A POSITION TO MAKE LIFESTYLE CHANGES TO PROMOTE GOOD HEALTH. IN CHENANGO COUNTY MANAGING EXPENSES RELATED TO FOOD, HOUSING, CLOTHING, TRANSPORTATION, CHILD CARE AND HEALTH CARE IS A MAJOR STRESSOR FOR INDIVIDUALS PARTICULARLY WITH FAMILIES AND SENIOR ADULTS. CHENANGO COUNTY'S POVERTY LEVELS BRING TO FOCUS FOOD INSECURITIES FOR THAT POPULATION. ONE OF THE ISSUES OF GENERATIONAL POVERTY (FAMILIES AND INDIVIDUALS LIVING IN POVERTY GENERATION TO GENERATION) THAT IS EVIDENT IN THE COUNTY IS THE UTILIZATION OF FOOD PANTRIES AND FREE MEAL PROGRAMS OFFERED BY AREA CHURCHES. RESIDENTS WITH FOOD INSECURITY LIVE DAY-TO-DAY TO PROVIDE FOR THEMSELVES AND THEIR FAMILIES; THEY FOCUS ON DAY-TO-DAY SURVIVAL VERSUS DEVELOPING STRATEGIES TO PREVENT FOOD INSECURITY AND OTHER HEALTH CONCERNS.DATA FROM NYSDOH INDICATES THAT AS OF OCTOBER OF 2022, 29% OF THE CHENANGO COUNTY POPULATION (17,038 MEMBERS) WAS ENROLLED IN MEDICAID. THIS IS SLIGHTLY BELOW THE NYS RATIO OF 44.1% FOR THE SAME TIME PERIOD. THE NUMBER OF PEOPLE ENROLLED IN MEDICAID IN CHENANGO COUNTY HAS INCREASED BY 6.8% SINCE 2017 (13,912 MEMBERS), A RATE SLIGHTLY LOWER THAN NYS'S INCREASE OF 12.8%.THE INCREASE IN THE NUMBER OF MEDICAID ENROLLEES IS REFLECTED IN THE TREND TOWARD LOWER UNINSURED RATES. ACCORDING TO CENSUS DATA, THE PERCENTAGE OF THE COUNTY POPULATION WITHOUT INSURANCE DECLINED FROM 5.3% IN 2017 TO THE CURRENT LOW OF 4.1% IN 2022. THIS DATA SHOWS THAT AS THE PERCENTAGE OF PEOPLE WHO ARE INSURED HAS INCREASED, THE DISTRIBUTION OF PEOPLE COVERED BY DIFFERENT INSURANCE ENTITIES HAS ALSO CHANGED. IN 2022, A HIGHER PERCENTAGE OF CHENANGO COUNTY RESIDENTS WERE COVERED BY INSURANCE THAT THEY PURCHASED DIRECTLY (SUCH AS THROUGH THE STATE EXCHANGE) AND THROUGH MEDICAID ONLY, THAN WERE IN 2017. FEWER CHENANGO COUNTY RESIDENTS WERE ENROLLED IN MORE THAN ONE INSURANCE PLAN IN 2022, THAN COMPARED TO 2017. FEWER CHENANGO COUNTY RESIDENTS IN 2022 WERE ALSO NOT COVERED BY EMPLOYER-BASED INSURANCE PLANS THAN IN 2017. AS OF YEAR-END 2022, UHS CHENANGO MEMORIAL HOSPITAL SHOWED A PAYER MIX OF 39% MEDICARE, 25% MEDICAID, 18% COMMERCIAL, 10% SELF-PAY AND 8% OTHER.** CONTINUED ON SCHEDULE H SUPPLEMENTAL INFORMATION
PART VI, LINE 5:	COMMUNITY BOARDUHS CHENANGO MEMORIAL'S BOARD OF DIRECTORS TOTALS 16 MEMBERS, 11 OF WHOM ARE LOCAL RESIDENTS AND COMMUNITY LEADERS IN BANKING, LAW, PHARMACEUTICALS, MANUFACTURING, INSURANCE, INVESTMENTS, AND INDEPENDENT BUSINESS. THE BOARD MEETS BI-MONTHLY. THE BOARD ALSO HAS COMMITTEES THAT FOCUS ON FINANCES, STAFF CREDENTIALING, AND GOVERNANCE ALL OF WHICH HAVE REPRESENTATION FROM THE COMMUNITY.THE CMH AUXILIARY, WHO ALSO REPORT UNDER THE HOSPITAL'S TAX ID NUMBER, HAS ITS OWN BOARD THAT MEETS MONTHLY AND CONSISTS OF 16 MEMBERS ALL OF WHOM LIVE LOCALLY. THEY, TOO, REPRESENT A CROSS SECTION OF BUSINESSES SIMILAR TO THE HOSPITAL'S BOARD OF DIRECTORS. IN ADDITION, THEY INCLUDE RETIRED INDIVIDUALS AND FAMILY MEMBERS OF PROMINENT COMMUNITY LEADERS IN THE AREA.ALTHOUGH THE CHENANGO MEMORIAL HOSPITAL FOUNDATION, INC., HAS ITS OWN TAX ID NUMBER, ITS SOLE PURPOSE IS TO SUPPORT THE HOSPITAL THROUGH FUNDRAISING. THE FOUNDATION BOARD ALSO HAS 14 MEMBERS WHO REPRESENT BUSINESSES FROM THROUGHOUT THE COUNTY AND MEET APPROXIMATELY 3 TIMES PER YEAR.OPEN MEDICAL STAFF THE HOSPITAL REVIEWS MEDICAL STAFF PRIVILEGES OF ANY QUALIFIED PHYSICIANS AND ALLIED PROFESSIONALS IN THE COMMUNITY THAT APPLY. THE RIGOROUS CREDENTIALING PROCESS INCLUDES REVIEW BY AN INTERNAL CREDENTIALS COMMITTEE AND MEDICAL EXECUTIVE COMMITTEE. AFTER APPROVAL FROM THESE TWO COMMITTEES, THE APPLICATION PROCEEDS TO THE PROFESSIONAL ADVISORY COMMITTEE (PAC), A SUBCOMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES, FOR APPROVAL. AFTER APPROVAL BY PAC, THE APPLICATION PROCEEDS TO THE HOSPITAL'S BOARD OF DIRECTORS FOR FINAL APPROVAL AND CREDENTIALING. USE OF SURPLUS FUNDS SURPLUS FUNDS ARE MADE AVAILABLE PRIMARILY FOR PURCHASES OF EQUIPMENT, FACILITY IMPROVEMENTS, OR TECHNOLOGY TO IMPROVE PATIENT CARE. IN SOME INSTANCES, FUNDS ARE USED TO SUPPORT NEW SERVICES. CHENANGO MEMORIAL HOSPITAL WILL BEGIN TO DRAW FROM ITS 20 MILLION DOLLAR TRANSFORMATION II GRANT AWARDED BY THE NYS DEPARTMENT OF HEALTH IN 2022. THIS LATEST AWARD WILL BE USED FOR PRIMARY CARE AND SPECIALTY SERVICE RELOCATION, GROWTH AND UPDATES. THE FLOOR PLANS ARE BEING FINALIZED. MUCH WORK HAS GONE INTO CREATING A MORE MODERN AND USER FRIENDLY SPACE FOR BOTH STAFF AND PATIENTS. NEW WORK IS SCHEDULED TO BEGIN THE NEXT PHASE LATE IN 2023. THE HOSPITAL RELOCATED THE WOMEN'S HEALTH CENTER TO THE EATON CENTER IN DOWNTOWN NORWICH TO MAKE WAY FOR THE NEW EMERGENCY ROOM. THE CENTER NOW HAS SIGNIFICANTLY MORE SPACE AND INCLUDES A BREASTFEEDING AREA, TWO TREATMENT ROOMS, ADDITIONAL EXAM ROOMS, AND AN EDUCATION AREA SUITABLE FOR CHILDBIRTH EDUCATION CLASSES, SUPPORT GROUPS, ETC. CHENANGO MEMORIAL IS THE ONLY HOSPITAL ALONG THE ROUTE 12 CORRIDOR BETWEEN BINGHAMTON AND ONEIDA WITH OBSTETRIC SERVICES. MOST OF THE COSTS OF THE CONSTRUCTION HAVE BEEN ABSORBED IN THE LEASE. HOWEVER, THE HOSPITAL STILL PAID $30,000 FOR RELATED EXPENSES AND $18,000 FOR AN ADDITIONAL ULTRASOUND MACHINE. THE NEW SPACE WENT LIVE MARCH 27, 2020. RENOVATIONS TOOK PLACE IN THE HOSPITAL'S SIDNEY CLINIC AT THE END OF 2019 AND WE HAVE CONTINUED TO IMPROVE THE SPACE INTO 2022. 3D MAMMOGRAMS REDUCE THE NEED FOR MULTIPLE TESTS AND SAVE WOMEN ANXIETY ABOUT POTENTIALLY POSITIVE DIAGNOSES. THE TECHNOLOGY USES MULTIPLE ANGLED IMAGES AS THE MACHINE SWEEPS IN AN ARC OVER A WOMAN'S BREAST. THE RADIOLOGIST VIEWS THESE IMAGES SEQUENTIALLY. A MASS WILL STAND OUT IN THE SCAN NOT BE CAMOUFLAGED BY DENSE BREAST TISSUE AS SOMETIMES OCCURS WITH TRADITIONAL 2D MAMMOGRAPHY. THE FOLLOWING ARE THE TOP FIVE BENEFITS OF 3D MAMMOGRAPHY: A) MORE ACCURATE DETECTION, B) EARLIER DIAGNOSIS, C) BETTER DETECTION IN DENSE BREAST TISSUE, D) LESS ANXIETY FOR THE PATIENT DUE TO FALSE ALARMS WITH 2D MAMMOGRAPHY, E) IS SAFE AND EFFECTIVE WOMEN EXPERIENCE A MINIMAL AMOUNT OF ADDITIONAL RADIATION COMPARED WITH A STANDARD MAMMOGRAM. THE NEW SERVICE WENT LIVE IN FEBRUARY 13, 2022. DURING THE WINTER OF 2021-2022, THE ROOF OVER THE 1970 SECTION OF THE HOSPITAL NEEDED EMERGENCY REPLACEMENT. THIS WORK WAS COMPLETED IN APRIL OF 2022. NO SOONER HAD THAT WORK BEEN COMPLETED, WHEN THE ROOF OVER THE 1929 BUILDING STARTED LEAKING. THE REPLACEMENT OF THIS ROOF ALSO INVOLVED REPLACING AN AGING AIR HANDLING UNIT. THE PRICE OF BOTH THE ROOF AND AIR HANDLING UNIT TOTALED $900K AND WORK WAS COMPLETED IN THE SUMMER OF 2022. THE HOSPITAL EXPANDED GI SERVICES TO A FULL DAY PER MONTH FOR OFFICE VISITS AND TO 2 FULL DAYS PER MONTH FOR PROCEDURES THEREBY DOUBLING PATIENT ACCESS TO THIS SERVICE. IN ADDITION, PHYSICIANS STARTING USING PROPOFOL DURING COLONOSCOPIES AND ENDOSCOPIES. PROPOFOL REDUCES PATIENT RECOVERY TIMES WHILE MAINTAINING PATIENT SAFETY. THE FASTER TURNAROUND TIME OPENS THE SCHEDULE FOR MORE PATIENTS SEEKING CANCER SCREENINGS. THE HOSPITAL SPENT $22,000 TO PURCHASE ADDITIONAL SCOPES AND ANESTHESIA MACHINES TO SUPPORT THE INCREASED VOLUME OF PROCEDURES IN OUR AMBULATORY SURGERY DEPARTMENT. IN SEPTEMBER 2020, CHENANGO MEMORIAL WENT LIVE WITH A NEW ELECTRONIC MEDICAL RECORD SYSTEM CALLED EPIC. IMPRESSIVE UPDATES WERE MADE, INSTALLED AND TAUGHT THROUGHOUT 2022. THIS NEW SYSTEM ALLOWS CMH TO ACCESS, ORGANIZE, STORE AND SHARE ELECTRONIC MEDICAL RECORDS ACROSS THE UHS SYSTEM AS WELL AS PROVIDE VALUABLE POPULATION HEALTH INFORMATION TO GOVERNMENT AGENCIES. FROM A PATIENT PERSPECTIVE, PATIENTS CAN NOW ACCESS THEIR HEALTH INFORMATION THROUGH A NEW PATIENT PORTAL CALLED MYCHART. THROUGH MYCHART, A PATIENT CAN SEND AND RECEIVE MESSAGES FROM THEIR PROVIDER, REFILL PRESCRIPTIONS, AND SEE THEIR TEST RESULTS AMONG OTHER FEATURES. THIS IS ESPECIALLY IMPORTANT FOR SOME OF OUR PATIENTS WHO LIVE IN THE RURAL PARTS OF OUR COUNTY WHERE TRANSPORTATION TO VISIT A PROVIDER'S OFFICE IS DIFFICULT. LIKE MANY HEALTHCARE FACILITIES, CMH LAUNCHED VIRTUAL VISITS DURING THE PANDEMIC SO PATIENTS COULD CONTINUE COMMUNICATING WITH THEIR PROVIDERS. THIS NEW FORM OF ACCESS HAS PROVEN TO BE VERY CONVENIENT FOR SOME OF OUR PATIENTS AND WILL REMAIN ANOTHER OPTION FOR OUR PATIENTS TO USE TO ACCESS THE CARE THEY NEED.** SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION FOR CONTINUATION
PART VI, LINE 6:	CMH IS AN IMPORTANT PART OF THE UNITED HEALTH SERVICES SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF CMH IN 1910 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATION INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. CMH PARTICIPATES IN THE UNITED HEALTH SERVICES SYSTEMSTRATEGIC PLANNING PROCESS. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSES ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND THREE OBJECTIVES: IMPROCE OUR CARE, MANAGE OUR COSTS, AND GROW OUR MARKET SHARE. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE S THEY RELATE TO THE HOSPITAL'S SERVICES AND THE NEEDS OF OUR PATIENTS. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE CMH COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO CMH. THE OTHER HOSPITAL MEMBERS OF THE UHS SYSTEM, UHS WILSON MEDICAL CENTER, UHS BINGHAMTON GENERAL HOSPITAL, AND DELAWARE VALLEY HOSPITAL SUBMIT SEPARATE REPORTS.- CLINICAL EXCELLENCE: CMH HAS FOCUSED ITS RESOURCES AND ENERGY AROUND ACHIEVING DISTINCTION AS A HEALTH SYSTEM IN CLINICAL QUALITY, PATIENT SAFETY AND SERVICE. CMH IS FOCUSED ON VIGOROUS ASSESSMENT AND IMPROVEMENT OF THE ORGANIZATION'S PERFORMANCE USING KEY PATIENT QUALITY, SAFETY AND SATISFACTION INDICATORS. THE PLAN PLACES A FOCUS IN PARTICULAR ON EMERGENCY ROOM PERFORMANCE, CLOSER INTEGRATION OF NON-ACUTE SERVICES WITH THE HOSPITALS, DEVELOPMENT AND IMPLEMENTATION OF STATE-OF-THE-ART INFORMATION TECHNOLOGY TO SUPPORT INITIATIVES IN PATIENT QUALITY AND SAFETY AND NEW INITIATIVES IN THE RECRUITMENT AND RETENTION OF A QUALITY PHYSICIAN AND ALLIED HEALTH WORKFORCE.- SERVICE EXCELLENCE: ADDRESS DELIVERING ON THE CMH BRAND PROMISE OF A MEANINGFULLY BETTER PATIENT EXPERIENCE. THE PLAN FOCUSES ON PATIENT-CENTERED CARE AND THE BRAND PROMISE OF RESPECT AND ACCOUNTABILITY. THIS GOAL ALIGNS TECHNOLOGY WITH PERFORMANCE STANDARDS TO IMPROVE ACCESS TO BETTER MEET PATIENT NEEDS.- MARKET GROWTH: THIS GOAL AREA ADDRESSES THE KEY ASPECTS OF ALIGNING TECHNOLOGY, PHYSICIAN RESOURCES AND PROGRAMS AROUND THE CLINICAL NEEDS OF THE SERVICE AREA. THE PLAN FOCUSES ATTENTION ON KEY TERTIARY SERVICES AND THE ASSURANCE OF AN ADEQUATE SUPPLY OF PRIMARY CARE AND SPECIALIST PHYSICIANS FOR THE AREA. AT THE SAME TIME, CMH REMAINS COMMITTED TO MEETING THE COMMUNITY'S BEHAVIORAL HEALTH SERVICES NEEDS.- FINANCIAL STRENGTH: TO ENSURE CMH HAS THE FINANCIAL CAPACITY TO SUPPORT ITS CLINICAL SERVICE AND GROWTH GOALS, THE STRATEGIC PLAN CALLS THE ORGANIZATION TO DEMONSTRATE CONSISTENT PERFORMANCE WITH RESPECT TO BENCHMARKED OPERATING EFFICIENCIES. THIS INCLUDES PARTICIPATING IN 340B INDIGENT CARE PHARMACY PRICING IN ORDER TO SERVE MORE ELIGIBLE PATIENTS AND PROVIDE MORE COMPREHENSIVE SERVICE.PART VI, LINE 7CHENANGO MEMORIAL HOSPITAL FILES THE COMMUNITY BENEFIT REPORT WITH NEW YORK STATE.

Schedule H (Form 990) 2022

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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

2022

Open to Public Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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? ..................

Yes

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

Yes

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) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1JOHN M CARRIGG BOARD MEMBER 2ND V CHAIR	(i) (ii)	0 ------------- 981,834	0 ------------- 50,000	0 ------------- 547,525	0 ------------- 71,251	0 ------------- 23,106	0 ------------- 1,673,716	0 ------------- 0
2ELIZABETH K BOLAND BOARD MEMBER	(i) (ii)	0 ------------- 629,157	0 ------------- 95,000	0 ------------- 413	0 ------------- 83,984	0 ------------- 15,777	0 ------------- 824,331	0 ------------- 0
3ROHAN JAYASENA FORMER PRES OF MED STAFF TO 12/31/17	(i) (ii)	386,939 ------------- 0	300 ------------- 0	0 ------------- 0	27,000 ------------- 0	24,623 ------------- 0	438,862 ------------- 0	0 ------------- 0
4JAY SMITH BOARD MEMBER	(i) (ii)	0 ------------- 386,900	0 ------------- 5,000	0 ------------- 0	0 ------------- 12,200	0 ------------- 14,652	0 ------------- 418,752	0 ------------- 0
5DRAKE LAMEN MD BOARD MEMBER/PRES/CEO/CMO	(i) (ii)	352,377 ------------- 0	0 ------------- 0	0 ------------- 0	6,100 ------------- 0	17,563 ------------- 0	376,040 ------------- 0	0 ------------- 0
6PHYLLIS SHERIFF-WHITE PRES OF MED STAFF	(i) (ii)	325,977 ------------- 0	0 ------------- 0	0 ------------- 0	3,050 ------------- 0	21,624 ------------- 0	350,651 ------------- 0	0 ------------- 0
7MATTHEW SALANGER TO 53118 FORMER 2ND VICE CHAIR	(i) (ii)	0 ------------- 253,227	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 80	0 ------------- 253,307	0 ------------- 0
8MARTIN MASARECH MD BOARD MEMBER	(i) (ii)	0 ------------- 193,271	0 ------------- 0	0 ------------- 0	0 ------------- 20,800	0 ------------- 22,480	0 ------------- 236,551	0 ------------- 0
9DESIREE AXLEY VP FINANCE AND CFO	(i) (ii)	208,710 ------------- 0	0 ------------- 0	0 ------------- 0	4,237 ------------- 0	1,208 ------------- 0	214,155 ------------- 0	0 ------------- 0
10KRISTINA K HUMMER VP OF MEDICAL	(i) (ii)	175,894 ------------- 0	0 ------------- 0	0 ------------- 0	1,875 ------------- 0	28,287 ------------- 0	206,056 ------------- 0	0 ------------- 0
11DAVID FINNEY VP, NURSING	(i) (ii)	0 ------------- 161,481	0 ------------- 0	0 ------------- 0	0 ------------- 10,958	0 ------------- 27,894	0 ------------- 200,333	0 ------------- 0
12CHRISTINA KISACKY VP OF OPERATIONS	(i) (ii)	173,540 ------------- 0	0 ------------- 0	0 ------------- 0	3,609 ------------- 0	20,043 ------------- 0	197,192 ------------- 0	0 ------------- 0
13MARGARET SWARTWOOD CONTROLLER	(i) (ii)	162,675 ------------- 0	0 ------------- 0	0 ------------- 0	3,284 ------------- 0	12,786 ------------- 0	178,745 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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
PART I, LINE 4B	PAYMENT IN 2022 FROM A NON-QUALIFIED PLAN: JOHN CARRIGG $540,006 RE: SCHEDULE J, PART II, LINE 1, BIII - OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $540,006 INCLUDES NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). EARLY SERP DISTRIBUTIONS WERE RELATED TO INCOME TAX PAYMENTS; THE REMAINING AMOUNTS ARE DEFERRED UNTIL SUBSEQUENT TRIGGERING EVENTS.
PART I, LINE 6	THE EXECUTIVE COMPENSATION INCENTIVE PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2022 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS.
FORM 990, PART VII, SECTION A, LINE 5:	INDIVIDUAL: KRISTINA HUMMER, D.O. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $175,894
FORM 990, PART VII, SECTION A, LINE 5:	INDIVIDUAL: PHYLLIS SHERIFF-WHITE, M.D. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $325,977
FORM 990, PART VII, SECTION A, LINE 5:	INDIVIDUAL: ROHAN JAYASENA, M.D. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $387,239

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	UNITED HEALTH SERVICES, INC. IS THE SOLE MEMBER OF CHENANGO MEMORIAL HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER, UNITED HEALTH SERVICES, INC, SHALL ELECT TRUSTEES AT THE ANNUAL MEETING OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7B	UHS INC, (THE MEMBER AS DEFINED BY THE CMH BI-LAWS) MUST PROVIDE PRIOR WRITTEN APPROVAL FOR VARIOUS ACTIONS BY THE CMH BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE HOSPITALS BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF THE 990 TO MANAGEMENT. THE FINANCE DIVISION PREPARED THE 990 FORMS WHICH WERE REVIEWED BY THE ORGANIZATION'S CONTROLLER, ASSISTANT VP OF FINANCE, CORPORATE CFO AND INDEPENDENT AUDITORS PRIOR TO FILING. A SUMMARY OF KEY ELEMENTS OF THE 990 IS SHARED WITH THE BOARD OF DIRECTORS FOR INFORMATIONAL PURPOSES.
FORM 990, PART VI, SECTION B, LINE 12C	DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS ANNUALLY WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15	IT IS THE PHILOSOPHY OF THE HOSPITAL THAT ALL STAFF INCLUDING EXECUTIVE STAFF BE COMPENSATED FAIRLY FOR THEIR WORK. BASE SALARY LEVELS, INCENTIVE/BONUS PROGRAMS AND BENEFIT PLANS SHALL TAKE INTO ACCOUNT THE LOCAL, REGIONAL AND NATIONAL MARKETS TO ALLOW UHS HOSPITALS TO RECRUIT, MOTIVATE, REWARD, RECOGNIZE AND RETAIN HIGHLY TALENTED EXECUTIVES WITH THE SKILL SETS REQUIRED TO FULFILL ITS MISSION. THE EXECUTIVE COMPENSATION PROGRAM MUST FOCUS EXECUTIVES' ATTENTION ON UHS'S STRATEGIC INITIATIVES AND MISSION CRITICAL PERFORMANCE OBJECTIVES THAT WILL LEAD TO THE ORGANIZATION'S AND SYSTEM'S SUCCESS. TO CARRY OUT THIS COMPENSATION PHILOSOPHY, THE UHS HOSPITALS (WHICH INCLUDES CHENANGO MEMORIAL HOSPITAL) BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE REVIEWS ANNUALLY A COMPREHENSIVE REPORT PREPARED BY AN EXTERNAL EXECUTIVE COMPENSATION CONSULTING FIRM, SULLIVAN COTTER ASSOCIATES TO DETERMINE THE APPROPRIATENESS OF THE BASE AND TOTAL COMPENSATION LEVELS FOR THE SENIOR MANAGEMENT STAFF. THIS ANNUAL REPORT FOCUSES ON TWO KEY AREAS; 1) THE COMPETITIVENESS OF THE SENIOR MANAGEMENT STAFF'S BASE AND TOTAL COMPENSATION (INCLUDING BENEFITS) VS. NATIONAL BENCHMARK DATA FOR COMPARABLY SIZED HEALTH CARE SYSTEMS AND HOSPITALS (BASED UPON 'TOTAL REVENUE' METRICS), AND 2) A 'REASONABLENESS ASSESSMENT' CONSISTENT WITH U.S. TREASURY DEPARTMENT REGULATIONS GOVERNING EXECUTIVE COMPENSATION FOR NOT-FOR-PROFIT ORGANIZATIONS. THE DATA FROM THIS REPORT ASSISTS THE EXECUTIVE COMPENSATION COMMITTEE IN DETERMINING THE APPROPRIATENESS OF THE SENIOR MANAGEMENTS' CURRENT BASE AND TOTAL COMPENSATION LEVELS AND THE NEED FOR ANY ADJUSTMENTS FOR THAT CALENDAR YEAR.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION PROVIDES FORM 1023, FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC, UPON REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIAN SERVICE FEES: PROGRAM SERVICE EXPENSES 14,636,948. MANAGEMENT AND GENERAL EXPENSES 2,187,130. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,824,078.
FORM 990, PART XI, LINE 9:	CUMULATIVE EFFECT OF AUXILIARY INCOME AND EXPENSE -37,572. CHANGE IN INTEREST IN CHENANGO MEMORIAL HOSPITAL FOUNDATION -953,613. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS 3,668,418. RENTAL INCOME INCLUDED IN CONTRIBUTIONS -250. CHANGE IN VALUE OF FUNDS HELD IN TRUST -1,321,351. CHANGE IN ACCOUNTING PRINCIPLE 3,269.
FORM 990, PART XII, LINE 2C:	NEITHER THE PROCESS FOR THE OVERSIGHT OF THE AUDIT NOR THE PROCESS FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT HAS CHANGED DURING THE YEAR. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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

2021

Open to Public Inspection

Name of the organization

CHENANGO MEMORIAL HOSPITAL INC

Employer identification number

15-0532180

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)UNITED HEALTH SERVICES HOSPITALS INC 33-57 HARRISON STREET JOHNSON CITY,NY13790 16-1165049	HOSPITAL	NY	501 (C) (3)	3	UNITED HEALTH SERVICES INC		No
(2)IDEAL SENIOR LIVING CENTER INC 508 HIGH AVENUE ENDICOTT,NY13760 22-2902896	SENIOR LIVING CENTER	NY	501 (C) (3)	3	UNITED HEALTH SERVICES INC		No
(3)IDEAL SENIOR LIVING CENTER HOUSING CO 508 HIGH AVENUE ENDICOTT,NY13760 22-2902899	SENIOR HOUSING	NY	501 (C) (3)	10	UNITED HEALTH SERVICES INC		No
(4)TWIN TIER HOME HEALTH INC 601 RIVERSIDE DRIVE JOHNSON CITY,NY13790 22-2348211	HOME HEALTH CARE	NY	501 (C) (3)	10	UNITED HEALTH SERVICES INC		No
(5)PROFESSIONAL HOME CARE INC 601 RIVERSIDE DRIVE JOHNSON CITY,NY13790 16-1261977	HOME HEALTH CARE	NY	501 (C) (3)	10	UNITED HEALTH SERVICES INC		No
(6)DELAWARE VALLEY HOSPITAL INC ONE TITUS PLACE WALTON,NY13856 15-0524324	HOSPITAL	NY	501 (C) (3)	3	UNITED HEALTH SERVICES INC		No
(7)CMH FUND 179 NORTH BROAD STREET NORWICH,NY13815 22-2985550	INACTIVE	NY	501 (C) (3)	12B	CHENANGO MEMORIAL HOSPITAL INC		No
(8)UNITED HEALTH SERVICES INC 20-42 MITCHELL AVENUE BINGHAMTON,NY13903 22-2682421	PARENT COMPANY	NY	501 (C) (3)	10	BOARD OF DIRECTORS UHS INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

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	(h) Percentage ownership	Yes	No
(1) PATHWAY HEALTH MANAGEMENT INC 20 MITCHELL AVENUE BINGHAMTON,NY13903 16-1228654	WINDING DOWN OF MANAGEMENT SERVICES TO SUSQUEHANNA MEDICAL ASSOCIATES	NY	N/A	C					No
(2) CHENANGO MADA INC 179 N BROAD STREET NORWICH,NY13915 16-1290726	INACTIVE	NY	CMH FUND INC	C			100.000 %	Yes

Schedule R (Form 990) 2021

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) ............................

Yes

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) ......................

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

Yes

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) ...................

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) ............................

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

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: (SEE SCHUDULE O)CHENANGO MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO OPERATE ACUTE AND SKILLED NURSING FACILITIES IN NORWICH, NEW YORK. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CHENANGO AND SURROUNDING COUNTIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	526
6	Total number of volunteers (estimate if necessary) .............	6	116
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	3,600
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	8,072,846	6,127,988
9	Program service revenue (Part VIII, line 2g) .........	78,367,048	83,132,744
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	345,856	158,369
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,157,492	1,379,607
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	88,943,242	90,798,708
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)	28,277,046	30,012,716
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)....	50,058,249	57,673,915
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	78,335,295	87,686,631
19	Revenue less expenses. Subtract line 18 from line 12.......	10,607,947	3,112,077
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	91,078,549	91,116,827
21	Total liabilities (Part X, line 26).............	43,726,451	39,316,179
22	Net assets or fund balances. Subtract line 21 from line 20.....	47,352,098	51,800,648

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 21,481,407 including grants of $ ) (Revenue $ 18,068,948 )
	INPATIENT, ACUTE AND LONG TERM SKILLED NURSING SERVICES- CHENANGO MEMORIAL HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES AND THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM INPATIENT ACUTE SERVICES AND LONG-TERM SKILLED NURSING CARE. CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF MEDICAL-SURGICAL SERVICES, INCLUDING: OPHTHALMOLOGY, EMERGENCY MEDICINE, MATERNITY CARE, PULMONARY MEDICINE, AND PEDIATRICS. TOTAL INPATIENT DAYS FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 4,685. DISCHARGES WERE 1,273, AND AVERAGE LENGTH OF STAY WAS 3.68 DAYS. LONG TERM SKILLED NURSING DAYS WERE 10,834. THERE WERE 201 BIRTHS AND 199 INPATIENT SURGERIES PERFORMED AT CHENANGO MEMORIAL HOSPITAL IN 2022. IN 2022, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 59 INDIVIDUALS FOR WHICH $558,551 OF INPATIENT CARE (AT CHARGES) WAS PROVIDED.

4b	(Code: ) (Expenses $ 36,941,035 including grants of $ ) (Revenue $ 55,560,988 )
	OUTPATIENT AND AMBULATORY SERVICES- CHENANGO MEMORIAL HOSPITAL ALSO PROVIDES A WIDE RANGE OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES, INCLUDING EMERGENCY DEPARTMENT, AMBULATORY SURGERY, FULL-SERVICE LABORATORY, COMPREHENSIVE IMAGING AND OTHER PROCEDURAL OUTPATIENT SERVICES. TOTAL PATIENT VISITS FOR OUTPATIENT SERVICES FOR YEAR-ENDED 2022 WAS 185,396. INCLUDED IN THE 185,396 VISITS WERE 15,372 EMERGENCY ROOM VISITS, 860 EMERGENCY ROOM TREATED AND ADMITTED AS ACUTE CARE PATIENTS, 3,699 VARIOUS OUTPATIENT SURGICAL CASES, AND 165,465 OTHER OUTPATIENT DEPARTMENT VISITS. IN 2022, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 2,153 INDIVIDUALS FOR WHICH $1,422,889 OF OUTPATIENT CARE (AT CHARGES) WAS PROVIDED.

4c	(Code: ) (Expenses $ 17,844,546 including grants of $ ) (Revenue $ 9,502,808 )
	CLINICS- CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY CARE AND SPECIALTY CARE CLINICS. PRIMARY CARE SERVICES ARE THE FOUNDATION FOR SERVING THE COMMUNITY WITH A COORDINATED SYSTEM OF CARE, WITH SPECIAL ATTENTION TO UNDER-SERVED AREAS. CMH OFFERS FIVE FAMILY HEALTH CENTERS LOCATED THROUGHOUT A MULTI-COUNTY SERVICE AREA: 1) NORWICH FAMILY HEALTH CENTER 2) INTERNAL MEDICINE 3) OXFORD FAMILY HEALTH CENTER 4) SHERBURNE FAMILY HEALTH CENTER AND 5) SIDNEY FAMILY HEALTH CENTER. OTHER OUTPATIENT SERVICES INCLUDE: GERIATRICS, WOMEN'S HEALTH CENTER, GENERAL SURGERY, HEART CENTER, GI, ORTHOPEDICS, PODIATRY, ONCOLOGY AND PAIN MANAGEMENT CLINIC. TOTAL PATIENT VISITS FOR THE CMH CLINICS AT YEAR-ENDED 2022 WAS 72,906.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ 1,356,950 )


4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ 1,356,950 )
4e	Total program service expenses76,266,988

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,504,640	3,303,808	573,626

1a	Federated campaigns..		1a
b	Membership dues..		1b	1,150
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	5,149,246

f	All other contributions, gifts, grants, and similar amounts not included above		1f	977,592

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

h Total. Add lines 1a-1f.......		6,127,988

		Business Code
2a	OUTPATIENT AND AMBULATORY SERVICE	623000	55,560,988	55,560,988
b	INPATIENT, ACUTE AND LONG TERM SK	623000	18,068,948	18,068,948
c	CLINICS	623000	9,502,808	9,502,808
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		83,132,744

3 Investment income (including dividends, interest, and othersimilar amounts) ......			369,057			369,057
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		3,600	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		3,600	6c
d	Net rental income or (loss).......			3,600		3,600
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses	210,688		7b
c	Gain or (loss)	-210,688		7c
d	Net gain or (loss).........			-210,688			-210,688
8a	Gross income from fundraising events (not including $ of 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	NON OPERATING REVENUE		623000	697,419	697,419
b	OTHER OPERATING REVENUE		623000	651,532	651,532
c	CAFETERIA REVENUE		623000	7,999	7,999
d	All other revenue ....			19,057			19,057
e	Total. Add lines 11a–11d ......			1,376,007
12	Total revenue. See instructions.....			90,798,708	84,489,694	3,600	177,426

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,686,627	2,686,627
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	21,785,483	18,971,370	2,814,113
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	871,544	758,243	113,301
9	Other employee benefits .......	3,015,836	2,641,434	374,402
10	Payroll taxes ...........	1,653,226	1,438,307	214,919
11	Fees for services (non-employees):
a	Management ......	844,393		844,393
b	Legal .........	55,419		55,419
c	Accounting ...........	89,516		89,516
d	Lobbying ...........	12,431		12,431
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	16,824,078	14,636,948	2,187,130
12	Advertising and promotion ....	76,331	1,698	74,633
13	Office expenses .......	229,833	120,024	109,809
14	Information technology ......	225,981	223,241	2,740
15	Royalties ..
16	Occupancy ...........	1,528,061	1,327,849	200,212
17	Travel ............	75,522	39,616	35,906
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	574,404	574,404
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,094,366	4,094,366
23	Insurance ...	680,149	680,149
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	SUPPLIES	27,263,070	23,661,413	3,601,657
b	BAD DEBTS	2,304,237	2,304,237
c	NEW YORK STATE CASH REC	443,182	443,182
d	MISCELLANEOUS AUXILLARY	7,361	7,361
e	All other expenses	2,345,581	1,656,519	689,062
25	Total functional expenses. Add lines 1 through 24e	87,686,631	76,266,988	11,419,643	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 ........			15,433,504	1	12,488,629
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			7,440,372	3	6,119,022
4	Accounts receivable, net .............			8,045,908	4	8,544,100
5	Loans and other receivables from 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
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
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			708,498	8	803,083
9	Prepaid expenses and deferred charges ......			669,872	9	1,501,243
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	117,024,356
b	Less: accumulated depreciation	10b	66,935,615	46,169,200	10c	50,088,741
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			148,033	12	125,605
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			12,463,162	15	11,446,404
16	Total assets. Add lines 1 through 15 (must equal line 33)...			91,078,549	16	91,116,827

17	Accounts payable and accrued expenses .....	7,074,816	17	7,694,607
18	Grants payable ...		18
19	Deferred revenue .........		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 ..	9,599,087	23	13,100,895
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	27,052,548	25	18,520,677
26	Total liabilities. Add lines 17 through 25..	43,726,451	26	39,316,179

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	24,645,677	27	44,052,620
28	Net assets with donor restrictions ...........	22,706,421	28	7,748,028
	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 ...........	47,352,098	32	51,800,648
33	Total liabilities and net assets/fund balances ........	91,078,549	33	91,116,827