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) ROBERT NESSELBUSH...................................................................... CHIEF EXECUTIVE OFFICER (UNTIL 9/22)	40.00 .................	X	X	3,694,133	0	11,541
(2) DONALD BOYD...................................................................... PRESIDENT AND CEO (AS OF 7/22)	40.00 ................. 1.00	X	X	2,075,977	0	-29,039
(3) NICHOLAS J AQUINO MD...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(4) THOMAS BEAUFORD...................................................................... DIRECTOR (AS OF 5/22)	1.00 .................	X		0	0	0
(5) LORRIE A CLEMO PHD...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(6) GARY M CROSBY...................................................................... CHAIRMAN (AS OF 5/22)	1.00 .................	X		0	0	0
(7) ABEER EDDIB MD...................................................................... DIRECTOR	1.00 .................	X		23,282	0	315
(8) MUHAMMED JAVED MD...................................................................... DIRECTOR	1.00 .................	X		0	147,167	0
(9) WILLIAM J MAGGIO JR...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(10) GEORGE E MATTHEWS MD...................................................................... DIRECTOR	1.00 .................	X		0	181,839	0
(11) TIMOTHY G MCEVOY ESQ...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(12) PAUL O'LEARY...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(13) JOHN PERSONS...................................................................... DIRECTOR (AS OF 5/22)	1.00 .................	X		0	0	0
(14) CHRISTOPHER ROSS...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(15) MARY LOU RUSIN RD EDD...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(16) FRANK CURCI...................................................................... CHAIRMAN (UNTIL 5/22)	1.00 .................	X		0	0	0
(17) DAVID HUGHES MD...................................................................... EVP, CMO (UNTIL 5/22)	40.00 ................. 1.00		X	515,677	0	6,432

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(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) CHERYL KLASS........................................................................ EVP, CHIEF NURSE EXECUTIVE	40.00 .......................	X				749,148	-452
(19) ALYSON SPAULDING........................................................................ GENERAL COUNSEL	40.00 .......................	X				838,665	11,980
(20) THOMAS HULL........................................................................ SVP, CHIEF INFO OFFICER (AS OF 1/22)	40.00 .......................	X				508,118	13,581
(21) MICHAEL MINEO MD........................................................................ EVP, CHIEF MED OFFICER (AS OF 7/22)	40.00 .......................	X				640,616	21,873
(22) IAN BARRET AS OF 1022........................................................................ EVP, CHIEF HUMAN RES OFF	40.00 .......................	X				203,263	1,625
(23) MATTHEW DRAKE........................................................................ EVP, CHIEF FIN OFFICER (AS OF 4/22)	40.00 .......................	X				662,608	13,139
(24) CHRISTOPHER LANE........................................................................ PRESIDENT BGMC AND GVI (UNTIL 3/22)	40.00 .......................		X			295,020	-35,939
(25) ALLEGRA JAROS........................................................................ PRESIDENT WCHOB	40.00 .......................1.00		X			625,737	-26,484
(26) MICHAEL HUGHES........................................................................ CHIEF ADMINISTRATIVE OFFICER	40.00 .......................		X			659,493	-26,686
(27) JUDY BAUMGARTNER........................................................................ PRESIDENT MFS AND DEGRAFF	40.00 .......................		X			594,391	5,953
(28) STEPHEN HARDY........................................................................ VP FINANCE	40.00 .......................		X			366,909	24,364
(29) BETH HUGHES........................................................................ PRESIDENT BGMC AND GVI (AS OF 10/22)	40.00 .......................		X			244,372	4,344
(30) CHRISTOPHER MALLAVARAPU MD........................................................................ EMPLOYED PHYSICIAN	40.00 .......................			X		834,888	31,681
(31) KAVEH VALI MD........................................................................ EMPLOYED PHYSICIAN	40.00 .......................			X		781,370	-15,621
(32) CARROLL HARMON MD........................................................................ EMPLOYED PHYSICIAN	40.00 .......................			X		714,793	7,503
(33) LUCY CAMPBELL MD........................................................................ EMPLOYED PHYSICIAN	40.00 .......................			X		500,226	-10,536
(34) VICTOR FILADORA II........................................................................ PRESIDENT GREAT LAKES CANCER CARE	40.00 .......................			X		678,876	6,663
(35) JODY LOMEO........................................................................ FMR PRES/CEO	0.00 .......................				X	1,258,511	-11,285

(A) Name and business address	(B) Description of services	(C) Compensation
PROLINK HEALTHCARE 4700 ROCKSIDE RD 640 INDEPENDENCE,OH44131	STAFFING SERVICES	66,506,541
CERNER CORPORATION PO BOX 959156 ST LOUIS,MO63195	TECH CONSULTANT	20,897,892
RESEARCH FOUNDATION FOR SUNY PO BOX 9 ALBANY,NY12201	EDUCATIONAL SERVICES	19,051,910
METZ CULINARY MANAGEMENT TWO WOODLAND DRIVE DALLAS,PA18612	DINING SERVICES	9,156,805
WNY RADIOLOGY LLC PO BOX 4029 BUFFALO,NY14240	RADIOLOGY SERVICES	7,429,016
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 113

- 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.
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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

KALEIDA HEALTH

Employer identification number

16-1533232

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

KALEIDA HEALTH

Employer identification number

16-1533232

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 KALEIDA HEALTH

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 KALEIDA HEALTH		Employer identification number 16-1533232

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 KALEIDA HEALTH			Employer identification number 16-1533232
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

KALEIDA HEALTH

Employer identification number

16-1533232

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

Yes

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

Yes

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

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

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

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

Yes

307,978

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

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

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

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

307,978

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:	GRANTS TO OTHER ORGANIZATIONS THE AMOUNT REFLECTED FOR PART II-B, QUESTION 1F REPRESENTS PAYMENTS MADE TO ORGANIZATIONS IN AN EFFORT TO ADVOCATE ON THE ORGANIZATION'S BEHALF AT THE NEW YORK STATE AND FEDERAL LEVELS AS IT SPECIFICALLY RELATES TO HEALTH CARE LEGISLATION AND REGULATORY ISSUES.

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

KALEIDA HEALTH

Employer identification number

16-1533232

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 ....	22,489,715	23,437,656	24,333,765	26,993,388	27,593,062
b	Contributions ...	1,245,004	2,424,618	2,424,618	2,231,957	2,596,681
c	Net investment earnings, gains, and losses	394,138	-879,004	-827,172	-2,293,720	-995,040
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,156,907	2,493,555	2,493,555	2,597,860	2,201,315
f	Administrative expenses ....
g	End of year balance ......	22,971,950	22,489,715	23,437,656	24,333,765	26,993,388

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

Board designated or quasi-endowment SchDMd Bullet

48.460 %

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

51.540 %

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 .....	6,713,867		6,713,867
b	Buildings ....	854,449,052	526,181,185	328,267,867
c	Leasehold improvements
d	Equipment ....	1,246,299,392	995,596,316	250,703,076
e	Other .....	17,190,819	12,262,840	4,927,979
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				590,612,789

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)OTHER RECEIVABLES				92,195,395
(2)OTHER ASSETS				9,188,420
(3)ESTIMATED 3RD PARTY PAYOR REC				19,829,000
(4)OPERATING LEASE RIGHT-USE ASSETS				138,421,965
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				259,634,780

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
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	604,741,782
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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART V, LINE 4:

INTENDED USE OF ENDOWMENTS: THE FOLLOWING ARE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS: 1) CAPITAL EXPANSION AND IMPROVEMENT 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES 3) SUPPORT PEDIATRIC HEALTH CARE SERVICES

PART X, LINE 2:

KALEIDA AND SUBSTANTIALLY ALL OF ITS AFFILIATES HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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
KALEIDA HEALTH

Employer identification number

16-1533232

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN			INVESTMENTS	319,539,563
	EUROPE (INCLUDING ICELAND AND GREENLAND)			INVESTMENTS	20,474,453
	SUB-SAHARAN AFRICA			INVESTMENTS	2,351,498














3a	Sub-total ....	0	0		342,365,514
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		342,365,514

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022

Schedule F (Form 990) 2022

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2022

Schedule F (Form 990) 2022Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2022

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2022

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
PART I, LINE 3:	INVESTMENT AMOUNTS REPORTED ARE DERIVED FROM KALEIDA'S BOOKS AND RECORDS WHICH ARE MAINTAINED ON AN ACCRUAL BASIS.
PART III ACCOUNTING METHOD:

Schedule F (Form 990) 2022

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

KALEIDA HEALTH

Employer identification number

16-1533232

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	11,148,386	6,168,000	4,980,386	0.330 %
b	Medicaid (from Worksheet 3, column a) . . . . .	452,090,980	273,424,125	178,666,855	11.820 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	463,239,366	279,592,125	183,647,241	12.150 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	6,711,786	0	6,711,786	0.440 %
f	Health professions education (from Worksheet 5) . . .	30,981,850	28,234,894	2,746,956	0.180 %
g	Subsidized health services (from Worksheet 6) . . . .	47,776,742	21,565,558	26,211,184	1.730 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	85,470,378	49,800,452	35,669,926	2.350 %
k	Total. Add lines 7d and 7j .	548,709,744	329,392,577	219,317,167	14.500 %

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	145	14,075	75,233	75,233	0 %
8	Workforce development
9	Other
10	Total	145	14,075	75,233	75,233	0 %

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. ......

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. ......

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).....

192,008,463

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

180,060,526

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

11,947,937

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 %	(e) Physicians' profit % or stock ownership %
11 HARLEM ROAD LEASING	MRI EQUIPMENT LEASING	50.000 %	50.000 %
22 AMTON IMAGING LLC	HEALTH CARE SERVICES	50.000 %	50.000 %
33 SITE E LLC	REAL ESTATE LEASING CO	50.140 %	49.860 %
44 SOUTHTOWNS IMAGING	IMAGING EQUIPMENT LEASING	70.000 %	30.000 %
55 GL MEDICAL BILLING	MEDICAL BILLING	50.000 %	50.000 %
66 SOUTHTOWNS SURG CTR	PHYSICIAN SERVICES	63.950 %	36.040 %
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?4Name, 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)							Facility reporting group
1	BUFFALO GENERAL MEDICAL CENTER 100 HIGH STREET BUFFALO,NY14203 WWW.KALEIDAHEALTH.ORG 1401014H	X	X		X	X	A
2	OISHEI CHILDREN'S HOSPITAL 818 ELLICOTT STREET BUFFALO,NY14203 WWW.KALEIDAHEALTH.ORG 1401014H	X	X	X	X	X	A
3	MILLARD FILLMORE SUBURBAN HOSPITAL 1540 MAPLE ROAD WILLIAMSVILLE,NY14221 WWW.KALEIDAHEALTH.ORG 1401014H	X	X		X	X	A
4	DEGRAFF MEMORIAL HOSPITAL 445 TREMONT STREET NORTH TONAWANDA,NY14120 WWW.KALEIDAHEALTH.ORG 1401014H	X	X		X	X	A

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)

	GROUP A
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): WWW.KALEIDAHEALTH.ORG/COMMUNITY

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): WWW.KALEIDAHEALTH.ORG/COMMUNITY

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)

	GROUP A
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 400.000000000000%

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):

WWW.KALEIDAHEALTH.ORG

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

WWW.KALEIDAHEALTH.ORG

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

	GROUP A
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)

	GROUP A
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
PART V, SECTION B, LINE 5	IN CONDUCTING ITS 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP), KALEIDA HEALTH TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITALS LOCATED IN ERIE AND NIAGARA COUNTIES, THE PRIMARY SERVICE AREA. FOR EACH COUNTY, KALEIDA HEALTH PARTICIPATED IN COLLABORATIVE WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH AND COMPRISED OF REPRESENTATIVES FROM OTHER HOSPITALS, ORGANIZATIONS, AGENCIES, AND SCHOOLS; AND INCLUDED INPUT FROM THE COMMUNITY INCLUDING THE MEDICALLY UNDERSERVED.THE ERIE COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON DECEMBER 2, 2021 AND HELD REGULAR MEETINGS THROUGHOUT 2021-2022, BOTH VIRTUALLY AND IN-PERSON AT THE ERIE COUNTY FIRE TRAINING FACILITY. THE ERIE COUNTY WORK GROUP COLLABORATED TO CONDUCT A CONSUMER HEALTH SURVEY, COMMUNITY CONVERSATIONS, AND PROFESSIONAL STAKEHOLDER FOCUS GROUP SESSIONS TO SOLICIT INPUT FROM THE COMMUNITY ON THE HEALTH STATUS AND CHALLENGES OF ERIE COUNTY RESIDENTS.COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2022 INCLUDING A CONSUMER SURVEY WITH 1,394 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. CONCENTRATED EFFORTS WERE MADE TO TARGET LOW-INCOME AND UNDERSERVED POPULATIONS AT SITES INCLUDING THE OFFICE OF THE ERIE COUNTY DEPARTMENT OF SOCIAL SERVICES, ST. LUKE'S MISSION OF MERCY, TOPS MARKETS/AMHERST ST., NIAGARA ST., SAVE-A-LOT/ABBOTT RD.-LACKAWANNA, ERIE COUNTY VACCINATION PODS, VARIOUS LOCATIONS, AMONG OTHERS. SURVEYS WERE DISSEMINATED VIRTUALLY TO ERIE COUNTY RESIDENTS THROUGH PUBLIC WEBSITES, EMPLOYEE/ASSOCIATES INTRANET, FACEBOOK, INSTAGRAM, TWITTER OF ERIE COUNTY DEPARTMENT OF HEALTH, CATHOLIC HEALTH SYSTEMS, AND KALEIDA HEALTH. THREE VIRTUAL COMMUNITY CONVERSATIONS AND FOUR IN-PERSON COMMUNITY CONVERSATIONS WERE HELD IN MARCH AND APRIL 2022 WITH 93 TOTAL PARTICIPANTS. IN ADDITION, 63 ADDITIONAL INDIVIDUAL CONVERSATIONS TOOK PLACE IN MARCH-JUNE 2022 UTILIZING THE SAME QUESTIONS POSED TO THE GROUPS. THESE SESSIONS WERE CONDUCTED TO CAPTURE COMMUNITY INPUT ON THE STATUS OF HEALTH AND HEALTHCARE NEEDS. SESSION LOCATIONS TARGETED A GEOGRAPHIC CROSS-SECTION OF SITES, AGES, AND INCOME LEVELS. WITH THE EXCEPTION OF ONE SUBURBAN LOCATION, THE LOCATIONS OF THE CONVERSATIONS WERE CHOSEN IN AN EFFORT TO INCREASE INPUT FROM POPULATIONS WHOSE VIEWS WERE UNDERREPRESENTED IN COMMUNITY SURVEY RESPONSE. IN FEBRUARY AND MARCH 2022, THE ERIE COUNTY DEPARTMENT OF HEALTH, KALEIDA HEALTH, AND CATHOLIC HEALTH SYSTEM HOSTED THREE PROFESSIONAL STAKEHOLDER FOCUS GROUP SESSIONS TO GATHER INFORMATION FOR THE 2022-2024 CHNA-CSP. PROFESSIONALS FROM HEALTH, MENTAL HEALTH, AND SOCIAL SERVICES ORGANIZATIONS PROVIDED INPUT ON THE COMMUNITY'S CURRENT HEALTH STATUS, NEEDS, AND ISSUES. THE SESSIONS WERE HELD VIA ZOOM ON FEBRUARY 28, 2022, MARCH 1, 2022, AND MARCH 4, 2022 AND INCLUDED 16 PARTICIPANTS PRIMARILY FROM COMMUNITY-BASED OUTPATIENT SITES OF CATHOLIC HEALTH SYSTEMS AND KALEIDA HEALTH. IN ADDITION TO THE REVIEW OF DATA FROM THE NYS PREVENTION AGENDA DASHBOARD AND OTHER RELIABLE SOURCES, THESE ACTIVITIES HELPED TO PRIORITIZE THE HEALTH CARE NEEDS OF THE COUNTY AND THE RESULTING IMPLEMENTATION STRATEGIES; AND ARE INCLUDED IN KALEIDA HEALTH'S 2022-2024 CHNA-CSP AND ALIGNED WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, COMMUNITY HEALTH IMPROVEMENT PLAN.AFTER A DELAY RESULTING FROM COVID-19, THE NIAGARA COUNTY WORK GROUP LAUNCHED THEIR EFFORTS ON FEBRUARY 23, 2022 AND HELD REGULAR MEETINGS THROUGHOUT 2022, BOTH VIRTUALLY AND IN-PERSON AT VARIOUS PARTNER LOCATIONS. THE WORK GROUP COLLABORATED TO CONDUCT A CONSUMER HEALTH SURVEY, FOCUS GROUP SESSIONS, AND A COUNTY-WIDE COMMUNITY STAKEHOLDER EVENT TO SOLICIT INPUT FROM THE COMMUNITY, INCLUDING THE UNDERSERVED, ON THE HEALTH STATUS AND CHALLENGES OF NIAGARA COUNTY RESIDENTS. COUNTY-WIDE ASSESSMENT ACTIVITIES WERE CONDUCTED IN 2022 INCLUDING A CONSUMER SURVEY CONDUCTED IN MARCH-JUNE 2022 WITH 2,399 RESPONDENTS TO DETERMINE HEALTH STATUS AND COMMUNITY HEALTH NEEDS, HEALTH BEHAVIORS, BARRIERS TO HEALTH, HEALTHCARE ACCESS AND UTILIZATION, AND DEMOGRAPHIC INFORMATION. INPUT WAS RECEIVED FROM THE UNDERSERVED WITH CONCENTRATED EFFORTS MADE TO DISTRIBUTE SURVEYS TO LOW-INCOME RESPONDENTS. LINKS WERE PROVIDED ON THE NIAGARA COUNTY DEPARTMENT OF HEALTH'S WEBSITE AND SOCIAL MEDIA AND SHARED WITH THE PARTNERING HOSPITALS FOR ADDITIONAL ELECTRONIC AND PRINT DISSEMINATION. IN-PERSON SURVEY DISTRIBUTION WAS ALSO CONDUCTED BY VARIOUS NIAGARA COUNTY PUBLIC AGENCIES AND ORGANIZATIONS. KALEIDA HEALTH AND DEGRAFF MEDICAL PARK POSTED THE SURVEYS ON THE KALEIDA HEALTH PUBLIC WEBSITE, KALEIDA HEALTH EMPLOYEE WEBSITE, AND ON FACEBOOK AND TWITTER. FIVE FOCUS GROUP SESSIONS WERE CONDUCTED IN MAY 2022 AT NIAGARA COUNTY LOCATIONS INCLUDING HEALTHCARE CLINICS, SUBSIDIZED HOUSING FACILITIES, AND FAITH-BASED/COMMUNITY/SENIOR CENTERS AND INCLUDED THE UNDERSERVED. THE FOCUS GROUPS WERE FACILITATED BY THE NIAGARA COUNTY DEPARTMENT OF HEALTH AND HOSPITAL PARTNERS. THE QUESTIONS WERE CREATED BY POPULATION HEALTH COLLABORATIVE AND USED AT ALL FOCUS GROUPS TO MAINTAIN CONSISTENCY. ADDITIONALLY, A COUNTYWIDE KEY STAKEHOLDER MEETING WAS CONVENED ON SEPTEMBER 12, 2022 AT PUBLIC SAFETY TRAINING CENTER IN LOCKPORT, NY. THE WORK GROUP PARTNERS DEVELOPED THE SESSION AGENDA AND LOGISTICS IN COORDINATION WITH POPULATION HEALTH COLLABORATIVE SERVING AS FACILITATOR. THERE WERE 49 ATTENDEES IN TOTAL. IN ADDITION TO THE PARTNERS, PARTICIPATING ORGANIZATIONS INCLUDED AMS NUTRITION COUNSELING, MENTAL HEALTH ASSOCIATION OF NIAGARA COUNTY, MARCH OF DIMES, GENESEE COUNCIL ON ALCOHOLISM AND SUBSTANCE ABUSE, HIGHMARK HEALTH, FIDELIS CARE, MOBILE SAFETY NET TEAM OF WNY, HORIZON HEALTH SERVICES, NIAGARA COUNTY WIC, AMERICAN HEART ASSOCIATION, ROSWELL PARK CANCER INSTITUTE, NIAGARA PRIDE, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, NIAGARA COUNTY OFFICE FOR THE AGING, NIAGARA UNIVERSITY, NIAGARA ORGANIZING ALLIANCE FOR HOPE, FAMILY RESIDENCY PROGRAM OF NIAGARA FALLS MEMORIAL MEDICAL CENTER, LEWISTON PORTER CENTRAL SCHOOL DISTRICT, LOCKPORT CITY SCHOOL DISTRICT, NEWFANE CENTRAL SCHOOL DISTRICT, NIAGARA WHEATFIELD CENTRAL SCHOOL DISTRICT, WNY INTEGRATED CARE COLLABORATIVE AND HEART LOVE AND SOUL. DURING THIS MEETING PARTICIPANTS LEARNED ABOUT NIAGARA COUNTY'S CHNA-CSA PROCESS AND INFORMATION AND DATA WAS SHARED FROM THE CONSUMER HEALTH SURVEYS, PROVIDER SURVEYS, AND FOCUS GROUP SESSIONS IMPLEMENTED BY THE WORK GROUP PARTNERS. THE 2019-2024 NYS PREVENTION AGENDA WAS DISCUSSED INCLUDING NIAGARA COUNTY'S PLANS TO FOCUS ON THE PREVENT CHRONIC DISEASE AND PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PRIORITY AREAS. BREAKOUT SESSIONS WERE HELD AND EACH ORGANIZATION HAD THE OPPORTUNITY TO PROVIDE INPUT FOR THE DEVELOPMENT OF FOCUS AREAS AND INTERVENTIONS ACTIVITES AS A PART OF THE 2022-2024 NIAGARA COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN AND KALEIDA'S CHNA-CSP.THE KALEIDA HEALTH 2022-2024 CHNA-CSP WAS APPROVED BY THE KALEIDA HEALTH BOARD OF DIRECTORS ON DECEMBER 15, 2022. IT IS AVAILABLE TO THE PUBLIC IN THE COMMUNITY HEALTH SECTION OF THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. A PAPER VERSION IS AVAILABLE UPON REQUEST AT NO CHARGE AT THE HOSPITALS. WRITTEN COMMENTS ON THE CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN" LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK. THIS INFORMATION IS DOCUMENTED IN THE CHNA-CSP IN THE DISSEMINATION TO THE PUBLIC SECTION. NO COMMENTS ON THE 2022-2024 CHNA-CSP WERE RECEIVED FROM THE PUBLIC IN 2022.
PART V, SECTION B, LINE 6A	KALEIDA HEALTH'S FOUR HOSPITALS ARE INCLUDED IN ITS 2022-2024 CHNA-CSP: BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL, ALL LOCATED IN ERIE COUNTY AND DEGRAFF MEDICAL PARK LOCATED IN NIAGARA COUNTY.IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND INCLUDED UNRELATED HOSPITAL FACILITIES OF CATHOLIC HEALTH SYSTEM.IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE CHNA-CSP PROCESS THROUGH A PARTNERSHIP LED BY THE NIAGARA COUNTY DEPARTMENT OF HEALTH, AND INCLUDED THE FOLLOWING UNRELATED HOSPITAL FACILITIES: CATHOLIC HEALTH SYSTEM- MOUNT SAINT MARY'S HOSPITAL AND HEALTH CENTER, EASTERN NIAGARA HOSPITAL SYSTEM AND NIAGARA FALLS MEMORIAL MEDICAL CENTER.
PART V, SECTION B, LINE 6B	IN ERIE COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2022-2024 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: ERIE COUNTY DEPARTMENT OF HEALTH, BUFFALO STATE COLLEGE (SUNY), D'YOUVILLE UNIVERSITY, NEW YORK STATE PUBLIC HEALTH CORPS/CSSI, POPULATION HEALTH COLLABORATIVE OF WNY, UNITED WAY OF BUFFALO & ERIE COUNTY AND THE UNIVERSITY AT BUFFALO (SUNY)DEPARTMENT OF EPIDEMIOLOGY AND ENVIRONMENTAL HEALTH. IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED ON THE 2022-2024 CHNA-CSP PROCESS WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: NIAGARA COUNTY DEPARTMENT OF HEALTH, NIAGARA COUNTY DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, AND THE POPULATION HEALTH COLLABORATIVE OF WNY.
PART V, SECTION B, LINE 11	WITH HOSPITALS IN BOTH ERIE AND NIAGARA COUNTIES, KALEIDA HEALTH WORKED COLLABORATIVELY WITH WORK GROUPS LED BY THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH TO REVIEW HEALTH CARE DATA, DISSEMINATE CONSUMER SURVEYS AND CONDUCT FOCUS GROUP SESSIONS TO PRIORITIZE SIGNIFICANT HEALTH NEEDS AND IMPLEMENTATION STRATEGIES FOR EACH COUNTY. THE STRATEGIES FURTHER ALIGN WITH THE PRIORITY AREAS OF THE NEW YORK STATE PREVENTION AGENDA. KALEIDA HEALTH INCLUDED THESE COLLABORATIVE PRIORITY AREAS ITS 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICES PLAN (CHNA-CSP).ERIE COUNTY:PREVENT CHRONIC DISEASE, PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN (WHILE ONLY TWO PRIORITY AREAS ARE REQUIRED PER COUNTY, BASED ON COMMUNITY NEED, THE ERIE COUNTY DEPARTMENT OF HEALTH AND KALEIDA HEALTH ADDED THIS THIRD PRIORITY AREA).NIAGARA COUNTY: PREVENT CHRONIC DISEASE, PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS.HEALTH CARE NEEDS ADDRESSED IN KALEIDA HEALTH'S 2022-2024 CHNA-CSPHEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES ACCOUNTING FOR 164.9 PER 100,000 POPULATION OF ALL DEATHS IN ERIE COUNTY AND 211.3 PER 100,000 IN NIAGARA COUNTY (2019 COUNTY HEALTH RANKINGS), AND THERE IS A HIGH INCIDENCE OF RISK FACTORS AMONG RESIDENTS INCLUDING HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING. HEART DISEASE FURTHER AFFECTS MINORITY AND UNDERSERVED POPULATIONS DISPROPORTIONALLY. THE MORTALITY RATE FOR DISEASES OF THE HEART PER 100,000 POPULATION (AGE-ADJUSTED) FOR ERIE COUNTY IS 199.5 FOR NON-HISPANIC, AFRICAN AMERICANS, 168.4 FOR WHITES, AND 132.3 FOR HISPANICS; AND IN NIAGARA COUNTY, THE MORTALITY RATES ARE 306.1 FOR NON-HISPANIC, AFRICAN AMERICANS, 201.2 FOR WHITES, AND 132 FOR HISPANICS (2017-2019, ERIE COUNTY AND NIAGARA COUNTY HEALTH INDICATORS BY RACE/ETHNICITY, NYS DEPARTMENT OF HEALTH). IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH WORK GROUPS, KALEIDA HEALTH SELECTED "PREVENT CHRONIC DISEASE" AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES. KALEIDA HEALTH HOSPITALS IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS CHRONIC DISEASE IN ITS 2022-2024 CHNA-CSP:ERIE COUNTY- HEALTHY EATING AND FOOD SECURITY - COMMUNITY NUTRITION EDUCATION AND HEALTHY MOBILE FOOD MARKETS (DISPARITY-LOW INCOME POPULATION), WORKSITE NUTRITION AND WELLNESS PROGRAM - PREVENTIVE CARE AND MANAGEMENT - CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IN OB-GYN CENTERS (DISPARITY - FEMALE, MEDICAID POPULATION), CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITYNIAGARA COUNTY- HEALTHY EATING AND FOOD SECURITY - LITTLE FREE PANTRY (DISPARITY - FOOD INSECURE POPULATION- PREVENTIVE CARE AND MANAGEMENT - CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS FOR THE COMMUNITYIN 2022, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING CHRONIC DISEASE INTERVENTIONS:- A HEALTHY MOBILE FOOD MARKET WITH FRESH PRODUCE WAS SET UP AT AN OUTDOOR SITE ON THE MFSH CAMPUS IN JUNE - NOVEMBER 2022. COULTER FARMS WAS THE VENDOR AND WAS ON SITE TUESDAYS AND FRIDAYS EACH WEEK FROM 11 AM - 4 PM. NUTRITION EDUCATION WAS DISTRIBUTED AT THE MARKET. BUFFALO GENERAL MEDICAL CENTER [IN CLOSE PROXIMITY TO JOHN R. OISHEI HOSPITAL] PLANNED TO HOST BUFFALO-BASED URBAN FRUITS AND VEGGIES, AN OUTDOOR MARKET OF HEALTHY FRUITS AND VEGETABLES AND NUTRITIONAL EDUCATION SERVING THE CAMPUS AND ADJACENT LOW-INCOME FRUIT BELT NEIGHBORHOOD. IN 2022, PROGRAM IMPLEMENTATION PLANNING FOR THE 2023-2024 GOALS OUTLINED IN THE CHNA-CSP OCCURRED. ADDITIONALLY, JOHN R. OISHEI CHILDREN'S HOSPITAL PARTNERED WITH A LOCAL URBAN FARM, MASSACHUSSETTS AVENUE PROJECT, TO BRING THEIR MOBILE FRESH FOOD MARKET TO OISHEI'S 1021 BROADWAY CLINIC. THE MARKET OFFERED FRESH FRUITS AND VEGETABLES TO PATIENTS AND RESIDENTS OF THE SURROUNDING EAST BUFFALO NEIGHBORHOOD.- IN 2022, THE PARTNERSHIP BETWEEN KALEIDA HEALTH AND ITS FOOD VENDOR METZ CULINARY MANAGEMENT AND THE BUFFALO NIAGARA MEDICAL CAMPUS CONTINUED TO HELP BRING MORE LOCALLY GROWN AND SOURCED PRODUCE, MEATS AND OTHER MENU ITEMS TO THE CAFETERIAS AT BUFFALO GENERAL MEDICAL CENTER, JOHN R. OISHEI CHILDREN'S HOSPITAL, AND HIGHPOINTE ON MICHIGAN. KALEIDA HEALTH EMPLOYEES, PATIENTS AND VISITORS WERE PROVIDED INFORMATION ON HEALTHY EATING AND NUTRITION, AND WERE INTRODUCED TO THE FARMERS BEHIND THE PRODUCTS. THE METZ CHEFS AND GENERAL MANAGERS VISITED LOCAL FARMS TO LEARN NEW AGRICULTURAL METHODS AND SUSTAINABLE PRACTICES. THROUGH THE METZ FARM TO HOSPITAL PARTNERSHIP, KALEIDA HEALTH PROVIDES EMAILS VIA CAMPUS E-NEWS TO EMPLOYEES OF PARTICIPATING FACILITIES, PROMOTING FACTS ON THE BENEFITS OF LOCAL FRUIT AND VEGETABLES, AS THEY ARE FRESHER AND SAFER THAN MANY STORE-BOUGHT OPTIONS.- NUTRITION TUNE-UP DAYS FOR EMPLOYEES WERE NOT HELD IN 2021 AND 2022 DUE TO COVID-19 RESTRICTIONS. IN THE ABSENCE OF THE NUTRITION TUNE-UP DAYS, EMPLOYEES VISITED A KALEIDA HEALTH DIETICIAN AT VARIOUS TIMES AT BUFFALO GENERAL MEDICAL CENTER FOR NUTRITION/WELLNESS CONCERNS AND RECEIVED NUTRITION EDUCATION AND PRINT MATERIALS.- IN 2022, WELLNESS ACTIVITIES FOR EMPLOYEES OF BUFFALO GENERAL MEDICAL CENTER AND JOHN R. OISHEI CHILDREN'S HOSPITAL IN COLLABORATION WITH THE BUFFALO NIAGARA MEDICAL CAMPUS (BNMC) WERE PRIMARILY ON HOLD DUE TO COVID-19 RESTRICTIONS. HOWEVER, THE WALKS ON WEDNESDAY PROGRAM DID SUCCESSFULLY RESUME IN 2021, AND CONTINUED ON IN 2022.-CARDIOVASCULAR EDUCATION AND SCREENING TARGETING LOW-INCOME PATIENTS WAS PROVIDED AT KALEIDA HEALTH'S OB-GYN CENTERS WHERE AN ESTIMATED 72% (2022) OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID. IN 2022, 205 CLINIC PATIENTS WERE SCREENED FOR CARDIOVASCULAR DISEASE AND PROVIDED COUNSELING AND EDUCATION.-DUE TO COVID 19 RESTRICTIONS AND THE NEED FOR COMMUNITY SAFETY FROM THE VIRUS, IN-PERSON CHRONIC DISEASE RISK FACTOR EDUCATION AND SCREENING EVENTS THROUGH KALEIDA HEALTH HOSPITALS IN ERIE AND NIAGARA COUNTIES WERE REPLACED WITH VIRTUAL PROGRAMS.- IN 2022, 9,348 INDIVIDUALS PARTICIPATED IN VIRTUAL HEALTHY U PROGRAMS VIA FACEBOOK LIVE AND 120 INDIVIDUALS ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION.- IN 2022, 39 WEEKLY MEDICAL MINUTE VIDEOS REACHING 37,415 INDIVIDUALS WERE PRESENTED ON WIVB-TV, CH. 4 AND KALEIDA HEALTH SOCIAL MEDIA ON HEALTH RELATED TOPICS.- IN 2022, THE MEDICALLY SPEAKING INTERVIEW SERIES PROVIDED 12 COMMUNITY HEALTH EDUCATION VIDEOS ON VARIOUS HEALTH TOPICS INCLUDING THE COVID-19 PANDEMIC TO 18,173 VIEWERS ON KALEIDA HEALTH FACEBOOK AND AT WWW.KALEIDAHEALTH.ORG/MEDICALLY-SPEAKING. 462 INDIVIDUALS FURTHER ENGAGED WITH THE SPEAKER OR RESPONDED TO THE PRESENTATION.- IN 2022, THE LITTLE FREE PANTRY AT DEGRAFF MEDICAL PARK CONTINUED TO PROVIDE COMMUNITY ACCESS TO A FREE SOURCE OF FOOD AT AN ON-SITE,SELF-CONTAINED OUTDOOR PANTRY TO PROMOTE FOOD SECURITY AMONG UNDERSERVED POPULATIONS. DEGRAFF PROVIDES HEALTH EDUCATION LITERATURE AND EMPLOYEES AND COMMUNITY MEMBERS WORK TO KEEP THE PANTRY STOCKED WITH HEALTHY, NUTRITIONAL ITEMS. - IN 2022, KALEIDA HEALTH'S HERTEL-ELMWOOD INTERNAL MEDICINE CLINIC RECEIVED FUNDING FROM NEW YORK STATE DEPARTMENT OF HEALTH AND HEALTH RESEARCH INC. THROUGH THE COMPREHENSIVE CANCER CONTROL PROGRAM TO PROVIDE A COLORECTAL CANCER SCREENING-PROFESSIONAL EDUCATION PROGRAM FOR STAFF, PHYSICIANS, AND RESIDENTS; AND A LUNG CANCER SCREENING AND EDUCATION PROGRAM TARGETING THE CLINIC'S SURROUNDING LOW-INCOME COMMUNITY. PARTNERS INCLUDED UBMD, UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES, NYS ERIE COUNTY CANCER SERVICES, GREAK LAKES IMAGING, AMERICAN CANCER SOCIETY, AND AMERICAN LUNG ASSOCIATION.
PART V, SECTION B, LINE 11, CONTINUED	MENTAL AND SUBSTANCE USE DISORDERSKALEIDA HEALTH, IN COLLABORATION WITH THE ERIE COUNTY DEPARTMENT OF HEALTH AND THE NIAGARA COUNTY DEPARTMENT OF HEALTH IDENTIFIED THE RISING OPIOID ADDICTION PROBLEM AS A DIRE AREA OF CONCERN FOR THEIR COMMUNITIES. THE PROBLEM HAS BEEN ON THE RISE NATIONALLY AND BOTH COUNTIES HAVE BEEN SIGNIFICANTLY AFFECTED. IN 2015 AND 2016, OPIOID USE INCREASED DRAMATICALLY IN NEW YORK STATE (NYS) AND THE COUNTIES OF ERIE AND NIAGARA WERE LARGELY IMPACTED. IN 2016, THE OPIOID BURDEN (CRUDE RATE PER 100,000 POPULATION) WAS 352.2 IN ERIE COUNTY AND 416.5 IN NIAGARA COUNTY, SOME OF THE HIGHEST RATES IN NYS. IN ADDITION TO STATISTICAL DATA ON OPIOID USE, RESULTS FROM ERIE COUNTY AND NIAGARA COUNTY CONSUMER SURVEYS AND FOCUS GROUP SESSIONS INDICATED THE NEED TO ADDRESS THE PROBLEM. WHILE THE OPIOID BURDEN RATE DECREASED FROM 2016-2019, IT INCREASED AGAIN SHARPLY IN 2020 AND 2021 AS A RESULT OF THE COVID-19 PANDEMIC, AND IMPACTS INDIVIDUALS OF ALL RACES AND BACKGROUNDS, WHETHER THEY RESIDE IN URBAN, RURAL OR SUBURBAN AREAS. OPIOID USE INCLUDES BOTH SYNTHEITCS AND HEROIN, AND THE PROBLEM HAS BECOME EXACERBATED BY THE LACING OF OPIOIDS WITH DEADLY ADDITIVES SUCH AS FENTANYL.KALEIDA HEALTH IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES IN ITS 2022-2024 CHNA-CSP TO ADDRESS THE OPIOID ADDICTION PROBLEM:ERIE COUNTY AND NIAGARA COUNTY- PREVENT OPIOID AND OTHER SUBSTANCE MISUSE AND DEATH MATTERS BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM; AVAILABILITY, ACCESS, LINKAGE TO OPIOID OVERDOSE REVERSAL MEDICATIONS; MEDICATION AND SYRINGE DROP BOXES IN HOSPITAL EMERGENCY DEPARTMENTS AND DRUG TAKE-BACK DAYS (DISPARITY SUBSTANCE USE POPULATION)IN 2022, KALEIDA HEALTH HOSPITALS PROVIDED THE FOLLOWING SUBSTANCE USE DISORDER INTERVENTIONS:-IN 2022, KALEIDA HEALTH HOSPITALS PARTICIPATED IN NEW YORK MATTERS, A HOSPITAL-INITIATED BUPRENORPHINE AND TREATMENT REFERRAL PROGRAM. THIS ONLINE, REAL-TIME REFERRAL PROGRAM CONNECTS PATIENTS PRESENTING IN THE EMERGENCY ROOM WITH OPIATE USE DISORDERS TO A NETWORK OF 20 WESTERN NEW YORK TREATMENT AGENCIES. IN 2021, 18 REFERRALS WERE MADE TO NEW YORK MATTERS AT KALEIDA HEALTH EMERGENCY DEPARTMENTS.-KALEIDA HEALTH EMERGENCY DEPARTMENTS AT BUFFALO GENERAL MEDICAL CENTER AND MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK PROVIDE PATIENT ACCESS TO OVERDOSE REVERSAL MEDICATION INCLUDE NALOXONE THROUGH THE KALEIDA HEALTH PHARMACY. IN 2022, 44 NALOXONE KITS, AN OVERDOSE REVERSAL MEDICATION, WERE PROVIDED TO PATIENTS/FAMILIES IN KALEIDA HEALTH EMERGENCY DEPARTMENTS. IN 2021, FENTANYL TEST STRIPS WERE ADDED TO THE NARCAN KITS TO HELP TO DECREASE ACCIDENTAL OVERDOSE DUE TO FENTANYL-LACED PRODUCTS THIS CONTINUED IN 2022.-IN PARTNERSHIP WITH THE ERIE COUNTY DEPARTMENT OF HEALTH, MEDICATION AND SYRINGE DROP BOXES ARE PROVIDED AT THE EMERGENCY DEPARTMENTS OF KALEIDA HEALTH HOSPITALS. NIAGARA COUNTY SHERIFF'S OFFICES PICK UP AND TRANSPORT CONTENTS OF DROP BOXES ON A REGULAR BASIS FOR INCINERATION.-PRESCRIPTION DRUG TAKE BACK DAYS WERE HELD ON APRIL 30, 2022 AND OCTOBER 29, 2022 AT MILLARD FILLMORE SUBURBAN HOSPITAL IN ERIE COUNTY AND AT DEGRAFF MEDICAL PARK IN NIAGARA COUNTY.PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDRENTHE HEALTH OF WOMEN, INFANTS, CHILDREN AND THEIR FAMILIES IS FUNDAMENTAL TO POPULATION HEALTH AND IS A PRIORITY AREA FOR THE 2019-2024 NYS PREVENTION AGENDA. ERIE COUNTY AND NIAGARA COUNTY BOTH HAVE HIGH RATES OF INFANT AND MATERNAL MORTALITY, PREMATURE BIRTH, LOW BIRTHWEIGHT BABIES, AND TEEN PREGNANCY RATES. THESE RATES ARE AFFECTED BY MULTIPLE DISPARITIES INCLUDING RACE, POVERTY, AND LACK OF ACCESS TO QUALITY PRENATAL CARE, AS WELL AS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS OBESITY, SMOKING, SUBSTANCE USE, AND MENTAL HEALTH DISORDERS. ERIE COUNTY AND NIAGARA COUNTY INFANT MORTALITY RATES ARE SIGNIFICANTLY HIGHER THAN NYS RATES PER 2014-2016 NYS VITAL STATISTICS DATA:-THE INFANT MORTALITY RATE PER 1,000 LIVE BIRTHS (<1 YEAR) FOR ERIE COUNTY IS 5.6, AND THE RATE FOR NIAGARA COUNTY IS 5.4 WHILE THE NYS RATE IS 4.4.-THE PERCENTAGE OF LOW BIRTHWEIGHT BIRTHS (<2.5 KG) IS 8.8% IN ERIE COUNTY, 6.6% IN NIAGARA COUNTY VERSUS THE NYS RATE OF 9.0% DISPARITIES EXIST AMONG MINORITY POPULATIONS GIVEN THAT THE PERCENTAGE OF LOW BIRTHWEIGHT BABIES IN ERIE COUNTY IS 6.7% AMONG THE WHITE POPULATION AND 13.8% AMONG THE AFRICAN AMERICAN/BLACK POPULATION.-WHILE THE HEALTH BENEFITS OF BREASTFEEDING ARE WELL DOCUMENTED AND PROMOTED AMONG NEW MOTHERS, THERE IS MORE WORK TO BE DONE TO INCREASE RATES THROUGHOUT ERIE AND NIAGARA COUNTIES. THE PERCENTAGE OF INFANTS FED ANY BREAST MILK IN A DELIVERY HOSPITAL IS 76% IN ERIE COUNTY, 70.9% IN NIAGARA COUNTY, MUCH LOWER THAN THE NYS RATE OF 88.6%.KALEIDA HEALTH'S DELIVERY HOSPITALS OF OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) ARE LOCATED IN ERIE COUNTY. THEREFORE, KALEIDA HEALTH SELECTED MATERNAL, INFANT, AND CHILD HEALTH AS ONE OF ITS NYS PREVENTION AGENDA PRIORITIES FOR ERIE COUNTY AND IDENTIFIED THE FOLLOWING COMMUNITY HEALTH ACTIVITIES TO ADDRESS IN ITS 2022-2024 CHNA-CSP:ERIE COUNTY-PERINATAL AND INFANT HEALTH SAFE SLEEP INITIATIVE, YOMINGO ONLINE PARENT EDUCATION, BREASTFEEDING PROMOTION AND EDUCATION PROGRAMIN 2022, KALEIDA HEALTH PROVIDED THE FOLLOWING MATERNAL, INFANT, CHILD HEALTH INTERVENTIONS:-THROUGH THE SAFE SLEEP INITIATIVE, IN 2022, OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) PROVIDED SAFE SLEEP EDUCATION AND THE HALO SLEEP SACK FOR ALL NEWBORNS; AND AT OCH FOR ADMITTED PEDIATRIC PATIENTS UP TO ONE YEAR OF AGE AS PROVIDED BY TOPS FRIENDLY MARKETS AND THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION. IN SEPTEMBER 2022, OCH IMPLEMENTED EVIDENCE-BASED PRACTICE STRATEGIES AND ACHIEVED GOLD SAFE SLEEP CERTIFICATION THROUGH THE CRIBS FOR KIDS NATIONAL SAFE SLEEP HOSPITAL CERTIFICATION PROGRAM. MFS WILL BE MODELING SIMILAR PRACTICES TO ACHIEVE A SILVER OR GOLD CERTIFICATION. THROUGH A SAFE SLEEP INITIATIVE, OCH AND MFS WILL PROVIDE SAFE SLEEP EDUCATION FOR PARENTS/CAREGIVERS AND THE HALO SLEEP SACK FOR ALL NEWBORNS TO TAKE HOME TO REPLACE THE USE OF LOOSE BEDDING. THROUGH A PARTNERSHIP WITH THE CHILD ADVOCACY CENTER AND THE SAFE SLEEP AMBASSADOR, PER AN ASSESSMENT, OCH FAMILIES REQUIRING A SAFE SLEEP ENVIRONMENT FOR THEIR NEWBORN ARE PROVIDED A SAFE SLEEP PACK AND PLAY UPON DISCHARGE. -MILLARD FILLMORE SUBURBAN HOSPITAL OFFERED CHILDBIRTH EDUCATION TO PREGNANT WOMEN AND PARENTS WITH INFORMATION ON PRENATAL, PERINATAL, INFANT AND CHILD CARE THROUGH THE USE OF THE YOMINGO APP (WWW.MYYOMINGO.COM) TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES. IN 2022, MILLARD FILLMORE SUBURBAN HOSPITAL RECORDED 235 ACTIVE USERS ON YOMINGO AND THE PROGRAM WAS PROMOTED THROUGH YOMINGO FLYERS DELIVERED TO 250 PHYSICIANS/PROVIDERS THROUGHOUT THE COMMUNITY.-THROUGHOUT 2022, JOHN R. OISHEI CHILDREN'S HOSPITAL (OCH) AND MILLARD FILLMORE SUBURBAN HOSPITAL (MFS) CONTINUED THEIR BREASTFEEDING PROMOTION AND EDUCATION ACTIVITIES TO INCREASE INITIATION AND EXCLUSIVE BREASTFEEDING RATES. AT OCH, A HOSPITAL WITH 63.8% OF PATIENTS WITH MEDICAID, THE AVERAGE BREASTFEEDING RATES IN 2022 WERE 71.3% INITIATION AND 36.2% EXCLUSIVE (3,715 BIRTHS). AT MFS, THE AVERAGE RATES IN 2021 WERE 72.0% INITIATION AND 53.0% EXCLUSIVE (2,768 BIRTHS).THE CENTERING PREGNANCY PROGRAM WAS NOT PROVIDED AT KALEIDA HEALTH OB-GYN CLINICS IN 2022 DUE TO COVID-19 RESTRICTIONS. PLANNING IS UNDERWAY TO CONTINUE THE PROGRAM WHEN RESTRICTIONS ARE LIFTED.HEALTH CARE NEEDS NOT ADDRESSED IN KALEIDA HEALTH 2022-2024 CHNA-CSP
PART V, SECTION B, LINE 11, CONTINUED	CANCERWHILE CANCER IS THE NUMBER TWO CAUSE OF DEATH IN ERIE AND NIAGARA COUNTIES, THE COUNTY WORK GROUPS AGREED TO INSTEAD PRIORITIZE CARDIOVASCULAR DISEASE, THE NUMBER ONE CAUSE OF DEATH, IN THEIR 2022-2024 PLANS. THE IMPACT OF CANCER ON THE HEALTH OF RESIDENTS IS WELL RECOGNIZED AND ADDRESSED WITH SEVERAL ONGOING CANCER PREVENTION, EDUCATION, SCREENING AND TREATMENT INITIATIVES IN PLACE IN THE REGION. ROSWELL PARK COMPREHENSIVE CANCER CENTER, LOCATED IN BUFFALO, HOLDS THE NATIONAL CANCER INSTITUTE DESIGNATION AS A COMPREHENSIVE CANCER CENTER AND HAS A PROVEN MULTIDISCIPLINARY APPROACH. OISHEI CHILDREN'S HOSPITAL PARTNERS WITH ROSWELL ON THE ROSWELL PARK OISHEI CHILDREN'S CANCER AND BLOOD DISORDERS PROGRAM PROVIDING BOTH INPATIENT AND OUTPATIENT CARE AND A MULTIDISCIPLINARY APPROACH FOR CHILDREN AND ADOLESCENTS WITH CANCER AND HEMATOLOGIC DISORDERS. KALEIDA HEALTH'S MILLARD FILLMORE SUBURBAN HOSPITAL AND DEGRAFF MEDICAL PARK OFFER CANCER REHABILITATION AND RECOVERY THROUGH THE SURVIVOR STEPS PROGRAM. KALEIDA HEALTH PARTICIPATES IN THE GREAT LAKES CANCER CARE COLLABORATIVE, IN PARTNERSHIP WITH CANCER CARE OF WESTERN NEW YORK, ECMC, GASTROENTEROLOGY ASSOCIATES, LLP, GENERAL PHYSICIAN, PC, GREAT LAKES MEDICAL IMAGING, UBMD PHYSICIANS' GROUP, WESTERN NEW YORK UROLOGY ASSOCIATES, WINDSONG, AND THE VISITING NURSING ASSOCIATION OF WESTERN NEW YORK- WITH THE GOAL TO HARNESS THE REGION'S TOP TALENT AND MOST ADVANCED TECHNOLOGY IN A UNIQUE COLLABORATION TO DIAGNOSE, TREAT AND ELIMINATE CANCER.SMOKING AND E-CIGARETTESE-CIGARETTES HAVE BEEN THE MOST COMMONLY USED TOBACCO PRODUCE AMONG YOUTH SINCE 2014. MOST E-CIGARETTES CONTAIN NICOTINE - THE ADDICTIVE DRUG IN REGULAR CIGARETTES. TOBACCO CESSATION PROGRAMS ARE PROVIDED THROUGHOUT ERIE AND NIAGARA COUNTIES, AND KALEIDA HEALTH'S INPATIENT AND OUTPATIENT PROGRAMS CONTINUE TO PROVIDE PATIENT EDUCATION ON THE HEALTH BENEFITS OF NOT SMOKING AND WILL CONTINUE TO REFER PATIENTS TO THESE PROGRAMS.ENVIRONMENTAIR AND WATER QUALITY, FOOD SAFETY, BUILT ENVIRONMENTS TO PROMOTE PHYSICAL HEALTH, SUSTAINABILITY, HEALTHY HOME AND SCHOOL ENVIRONMENTS ARE ADDRESSED THROUGH FEDERAL, STATE AND LOCAL GOVERNMENTS AND NEIGHBORHOOD AND COMMUNITY-BASED ORGANIZATIONS. KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PARTNERS WITH THE WNY ASTHMA COALITION TO IMPROVE AIR QUALITY IN THE HOME TO IMPROVE ADULT AND CHILDHOOD ASTHMA RATES. THE HOSPITAL FURTHER ADDRESSES HOME SAFETY THROUGH ITS LEAD POISONING PREVENTION PROGRAM.MENTAL HEALTHKALEIDA HEALTH PROVIDES INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES FOR CHILDREN THROUGH THE CHILDREN'S PSYCHIATRY CENTER OF OISHEI CHILDREN'S HOSPITAL. THE CENTER ALSO PARTNERS WITH OTHER COMMUNITY-BASED PROVIDERS TO ASSURE IMPROVED ACCESS TO THE MOST APPROPRIATE CARE FOR CHILDREN WITH MENTAL HEALTH CONDITIONS. KALEIDA HEALTH IS A PARTNER WITH ERIE COUNTY MEDICAL CENTER, HOME OF THE REGIONAL CENTER OF EXCELLENCE FOR BEHAVIORAL HEALTH OFFERING MENTAL HEALTH AND PSYCHIATRY SERVICES, AS WELL AS ALCOHOL AND DRUG ADDICTION DETOXIFICATION AND REHAB.INJURY PREVENTION:KALEIDA HEALTH WORKS TO PREVENT INJURIES AMONG CHILDREN THROUGH ITS CAR PASSENGER SAFETY PROGRAM OF THE NYS GOVERNOR'S TRAFFIC SAFETY COMMITTEE. NYS FUNDING THROUGH THIS PROGRAM SUPPORTS CAR SEAT SAFETY CHECKS FOR THE COMMUNITY INCLUDING EDUCATION AND AWARENESS AS WELL AS THE PROVISION OF FREE CAR SEATS FOR THOSE WHO ARE OF LOW INCOME AND IN NEED. THE PROGRAM HAS BEEN PROVIDED SINCE 2020. PLANS ARE ALSO UNDERWAY FOR A BICYCLE HELMET SAFETY CHECK EVENT AT DEGRAFF MEDICAL PARK IN SPRING 2023. THESE PROGRAMS ALIGN WITH THE NYS PREVENTION AGENDA PRIORITY AREA TO PROMOTE A HEALTHY AND SAFE ENVIRONMENT.KALEIDA HEALTH'S OISHEI CHILDREN'S HOSPITAL PROVIDES THE FOLLOWING:- YOUTH LINK AND BE PREPARED PROGRAM - SUPPORTIVE SERVICES TO YOUTH AND YOUNG ADULTS, AGES 13-24, WHO IDENTIFY AS LGBTQ+, ARE LIVING WITH OR ARE AT RISK FOR HIV AND STIS, ARE EXPERIENCING HOMELESSNESS, SEXUAL ABUSE, SUBSTANCE USE AND/OR MENTAL HEALTH RELATED ISSUES.- THE FAMILY PLANNING CLINIC AND THE WOMEN'S HEALTH CENTERS ADDRESS STIS, HIV AND HCV.ALL KALEIDA HEALTH HOSPITALS ASSURE AND ALSO PROVIDE COVID-19 TESTING AND VACCINES FOR ITS EMPLOYEES AND PATIENTS.
PART V, SECTION B, LINE 16J	INFORMATION THAT EXPLAINS HOW QUALIFIED PATIENTS CAN ACCESS FINANCIAL ASSISTANCE THROUGH THE HOSPITAL IS INCLUDED ON BILLS AND STATEMENTS TO PATIENTS.APPLICATION MATERIALS INCLUDE A NOTICE TO PATIENTS THAT ONCE THEY SUBMIT A COMPLETED APPLICATION AND DOCUMENTATION, THEY MAY DISREGARD ANY BILLS UNTIL THE HOSPITAL HAS RENDERED A WRITTEN DECISION ON THE APPLICATION. THE HOSPITAL MAY NOT FORWARD ACCOUNTS TO COLLECTION WHILE AND APPLICATION IS PENDING.

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?20
Name and address		Type of Facility (describe)
1	1 - HIGHPOINTE ON MICHIGAN 1031 MICHIGAN AVE BUFFALO,NY14203	INPATIENT SKILLED NURSING FACILITY
2	2 - CENTER FOR LABORATORY MEDICINE 115 FLINT ROAD AMHERST,NY14226	HOSPITAL BASED LAB SERVICES
3	3 - DEGRAFF SKILLED NURSING FACILITY 445 TREMONT STREET NORTH TONAWANDA,NY14120	INPATIENT SKILLED NURSING FACILITY
4	4 - MILLARD FILLMORE SURGERY CENTER 215 KLEIN ROAD WILLIAMSVILLE,NY14221	AMBULATORY SURGERY CENTER
5	5 - MAPLE WEST MEDICAL COMPLEX 705 MAPLE ROAD AMHERST,NY14221	MEDICAL SERVICES - OTHER MEDICAL SPECIALTIES
6	6 - NORTH BUFFALO MEDICAL PARK 900 HERTEL AVE BUFFALO,NY14207	MEDICAL SERVICES - PRIMARY CARE, RADIOLOGY OUTPATIENT, OUTPATIENT THERAPY
7	7 - KALEIDA HEALTH FAMILY PLANNING CENTER 1313 MAIN STREET BUFFALO,NY14209	OUTPATIENT FAMILY PLANNING
8	8 - TOWNE GARDEN PEDIATRICS 461 WILLIAM STREET BUFFALO,NY14204	MEDICAL SERVICES - PRIMARY CARE
9	9 - SOUTHTOWNS SURGERY CENTER 5959 BIG TREE ROAD SUITE 100 ORCHARD PARK,NY14217	AMBULATORY SURGERY CENTER
10	10 - WCHOB WOMEN'S OBGYN HEALTH CENTER 462 GRIDER STREET BUFFALO,NY14215	MEDICAL SERVICES - PRIMARY CARE
11	11 - WCHOB MCKINLEY OBGYN 3860 MCKINLEY PARKWAY HAMBURG,NY14219	MEDICAL SERVICES - PRIMARY CARE
12	12 - WCHOB CHILD PROTECTION CENTER 556 FRANKLIN STREET BUFFALO,NY14202	MEDICAL SERVICES - PRIMARY CARE
13	13 - STANLEY MAKOWSKI SBHC 1095 JEFFERSON AVE BUFFALO,NY14214	SCHOOL BASED PRIMARY CARE SERVICES
14	14 - HILLERY PARK #27 SBHC 72 PAWNEE PARKWAY BUFFALO,NY14210	SCHOOL BASED PRIMARY CARE SERVICES
15	15 - WESTMINSTER #86 SBHC 24 WESTMINSTER AVE BUFFALO,NY14215	SCHOOL BASED PRIMARY CARE SERVICES
16	16 - DR LYDIA WRIGHT #89 SBHC 106 APPENHEIMER STREET BUFFALO,NY14214	SCHOOL BASED PRIMARY CARE SERVICES
17	17 - BUILD ACADEMY #91 SBHC 340 FOUGERON STREET BUFFALO,NY14211	SCHOOL BASED PRIMARY CARE SERVICES
18	18 - BUFFALO SCHOOL OF TECHNOLOGY SBHC 414 SOUTH DIVISION STREET BUFFALO,NY14204	SCHOOL BASED PRIMARY CARE SERVICES
19	19 - HERMAN BADILLO #76 SBHC 315 CAROLINE STREET BUFFALO,NY14201	SCHOOL BASED PRIMARY CARE SERVICES
20	20 - SOUTHTOWNS CLINIC 4535 SOUTHWESTERN BLVD HAMBURG,NY14075	MEDICAL SERVICES PRIMARY CARE

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 3C:	KALEIDA HEALTH HAS IMPLEMENTED AND COMMUNICATES ITS FINANCIAL ASSISTANCE (CHARITY CARE) POLICY, WHICH ASSISTS LOW INCOME, UNINSURED OR UNDERINSURED INDIVIDUALS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR MEDICAL SERVICES RENDERED. LEVELS OF DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION AND IN ACCORDANCE WITH THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. INDIVIDUALS ARE PROVIDED FINANCIAL ASSISTANCE CONTACT INFORMATION DURING INTAKE AND REGISTRATION. THE APPLICANT FOR FREE OR REDUCED PRICE CARE WORKS DIRECTLY WITH A MEMBER OF THE FINANCIAL COUNSELING OR CHARITY CARE TEAM FOR FINANCIAL SCREENING AND ENROLLMENT IN A GOVERNMENT-FUNDED PROGRAM, IF ELIGIBLE.AFTER REVIEW OF INCOME AND ASSETS, AN INDIVIDUAL MAY BE APPROVED FOR FREE CARE (100% DISCOUNT) OR A DISCOUNT LEVEL OF 50, 60, 75, OR 90%, FOR MEDICALLY NECESSARY SERVICES RENDERED AT A KALEIDA HEALTH FACILITY, AS FOLLOWS: LESS THAN 200% OF FEDERAL POVERTY GUIDELINE IS AWARDED 100% DISCOUNT200% - 249% OF FEDERAL POVERTY GUIDELINE IS AWARDED 90% DISCOUNT250% - 299% OF FEDERAL POVERTY GUIDELINE IS AWARDED 75% DISCOUNT300% - 349% OF FEDERAL POVERTY GUIDELINE IS AWARDED 60% DISCOUNT350% - 400% OF FEDERAL POVERTY GUIDELINE IS AWARDED 50% DISCOUNT
PART I, LINE 7:	THE AMOUNTS REPORTED IN THE TABLE UNDER PART 1, LINE 7 WERE DETERMINED USING THE HEALTH SYSTEM'S DECISION SUPPORT SOFTWARE PROGRAM AND REVENUE AND EXPENSES FROM THE GENERAL LEDGER. THE OVERALL REVENUE AND EXPENSES INCLUDED IN THE DECISION SUPPORT SOFTWARE PROGRAM WERE RECONCILED TO THE GENERAL LEDGER WHICH RECONCILES TO THE AUDITED FINANCIAL STATEMENTS. THE DECISION SUPPORT SOFTWARE PROGRAM ALLOCATES DIRECT COSTS TO EACH PATIENT ACCOUNT BASED ON THE RESOURCES USED BY THAT PATIENT WITHIN THE SPECIFIC COST CENTER. INDIRECT COSTS ARE ALLOCATED USING SIMILAR STEPDOWN METHODOLOGY USED BY CMS IN THE INSTITUTIONAL COST REPORT.
PART II, LINE 7	KALEIDA HEALTH'S COMMUNITY HEALTH SERVICES SUPPORTS A COMPREHENSIVE PROGRAM OF COMMUNITY HEALTH IMPROVEMENT ADVOCACY. OUTREACH IS CONDUCTED IN MULTIPLE WESTERN NEW YORK COMMUNITIES TARGETING VARIED POPULATIONS OF ALL AGES AND ETHNICITIES, INCLUDING THE MEDICALLY UNDERSERVED. PROGRAMS AND EVENTS PROMOTE THE REDUCTION OF HEALTH DISPARITIES, ACCESS TO CARE, AND PROMOTE OVERALL COMMUNITY HEALTH AND WELLNESS; AND INCLUDE HEALTH EDUCATION AND SCREENING, SPEAKERS ON HEALTH-RELATED TOPICS, AND COMMUNITY REFERRALS. TOPICS RANGE FROM HEALTH INSURANCE ENROLLMENT TO DIABETES, STROKE, HEART DISEASE, MATERNAL AND CHILD HEALTH, AND HEALTH CAREER EXPLORATION.IN 2022, COVID-19 RESTRICTIONS CONTINUED, ALTHOUGH MANY WERE EASED, AND SOMEWHAT LIMITED KALEIDA HEALTH'S ABILITY TO PROVIDE THE SAME COMPREHENSIVE PROGRAM OF COMMUNITY OUTREACH AND EDUCATION IT HAS IN PREVIOUS YEARS. HOWEVER, WORKING AROUND THE EASING RESTRICTIONS, KALEIDA HEALTH PARTNERED WITH VARIOUS ORGANIZATIONS AND PARTICIPATED IN 113 IN-PERSON AND VIRTUAL EVENTS TO REACH 14,075 INDIVIDUALS WITH COMMUNITY SERVICE PROGRAMMING. ALL OF THE OUTREACH PROGRAMS ARE FREE AND REACH A CROSS SECTION OF CULTURES, ETHNICITIES, ECONOMIC DEMOGRAPHICS, LANGUAGES, RELIGIONS AND ALL GENDERS INCLUDING LGBTQ+ COMMUNITY. MATERIALS PROVIDED TO THE COMMUNITY DURING OUTREACH EVENTS INCLUDED: INFORMATION ON FREE PSA SCREENINGS; BREAST, PROSTATE, COLON CANCER; STROKE PREVENTION; DIABETES PREVENTION; HEART DISEASE AND RISK FACTORS; CHILDREN'S HEALTH; BARIATRIC /OBESITY/ BMI; FAMILY PLANNING; HPV/ STD/STI; CHILDREN'S MEDICAID HEALTH HOMES; NUTRITION; WOMEN'S HEALTH; MATERNITY INCLUDING BREASTFEEDING; KALEIDA HEALTH WELLNESS SERIES/ "HEALTHY YOU".KALEIDA HEALTH COMMUNITY OUTREACH EXTENDED THROUGHOUT ITS SERVICE AREA AND PRIMARILY IN THE CITY OF BUFFALO, A CITY WITH A POVERTY RATE OF 28.3% AND A HIGH MINORITY POPULATION WITH 35.2% BLACK/AFRICAN AMERICAN AND 12.2% HISPANIC (US CENSUS 2020). BUFFALO HAS SEVERAL CENSUS TRACTS THAT ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS. IN-PERSON AND VIRTUAL OUTREACH IN THE BUFFALO AREA INCLUDED THE FOLLOWING:GREAT LAKES CANCER COLLABORATIVE CARE:KALEIDA HEALTH'S COMMUNITY OUTREACH SPECIALIST SERVED AS A COMMUNITY LIAISON FOR GREAT LAKES CANCER CARE (GLCC) TO ASSIST WITH ACCREDITATION REQUIREMENTS. WORKING CLOSELY WITH CONSULTANTS FROM ONCOLOGY SOLUTIONS, THE COMMUNITY OUTREACH SPECIALIST LEAD GLCC WITH THE FOLLOWING INITIATIVES:-CANCER PREVENTION: IN 2022, WORKING CLOSELY WITH WNY UROLOGY ASSOCIATES, KALEIDA HEALTH FAMILY PLANNING, GLCC,THE COMMUNITY LIAISON TRACKED CENSUS DATA TO DETERMINE COMMUNITIES WITH THE GREATEST HEALTHCARE NEEDS AND HEALTHCARE DISPARITIES IN BUFFALO. USING THIS DATA AND EXISTING ZIP CODES DEETERMINED BY THE COMMISSION ON CANCER/BGMC/MSF CANCER COMMITTEE, THE LIAISON RESEARCHED AND ORGANIZED THE LOGISTICS FOR OUTREACH OPPORTUNITIES AND EVENTS FOR WNY UROLOGY ASSOCIATES, KALEIDA HEALTH FAMILY PLANNING, AND GLCC.-CANCER SCREENINGS: BASED ON ERIE COUNTY DATA, LOCATIONS WERE IDENTIFIED BASED ON NEED (USING DATA OUTLINED ABOVE). THE LIASION THEN IDENTIFIED COLLABORATING ORGANIZATIONS FOR CANCER SCREENINGS. CANCER SCREENINGS WERE HELD IN AREAS OF HIGH NEED FOR PROSTATE CANCER, ORAL CANCER (WITH ECMC DENTAL TEAM), AND HPV. -GREAT LAKES HEALTH RADIO: KALEIDA'S COMMUNITY LIAISON CREATED AND PRODUCED VIRTUAL INTERVIEWS FOR EMPLOYEES OF GLCC, ECMC, WNY UROLOGY, AND KALEIDA HEALTH COMMUNITIES DISCUSS HEALTH TOPICS THAT HAVE A DISPROPORTIONATE IMPACT ON THE LIVES OF PERSONS OF COLOR OR PERSONS RESIDING IN LOW-INCOME COMMUNITIES. THE PROGRAM WAS RECORDED AND POSTED ON THE KALEIDA HEALTH WEBSITE. IT AIRED 2 TIMES A MONTH IN 2022 ON WUFO 1080 AM AND POWER 96.5 FM. IT FEATURES 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS, INCLUDING PHYSICIANS, NURSES AND OTHER HEALTH PROFESSIONALS. A SENIOR MOMENT PROGRAM ALSO AIRED AND FEATURED 30 MINUTE INTERVIEWS WITH GUEST SPEAKERS ON HEALTH AND WELLNESS TOPICS FOR AGES 60+. THESE PROGRAMS REACH A PREDOMINANTLY URBAN POPULATION OF ALL AGES RACES AND SEXUAL ORIENTATIONS.-EXECUTIVE DIRECTOR OF NEAR EAST AND WEST SIDE TASK FORCE (NEWS TF)- THE COMMUNITY OUTREACH SPECIALIST ORGANIZED OUTREACH PROGRAMS WITH KALEIDA HEALTH AND COMMUNITY PARTNER ORGANIZATIONS. PROGRAMS AND OUTREACH WERE HELD IN LOW-INCOME NEIGHBORHOODS IN BUFFALO WHERE UNDERSERVED POPULATIONS RESIDE. AS NYS BEGAN TO LIFT COVID RESTRAINTS IN 2022, COMMUNITY OUTREACH RESUMED INDOORS AND OUTDOORS, AND CONTINUED TO BE HELD VIRTUALLY.KALEIDA HEALTH WAS PRESENT AT 83 COMMUNITY OUTREACH EVENTS REPRESENTING EITHER KALEIDA HEALTH, GLCC, WNY UROLOGY, OR ECMC. KALEIDA'S COMMUNITY OUTREACH SPECIALIST ATTENDED 30 EVENTS REPRESENTING KALEIDA HEALTH.14,075 MEMBERS OF THE COMMUNITY WERE REACHED THROUGH OUTREACH PROGRAMS. THIS DOES NOT INCLUDE GREAT LAKES RADIO, SENIOR MOMENT, OR NAACP SPEAKS RADIO PROGRAMS, WHERE KALEIDA'S COMMUNITY OUTRACH SPECIALIST SERVES AS HOST OR IS OFTEN A GUEST-HOST. THROUGH EMAIL, HUNDREDS OF COMMUNICATIONS ARE SHARED WITH THE COMMUNITY THROUGH KALEIDA HEALTH.-KALEIDA HEALTH'S COMMUNITY OUTREACH SPECIALIST COORDINATED SPONSORSHIP OUTREACH FOR THE FOLLOWING EVENTS:-SUSAN J. KOMEN WALK-MAKING STRIDES AGAINST BREAST CANCER-NAACP ANNUAL DINNER-JUNETEENTH FESTIVAL-BLACK ACHIEVERS-HISPANIC WOMEN'S LEAGUE-TAKING IT TO THE STREETS-HOSPITAL TOURS AND SPEAKING ENGAGEMENTS: KALEIDA'S COMMUNITY OUTREACH SPECIALIST HAD 8 SPEAKING ENGAGEMENTS, EITHER IN PERSON OR VIRTUAL, WITH KH COLLEAGUES FOR COMMUNITY GROUPS, FAITH BASED ORGANIZATIONS, THE CITY OF BUFFALO, AND CITY OF BUFFALO SCHOOLS. SHE LED FOUR TOURS OF LABS AND BUFFALO GENERAL MEDICAL CENTER.ADDITIONALLY, KALEIDA HEALTH'S COMMUNITY RELATIONS SPECIALIST ACTIVELY PARTICIPATES IN THE FOLLOWING COMMUNITY ORGANIZATIONS:-NEAR EAST AND WEST SIDE TASK FORCE - EXECUTIVE DIRECTOR-CRISIS SERVICES- OUTREACH, MEMBERSHIP-WNED - COMMUNITY ADVISORY COMMITTEE-UB MINI MEDICAL SCHOOL - COMMUNITY COMMITTEE MEMBER-NAACP - BOARD OF DIRECTORS 2ND VP, BUFFALO; CHAIR HEALTH COMMITTEE, BUFFALO AND NEW YORK STATE-LEADERSHIP BUFFALO -CLASS CHAIR-HISPANIC WOMEN'S LEAGUE- MEMBERSHIP CHAIR AND SPECIAL PROJECTS-ALBRIGHT-KNOX ART GALLERY - ADVANCEMENT COMMITTEE-ST. JOHN BAPTIST CHURCH - CHAIR, HEALTH COMMITTEE AND OUTREACH-BUFFALO NIAGARA MEDICAL CAMPUS - NEIGHBORHOOD ENGAGEMENT & GOVERNMENT AFFAIRS COUNCIL-UB MEDICAL SCHOOL CURRICULUM REVISION COMMITTEE - COMMUNITY ADVISORY-HEALTH SCIENCES CHARTER SCHOOL - BOARD OF DIRECTORSKALEIDA HEALTH'S COMMUNITY RELATIONS SPECIALIST WAS RECOGNIZED AS A BUFFALO BUSINESS FIRST WOMEN OF INFLUENCE RECIPIENT AND FEATURED IN HEALTHY LIVING MAGAZINE'S AUGUST EDITION.PART III, SECTION A, LINE 2BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING 2022 AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS.KALEIDA ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT'S CARE MAY BE CLASSIFIED AS CHARITY CARE IN ACCORDANCE WITH CERTAIN ESTABLISHED POLICIES OF KALEIDA. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED.TO ENHANCE AND ACCELERATE THE CHARITY CARE QUALIFICATION PROCESS, KALEIDA UTILIZES A PRESUMPTIVE CHARITY SCORING SYSTEM IN ORDER TO DETERMINE CHARITY CARE ELIGIBILITY. THE SYSTEM USES DEMOGRAPHIC AND PUBLIC FINANCIAL INFORMATION TO QUALIFY PATIENT ACCOUNTS FOR CHARITY CARE. IN ADDITION, KALEIDA MAKES AND RECEIVES PAYMENTS TO AND FROM A STATEWIDE POOL TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT NEW YORK. THESE NET PAYMENTS ARE REPORTED AS A COMPONENT OF PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8:	THERE ARE NO MEDICARE SHORTFALLS INCLUDED IN THE CALCULATION OF COMMUNITY BENEFIT.COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT, AS REFLECTED IN PART III, LINE 6: KALEIDA HEALTH USED THE FILED, BUT UNAUDITED 2022 CMS MEDICARE COST REPORT TO DETERMINE THE AMOUNTS REPORTED ON THESE LINES.
PART III, LINE 9B:	ONCE PATIENT LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE, THE PATIENT STATEMENT IS MAILED FOR PAYMENT RECOVERY. KALEIDA HEALTH HAS A PRE-COLLECTION PROCESS FOR ACCOUNTS WITH A POSITIVE PATIENT BALANCE GREATER THAN $4.99 AND A FIRST BILL DATE OLDER THAN 60 DAYS, BUT NOT PREVIOUSLY PAID IN FULL BY THE PATIENT (EXCLUDING ACCOUNTS FOR PATIENTS THAT HAVE SUBMITTED A COMPLETED APPLICATION FOR CHARITY CARE, MEDICAID, OR CHILD HEALTH PLUS, AND AN ELIGIBILITY DETERMINATION IS PENDING).UPON A PATIENT EXPRESSING FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE (CHARITY CARE). ONCE THE PATIENT SUBMITS THE COMPLETED APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THEN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THEN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY.
PART VI, LINE 2:	KALEIDA HEALTH ASSESSES THE NEEDS OF THE COMMUNITY THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP) WITH ITS MOST RECENT PLAN COMPLETED IN 2022.THE 2022-2024 CHNA-CSP IS AVAILABLE TO THE PUBLIC ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/ AND A PRINTED COPY IS AVAILABLE UPON REQUEST AT NO CHARGE. WRITTEN COMMENTS ON THE 2022-2024 CHNA-CSP ARE INVITED FROM THE PUBLIC THROUGH A LINK ENTITLED "COMMENT ON PLAN", LOCATED NEXT TO THE DOCUMENT THROUGH THE ABOVE LINK.IN ADDITION TO THE 2022-2024 CHNA-CSP (AS REPORTED IN PART V, SECTION B), KALEIDA HEALTH STAFF ENGAGE IN OTHER METHODS TO ASSESS THE NEEDS OF THE COMMUNITY. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH, AND LOCAL COMMUNITY HEALTH NEEDS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING SERVICES AND PROGRAMS. RESPONSIVE TO COMMUNITY PRIORITIES, PROGRAM DEVELOPMENT AND SERVICES FILL IDENTIFIED GAPS OR SUPPLEMENT EXISTING PROGRAMS.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE KALEIDA HEALTH INFORMS INDIVIDUALS OF FINANCIAL ASSISTANCE MADE AVAILABLE AT THE TIME OF REGISTRATION INTO THE INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, AND LONG-TERM CARE FACILITY. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE AVAILABLE THROUGHOUT THE KALEIDA LOCATIONS. BROCHURES AND PAMPHLETS INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AS WELL AS APPLICATION IS ALSO MADE AVAILABLE THROUGH KALEIDA HEALTH'S WEBSITE. KALEIDA HEALTH OFFERS ASSISTANCE TO INDIVIDUALS IN OUR COMMUNITY FOR ACCESSING AFFORDABLE HEALTH CARE, INCLUDING:- FACILITATED ENROLLMENT: ASSISTS ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, ESSENTIAL PLANS, STATE AID PROGRAM FOR CHILDREN WITH SPECIAL NEEDS AND ALL QUALIFIED HEALTH PLANS MADE AVAILABLE THROUGH THE NEW YORK STATE OF HEALTH, HEALTH PLAN MARKETPLACE. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN BROCHURES AT KALEIDA SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. - FINANCIAL ASSISTANCE PROGRAM: AS DESCRIBED ABOVE, THE KALEIDA FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE PROVIDES FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT KALEIDA HEALTH HOSPITALS OR LONG-TERM CARE FACILITIES. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. - PRESUMPTIVE ELIGIBILITY: KALEIDA HEALTH HAS SHOWN A WILLINGNESS TO EXTEND FINANCIAL ASSISTANCE TO NEEDY PATIENTS WITH OUTSTANDING BILLS WHO HAVE NOT COMPLETED THE CHARITY APPLICATION PROCESS. THIS IS ACHIEVED THROUGH AN AUTOMATED PARO SCORING PROCESS USING PUBLIC RECORDS, REGIONAL COST OF LIVING, ESTIMATED HOUSEHOLD INCOME THRESHOLDS, COMMUNITY DEMOGRAPHICS TO DERIVE AN ESTIMATED FINANCIAL POSITION FOR EACH PATIENT. THOSE PATIENTS SCREENED THROUGH THIS AUTOMATED PROCESS AND DEEMED ELIGIBLE ARE ADJUSTED OFF TO CHARITY CARE IN LIEU OF BAD DEBT.
PART VI, LINE 4:	KALEIDA HEALTH SERVES WESTERN NEW YORK'S EIGHT COUNTIES OF ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS, AND WYOMING. THE POPULATION FOR THE REGION IS APPROXIMATELY 1.5 MILLION WITH ERIE COUNTY AND NIAGARA COUNTY COMPRISING AN ESTIMATED 1.1 MILLION OF THIS TOTAL. THREE KALEIDA HEALTH HOSPITALS INCLUDING BUFFALO GENERAL MEDICAL CENTER, MILLARD FILLMORE SUBURBAN HOSPITAL, AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN ERIE COUNTY, THE HOSPITALS' PRIMARY SERVICE AREA. DEGRAFF MEDICAL PARK IS LOCATED IN NIAGARA COUNTY, ITS PRIMARY SERVICE AREA. DEGRAFF ALSO SERVES A NUMBER OF ERIE COUNTY RESIDENTS GIVEN ITS LOCATION LESS THAN ONE MILE FROM THE ERIE COUNTY BORDER. EACH FACILITY'S PRIMARY SERVICE AREA IS DEFINED AS THE COUNTY WITH THE HIGHEST PERCENTAGE OF ALL WNY COUNTIES FOR INPATIENT DISCHARGES, EMERGENCY DEPARTMENT VISITS, AND OUTPATIENT VISITS AS IDENTIFIED IN THE 2022-2024 CHNA-CSP.ERIE COUNTYERIE COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE BORDERING LAKE ERIE, AND ALSO LIES ON THE INTERNATIONAL BORDER BETWEEN THE UNITED STATES AND CANADA. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR ERIE COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, APRIL 1, 2020 AS INDICATED IN KALEIDA HEALTH'S 2022-2024 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 954,236 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. ERIE COUNTY'S MEDIAN HOUSEHOLD INCOME IS $59,464. ITS POVERTY RATE IS 13.2%, AND 18.4% OF ITS POPULATION IS 65 YEARS AND OVER. ITS LARGEST CITY AND COUNTY SEAT IS BUFFALO WITH A POPULATION OF 278,349. THE CITY HAS A 28.3% POVERTY RATE THE MEDIAN HOUSEHOLD INCOME IN BUFFALO IS $39,677 WHILE THE MEDIAN HOUSEHOLD INCOME IN ERIE COUNTY IS $59,464 AND IN NEW YORK STATE, $71,117. BUFFALO HAS THE FOURTH HIGHEST YOUTH POVERTY RATE IN THE COUNTRY. OF THE 58,618 BUFFALO RESIDENTS UNDER 18 YEARS OF AGE, 27,678 OR 47% OF THOSE CHILDREN LIVE BELOW THE FEDERAL POVERTY LEVEL. THE ERIE COUNTY YOUTH POVERTY RATE IS 19.8% AND THE NYS RATE IS 20.8%. ONLY DETROIT, ROCHESTER AND CLEVELAND HAVE WORSE YOUTH POVERTY RATES (BUFFALO BUSINESS FIRST, 1-15-19). BUFFALO ALSO HAS A HIGH MINORITY POPULATION WITH 35.2% OF ITS RESIDENTS BEING BLACK NON-HISPANIC AND 12.2% HISPANIC AS COMPARED TO 14% BLACK NON-HISPANIC AND 5.8% HISPANIC FOR ALL OF ERIE COUNTY. PERSONS UNDER 65 WITHOUT HEALTH INSURANCE COMPRISE 4.1% OF ERIE COUNTY'S POPULATION AND 4.9% OF BUFFALO'S POPULATION. BUFFALO GENERAL MEDICAL CENTER AND OISHEI CHILDREN'S HOSPITAL ARE LOCATED IN THE CITY OF BUFFALO AND SERVE A HIGH PERCENTAGE OF BUFFALO'S POOR AND UNDERSERVED POPULATION. MOST CENSUS TRACTS IN BUFFALO ARE FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. THE TOWN OF AMHERST IS ONE OF THE COUNTY'S LARGEST SUBURBS WITH A POPULATION OF 129,595 AND IS HOME TO MILLARD FILLMORE SUBURBAN HOSPITAL. IN CONTRAST TO BUFFALO, THE TOWN OF AMHERST HAS A POVERTY RATE OF 9.8% AND THE MEDIAN HOUSEHOLD INCOME IN 2020 IS $76,781. AMHERST'S POPULATION IS 78.6% WHITE NON-HISPANIC. THE TOWN ALSO HAS 8.9% ASIAN POPULATION, COMPARABLE TO THE NYS RATE OF 10.2% WHILE THE ERIE COUNTY RATE IS 3.8%.THE TOWN HAS A SIGNIFICANT SENIOR POPULATION WITH 20.9% OF RESIDENTS 65 YEARS AND OVER, AND MILLARD FILLMORE SUBURBAN HOSPITAL SERVES A HIGH PERCENTAGE OF THE TOWN'S AGING POPULATION.NIAGARA COUNTYNIAGARA COUNTY IS LOCATED IN THE WESTERN PORTION OF NEW YORK STATE, JUST NORTH OF BUFFALO (ERIE COUNTY) AND ADJACENT TO LAKE ONTARIO ON ITS NORTHERN BORDER AND THE NIAGARA RIVER AND CANADA ON ITS WESTERN BORDER. THE FOLLOWING DEMOGRAPHIC STATISTICS FOR NIAGARA COUNTY ARE FROM THE US CENSUS, QUICK FACTS, POPULATION ESTIMATES, APRIL 1, 2020 AS INDICATED IN KALEIDA HEALTH'S 2022-2024 CHNA-CSP. THE COUNTY'S TOTAL POPULATION IS 212,666 AND IS COMPRISED OF URBAN, SUBURBAN, AND RURAL CITIES, TOWNS, AND VILLAGES. NIAGARA COUNTY'S MEDIAN HOUSEHOLD INCOME IN 2020 IS $57,252. ITS POVERTY RATE IS 11.7% AND 19.5% OF ITS POPULATION IS 65 YEARS AND OVER. ITS CITIES INCLUDE NIAGARA FALLS, POPULATION 48,671; NORTH TONAWANDA, POPULATION 30,496; AND ITS COUNTY SEAT OF LOCKPORT, POPULATION 20,876. THESE CITIES INCLUDE A HIGH PROPORTION OF THE COUNTY'S LOW INCOME AND UNDERSERVED POPULATION. 20% OF NIAGARA FALLS RESIDENTS ARE BLACK/AFRICAN AMERICAN AND THE CITY HAS A 23.5% POVERTY RATE. ADDITIONALLY, NIAGARA FALLS IS FEDERALLY DESIGNATED AS AN AREA WITH A MEDICALLY UNDERSERVED POPULATION. THE POVERTY RATE FOR NORTH TONAWANDA IS 10.2%, AND 14.2% FOR LOCKPORT. THE PERCENTAGE OF RESIDENTS UNDER 65 YEARS WITHOUT HEALTH INSURANCE RANGES FROM 4.3% IN NIAGARA FALLS AND 2.8% IN NORTH TONAWANDA AND 5.9% IN LOCKPORT. NIAGARA COUNTY IS ALSO HOME TO THE TUSCARORA RESERVATION WITH A POPULATION OF 1,167, A POVERTY RATE OF 39.9% AND A MEDIAN INCOME OF $14,323, MUCH LOWER THAN THAT OF NIAGARA COUNTY. NORTH TONAWANDA IS HOME TO DEGRAFF MEDICAL PARK, AND, A COMMUNITY HOSPITAL A WITH A RECENTLY EXPANDED, NEW STATE-OF-THE ART EMERGENCY ROOM TO BETTER SERVE THE GROWING EMERGENCY CARE NEEDS OF THE COMMUNITY.DURING 2022, THERE WERE 53,569 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED CARE, 41% MEDICARE AND MEDICARE MANAGED CARE, 1% WERE UNINSURED, AND 31% WERE OTHER.IN ADDITION TO KALEIDA HEALTH'S 3 HOSPITALS IN ERIE COUNTY AND 1 HOSPITAL IN NIAGARA COUNTY, THERE ARE 9 OTHER HOSPITALS IN ERIE COUNTY AND 3 OTHER HOSPITALS IN NIAGARA COUNTY SERVING WESTERN NEW YORK PER THE NEW YORK STATE DEPARTMENT OF HEALTH WEBSITE.MORE INFORMATION IS AVAILABLE IN THE KALEIDA HEALTH 2022-2024 COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY SERVICE PLAN (CHNA-CSP). THE DOCUMENT WAS COMPLETED IN FALL 2021, AND CAN BE FOUND ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY/. PRINTED COPIES AVAILABLE UPON REQUEST AT NO CHARGE AT KALEIDA HEALTH HOSPITALS. WRITTEN COMMENTS ON THE 2022-2024 CHNA-CSP ARE INVITED AND A "COMMENT LINK" IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTHKALEIDA HEALTH'S MISSION IS TO "ADVANCE THE HEALTH OF ITS COMMUNITY AND ITS VISION IS TO "PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE."KALEIDA HEALTH BOARD OF DIRECTORSKALEIDA HEALTH MAINTAINS CONTROL OVER THE CORPORATION THROUGH ITS SELF-PERPETUATING,15 MEMBER GOVERNING BOARD OF DIRECTORS. A MAJORITY OF THE BOARD OF DIRECTORS RESIDES IN KALEIDA HEALTH'S PRIMARY SERVICE AREA OF ERIE AND NIAGARA COUNTIES AND IS NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF KALEIDA HEALTH, NOR FAMILY MEMBERS THEREOF. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY LEADERS FROM THE BUSINESS, INDUSTRY, AND HEALTHCARE SECTORS, INCLUDING PHYSICIANS WHO ARE ON THE MEDICAL STAFF. EACH DIRECTOR SIGNS A CONFLICT OF INTEREST STATEMENT AND SERVES A THREE-YEAR TERM. ROBERT NESSELBUSH (JAN 1-JULY 12, 2022) AND DONALD BOYD (JULY 13-DEC 31, 2022), SERVED AS PRESIDENT AND CEO OF KALEIDA HEALTH, AND SERVED AS AN EX-OFFICIO DIRECTOR WITH VOTING RIGHTS.USE OF SURPLUS FUNDSSURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY. IN ADDITION TO THE COMMUNITY SERVICE PROGRAMS ADDRESSED IN THE SECTION VI, PART II COMMUNITY BUILDING SECTION, KALEIDA HEALTH PROVIDES A NUMBER OF ADDITIONAL PROGRAMS AND COLLABORATIONS.KALEIDA HEALTH IS COMMITTED TO EDUCATION AND RESEARCH AS IT SERVES AS A MAJOR CLINICAL TEACHING AFFILIATE OF THE UNIVERSITY AT BUFFALO, JACOBS SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES. THROUGH AFFILIATIONS WITH A NUMBER OF EDUCATIONAL INSTITUTIONS , KALEIDA HEALTH ALSO PROVIDES A CLINICAL EXPERIENCE FOR HEALTH CARE PROFESSIONALS IN TRAINING IN THE FIELDS OF PHARMACY, NURSING, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND REHABILITATION SERVICES.AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATION, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS, AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING KALEIDA HEALTH'S MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.KALEIDA HEALTH IS COMMITTED TO PROVIDING HEALTH CARE FOR THE UNINSURED AND UNDERINSURED, OFFERS PROGRAMS AND SERVICES IN COMMUNITY-BASED SETTINGS AND IN ITS CAMPUSES AND FACILITIES, AND WORKS WITH PARTNERING ORGANIZATIONS TO FURTHER MEET THE COMMUNITY'S HEALTH AND SOCIAL NEEDS. PROGRAMS AND EVENTS TARGET ALL AGES AND BACKGROUNDS, INCLUDING THE MEDICALLY UNDERSERVED; AND FOCUS ON THE REDUCTION OF HEALTH DISPARITIES, IMPROVED ACCESS TO CARE, EFFECTIVE USE OF HEALTH SERVICES, AND THE PROMOTION OF OVERALL COMMUNITY HEALTH AND WELLNESS.IN 2019, THE MED-LAW PARTNERSHIP OF WESTERN NEW YORK OPENED AT BUFFALO GENERAL MEDICAL CENTER/GATES VASCULAR INSTITUTE OFFERING PATIENTS LEGAL EXPERTISE AND SERVICES AT NO CHARGE TO ADDRESS PATIENTS' HEALTH-RELATED SOCIAL NEEDS.IN 2022, KALEIDA HEALTH CONTINUED ITS PARTNERSHIPS WITH CHARTER SCHOOLS LOCATED IN UNDERSERVED COMMUNITIES IN THE CITY OF BUFFALO. IN 2021, KALEIDA HEALTH BECAME A MEMBER OF THE HEALTH SCIENCES CHARTER SCHOOL AND A KALEIDA HEALTH STAFF MEMBER BEGAN SERVING ON THE SCHOOL'S BOARD OF DIRECTORS. IN 2022, KALEIDA CONTINUED TO SUPPORT AND SERVE ON THE BOARD OF DIRECTORS AT HEALTH SCIENCES CHARTER SCHOOL. IN 2022, KALEIDA HEALTH'S PLANNED ACTIVITIES RESUMED FOLLOWING EASING PANDEMIC RESTRICTIONS AND INCLUDED VENDOR TABLES WITH FAMILY PLANNING INFORMATION, SPEAKERS, AND HOSPITAL TOURS WITH KALEIDA HEALTH'S COMMUNITY OUTREACH SPECIALIST.A NYS MEDICAID HEALTH HOME SERVING CHILDREN WAS ESTABLISHED IN 2016 THROUGH OISHEI CHILDREN'S HOSPITAL TO PROVIDE CARE MANAGEMENT TO WNY CHILDREN WITH MEDICAID WHO HAVE COMPLEX PHYSICAL AND/OR BEHAVIORAL HEALTH CONDITIONS. THE HOSPITAL ALSO OPERATES SEVEN SCHOOL BASED HEALTH CENTERS IN BUFFALO PUBLIC SCHOOLS, A SCHOOL DISTRICT WITH 82% OF STUDENTS ECONOMICALLY DISADVANTED (2019-2020 DATA.NYSED.GOV).OISHEI CHILDREN'S HOSPITAL IS KNOWN FOR ITS COMMUNITY COLLABORATIONS TO ADDRESS PUBLIC HEALTH CONCERNS AND ASSURE ACCESS TO CARE FOR WOMEN AND CHILDREN, MANY OF WHOM ARE MEDICALY UNDERSERVED. IN ADDITION TO ITS WIDE RANGE OF SPECIALIZED PEDIATRIC AND MATERNAL SERVICES, THE HOSPITAL SERVES THE REGION AS A NEW YORK STATE REGIONAL PERINATAL CENTER, NYS DESIGNATED EBOLA PREPARED CENTER, AND THE PEDIATRIC & ADOLESCENT AIDS DESIGNATED CETNER OF WNY. IT HAS A LEVEL IV NEONATAL INTENSIVE CARE UNIT, LEVEL I PEDIATRIC TRAUMA UNIT, AND PEDIATRIC INTENSIVE CARE UNIT AND IS HOME TO THE ROBERT WARNER CENTER FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS, CHILDREN'S GUILD FOUNDATION AUTISM SPECTRUM DISORDER CENTER, REGIONAL LEVEL IV EPILEPSY MONITORING CENTER OF WNY, SAFE BABIES NEW YORK PROGRAM, LEAD POISONING PREVENTION RESOURCE CENTER OF WESTERN NEW YORK, SICKLE CELL & HEMOGLOBINOPATHY CENTER OF WESTERN NEW YORK, ROSWELL PARK AND OISHEI CHILDREN'S CANDER AND BLOOD DISORDER CENTER AND CYSTIC FIBROSIS CENTER OF WNY, AMONG OTHERS.INCREASING BREASTFEEDING RATES IS A PUBLIC HEALTH PRIORITY OF THE NEW YORK STATE PREVENTION AGENDA. AS DELIVERY HOSPITALS, BOTH OISHEI CHILDREN'S HOSPITAL AND MILLARD FILLMORE SUBURBAN HOSPITAL ARE ENGAGED IN SEVERAL EDUCATIONAL AND CLINICAL INITIATIVES TO IMPROVE EXCLUSIVE BREASTFEEDING RATES THROUGH NEW YORK STATE DEPARTMENT OF HEALTH GUIDELINES. IN 2019, ADDITIONALLY, KALEIDA HEALTH'S OB-GYN CENTERS HAVE ALL ACHIEVED NEW YORK STATE BABY-FRIENDLY PRACTICE DESIGNATION. IN 2018, OISHEI CHILDREN'S OPENED A BABY CAFE TO PROVIDE FREE BREASTFEEDING SUPPORT AND GUIDANCE TO PREGNANT AND BREASTFEEDING MOMS. EVIDENCE BASED PATIENT EDUCATION MATERIALS IN ENGLISH AND SPANISH WERE PROVIDED FOR LABOR AND DELIVERY PATIENTS AT OCH AND MFSM AND FOR OB PATIENTS AT OCH'S OB-GYN CENTERS. CLINICAL EDUCATORS PROVIDED BREAST FEEDING EDUCATION TO STAFF AND OFFER AN ONLINE PROVIDER EDUCATION MODEL ON BREASTFEEDING PRACTICES TO PROVIDERS. BY THE END OF 2022, A LACTATION CONSULTANT INCREASED THE NUMBER OF NICU PARENTS WHO STARTED BREAST PUMPING WITHIN 2 HOURS AFTER DELIVERY OF INFANT. BY THE END OF 2024 THERE WILL BE A BREAST FEEDING "LOUNGE" WHERE THE BREAST FEEDING CLIENT CAN RECEIVE ADDITIONAL SUPPORT AND EDUCATION FROM THE LACTATION NURSE AS WELL AS OTHER BREAST FEEDING PARENTS. OCH SUPPORTED BREASTFEEDING PATIENTS BY PERFORMING FOLLOW UP PHONE CALLS AFTER DISCHARGE AND OFFERING LACTATION ASSISTANCE. CARDIOVASCULAR DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN BOTH ERIE AND NIAGARA COUNTIES AND KALEIDA HEALTH SUPPORTS SEVERAL CARDIOVASCULAR INITIATIVES. CARDIAC AND STROKE CARE IS A MAJOR SERVICE LINE FOR KALEIDA HEALTH AND THE GATES VASCULAR INISTITUTE OF BUFFALO GENERAL MEDICAL CENTER SERVES AS A REGIONAL SPECIALTY CARE AND RESEARCH FACILITY FOCUSING ON THE HEART, NEUROLOGICAL, AND RELATED VASCULAR SYSTEM. IN 2022, 6 LIVE SEMINARS OCCURRED WITH 9,348 INDIVIDUALS PARTIPATING IN HEALTHY U PROGRAMS VIA FACEBOOK.ADDITIONALLY, 39 MEDICAL MINUTE VIDEOS ON HEALTH TOPICS AIRED ON WIVB-TV AND KALEIDA SOCIAL MEDIA REACHING 37,415 AND THE MEDICALLY SPEAKING INTERVIEW SERIES AIRED 12 VIDEOS AND REACHED 18,173 VIA FACEBOOK AND THE KALEIDA WEBSITE. A TARGETED CARDIOVASCULAR EDUCATION AND SCREENING PROGRAM IS PROVIDED TO MEDICALLY UNDERSERVED FEMALES AT THE OB-GYN CENTERS OF OISHEI CHILDREN'S HOSPITAL, WHERE A MAJORITY OF PATIENT VISITS ARE REIMBURSED THROUGH MEDICAID.COLLABORATION AND ACCESS TO CARE ACROSS ALL OF WESTERN NEW YORK IS A PRIORTY FOR KALEIDA HEALTH. TO ADDRESS THE NEED FOR CARDIAC CATHETERIZATION SERVICES IN NIAGARA COUNTY, KALEIDA HEALTH COLLABORATED WITH NIAGARA FALLS MEMORIAL MEDICAL CENTER (NFMMC), CATHOLIC HEALTH SYSTEM, AND ERIE COUNTY MEDICAL CENTER TO MAKE THIS LIFESAVING CARE READILY ACCESSIBLE TO RESIDENTS THROUGHOUT THE NIAGARA REGION. A NEW CARDIAC CATHETERIZATION LABORATORY OPENED IN 2017 AT THE HEART CENTER OF NIAGARA ON THE NFMMC'S DOWNTOWN NIAGARA FALLS CAMPUS.
PART VI, LINE 5 - CONTINUED	MILLARD FILLMORE SUBURBAN HOSPITAL SERVES THE WESTERN NEW YORK COMMUNITY WITH A COMPREHENSIVE CANCER REHAB PROGRAM. THE HOSPITAL FURTHER PROVIDES CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS AND PARTICIPATES IN COMMUNITY EVENTS INCLUDING NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS.KALEIDA HEALTH'S DEGRAFF MEDICAL PARK PARTICIPATES IN SEVERAL COMMUNITY EVENTS TO PROVIDE CHRONIC DISEASE EDUCATION AND SCREENING PROGRAMS, AND SERVES AS A SITE FOR NATIONAL PRESCRIPTION DRUG TAKE-BACK DAYS. DEGRAFF MEDICAL PARK PROVIDES CANCER REHABILITATION AND RECOVERY SERVICES, CARDIAC REHABILITATION SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY.KALEIDA HEALTH HOSPITALS ARE RESPONDING TO THE COMMUNITY'S OPIATE PROBLEM THROUGH THE NEW YORK MATTERS BUPRENORPHINE TREATMENT PROGRAM IN THE EMERGENCY DEPARTMENTS WITH IMMEDIATE BUPRENORHINE TREATMENT AND PATIENT REFERRAL TO COMMUNITY TREATMENT AGENCIES. ADDITIONALLY, MEDICATION AND SYRINGE DROP BOXES ARE ON-SITE AT EACH HOSPITAL.KALEIDA HEALTH'S HUMAN RESOURCES DEPARTMENT PARTNERS WITH THE BUFFALO AND ERIE COUNTY WORKFORCE DEVELOPMENT COUNCIL AND THE BUFFALO EDUCATION AND TRAINING CENTER ON DIFFERENT WORKFORCE DEVELOPMENT INITIATIVES AND EVENTS, INCLUDING THOSE TARGETING THE UNDERSERVED. ADDITIONALLY, KALEIDA HEALTH NURSE RECRUITERS PARTNER WITH LOCAL SCHOOLS AND COLLEGES TO ADVANCE RECRUITMENT EFFORTS.INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE PROGRAMS IS PROMOTED TO THE PUBLIC THROUGH MULTIPLE COMMUNITY OUTREACH ACTIVITIES AND EVENTS, ON THE KALEIDA HEALTH WEBSITE WWW.KALEIDAHEALTH.ORG, ON FACEBOOK AND TWITTER; AND AS INCLUDED IN THE 2022-2024 CHNA-CSP. THE CHNA-CSP IS AVAILABLE ON THE KALEIDA HEALTH WEBSITE AT HTTPS://WWW.KALEIDAHEALTH.ORG/COMMUNITY OR IN PRINT FORMAT UPON REQUEST. WRITTEN COMMENTS ON THE 2022-2024 CHNA-CSP ARE INVITED AND A COMMENT LINK IS PROVIDED NEXT TO THE PLAN FOUND ON THE KALEIDA HEALTH WEBSITE.PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEMKALEIDA HEALTH IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHOSE MEMBERS INCLUDE: THE UPPER ALLEGHENY HEALTH SYSTEM, KALEIDA HEALTH FOUNDATION, VISITING NURSING ASSOCIATION OF WNY, INC., VNA HOMECARE SERVICE, INC., AND OISHEI CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION.

Schedule H (Form 990) 2022

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
KALEIDA HEALTH

Employer identification number
16-1533232

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(h) Purpose of grant or assistance
(1) UNIVERSITY ORTHOPEDIC SERVICE 5500 MAIN STREET BUFFALO,NY14221	16-1406947	N/A	100,000	FMV	SPONSORSHIP
(2) WNY CLINICAL INFO EXCHANGE 2475 GEORGE URBAN BLVD BUFFALO,NY14043	36-4594483	N/A	90,000	FMV	CONTRIBUTION
(3) WNY HEALTHENET 2475 GEORGE URBAN BLVD DEPEW,NY14043	04-3726634	N/A	36,000	FMV	SPONSORSHIP
(4) AMHERST CHAMBER OF COMMERCE 400 ESSJAY RD WILLIAMSVILLE,NY14221	16-0959485	N/A	12,000	FMV	SPONSORSHIP
(5) UB FOUNDATION 3435 MAIN ST 704 KIMBALL TOWE BUFFALO,NY142310590	16-1372561	501(C)(3)	35,500	FMV	CONTRIBUTION
(6) NIAGARA UNIVERSITY PO BOX 2002 NIAGARA,NY14109	16-0755807	501(C)(3)	6,495	FMV	CONTRIBUTION

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: KALEIDA HEALTH MAKES CONTRIBUTIONS TO ORGANIZATONS IN WESTERN NEW YORK THAT ALSO HAVE HEALTH CARE RELATED ACTIVITIES. ALL CONTRIBUTIONS MUST BE APPROVED BY THE GOVERNING BODY BEFORE MONEY IS DISTRIBUTED.

Schedule I (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

KALEIDA HEALTH

Employer identification number

16-1533232

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 .....

Yes

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? ....

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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)
1ROBERT NESSELBUSH CHIEF EXECUTIVE OFFICER (UNTIL 9/22)	(i) (ii)	933,192 ------------- 0	927,083 ------------- 0	1,833,858 ------------- 0	11,045 ------------- 0	496 ------------- 0	3,705,674 ------------- 0	0 ------------- 0
2DONALD BOYD PRESIDENT AND CEO (AS OF 7/22)	(i) (ii)	1,002,946 ------------- 0	280,000 ------------- 0	793,031 ------------- 0	-47,000 ------------- 0	17,961 ------------- 0	2,046,938 ------------- 0	0 ------------- 0
3JODY LOMEO FMR PRES/CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	1,258,511 ------------- 0	-11,600 ------------- 0	315 ------------- 0	1,247,226 ------------- 0	0 ------------- 0
4CHRISTOPHER MALLAVARAPU MD EMPLOYED PHYSICIAN	(i) (ii)	830,413 ------------- 0	0 ------------- 0	4,475 ------------- 0	14,227 ------------- 0	17,454 ------------- 0	866,569 ------------- 0	0 ------------- 0
5ALYSON SPAULDING GENERAL COUNSEL	(i) (ii)	486,300 ------------- 0	148,200 ------------- 0	204,165 ------------- 0	-5,315 ------------- 0	17,295 ------------- 0	850,645 ------------- 0	0 ------------- 0
6KAVEH VALI MD EMPLOYED PHYSICIAN	(i) (ii)	755,755 ------------- 0	25,000 ------------- 0	615 ------------- 0	-16,680 ------------- 0	1,059 ------------- 0	765,749 ------------- 0	0 ------------- 0
7CHERYL KLASS EVP, CHIEF NURSE EXECUTIVE	(i) (ii)	526,897 ------------- 0	192,500 ------------- 0	29,751 ------------- 0	-5,161 ------------- 0	4,709 ------------- 0	748,696 ------------- 0	0 ------------- 0
8CARROLL HARMON MD EMPLOYED PHYSICIAN	(i) (ii)	681,475 ------------- 0	25,000 ------------- 0	8,318 ------------- 0	6,389 ------------- 0	1,114 ------------- 0	722,296 ------------- 0	0 ------------- 0
9VICTOR FILADORA II PRESIDENT GREAT LAKES CANCER CARE	(i) (ii)	522,732 ------------- 0	130,683 ------------- 0	25,461 ------------- 0	5,658 ------------- 0	1,005 ------------- 0	685,539 ------------- 0	0 ------------- 0
10MATTHEW DRAKE EVP, CHIEF FIN OFFICER (AS OF 4/22)	(i) (ii)	489,991 ------------- 0	148,750 ------------- 0	23,867 ------------- 0	5,420 ------------- 0	7,719 ------------- 0	675,747 ------------- 0	0 ------------- 0
11MICHAEL MINEO MD EVP, CHIEF MED OFFICER (AS OF 7/22)	(i) (ii)	518,202 ------------- 0	93,000 ------------- 0	29,414 ------------- 0	4,540 ------------- 0	17,333 ------------- 0	662,489 ------------- 0	0 ------------- 0
12MICHAEL HUGHES CHIEF ADMINISTRATIVE OFFICER	(i) (ii)	413,812 ------------- 0	103,750 ------------- 0	141,931 ------------- 0	-27,549 ------------- 0	863 ------------- 0	632,807 ------------- 0	0 ------------- 0
13JUDY BAUMGARTNER PRESIDENT MFS AND DEGRAFF	(i) (ii)	456,923 ------------- 0	110,000 ------------- 0	27,468 ------------- 0	5,638 ------------- 0	315 ------------- 0	600,344 ------------- 0	0 ------------- 0
14ALLEGRA JAROS PRESIDENT WCHOB	(i) (ii)	481,877 ------------- 0	117,500 ------------- 0	26,360 ------------- 0	-43,768 ------------- 0	17,284 ------------- 0	599,253 ------------- 0	0 ------------- 0
15DAVID HUGHES MD EVP, CMO (UNTIL 5/22)	(i) (ii)	260,316 ------------- 0	224,588 ------------- 0	30,773 ------------- 0	5,800 ------------- 0	632 ------------- 0	522,109 ------------- 0	0 ------------- 0
16THOMAS HULL SVP, CHIEF INFO OFFICER (AS OF 1/22)	(i) (ii)	375,516 ------------- 0	103,125 ------------- 0	29,477 ------------- 0	5,304 ------------- 0	8,277 ------------- 0	521,699 ------------- 0	0 ------------- 0
17LUCY CAMPBELL MD EMPLOYED PHYSICIAN	(i) (ii)	495,883 ------------- 0	0 ------------- 0	4,343 ------------- 0	-27,621 ------------- 0	17,085 ------------- 0	489,690 ------------- 0	0 ------------- 0
18STEPHEN HARDY VP FINANCE	(i) (ii)	301,842 ------------- 0	61,200 ------------- 0	3,867 ------------- 0	7,013 ------------- 0	17,351 ------------- 0	391,273 ------------- 0	0 ------------- 0
19CHRISTOPHER LANE PRESIDENT BGMC AND GVI (UNTIL 3/22)	(i) (ii)	130,747 ------------- 0	143,000 ------------- 0	21,273 ------------- 0	-36,442 ------------- 0	503 ------------- 0	259,081 ------------- 0	0 ------------- 0
20BETH HUGHES PRESIDENT BGMC AND GVI (AS OF 10/22)	(i) (ii)	208,266 ------------- 0	35,000 ------------- 0	1,106 ------------- 0	2,669 ------------- 0	1,675 ------------- 0	248,716 ------------- 0	0 ------------- 0
21IAN BARRET AS OF 1022 EVP, CHIEF HUMAN RES OFF	(i) (ii)	77,543 ------------- 0	125,000 ------------- 0	720 ------------- 0	692 ------------- 0	933 ------------- 0	204,888 ------------- 0	0 ------------- 0
22GEORGE E MATTHEWS MD DIRECTOR	(i) (ii)	0 ------------- 181,839	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 181,839	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 1A	HEALTH OR SOCIAL CLUB DUES AS PART OF THEIR COMPENSATION PACKAGE, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE ENTITLED TO CHOOSE AS AN EXECUTIVE PERK THE BENEFIT OF BUSINESS RELATED SOCIAL DUES OR INITIATION FEES.
PART I, LINE 4A	THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). - JODY LOMEO - $1,258,511 - ROBERT NESSELBUSH - $498,519
PART I, LINE 7	CERTAIN INDIVIDUALS QUALIFIED TO RECEIVE BONUS/INCENTIVE COMPENSATION PAYMENTS BASED ON CERTAIN PERFORMANCE METRICS BEING MET. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN(B)(II).

Schedule J (Form 990) 2022

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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
KALEIDA HEALTH

Employer identification number
16-1533232

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	DORMITORY AUTHORITY - STATE OF NEW YORK	14-6000293	000000000	09-30-2016	7,650,258	LEASE OF EQUIPMENT		X		X		X
B	DORMITORY AUTHORITY - STATE OF NEW YORK	14-6000293	000000000	09-30-2016	7,349,742	LEASE OF EQUIPMENT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	6,664,997		6,403,183
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	7,650,424		7,350,549
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	197,725		525,560
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	104,266
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	7,348,433		6,748,676
11 Other spent proceeds .............			76,312
12 Other unspent proceeds .............
13 Year of substantial completion .............	2017		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........	X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?	X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference

Explanation

SCHEDULE K, PART II, LINE 3

THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS AND MARKET VALUE FLUCTUATIONS.

SCHEDULE K, PART IV, ARBITRAGE, LINE 2C

(A) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK. DATE OF REBATE COMPUTATION PERFORMED: 09/30/2020. (B) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK. DATE OF REBATE COMPUTATION PERFORMED: 05/31/2021. NOTE REGARDING THE REBATE COMPUTATIONS ON 9/30/20 & 5/31/21: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASES, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.

Schedule K (Form 990) 2021

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

KALEIDA HEALTH

Employer identification number

16-1533232

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MEDICAL EQUIPMENT )	X	2	1,702,626	FMV
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2022)

Additional Data

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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

KALEIDA HEALTH

Employer identification number

16-1533232

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	REVIEW PROCESS FOR FORM 990 ORGANIZATION'S MANAGEMENT, IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, KPMG, REVIEW THE FORM 990. THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE FORM 990 IS FILED WITH THE IRS, THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE SAME TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE, OFFICER OR DIRECTOR OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE POTENTIAL, ACTUAL, OR EVEN APPEARANCE, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. THE COMPLETED CONFLICTS OF INTEREST AND DISCLOSURE FORMS FOR DIRECTORS ARE RETURNED TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION APPROVAL PROCESS ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES FOR REVIEW AND APPROVAL. SUCH INFORMATION IS COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT AND INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS OFFICE AT 726 EXCHANGE STREET, SUITE 200, BUFFALO, NY 14210. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 84,618,174. MANAGEMENT AND GENERAL EXPENSES 3,259,512. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,877,686. INTERNS & RESIDENTS FEES: PROGRAM SERVICE EXPENSES 30,657,583. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,657,583. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 28,018,679. MANAGEMENT AND GENERAL EXPENSES 4,028,675. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,047,354. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 990,681. MANAGEMENT AND GENERAL EXPENSES 2,930,682. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,921,363. EMPLOYMENT AGENCY FEES: PROGRAM SERVICE EXPENSES 84,904,197. MANAGEMENT AND GENERAL EXPENSES 338,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,242,593.
FORM 990, PART XI, LINE 9:	MINORITY INTEREST IN SUBSIDIARY -29,180,000. NET ACTUARIAL GAIN ON PENSION PLAN 120,299,000. OTHER TRANSFERS, NET -2,206,444.

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

KALEIDA HEALTH

Employer identification number

16-1533232

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
(1) KALEIDA MCO LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1570311	DORMANT	NY	0	0	KH
(2) KALEIDA IPA LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1570380	DORMANT	NY	0	0	KH
(3) KALEIDA WNYI LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 45-3189404	HEALTH CARE	NY	1,505,208	616,339	KH
(4) KALEIDA SERVICES LLC 2100 WEHRLE DRIVE WILLIAMSVILLE,NY14221 47-2284036	ADULT DAYCARE	NY	-82,006	167,622	KH
(5) MFSC LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 26-1582864	HEALTH CARE	NY	103,702	3,662,960	KH

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)MILLARD FILLMORE AMBULATORY SURGER CTR 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1307129	SUPPORT ORG	NY	501(C)(3)	12A	KH	Yes
(2)VNA HOME CARE SERVICES 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1491203	HOME HLTH CAR	NY	501(C)(3)	10	KH	Yes
(3)VNA OF WESTERN NEW YORK 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-0743214	HOME HLTH CAR	NY	501(C)(3)	10	KH	Yes
(4)VISK 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 22-2738425	SUPPORT ORG	NY	501(C)(3)	10	KH	Yes
(5)KALEIDA HEALTH FOUNDATION 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1579143	FUNDRAISING	NY	501(C)(3)	7	KH	Yes
(6)THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1332044	FUNDRAISING	NY	501(C)(3)	7	KH	Yes
(7)CHILDREN'S HEALTH HOME OF WNY INC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 81-4086046	PED HOME HLTH	NY	501(C)(3)	10	KH	Yes
(8)UPPER ALLEGHENY HEALTH SYSTEM INC 515 MAIN STREET OLEAN,NY14760 27-1255425	SUPPORT ORG	NY	501(C)(3)	12A	KH	Yes
(9)OLEAN GENERAL HOSPITAL 515 MAIN STREET OLEAN,NY14760 16-0743102	HOSPITAL	NY	501(C)(3)	3	UAHS	Yes
(10)BRADFORD REGIONAL MED SERVICES 116 INTERSTATE PARKWAY BRADFORD,PA16701 23-2875157	PHYS. GROUP	NY	501(C)(3)	3	BRMC	Yes
(11)HEALTH SYSTEM PHYSICIAN PC 130 SOUTH UNION STREET OLEAN,NY14760 46-4304317	PHYS. GROUP	NY	501(C)(3)	10	OGH	Yes

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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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
(1) HARLEM ROAD LEASING LLC 3435 MAIN STREET BUFFALO,NY14214 20-5588135	EQUIPMENT LEASING	NY	KALEIDA HEALTH	UNRELATED	18,512	239,741		No		Yes		50.000 %
(2) AMTON IMAGING LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE,NY14221 26-2925470	HEALTH CARE	NY	KALEIDA WNYI	RELATED	950,014	-2,814,069		No		Yes		50.000 %
(3) SITE E LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 27-2124795	REAL ESTATE MGMT	NY	KPI	EXCLUDED	90,945	1,687,488		No			No	50.150 %
(4) SOUTHTOWNS IMAGING LLC 5959 BIG TREE ROAD SUITE 105 ORCHARD PARK,NY14127 47-1123230	EQUIPMENT LEASING	NY	KALEIDA WNYI	UNRELATED	416,126	3,243,639		No		Yes		70.000 %
(5) COLLABORATIVE CARE VENTURES LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 47-2365690	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	-2,356	-221,538		No			No	60.000 %
(6) GREAT LAKES MEDICAL BILLING SVCS LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE,NY14221 46-1668448	MEDICAL BILLING	NY	KALEIDA WNYI	UNRELATED	139,068	186,769		No			No	50.000 %
(7) ALTUS MANAGEMENT LLC 840 AERO DRIVE SUITE 150 CHEEKTOWAGA,NY14225 90-0149133	GROUP PURCHASING	NY	KALEIDA HEALTH	EXCLUDED	180,271	3,116,017		No			No	59.190 %
(8) SOUTHTOWNS SURGERY CENTER LLC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 46-4742028	HEALTH CARE	NY	KALEIDA HEALTH	EXCLUDED	660,631	2,777,227		No		Yes		63.170 %

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) KALEIDA PROPERTIES INC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 22-2738483	PROP MGMT SVCS	NY	KALEIDA HEALTH	C	-685,923	4,758,503	100.000 %	Yes
(2) WESTLINK CORPORATION 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 16-1354421	MED & DIAGN SVCS	NY	KALEIDA HEALTH	C	-25		100.000 %	Yes
(3) GREAT LAKES INTEGRATED NETWORK INC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 82-3184375	HEALTH CARE	NY	KALEIDA HEALTH	C	-9,717,972	536,563	50.000 %		No
(4) KHBC INC 726 EXCHANGE STREET SUITE 200 BUFFALO,NY14210 82-3184375	HEALTH CARE	NY	KALEIDA HEALTH	C	-597,430	14,185,889	50.000 %		No
(5) OLEAN MEDICAL PRACTICE PLLC 726 EXCHANGE STREET SUITE 515 BUFFALO,NY14210 88-1324896	HEALTH CARE	NY	KALEIDA HEALTH	C	-3,149,276	1,967,941	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) ............................

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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 ............................

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MILLARD FILLMORE AMBULATORY SURGERY CENTER	C	539,156	ACTUAL COST
(2) VNA HOME CARE SERVICES	O	8,609	ACTUAL COST
(3) VNA HOME CARE SERVICES	Q	3,291,074	ACTUAL COST
(4) VNA HOME CARE SERVICES	E	213,182	ACTUAL COST
(5) VNA OF WESTERN NEW YORK	O	90,711	ACTUAL COST
(6) VNA OF WESTERN NEW YORK	L	358,004	ACTUAL COST
(7) VNA OF WESTERN NEW YORK	Q	15,452,469	ACTUAL COST
(8) VNA OF WESTERN NEW YORK	D	597,117	ACTUAL COST
(9) KALEIDA PROPERTIES INC	Q	44,669	ACTUAL COST
(10) KALEIDA PROPERTIES INC	D	342,025	ACTUAL COST
(11) VISK	D	300,700	ACTUAL COST
(12) THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION	C	114,987	ACTUAL COST
(13) THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION	S	15,169,271	ACTUAL COST
(14) THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION	D	14,527,405	ACTUAL COST
(15) KALEIDA HEALTH FOUNDATION	C	1,587,639	ACTUAL COST
(16) KALEIDA HEALTH FOUNDATION	S	5,378,015	ACTUAL COST
(17) KALEIDA HEALTH FOUNDATION	D	16,280,958	ACTUAL COST
(18) SOUTHTOWNS IMAGING LLC	D	3,909,379	ACTUAL COST
(19) SOUTHTOWNS IMAGING LLC	J	242,651	ACTUAL COST
(20) SOUTHTOWNS IMAGING LLC	Q	206,903	ACTUAL COST
(21) SOUTHTOWNS SURGERY CENTER LLC	L	510,600	ACTUAL COST
(22) SOUTHTOWNS SURGERY CENTER LLC	J	864,958	ACTUAL COST
(23) SOUTHTOWNS SURGERY CENTER LLC	R	297,674	ACTUAL COST
(24) SOUTHTOWNS SURGERY CENTER LLC	D	4,812,542	ACTUAL COST
(25) COLLABORATIVE CARE VENTURES LLC	D	395,294	ACTUAL COST
(26) CHILDREN'S HOME HEALTH OF WNY INC	O	33,970	ACTUAL COST
(27) CHILDREN'S HOME HEALTH OF WNY INC	Q	138,840	ACTUAL COST
(28) CHILDREN'S HOME HEALTH OF WNY INC	E	238,836	ACTUAL COST
(29) UAHS	O	186,087	ACTUAL COST
(30) UAHS	Q	6,092,213	ACTUAL COST
(31) UAHS	D	8,036,341	ACTUAL COST
(32) HEALTH SYSTEM PHYSICIANS PC	O	19,460	ACTUAL COST
(33) HEALTH SYSTEM PHYSICIANS PC	Q	1,472,762	ACTUAL COST
(34) HEALTH SYSTEM PHYSICIANS PC	D	1,491,601	ACTUAL COST
(35) BRADFORD REGIONAL MEDICAL SERVICES PC	Q	1,926,113	ACTUAL COST
(36) BRADFORD REGIONAL MEDICAL SERVICES PC	D	5,724,543	ACTUAL COST
(37) OLEAN MEDICAL PRACTICE PLLC	D	3,275,000	ACTUAL COST

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: KALEIDA HEALTH PROVIDES HEALTHCARE SERVICES FOR THE EIGHT COUNTIES OF WNY AT FOUR ACUTE CARE, TWO LT CARE, AND OTHER OUTPATIENT AND PRIMARY CARE SITES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	9,140
6	Total number of volunteers (estimate if necessary) .............	6	1,170
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	7,596,654
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	200,832

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	13,902,955	41,185,625
9	Program service revenue (Part VIII, line 2g) .........	1,376,606,865	1,437,808,000
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,049,446	956,274
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	27,897,019	22,465,987
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,422,456,285	1,502,415,886
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	599,550	326,927
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)	719,279,567	746,273,761
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)....	694,657,051	764,843,936
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,414,536,168	1,511,444,624
19	Revenue less expenses. Subtract line 18 from line 12.......	7,920,117	-9,028,738
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,193,308,740	1,204,818,970
21	Total liabilities (Part X, line 26).............	1,131,944,176	1,098,748,588
22	Net assets or fund balances. Subtract line 21 from line 20.....	61,364,564	106,070,382

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,310,266,823 including grants of $ 326,927 ) (Revenue $ 1,439,624,604 )
	SEE SCHEDULE OKALEIDA HEALTH IS A VOLUNTARY, NOT-FOR-PROFIT; NEW YORK STATE DEPARTMENT OF HEALTH ARTICLE 28 LICENSED HOSPITAL-BASED HEALTHCARE DELIVERY SYSTEM SERVICING THE COMMUNITIES OF WESTERN NEW YORK STATE AT VARIOUS LEVELS AND WITH FACILITIES IN MULTIPLE LOCATIONS THROUGHOUT THE REGION. KALEIDA HEALTH INCLUDES THE BUFFALO GENERAL MEDICAL CENTER (BUFFALO GENERAL), MILLARD FILLMORE SUBURBAN HOSPITAL (MILLARD SUBURBAN), JOHN R. OISHEI CHILDREN'S HOSPITAL (OISHEI CHILDREN'S HOSPITAL, FORMERLY THE WOMEN & CHILDREN'S HOSPITAL OF BUFFALO), AND DEGRAFF MEMORIAL HOSPITAL (DEGRAFF). IN ADDITION TO THE FOUR KALEIDA HEALTH (KALEIDA) HOSPITALS, KALEIDA OPERATES TWO SKILLED NURSING FACILITIES, AND NUMEROUS OUTPATIENT CLINICS. THE ABOVE FACILITIES OPERATE UNDER ONE TAX IDENTIFICATION NUMBER.OUR FAMILY OF HEALTH CARE ORGANIZATIONS IS BLENDED TOGETHER INTO ONE FRAMEWORK FOR LEADERSHIP, GOVERNANCE, SHARED SERVICES, FINANCIAL INFRASTRUCTURE AND INFORMATION TECHNOLOGY PLATFORMS. COLLECTIVELY, KALEIDA HEALTH'S MARKET SHARE IS 32.9% IN WESTERN NEW YORK, 41.39% IN ERIE COUNTY AND 34.37% IN NIAGARA COUNTY. ANNUALLY $1.2 MILLION COMBINED INPATIENT, EMERGENCY DEPARTMENT AND OUTPATIENT VISITS OCCUR AT THE HEALTH CARE FACILITIES IN THE KALEIDA HEALTH SYSTEM, WHICH EMPLOYS APPROXIMATELY 8,500 STAFF AND HAVE APPROXIMATELY 2,300 MEDICAL STAFF MEMBERS. DURING 2022, THERE WERE 53,569 INPATIENT DISCHARGES, OF WHICH 27% WERE MEDICAID AND MEDICAID MANAGED, 41% MEDICARE AND MEDICARE MANAGED CARE, 1% WERE UNINSURED, AND 36% WERE OTHER. KALEIDA HEALTH'S MISSION IS TO ADVANCE THE HEALTH OF OUR COMMUNITY. OUR VISION IS TO PROVIDE COMPASSIONATE, HIGH-VALUE, QUALITY CARE, IMPROVING HEALTH IN WESTERN NEW YORK AND BEYOND, EDUCATING FUTURE HEALTH CARE LEADERS AND DISCOVERING INNOVATIVE WAYS TO ADVANCE MEDICINE. OUR VALUES CLEARLY STATE WHO WE ARE AND HOW WE PERFORM OUR WORK:CENTERED: REMAIN CENTERED AROUND THE PATIENT AND FAMILY.ACCOUNTABLE: BE ACCOUNTABLE TO PATIENTS AND EACH OTHER.RESPECT: SHOW RESPECT AND INTEGRITY.EXCELLENCE: PROVIDE EXCELLENCE IN ALL WE DO.KALEIDA HEALTH'S PROGRAMS AND AFFILIATES ARE LICENSED BY THE STATE OF NEW YORK DEPARTMENT OF HEALTH AND ACCREDITED BY DNV. KALEIDA IS CERTIFIED BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR PARTICIPATION IN MEDICARE AND MEDICAID. THE ACCREDITATION COUNSEL FOR GRADUATE MEDICAL EDUCATION APPROVES ALL RESIDENCY PROGRAMS FOR PHYSICIANS, AND THE AMERICAN DENTAL ASSOCIATION APPROVES ITS DENTAL AND ORAL SURGERY PROGRAMS. KALEIDA IS ALSO A MEMBER OF THE COUNCIL OF TEACHING HOSPITALS, THE AMERICAN DENTAL ASSOCATION, THE AMERICAN MEDICAL ASSOCATION AND THE GREATER NEW YORK HOSPITAL ASSOCATION.OPERATION OF EMERGENCY ROOMS:KALEIDA HEALTH OPERATES FOUR EMERGENCY ROOMS, ONE IN EACH OF THE ACUTE CARE HOSPITALS, GENERATING A TOTAL OF 162,635 PATIENT VISITS DURING 2022. THE EMERGENCY DEPARTMENTS, WHICH OPERATE 24 HOURS A DAY, SEVEN DAYS EACH WEEK, ARE OPEN TO ANYONE, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES.BOARD OF DIRECTORS AND COMMUNITY GUIDANCE:KALEIDA HEALTH MAINTAINS COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF KALEIDA HEALTH. THE MAJORITY OF THE DIRECTORS RESIDE IN WESTERN NEW YORK AND EACH DIRECTOR SERVES A THREE-YEAR TERM. OPEN MEDICAL STAFF:AS CONFERRED BY THE BOARD OF DIRECTORS, MEDICAL STAFF MEMBERSHIP IS OFFERED TO PROFESSIONALLY COMPETENT PHYSICIANS, DENTISTS, PODIATRISTS AND OTHER SPECIFIED INDIVIDUALS, WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OUTLINED IN THE BYLAWS, RULES AND REGULATIONS, POLICIES OF THE MEDICAL STAFF AND KALEIDA HEALTH, CONSISTENT WITH THE NEEDS OF KALEIDA HEALTH'S PATIENTS. STAFF MEMBERSHIP OR PARTICULAR CLINICAL PRIVILEGES SHALL NOT BE DENIED ON THE BASIS OF AGE, SEX, SEXUAL ORIENTATON, RACE, COLOR, CREED, NATIONAL ORIGIN, A DISABILITY UNRELATED TO THE ABILITY TO FULFILL PATIENT CARE AND MEDICAL STAFF RESPONSIBILITIES OR ANY OTHER CRITERION UNRELATED TO THE EFFICIENT DELIVERY OF QUALITY PATIENT CARE, TO PROFESSIONAL QUALIFICATIONS OR TO THE NEEDS OF THE COMMUNITY, OR TO THE PURPOSES, NEEDS AND CAPABILITIES OF KALEIDA HEALTH. EVERY MEMBER OF THE MEDICAL STAFF ASSISTS THE HOSPITALS IN FULFILLING OUR MISSION AND RESPONSIBILITY TO PROVIDE EMERGENCY AND UNCOMPENSATED CARE FOR THOSE IN NEED.USE OF SURPLUS FUNDS:SURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF KALEIDA HEALTH, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY.COMMUNITY BENEFIT PROGRAMS AND SERVICES:KALEIDA HEALTH OFFERS NUMEROUS COMMUNITY BENEFIT PROGRAMS AND SERVICES IN RESPONSE TO THE COMMUNITY'S NEEDS, BY IMPROVING ACCESS TO CARE, IMPROVE PUBLIC HEALTH, ADVANCE KNOWLEDGE AND RELIEVE GOVERNMENT PROGRAMS. THESE PROGRAMS ARE CONDUCTED IN COMMUNITY-BASED SETTINGS SUCH AS SCHOOLS, CHURCHES, COMMUNITY CENTERS, SENIOR CENTERS AND PROGRAMS ARE ALSO OFFERED AT KALEIDA'S HOSPITAL CAMPUSES AND FACILITIES. COMMUNITY BENEFIT PROGRAMS AND SERVICES INCLUDE HEALTH FAIRS, HEALTH SCREENINGS, HEALTH EDUCATION LECTURES AND WORKSHOPS FOR COMMUNITY GROUPS AND THE GENERAL PUBLIC, SCHOOL HEALTH EDUCATION PROGRAMS, AND CONSUMER HEALTH INFORMATION IN THE KALEIDA HEALTH LIBRARIES. KALEIDA ALSO OFFERS A NUMBER OF SUBSIDIZED HEALTH SERVICES SUCH AS OUTPATIENT CLINICS, LONG-TERM CARE SERVICES, WOMEN'S HEALTH CENTERS, DIALYSIS SERVICES, BEHAVIORAL HEALTH SERVICES, SCHOOL-BASED HEALTH CENTERS, EARLY CHILDHOOD PROGRAM, EARLY INTERVENTION SERVICES, FAMILY PLANNING SERVICES, WESTERN NEW YORK CLINICAL INFORMATION EXCHANGE AND HEALTH-E-LINK AND DIAGNOSTIC, THERAPEUTIC AND REHABILITATION SERVICES FOR CHILDREN WITH SPECIAL NEEDS. KALEIDA'S HOSPITALS SERVE AS A MAJOR TEACHING AFFILIATE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND DENTAL MEDICINE, WITH TRAINING TO 400 MEDICAL AND DENTAL RESIDENTS EACH YEAR. KALEIDA IS INVOLVED IN AND SPONSORS RESEARCH PROJECTS, AND WE PROVIDE LOAN FORGIVENESS FOR PHYSICIANS TO ESTABLISH OR JOIN EXISTING PRACTICES THAT SERVE THE UNDERSERVED COMMUNITIES OF BUFFALO AND WESTERN NEW YORK. KALEIDA OFFERS CLINICAL TRAINING FACILITIES AND SUPPORT FOR NURSING AND A NUMBER OF ALLIED HEALTH PROFESSIONAL TRAINING PROGRAMS AT LOCAL COLLEGES AND UNIVERSITIES, AND OTHER PROFESSIONAL DEVELOPMENT/CONTINUING EDUCATION TRAINING PROGRAMS FOR COLLEAGUES FROM HEALTH CARE ORGANIZATIONS ACROSS THE REGION.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,310,266,823

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	17,466,073	329,006	4,952

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,241,782
e	Government grants (contributions)		1e	36,059,533

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,884,310

g	Noncash contributions included in lines 1a - 1f:$		1g	1,702,626

h Total. Add lines 1a-1f.......		41,185,625

		Business Code
2a	NET PATIENT SERVICE REVENUE	623990	1,432,396,107	1,432,396,107
b	LAB SERVICES	621500	5,301,893		5,301,893
c	MANAGEMENT FEES	561000	110,000		110,000
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,437,808,000

3 Investment income (including dividends, interest, and othersimilar amounts) ......			5,671,469		2,007,571	3,663,898
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,959,034	6a
b	Less: rental expenses		581,812	6b
c	Rental income or (loss)		2,377,222	6c
d	Net rental income or (loss).......			2,377,222			2,377,222
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,084,805	7a
b	Less: cost or other basis and sales expenses		5,800,000	7b
c	Gain or (loss)		-4,715,195	7c
d	Net gain or (loss).........			-4,715,195			-4,715,195
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	MANAGEMENT & CONSULTING FEES		541610	11,698,162			11,698,162
b	REBATE REVENUE		900099	5,190,334			5,190,334
c	ALL OTHER REVENUE		900099	1,861,020	654,545		1,206,475
d	All other revenue ....			1,339,249	1,162,059	177,190
e	Total. Add lines 11a–11d ......			20,088,765
12	Total revenue. See instructions.....			1,502,415,886	1,434,212,711	7,596,654	19,420,896

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	326,927	326,927
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 ...........	12,674,129		12,674,129
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........	552,558,164	516,319,933	36,238,231
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	42,045,673	5,641,994	36,403,679
9	Other employee benefits .......	99,168,676	78,984,384	20,184,292
10	Payroll taxes ...........	39,827,119	37,973,810	1,853,309
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,532,824	1,033,763	1,499,061
c	Accounting ...........	566,844	30,456	536,388
d	Lobbying ...........	307,978		307,978
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)	239,746,579	229,189,314	10,557,265
12	Advertising and promotion ....	3,338,154	2,655,069	683,085
13	Office expenses .......	1,444,022	1,172,249	271,773
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	21,519,927	6,016,218	15,503,709
17	Travel ............	825,636	785,336	40,300
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	15,406,931	12,325,539	3,081,392
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	72,213,686	51,090,595	21,123,091
23	Insurance ...	15,892,344	11,385,450	4,506,894
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	HEALTH CARE SUPPLIES	275,214,063	275,952,053	-737,990
b	EQUIPMENT RENTAL & MAIN	44,366,755	15,249,393	29,117,362
c	OTHER	29,404,192	32,025,017	-2,620,825
d	SERVICE CONTRACTS	22,938,241	16,777,782	6,160,459
e	All other expenses	19,125,760	15,331,541	3,794,219
25	Total functional expenses. Add lines 1 through 24e	1,511,444,624	1,310,266,823	201,177,801	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 ........			13,128,710	1	0
2	Savings and temporary cash investments .........			9,566,264	2	47,844,949
3	Pledges and grants receivable, net ......			925,000	3	925,000
4	Accounts receivable, net .............			122,508,432	4	118,637,658
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 ............			44,619,757	8	44,933,961
9	Prepaid expenses and deferred charges ......			14,273,658	9	14,636,718
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,124,653,130
b	Less: accumulated depreciation	10b	1,534,040,341	621,989,564	10c	590,612,789
11	Investments—publicly traded securities .			89,191,534	11	92,274,118
12	Investments—other securities. See Part IV, line 11 .....			42,044,127	12	35,318,997
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			235,061,694	15	259,634,780
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,193,308,740	16	1,204,818,970

17	Accounts payable and accrued expenses .....	208,178,968	17	227,702,546
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	4,038,878	20	1,912,031
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 ..	282,668,611	23	264,392,229
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	637,057,719	25	604,741,782
26	Total liabilities. Add lines 17 through 25..	1,131,944,176	26	1,098,748,588

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	30,996,000	27	76,962,000
28	Net assets with donor restrictions ...........	30,368,564	28	29,108,382
	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 ...........	61,364,564	32	106,070,382
33	Total liabilities and net assets/fund balances ........	1,193,308,740	33	1,204,818,970

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No