PHHPC Committee Day - January 29, 2015 Attachments

STATE OF NEW YORK

PUBLIC HEALTH AND HEALTH PLANNING COUNCIL

COMMITTEE DAY

AGENDA

January 29, 2015

10:30 a.m.

90 Church Street 4th Floor, Room 4A & 4B, New York City

Sturman Conference Room, Wadsworth Center, Department of Health, Empire State Plaza,

Albany

I. JOINT MEETING OF THE COMMITTEE ON PUBLIC HEALTH AND THE AD HOC

COMMITTEE TO LEAD THE PREVENTION AGENDA

Jo Ivey Boufford, M.D., Chair

II. COMMITTEE ON ESTABLISHMENT AND PROJECT REVIEW

The Establishment and Project Review Committee will convene immediately following the

Joint Meeting of the Public Health Committee and the Ad Hoc Committee to Lead the

Prevention Agenda

Members of the public who will attending the Establishment and Project Review Committee, please

note that this meeting will not convene prior to NOON, we ask that you please plan accordingly

Jeffrey Kraut, Chair

A. Applications for Construction of Health Care Facilities

Acute Care Services - Construction Exhibit # 1

Number Applicant/Facility

1. 142081 C Huntington Hospital

(Suffolk County)

2. 142083 C Southside Hospital

(Suffolk county)

3. 142168 C Westchester Medical Center

(Westchester County)

4. 142181 C Orange Regional Medical Center

(Orange County)

2

5. 142185 C New York Presbyterian Hospital –

New York Weill Cornell Center

(New York County)

6. 142228 C Strong Memorial Hospital

(Monroe County)

Ambulatory Care Services - Construction Exhibit # 2


1. 142134 C Mohawk Valley Eye Surgery Center

(Montgomery County)

Residential Health Care Facilities – Construction Exhibit # 3


1. 132305 C Jewish Home of Rochester

(Monroe County)

B. Applications for Establishment and Construction of Health Care

Facilities/Agencies

Dialysis Services- Establish/Construct Exhibit # 4


1. 132178 E Big Apple Dialysis Management, LLC

(Kings County)

2. 142115 E Pure Life Renal of Buffalo, Inc.

(Erie County)

Acute Care Services – Establish/Construct Exhibit # 5


1. 142218 E NYU Lutheran Medical Center

(Kings County)

Ambulatory Surgery Centers - Establish/Construct

Exhibit # 6


1. 141253 E South Brooklyn Endoscopy Center

(Kings County)

3

Diagnostic and Treatment Centers - Establish/Construct Exhibit # 7


1. 142152 E Odyssey Community Services, Inc.

(New York County)

Residential Health Care Facilities - Establish/Construct Exhibit # 8


1. 142195 B Delhi Rehabilitation & Nursing Center

(Delaware County)

Certified Home Health Agencies – Establish/Construct Exhibit # 9


1. 142193 E Kindred Healthcare

(Saratoga County)

C. Home Health Agency Licensures

Home Health Agency Licensures

Exhibit # 10

Number

Applicant/Facility

2276 L 1st Class Care Services, Inc.

(Bronx, Queens, Kings, Richmond, New York and Nassau

Counties)

2178 L All Heart Homecare Agency, Inc.

(New York, Richmond, Kings, Bronx, Queens, and

Westchester Counties)

2292 L Angels of Mercy Counseling Center, Inc.

(Nassau Suffolk Queens and Westchester Counties)

2272 L A Plus Homecare Agency, Inc.

(Queens, Bronx, New York, Kings, Richmond, and

Nassau Counties)

2037 L Bright Home Care, Inc.

(New York, Bronx, Kings, Richmond, Queens and


2266 L Central Westchester Home Health Services, LLC

(Westchester County)

4

2268 L Chinatown Home Health Care, Inc.

(New York, Bronx, Kings, Queens, Richmond and Nassau

Counties)

2395 L Ciambella Home Care, Inc.

d/b/a FirstLight Home Care of East Buffalo

(Erie and Niagara Counties)

2218 L Comprehensive Elder Care, LLC

(Bronx, Richmond, Kings, New York, Queens, and

Nassau Counties)

2285 L Elite Home and Community Care Service, Inc.

(Rockland, Putnam, Westchester, Orange and Bronx

Counties)

2254 L Ellison Home Care Companion Agency, Inc.

(Nassau, Westchester, Rockland, Queens, and Suffolk

Counties)

2247 L Grupp KK, Inc.

(Bronx, Richmond, New York, Queens, Kings,


2152 L Guiding Angels Home Care, LLC

(Bronx, Kings, New York, Richmond, Queens and Nassau

Counties)

2138 L Home at Last Home Care Services, LLC

(Kings, Bronx, Queens, Richmond, and New York

Counties)

2175 L Human First Community Health Care, LLC

(Nassau, Suffolk and Queens Counties)

2215 L La’Dorch Homecare, Inc.

(Bronx, Richmond, Kings, New York, Queens, and


2261 L Marabi Homecare Agency, Inc.


Nassau Counties)

2274 L Masih Home Care Incorporated

(Queens, Kings, Richmond, New York, Bronx, and

Nassau Counties)

5

2202 L MY Care Health Services, Inc.

(Queens, New York, Bronx, Richmond, Kings, and

Nassau Counties)

2244 L New Hope Services, Inc.

(Bronx, Richmond, New York, Queens, Kings and


2259 L NMC Homecare Agency of NY, Inc.



2176 L Augusta Osinowo

d/b/a Nightingale Care Services

(Bronx, Queens, New York, Richmond, Kings, and

Nassau Counties)

2157 L Passion for Seniors of NY, Inc.


Counties)

2299 L Premium Home Services, LLC

(Queens, Kings, Bronx, New York, Richmond, and

Nassau Counties)

2279 L Scope Healthcare Services, Inc.

(Suffolk, Nassau and Queens Counties)

2163 L VIPrivate, LLC


Counties)

2461 L Alice Hyde Medical Center

(Franklin County)

2295 L Hyde Park Assisted Living Facility, Inc.

d/b/a Hyde Park Licensed Home Care Agency

(Dutchess County)

2319 L Acare HHC, Inc.

d/b/a Four Seasons Home Care

(Bronx, Queens, Kings, Richmond, Nassau and New York

Counties)

2281 L Anchor Home Care LLC

(Allegany, Erie, Orleans, Cattaraugus, Genesee,

Wyoming, Chautauqua and Niagara Counties)

6

2389 L Crown of Life Care NY, LLC

(Bronx, Queens, Kings, Richmond, Nassau and New York

Counties)

2342 L Elite HHC, LLC

(Bronx, Richmond, Kings, Westchester, New York and

Queens Counties)

2401 L Prestige LHCSA Management, Inc.

(Bronx, Richmond, Kings, Westchester, New York and

Queens Counties)

2556 L Quality Care – USA, Inc.

d/b/a Gentiva Health Services

(See exhibit for counties served)

III. COMMITTEE ON CODES, REGULATIONS AND LEGISLATION

Angel Gutiérrez, M.D., Chair

Exhibit # 11

For Emergency Adoption

13-08 Amendment of Subpart 7-2 of Title 10 NYCRR (Children’s Camps)

For Adoption

Sections 415.3 of Title 10 NYCRR ( Nursing Home Transfers and Discharge

Rights)

Principal Operating Entities of North Shore-LIJ Health System

D Obligated Group

D Not-For-Profit Corporation

North Shore-Long Island Jewish Health System, Inc. (Corporate parent and support services)

0 Division

II II Other Entities

North Shore-Long Island Jewish Health Care, Inc. (Corporate support services)

North

SWI~ II Huntin~n II Sou~side II Franklin II ~nox Hilt II No~ Shore-LIJ Plainview Forest Island Hospital Hospital Hospital Hospital Shore Stern Hospital Hills

University University Family Hospital

Hospital Center for Hospital Rehabili-

tation

Long Island Jewish Medical Center

Other Entities (See

"Other Health System

. Entities")

II Glen Cove Hospital

td 1-d t'%j t-1 ;:to 0

LJ,

;J> CD rt (") rt rt Ill (") ~ ::r'l-' s .!>CD N ::l 0 rt <X>

1-' ;:to

North Shore-Long Island Jewish Health System. Inc.

Conso lidating Statement of Financial Position

A~~d• Cur:c nt asscls:

C:.~ sh and c:rsh cqr ~ h ;1! cn:~

M:HLclab:c sc.::r::! rc5 and ot her ir.' cs: II!K·r:ts

December 31. ~013 (In 7/Jousandsj

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:":orth Shore-Long Island k11·ish Health System. Inc.

Combining Statement of Financial Position - Obligated Group Only

A nets (u;!"tn\ iiSSCIS '

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December 31, 20 13 I In Thousands)

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:t .. l9 2 ... 'i1

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1-'

'\o rth Shore-Long Island Jewi sh Health Sys tem. Inc.

Conso lidating Statement of Operat ions

Y car Ended December 31, 20 i 3 (In Thousa11ds)

Ot>t: r:III~K r~' ~nu::: Sc1 patient sc~T•cc rcn:m:c Ph~ s•d<lll ~r:tc llcc rc,·cnuc ?1ovlsion fer l:i\d ~ebu To!a l p l t:cnt TC\"Cr.!.:c. n:::t of ;>fO\"ISIOII ro: bad ci:::bts Other OjX'talmg rc\·cnu:: \"c: assets released frcr:• rcslHCIIO:'IS used :Or cpc r:~tion~

Total o~rill:n£ fC\ 'Cnuc

Opcr a 1 in~ C:\pcns::s · Sa lnn ;;s Empk>~cc bcncfl ts So:j'Jplics OUl<l c;\:po:nscs Ocprcci:ll i;,.~n and amort~7 .. 1lton Interest

Tot.1l opcr~tn;,g cxpcr.~ci

Excess !_dc tki:::ncy:• .:~f .;,pcraling ;cn:1:~«: O\"<:r op~ra~ i n,g cxp:::uscs

So::-cpc:<~ l ing gr.ms :Ltld l os-~cs ·

fn\'CSimc nl •ncomc (1-:Mgz in :let umcalt7.cd ga:ns and iosscs: and change ;n \-~:~:c

cf CC]U!lY mcth~xlm\':::stm:: nts Ch~M.Z :n f:m \'aiu:: of intcrcs! rat: swap agrc::m::nts

ckslgnu!::C ::s lkri' '''i'c mst;-:..~m::n t s E;vk ;..::ti r("mcnt :xo~ram C~lS!S Oth~r ncm-(lp.:~.:l lmg ~ga: n s ~nd lou~·s

T:>!lll non··(lj:l::r<lling gam~ ;md l ~Jss::s

Excess (dc f•c•<!r.cy) of X\ cnuc and ,!;ains and losses C\·cr cxpcns~s

~C! ::SSC!..~ r.:\c3SCd fron~ !CS:ncliOOS f~1r .:i!j)l(il! JSSC! JCq".!isit:C:lS Chil!igc in ftur \'::t luc of interest rotc ~"~'~P cgrccm::n:s d::si~net::rl

.:IS cash n.:tw hech:cs Tnmsfcrs t:oJ frtlm : ,flil ialc! Pension it'1d o~~::r posl!ct;r~mcnt ;:ab! l:: ~ adJti~tm::nts O:!tcr ch3ligcs in net nsse:s l!~crc .a sc idccrc!lsc l :n • mrc:;~:c tcd net :tsscts

:\'orth ShoreLone Island

Jewi sh Hea lth Sntem, Inc,

, Total

5J!53.492 K75.11!1K

EliminMtions

t? .C. I91

t:11.1UJ ;~ l.i.•i:7.:!92 l3.5-11 J

3~-1 .ti07 \·l:'i l ... n~ ·,

J<J,'J32 7.00 1.!0 !

3.5r.K.9'JI 9 2~.220

.2.0:!~1. 1 :!5 307.3~~

84,1<)3 6.9!1.R?4

~3 .')57

] LII 1.32U

hl5 ,1i7l

%~

t:3. 179J t !J. =-~-~~

l i)7.7D

:!5 l.tWO

-l tl,IJC•H

2.93 1

2.;K ,8i5 (6Jii)l

54l\.9tt;

{..;(i.J .IJ;:t)

:•;7.S5ZJ (17.6!!)

~3:.'9.Fil •

l'i7l ~J 5..; 77})

1 :0.2:"1!);

1!!,7(,(1

\:! . .::!!:;; 11.477

1 L?l3j

H.i.~UU

l..fOC ,·1, 877

~urlh Shore- \' orth Shorc-:'\orth Shur r-- The Feinstein Lone Island Lun g Island

l ong lsland Jtwi sh T he Hospice JnSiitut ( for Jewish llcll h h Jewish Hea lth C~&ptive Hell lt h O blig11ttd Long lsl1111d Cll rt Mcd k11 l S)·stern Sy:stl! rn lusun nce Dolan FMmiJy lnsunonce

Group l-l omt \'t~ ~·-~·-·-~_._ 1 !!~~ _R_~-!~!'_(t~h ____ fQ.~•-•- ~ _<!II tion, lnc. __ ~~-l!.9~!'_ !_(ll~irs -~~ ·-••pa n iu Utall h Center Comp~nies

5.CiiH.~~'J s ()U.451J l)fl3.f.>l') 2.(oU9

l!i7.4H3i ... I !,.J28} 1).15-t-175 ')1.6-W

3Ud127 1. ~4 7

2·DO : (o.(oli4.8U3 92.llR7

3.:7:!.n::•; 52.~ • ·1)

~-U!.IJ!1 ICJ.:'Ki ! .956.()41) .!tU56

290.41)4 2.3 .~ 7

82:6 11 UifJ2 6.450.(,1!7 'Hi)SC

!5-i, JJ{I !3}'15;

:;~.7~5 -'->

:3.0!4 {l\

1}(,5

t32.31J2) !\4i

!?5.\5'• 4<)

:?!\9,275 13)55 ;

43<3 1-t

1,67~ l.~53 {fll).9'i3} 237,(:01) I I .~ ~;(,

):J J.&83 s 9,i f!4

4:), 1(>1

C JUJ

T~.~J:

U.!f>~ -4iJ.I)i)l)

17.(..!9 .u.;.; ~4 . K1!2

51ij

~7.RJ3

2. l!i:;

3t)l

5U1/

t l75: ( ,{!.;

i.:-:!9

J.435

:: ,-135

-'~0

43o 4 I.O·Li 1-1 . 3~3

:'5.S(l6

4--l ,•):!H !L!-1! .!4. 17i 5.3 -10

:H.6':2

•3U!66}

14

16

(3 i.R50)

~.7;4

2(1.7!3

i.R.3 1i3;

-U.:!-1

t6<J(ol ___J0_ l6'.:tll 45 l&

~.n.:.n 37.930 :!.fi25 U!•l 23()

2.:.;.~;4] :n. 1i~O 7.3i? 1. .~0/

; 1.<·~! ·1.01 3 :!ill 1-l .. N~ ~ .5 !0t (,7

:%.634 3?'.9M.l 2. 15! 17,1) 15 1.621) 74

~24.33R 37 '183 7.!127 11\.:!(,U

22,?:!3 d31 !-'5.; ) ! 16.'15')!

1,130 ( ; H; 6.1167 39

Lv~<> :0.37:

,5i;l ·~ :JIJ; (:\.7::::-"i 32 i3.5".ll'l ( 5~ ~~ 16 .. 144 52

:~ . 59 I J .2 1.7-1 5 J(,3•H \ 402~ t:f,_1i59!

i_ltl,2t l(l) -l:; _ _:xo

•).59i.l s I :.5-IS )(,_?9l 1.--W.!) ;z.3ll

O tht rll e11lth S\-·s lcm t-:nt iti u

3.!.:!78 .!ii8J~ f;(:.

1 1 .6113~

2-'!.535 t ~!U .'! :.J

J71).0b4

:!::~ _ ·J7 1

•;.o: l m.61!

Co ,•i53 77

.. 1()] ,7(6

(3 1.(>4 1)

!): l l

Hi . .?.•;.J

:93! I Xo

r 1ur.~

rli.~76J

;Z.tl(l(l]

t13.~i61

t:t:! >Tj

:> :> rT rT Ill n ::r' 5 (1)

:::J rT

u:l

.--... n 0 ::l rT

.........,

'"0 t-i 0

LJ, (1)

n rt

~ ,_. ~ N 0 co ,_.

0 r 1

= c

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., ~~]~ ~~ :;~

..J

c 0

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... .. ~:) ~~~

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c:: ~; ;q ~~ ~. ~ 8-': .;:; .... 1--= r-.. :.::. X • ,.:,. ~' x; .... , .. , .,. :...e ... ! ,.., - ~~ ~~ ' -:

r •.,. :_-.. r-1 e r-, .... ,,,, .• -.=.. c-. r.., •r, - ""':'- ' '',.... !W) . ,.., <'"I...:; -:- ,.. , •r. oo

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I I 1 :£ ''!.

Project fll42081 BFA Attachment B (cont.)

Project /1142081 BFA Attachment B (cont.)

North Shore-Long Island Jewish 1-leaith System, Inc.

Consolidated Statements of Financial Position (In Thousum/.1)

Assets ( 'urn.:nl a,;sc:ts:

Cash and cash cquivaknts Markcl~rbk securities and other investments i\crounts n:ccivahk ltH. scrvicc:s to patients. net or allowance l(>r dnubtl[d

. accounts or$<.J0.500 in 2013 and $109.790 in 2012 1\ccounts re~;eivabk l(>r phys ician activities. net Assets lirnikd as to usc. current portion l'lcdgcs rcc..:ivabk. curre.nl portion Insurance daims rcccivabk. curn;nt portion Uther uu-rcnt ass..:.ts

Total current assets

/\,;sets limited as to usc. m:l oi' current portion l'kdgcs rc,c:civabk. ne t or current porlion Property. plant ami ..:quipment. net Insurance· claims rccc·i vab le. net or current portion Ol h..:r assc,ts Total assets

Liabilities and net assets Curn.:nt li~rbilitics:

Shmt-t.:nn borTowin[?.s ,\n:oums pay<rhk and accrued expenses 1\ccrucd salaries and relateJ bcnelit.s ( 'um:lll portion or capital lease oblig,ations ( 'urn:nt portion or long.-tcnn debt Curn:nt portion or insuranc:t; claims liability CutTL'lll portion ormalpracticc and llther insuranc.: liabilities Current portion orthird-pany payc·r structured liabilities l'urrc·nt portion llrcstinratcJ payable to third -part' p;tycrs

Total c:urrcnt liahilitic:s

/\ccrued rctin;rnent bc,m:lits. net or current portion ( 'ap ital kasc obligations. net or L'li!TCnl portion l .ong-tcnn debt. nd ol· curT<:nl portion lnsur;nrcc <:!aims I iabi lily. nc.t or current portion Malpractice ami other insurance liabilities, nc:t or CliiTl:nl portion Third-party payer struelllreu liabiliti~:s. net ol'curTcnt portion OthcT long-tcnn liabilities Total liabilities

l'onunilllH.:nts and eontingenci<.:s

Nl~t a~sl..!ts:

l.lmcslrictcd Tctnpor;u·ily restricted 1\:rnwnent ly rc·stric:tcd

Tot a I net assets Total liabi lities ~nrd net assets

.\'et' cJCL'OIII{J(II1Ying notes.

Dc..-cmhcr 31 __ _:2::..:(:_:ll_::_3 2012

$ 210,(itl I $ 2!LU5X 1,739,31!6 I .'1%.070

700,1911 6'>7.21 () 6S,.t43 W . ISI 711 ,956 11'!.1()(, 35,577 .\5,'1:2(> 91!,399 IO·L'X5

""'"'"'"' ' ' · ······!.~?_!?.~.1 ..... I).'!JQ<J

$

$

3,091,491

1,159,721 112,1!21

3,550,093 3]-t,073 175,155

s.~~~ ~~~~ ..

110,540 529,42] 56S, 16-t

6,3011 52,95-t 91!,39'> 7-t,252

5,43!! .t25,232

1,1!70,710

3-tl,04.t 76,814

$

$

2.\155.-10 1

X40.46~

l:'o.xxo :.LlE151

35'!S!X 15~U73

7JW6.79<> ........ .. .......... ~- ·------.. ~ ··

I I 0.5-10 ·l'J:\.994 s:~7.XJ~~

5.000 )().'):"!

104.2X5 59.5:'1

:i.·L;x :~5'!...995

I ,7 1 O.:i.\9

6(10,.\)(l

XU.'! 13 I ,665,372 1.·170.7:'X

334,1173 :;s9.:'i:~x

716,902 653.229 18,21!8 ' 23.951

___ 411 ,22?_ __ , ________ ~1_};·. ~2_1 __ _ ___ ::_5:_,·1:.::3..:4:..:,4.:..:2:.:!!:_. ___ _:_5:.:..:>:...:76.715

2,50!>,405 1.959.50 I 3.t(,,()4(J 3:11.(>(,<)

· ------- ··- -·!-~:'.1;:1_7_::.5 ____ .:.:1 ~~1 X:..:.·':...! :_:II_

___ 2:::•c.:9:.::8:.::S:..:, 9:...:2:.:<>:.... -------~g~~~~~_l_ __ s !!,423,354

Project /1142081 BFA Attachment B (cont.)

North Shore-Long Island Jewish Health System, Inc.

Consolidated Statements of Operations (/ n Thousand\)

Operating revenue: Net patient service revenue Physician practice revenue Provision f(Jr bad debts Total patient revenue, net of provision !'or bad debts Other operating revenue Net assets released from restrictions USL~d for ope rat ions

Total op<.:rating rev<.:nue

Operating expenses: Salaries l:Jnployee benefits Supplies and expenses Depreciation and amorti zation Interest

Total operating expenses

Excess of operating revenue over operating expenses

Non-operating gains and losses: Investment income Change in net unrealized gains and losses and change in value of

equity method investments Change in fair value of interest rate swap agreements designated as

lkrivativc instruments Loss on refunding and refinancing or long-term debt Contribution received in the acquisition of The Long Island Home Early retirement program costs Other non-operating gains and losses

Total non-operating gains and losses

Excess of revenue and gains and losses over expenses

Net assets released from n.'strictions for capital asset acquisitions Change in ntir va lt 1e ol' interest rate swap agreements designated

as cash flow hedges Pension and other postretirement liability adjustments Other changes in net assets Increase in unrestricted net assets

Sel! accompanying nores.

Year F:nded December 31 2013 2012

$ 5,853,492 875,088

... .... . _.\.?! ,28.1}J 6,637,292

324,607

s 5,598,408 758,409 ( 97. ()<) ,1

6.258.X:?.3 302H> I

---~_9~,:._9_3_2 ____ ~!~:.2_3 0_ 7,001,831 (J,606Js44

--~~~---~-

3,568,991 928,220

2,029,125 307,345

84,193 6,917,8_?1

83,957

100,320

105,971

965

(33, 179) (6,344)

:u 15,368 862,478

I ,lJ84,936 27 5,60 I

70,594

......... 6,508, 977

97 ,';36 7

4~?.636

( 4,495) (4,590) 12,823

(5,51 0)

_16_)7_,,_7.:._33 ____ 16~!~1_1_3-

251,690

46,068

:).62,280

38,5')()

2,931 (J77

H8,815 (7X,540) ____ .(600_,_) ____ ....::(J_9...::.6_

,,~~"·'~ .. ~}-~8,904 s 223,703

North Shore-Long Island Jewish Health System, lne.

Consolidated Statements of Financial Position .June 30, 2014 and December 31, 2013 (In Thousands)

Assets Cun·ent assets:

Cash and cash equivalents Marketable securities and other investments Accounts rcce i vable for services to patients. net of

a llowance for doubtful accounts Accounts receivable for physician activities, net Assets limited as to use. current portion Pledges receivable, current portion Insurance claims receivable, current portion Other current assets


Assets Iii11ited as to use, net of current portion Pledges receivabk, net of current portion Property, plant and equipment, net Insurance claims receivable, net of cun·ent portion

Other assets Total assets

Liabilities and net assets Current liabilities:

Short-term bon·owi ngs Accounts payable and accrued expenses Accrued salaries and related benefits Current ponion of capital lease obligations

Current ponion of long-term debt Current portion or insurance claims liability Current portion of malpractice and other insurance liabilities Current por1ion of third-pany payer structured liabilities Current portion or estimated payable to third-party payers

Total current liabilities

Accrued retirement benefits. net or current portion C<tpitall~ase obligations, net of current portion I .ong-term debt, net of current portion Insurance claims liability, net of current portion Malpractice and other insurance liabilities, net or current portion '!llird-party payer structured liabilities. net of currem ponion

Other long-term liabilities Total liabilities

Commitments and contingencies

Net assets: Unrestricted Temporarily restricted Permanently restricted

Total IWt asset·S Total liabilities and net assets

Project /!142081 BFA Attachment C

(Unaudited) (Audited) .June 30, December 31,

2014 2013

$ 242,925 $ 210.60 1 1,670,705 l.739,3H6

747,073 700, 19H 72,292 68.4-B 88,403 7H,956

36,931 35.577 94,480 98,399

~05,182 159,931 3,157,991 3,091,49 I

1,185,589 1.159,72 1 118,694 112.X21

3,652,699 3,550,093 320,322 334,073

171,002 175, 155

$ 8,606,297 $ 8,423,354

$ 110,218 $ 110.540

579,811 529.423

554,810 568,164

6,665 6,308

60,570 52.954

94,480 9li.399 73,718 74,252

5,438 5.4:~x

423,138 425,232

1,908,848 l ,i:l70.710

344,616 34 1,044

98,558 76,i:ll4

1,619,142 I .665.372 320,322 334.073 740,185 716.902

15,241 18,2li8

416,381 411.225

5,463,293 5,434.428

2,633,063 2.508.405 374,797 346.046

135,144 I 34.475

3,143,004 2,988.lJ26

$ 8,606,297 $ !\.423,354

Project #142081 BFA Attachment C (cont.)


Consolidated Statement<; of Operations For the Six Months Ended June 30, 2014 and 2013 (In Thousands)

(Unaudited) (Unaudited)

2014 2013

Operating revenue: Net patient service revenue $ 2,971,900 $ 2,879,672

Physician practice revenue 461,379 436,159

Provision for bad debts (49,717) (52,1 1 I)

Total patient revenue, net of provisioi1 for bad debts 3,383,562 3,263,720

Other operating revenue 198,736 154,136

Net assets released from restrictions used for operations 23,456 20,367

Total operating revenue 3,605,754 3,438,223

Operating expenses: Salaries 1,850,251 1,731.637

Employee henefits 469,071 461 ,792

Supplies and expenses 1,033,326 994,225

Depreciation and amortization 168,468 153,951

Interest 46,584 39,437

Total operating expenses 3,567,700 3,381 ,04:2

Excess of operating revenue over operating expenses 38,054 57,18 1

Non-operating gains and losses: Investment income 62,575 48,436

Change in net unrealized gains and losses and change in value of equity method investments 28,423 (7,011)

Change in fair value of interest rate swap agreements designated as derivative instruments 392 640

Other non-operating gains and losses (7,247) (I' 122)

'T'otal non-operating gains and losses 84,143 40,943

Excess of revenue and gains and losses over expenses 122,197 98,124

Net assets released from restrictions for capital asset acquisitions 3,134 17,769

Change in fair value of interest rate swap agreements designated as cash flow hedges 459 2,089

Other changes in net assets (1,132)

Increase in unrestricted net assets $ 124,658 $ 117,982

Sorth Shurt-J.nn~ lsl:md J e,~ish H r;~ llh S)'stem. Inc.

Cunsulldnti ng Statement ur F'in<~ ud;a l f 1u~illun

Jun~ 30. 201~ t L=na udilt:LI amJ In Thuusa ntls )

A~sct~

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l'orth Shon··Long Island Jewish Health System. Jm·.

Combinin~ Stulcmcnt uf Finundul Pusilion ·Obligated Group Only June 30. 2014 (l'mmdilcd and In Thousands}

.\sscts Current ~~~~et~:

Cusl: ;md t.' a~h cquivaicnts ~~a~ let<JI:ol:! '\t'C! ! ritit.·~ and t:thc:r in,·estmcnt~ A::~ol:nb re,ei,·ab le for serrices tu p:.~tien:s. aet or

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Accf'lllnts fC(:l'i\'abic for physiri:tn ac ti vitic~. r.c! Ass~t~ limitt.:ll as to usc. current ptJrti\m

Pkc! j!l!> rea.in.Jbh: . .: l irr~n; p\lll ion

Jn~uran::t!' duims re •. :eiv;:ble. Lu rren: port:on

O ther current ""~cts Total c~n~~t assets

O!.lc from aff1liates. nd Note rccC i\·abk f:-nm aflilia:c

Assets !imit~d O!S !>I ~1sc. n~~~ uf <:!.lrrcnt porliu:-~ Pled!!~" rctl!iV:ll:ok :!t'\ u f ~mrt"l\! p:mien

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h: s~ r<Jr.<:c claims rc~ci\·able. nt·t Clr c~rrcnt p<.,:-tiO!l

Othe r as'ich Total ~s.o;ets

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Sorth Shore-~

l.ong Island Long lslnnd

Tulnl Jt:wish .Sut·(h Shure Jewish S~tlcn bhmd Hunlln~lun

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North Shore-Long Island .Jewish Health System, Inc.

Consolidated Statements of Financial Position .June 30, 2014 and ncccmber 31,2013 (In Thousands)

Assets Current asso.:ts:

Cash and cash t:qu ivaknts Markt:tablc sccuritk~ and other invl"stments Account~ ret·t:ivablc for services to patients. net of

;~llowancc for doubtful otC<'Ounts Accounts reccivotblc fo r phy~idan activities. net Assets limited as to u~c. current portion Ph.:dges r~.·o.:civablc. current portion lnsur<tlll't! daims recciv;~hlc. curl\.'nt portion Other current a,;~~::~

Total cu rrent <tsscts

Asset~ limited as to U~l.'. net of current portion Pledges n:ceivabk~. net of o.:urrem port ion l'rojX'ny, plant and equipmelll . net Insurance dai 111~ ret.: t:ivah!t:. nl"t of cu rrent portion Other ;J~>t:t~ Total assl.' ts

[ .iabilities and net asset-; Currcm liabilitio.:s:

Shon-tenn borrowing' At.:counts payable and ac~.:ru~.·d cxpcns~.·.~

Accrued ~alar ies and rel.:ted hen~fi t~

Cum.:nt port ion of capital k ast\ obligatil>ns Currcm portion of long·t..:rm d..:bt Curl'l'nt portion of insun:m:e claims liability Current pon ion of malprattict• ant! oth..:r i:J,u ram:e liubil itit:s Current ponion of thinl·'1arty payt>r structured liabilit ie' Current ponion of eslimalcd pay;tbk l\lthird-pany pay..:rs

Tmal current liabil ities

Accrued r..:tiremcnt he:~cfits. net of ~:urrcnt ponion Capital lea~e obligat ions, net of current ponion Long-tem1 debt. net of cu rrent ponion lnsumnce claims liabi lity. net o f cllrrt:nt ponion Malpractice and other insur.uu.:c liabi lities. net of current ponion 'llt ird· pm1y payer stn tciUred liabilities. nc1 of current ponion Other long-t..:rm liabil ities '1\Hal liabilities

Cotnmitmcnl~ and ..:vmi n)!~ncics

N,·t a~~l"ts: llnl'l'~lr .ctcd

Tctnpomrily restricted J'c m wn:ntly restricted

Total net assl' ts Total liabilities and nl'l assets

Project lt l4208 3 BFA Attachment C (cont. )

(U nuuditcd ) (Audited ) June 30, I>cccmhcr 31,

2014 2013

$ 242,925 $ 210.60 I 1,670,705 1.7.39.386

747,073 7(Xl. I9X 72,292 68.443 88,403 7!i.956 36,931 35,577 94,480 'J~U9lJ

205,182 15').931 3,157.99 1 3.091.491

1,185,589 1.159.721 118,694 11 2.821

3,652,699 3.550.093 320,322 .~34.073

171,002 175.155 s 8,606,297 $ 8.423.}·54

$ I 10,218 $ I I 0.540 579,811 52<).423 554,810 56X.l 64

6,665 6.30!i 611,570 52.954 94,480 <J!i.3<)')

73,718 7~.252

5,438 5.43!i 423, 138 425.2.'2

1,908,848 1.!!70.710

344.616 341.044 98,558 76.!il4

1,619,142 I.M>5.372 320,322 :t\4.073 740,185 716.902

15,241 18.2!i8 416,381 4 11.225

5,463,21)3 5.434.42!\

2,633,o63 2.50!!,405 374,797 346.046 135,144 134.475

3,143,004 2.98!!.92() $ 8,606,297 s lU23J54

Project 1/142083 BFA Attachmetn C (cont . )


Consolidated Statements of Operations :For the Six Months Ended June 30, 2014 and 2013 (In Thousands)

(Unaudited ) ~U naudited )

2014 2013

Operating revenue: Net patient service.: revenue $ 2,97 1,900 $ 2,X79.672 Physician practice.: rewnue 461 ,379 436,1 5t)

Provision for bad debts (49,7 17) (52,1 11) Total patient revenue, net of provision for bad debts 3,383,562 3,263,720

Other operating revenue 198,736 154,136

Net assets released from res trict ions uscd for operations 23,456 20.367 Total operating revenue 3,605,754 3,438.223

Operating expenses:

Salaries 1,850,251 1.731.637

bnployec benefits 469,071 46 1,7<:)2

Supplies and e xpense~ 1,033,326 991\.225

Depreciation and amortization 168,468 153,95 1

Interest 46,584 39,437

Tt)tal operating expenses 3,567,700 3,381,042

Excess of operating revcrltle over oper~ting ex penses 38,054 57, 18 1

Non-operating gains and losses:

Investment income 62,575 48,436

Change in net unrealized gains and losses and change in

value of equity method investments 28,423 (7,0 1 I)

Change in fair value of interest rate swap agreements

dcsignatt.:d as dt.:rivativt.: instruments 392 640 Other 11011-opcrating gai ns and losses (7 ,247) ( 1.1 22)

Total non-operati ng gains and losses 84,143 40,943

Excess or reve nue and gains and losses over expenses 122,197 98,1:?.4

Net assets rekaseu from restrictions for capital asset acquisitions 3,134 17,769

Chang~.: in fair value of inwn:st rate sw~p a.greemcnts designated as cash flow hedges 459 2.089

O ther changes in net asse ts (1,132) Increase in unrestricted net assets $ 124,658 $ 117.982

BFA Attachment A

CON 142168- C

Westchester County Health 'C'a'ri"Corporation Statements of Net Position December 31, 2013 and 2012

2013 2011

Assets Current assets:

Cash and cash equivalents .$ 204,420,734 $ 190.851.694 Patient accounts receivable, net 127,674,680 115,519,295 Investments 593,329 591,532 Assets restricted as to use, required for current liabilities 24,090,325 23,681,335 Other current assets 32,991 ,767 28,555,365

Total current assets 389,770,835 359,199,221

Assets restricted as to use, net 158,294,119 160,247,807 Capital assets, net 318,117,1 53 304,807,732 Other assets, net 5,444,633 5,209,769

Total assets 87 i,626,740 829,464,529

Liabillties Current liabilities:

Current portion of long-term debt 18,650,555 15.909.310 Accounts payable and accrued expenses 76,469,754 74.759.978 Accrued salaries and related withholdings 69,053,991 61.357.771 Current portion of estimated liability to third-party payors 11,061,816 7,321,740 Current portion of post retirement health insurance liability 12,164,000 11,614,000 Current portion of estimated self-insurance liability 26,550,000 26,990,000 Current portion of other liabilities 7 069,114 5,515,236

Total current liabilities 221,019,230 203,468,035

Long-term debt, net 435,395,58 I 441,751,530 estimated liability to third-party payors, net 43,954,574 27,025,109 Estimated post retirement health insurance liability, net 61 ,555,000 59,899,000 Estimated self-insurance liability, net 90,046,615 89,394,951 Other liabilities, net 34,078,235 28,618,068

TotalliabWtics 886,049,235 850,156,693


Net Position Restricted

Expendable for capital acquisitions 2,717,305 1,758,330 Expendable for specific operating activities 5,665,000 5,347,770

Total restricted 8,382,305 7,106,100 Unrestricted

Net investment in capital assets 6,732,192 (3,247,397) Unrestricted (29 t536,992! (24,550,867}

Total unrestricted (22,804,800} (27,798,264}

Total net position $ ( 14,422,495~ $ (20,692,164)

Westchester County Health Care Corporation Statements of Revenues, Expenses, and Changes in Net Position years Ended December 31,2013 and 2012

Operating revenues 1'\ct patient service revenue (net of provision for bad debts of

S41,89tl,325 and $47,570,755 in 2013 and 2012, respectively) .$ Other revenue

Total operating revenues

Oper2ting expen.!es Salaries and benefits Supplies Md other expenses Pro!'cssional liability Depreciation a.nd 3111ortization

Total operating experu;es

Operating income

N ono~rating activities Interest income Interest expense

Increase in net position

Net position Beginning of year, as restated

End of year s

BFA Attachment A(coct 'd )

CON 142168- C

2013 2012

895,371,943 $ 867, 71!0,675 23,416,354 25,652,393

918,788,297 893,4331068

473,772,966 488,827,468 361.061 ,294 326, 173,658

13,714,339 15,029,291 44 105.277 43,849,809

892,653.876 873 .880.226

26,134,421 19.552.842

3,756,526 4,788,206 !2316211278) ~23,443,422)

6,269,669 897,626

!201692, 164} ~21,589,790}

~ 14,422,495l s (20,692.164 ~

WESTCIIESTER MEDICAL CENTER

STATE.i\fENTS OF NET POSITIO~ SEPTKM!ER 30,1014 AND DECEMBER 31, 2013

ASSETS

CURRENT ASSETS: Cash and cash equivalents...... ..... . . . . . . . . . . .. . . . . .. ... .. . ... S Patients =unts receivable· Net.. . .. ..... ... .. .............. Otba assetll .. ... ... . .. .. . ....... ... . ..... . ........ ... ... . . ........

Total current assets.. .... .. .. . .... .. .. .. ... .. ..... ..

ASSETS RESTR.JCI'ED AS TO USE, NET ................ ..

PROPERlY, PLANT AND EQUlPMffi\1, NET ....... .... ..

OTHER ASSETS, Nb:T ...... .....................................

TOTAL ASSETS...... .. .. .. .. .. .. .. . .. .. . .. .. . .. .. .. . .. .. .. .. .. .. . $

2014

136,822 s 149,357 49,294

335,473

54,805

394,600

11,713

796,591 s

2013 LIABILITIES A.."''D NET POSmON

CURRENT LIABILmES: 198,243 Current portion of long-tenn debt......... ..... .. ..... .. ... .... $ 127,675 Current portion of capital leases ..... .... ........ ... ......... ... 32,546 Current portion of post retiremeo.t health insurance .........

Aocounts payable and accrued expCilBes .. .. .... .. ... ... . ..... Accrued saleries and .related wit.'lho1dings . .. . .. .. . .... . .. ... . Estimated third-party peyors ...... ............ .. .... ........ .... Other liabilities . .. . ..... . .. ............ . ............. . ......... ...

358,464 Total current liabilities ...... .... .. ............. .....

LONG-TERM DEBT .. ........ ... ....... ....... .. .. .......... .. ... .

CAPITAL LEASES .......... .... . .. .. .. ...... ... .. .. .... ... ...... .

POST RETIREMENT HEAL Til INSURANCE ........ .......

62,629 ESTlMA TED THIRD P ARTI PA YORS ...... ...... ..... ... ..

318,117 OTIIER LJADILITIES ...... ........ ........... ... ......... .. .. ....

11~ ESTIMATED SELF-INSURANCE UABD...ITIES ... .. .. .....

TOTAL LIABILITIES .... ..... , .. ... .. .. .. .... .. ..

NET POSrnON: Invested in cspi:ai11.5Sets, net of related debt ... . ..... . ... .. .. U nrestrictcd .. .. .. ... . . ..... .... ............ . .. ............... ......

Net Position .. . .. ... .... .. ... ..... . ........ .. ... ... ... .

750,846 TOTAL LIABILITIES AND NET PO~rnON ....... .. ....... $

UNAUDITED

2014 2013

9,915 $ 9,915 10,591 8,735 L2,164 12,164 86,873 76,195 72,624 68,887 5,072 11 ,062 8,103 7,069

205,342 194,027

476,.584 419,275

35,252 16,121

62,933 61,555

11,932 43,955

34,078 3-4,078

32,366 33,685

858,487 802,696 (')

~~ 0 z ,_

6,732 6,732 ~ N

(68,628) (58,582) ...... 0' 00

~61,89~ (51 ,850) I

(')

796,591 $ 750,846

WESTCIIESTER MEDICAL CENTER

COMBrNJNG STATEMENTS OF OPERATIONS FOR THE PERIOD ENDED SEPTEMBER 30, 2014 (IN THOUSANDS)

WMC

Total Operating Revenues . .. . .... . ....... . ..... . $ 769,177

Operating Expenses: Personal services .. . ... ...... . ... ... ..... .. .. .. .. 302,220

Fringe benefits ... .. ..... ... . ........... . . .... ... . 106,104

All other operating expenses .. ..... ....... ... . 346,672

Total Operating Expense..'l .... ..... .... ..... ..... . 754,996

Operating Income {Loss) . . ........... .... . . .. . 14,181

Interest, net. ....... . . ....... . . . . ... .. ... . .. .. . .. . (14,321)

Income (Loss) .. .... . .. . .................. . ...... .. .. $ (140)

Consolidating Foundations Entries

$ 6,08& $ (3,520)

2,262 -124 -

2,860 (3,520)

5,246 (3,520)

842 0

16

$ 858 $ -

UNAUDITED

YTU I

Consolidated :

$ 771,745 '

304,482

106,228

346,012

756,722

15,023

(14,305) (") t;;;:l 0 "%j z ;J> ;.·

$ 718 ...... ;J> J::'- rt N rt ; ,.... Ill 0\ ()

00 ::J" I s r. ~

::l rt

:;.; ,...., 0 0 ::l rt

o; , ~ :-

Project //142181 BFA Attachment A

ORANGE REGIONAL MEDICAL CENTER

Consolidated Balance Sheets

June30, 2014 and December31, 2013

Assets Jun 30.2014

Current assets: Cash and cash equivalents s 19,298,119 Patient accounts receivable less allowance for uncollectible

accounts of$58,672,354 in 2014 and $56,131,235 in 2013, respectively 54,026,919 Investments 24,667,006 Assets limited or restricted as to use - CuJTent 4,788,594 Due From Third Pruty Payors 1,753,686 Other cw1·ent assets 15,969,344

Total cun·ent assets 120,503,668

Assets limited or restlicted as to use 27,476,132 Long-term Investments 26,952,342 Property, plant, and equipment, net 272,953,438 Interest in net assets of Orange Regional Medical

Center Foundation, Inc., net 5,350,914 Insurance Claims Receivable 12,889,968 Due From Third Party Payors, net of current portion 2,132,845 Other assets, net 11,787,894

Total assets $ 480,047,201

Liabilities and Net Assets Current liabilities:

Cun·ent instalbnents oflong-term debt $ 5,412,541 Accounts payable and accrued expenses 47,397,168 Deferred Revenue 628,154 Estimated third-party-payor liabilities, net 3.927,043

Total current liabilities 57,364,906

Long-tem1 debt, net of cwrent instalbnents 243,487,086 Estimated third-party-payor liabilities, net of current portion 4,307,272 Malpractice liability 15,921,075 Other liabilities 6,438,410 Deferred Revenue, net of current portion 3,479,012 Accrued retirement benefits 36,351,617

Total liabilities 367!349,378

Net Assets: Unrestricted 104,757,318 Temporari{y restricted 5,946,741 Pennanently restricted 1,993,764

Total net assets 112,697,823

Total liabilities and net assets s 480,047,201

Dec 31.2013

25,186,658

53,923,174 18,110,455 4,942,516 1,607,864

17,911,767

121,682,434

24,935,815 25,857,725

282,214,925

5,266,398 12,889,968 2,132,845

11,968,512

486,948,622

6,242,739 53,904,785

628,153 3,994,861

64,770,538

243,877,972 4,307,272

15,921,075 6,916,542 3,793,089

38,263,548

377,850,036

101,244,880 5,859,942 1,993,764

109,098,586

486,948,622

Project 11142181 BFA Attachment A (cont.)

ORANG£ REGIONAL MEDICAL CENTER

Consolidated Srntemen(s of Operations

Juoe 30,2014 and 20\3

l014 2013

Uni'Qtricted revenues, 1:11ins, Nld other JUpport: Palicnt service revenue, less conlrQCtuN and other allow~~nces s I 88,540,506 180,735,792 Provision for blld debts, net of rocovcries (5,303,292} (7 , 345,086~ Net patient service revenue 183,237)14 173,390,706 lnvcsuDCt\1 income 1,444,031 353,84!> Other n:'t'elluc 2..471, 194 2,664,551 Net RSSets released !'rom n:slrietions used Cor operotions 382 5942

Total un~icted n:venues, pins, ••KI other support 187,158,821 176,415,048

Expe11$C$: Salaries and wases 69,948,002 70,924,388 Employee benefits 28,891,024 32,226,476 Supplies 34,256,149 31,112,728 Purchased sen•ICC$ and other 31,020,923 28,623,134 lnte1e$1 7,157,573 8,056,158 Depreciocion and amortization 13,219,591 13,235,155

Total expenses 185,193~62 114,171,639

Income (Loss) from operations 1,965,559 (7,763,591)

Nooopcraeing gaills:

Nonopcratin1 income 120,H.S 34,028

Hxccss (deficiency) oC revenues, cains, un9 other suppon over expeDses 2,085,704 (7,729,563)

Other changes in net assets: Net wets r:eleii$Cd from mtrlclious used for fixed <mets

property, pl.at & eq11ipment 22,617 Transfa- from Gretller Hudson Valley Health Systems, toe., et 333,819 41,.S02 Cotttributions for property, plant & equipment 1,092,915 739,729

Jncrcae (dt:cnll$1:) itl unrestricted llCIC assets s 3,5121438 ~6192S171Sl

~~d:TO~~~i:! 20)4 l013

92,802,873 90,395,590 ~l.Sit2,611)

1;2200262 a ·579,877}

,8B,713 900,971 (7,895)

1,261,&29 \,4S<I,OH

93283,062 88,291,872

34,897,419 35,314,903 \3,565,682 15,240,727 17,710,940 15,534,029 16,060,822 14,533,005 3,946,725 4,035,121 6,601)93 6,617113

92,788,911 91,274,898

594,081 (2,983,026)

83 642 13 198

671,723 (2,969,S28)

212..890 113,890 400000

890,613 ~2,455,938~

Project /1142181 BFA Attachment B


Consolidated Balance Sheets

December 31, 20 13 and 2012

(In thousands)

Assets

Current assets: Cash and cash equivalents $ Patient accounts receivable less allowance for uncollectible

accounts of $56,131 in2013 and $53,456 in 2012 Investments Assets limited or restricted as to use Due fi'Om third-party payers Other current assets


Assets limited or restricted as to use, net of current portion Prope1ty, plant, and equipment, net Long-term investments Interest in net assets of Orange Regional Medical Center

Foundation, Inc., net Insurance claims receivable Due from third-party payers, net of current portion Other assets, net

Total nssets $

Liabilities nod Net Assets

Current liabilities: Current installments oflong-tenn debt and capital lease obligations $ Accounts payable and accrued expenses Deferred revenue CutTent portion of estimated third-party payor liabilities


Long-term debt and capital lease obligations, net of current installments

Estimated third-party payor liabilities, net of current pOl'tion Estimated malpractice liabilities Other liabilit ies, net Deferred revenue, net of current po1tion Accmed retirement benefits, net of current portion

Total liabilities


Unrestricted Temporarily restricted Pennaoently restricted

Total net assets

Total liabilities and net assets $

2013

25,187

53,923 18,110 4,943 1,608

17,912

121,683

24,936 282,215 25,858

5,266 12,890 2,133

I 1969

4861950

6,243 53,905

628 3,995

64,771

243,878 4,307

15,921 6,917 3,793

38,264

3771851

101,245 5,860 1,994

109,099

486!950

2012

63,308

41,937 8,489 5,813 1,511

16,053

137,111

24,063 304,201

4,778 13,708

11 ,677

495,538

7,134 49,358

628 2 709

59,829

249,694 2,330

16,715 5,160 4,421

61,969

400,1) 8

88,024 5,402 1,994

95,420

495,538

Project 11142181 BFA Attachment B (cont.)


Consolidated Statements of Operations

Years ended December 31, 20 I 3 and 20 J 2

(Jn thousands)

Unrestricted revenues, gains, and other suppott: Patient service revenue, less contractual and other allowances $ Provision for bad debts, net of recoveries

Net patient service revenue

Investment income Other revenue Net assets released from reshictions used for operations

Total unrestricted revenues, gains, and other suppott

Expenses: Salaries and wages Employee benefits Supplies Purchased services and other Interest Depreciation and amortization

Total expenses

Loss from operations

Nonoperating gains: Nonoperating income

Deficiency of revenues, gains, and other support over expenses

Other changes in net assets: Net assets released from restrictions used for property, plant,

and equipment · Transfer to Greater Hudson Valley Health Systems, Inc. Contributions for property, plant, and equipment Pension-related changes other than net periodic pension costs Postretirement-related changes other than net benefit cost

Increase (decrease) in unrestricted net assets $

2013

360,521 {13,6382

346,883

1,620 7,278

7

355,788

139,347 61,161 64,572 58,187 16,187 26,407

365!861

(10,073)

266

(9,807)

24 (38) 740

23,040 {738)

13,221

2012

357,820 {13,738)

344,082

676 8,974

29

353,761

138,634 59,426 61,790 55,915 16,544 27,143

359,452

(5,691)

935

(4,756)

(4,108) 1,150

(12,750) {1,027)

{21,491)

New York Presbyterian Hospital

Balance Sheet and Income Statements

For the period 1/1/12-a/30/14

lnt Fin Stat for the period 1/1/14-8/30/14 2013

Balance Sheet

Assets

Cash, cash equivalents and short-term investments $1,224,929,000 $1,035,481,000 Total Accounts Receivable· & Other Current Assets $771 ,907,000 $788,512,000 Total Fixed Assets $4,125,956,000 $4,056,453,000 Total Other Restrticted Assets I1,5~2,438,QQQ I1,490,430,QOO Total Assets $7,675,230,000 $7,370,876,000

Liabilities and Equity

Total Accounts Payable $358,141,000 $334,479,000 Total Other Current Liabilities i516,377,QOO $487,708,000

Total Current Liabilities $874,518,000 $822,187,000

Total Long Term Liabilities 11 ,774,388,000 11,753,376,000 Total Liabilities $2,648,906,000 $2,575,563,000

Equity

Total Equity $5.026,324,000 $4,795,313,000

Total Liabilities and Equity $7,675,230,000 sz 370 876 goo

Income Statement

Revenues $2,883,759,000 $4,264,510,000 Expenses $2,759,252,000 $4,062,347,000 Total Other lncome/(Expense) ~115, 1 02,000 l154,j ~9,000 Total Net Income i~aa ~!la.ooo 1a~g a~~ egg

2012

$952,629,000

$694,858,000 $3,678,128,000

I906,287,00Q $6,231,902,000

$320,266,000 i48~,184,QOQ

$806,450,000

11,496,197,000 $2,302,647,000

$3,929,255,000

$§ 231 ,902,000

$3,913,871,000 $3,720,463,000

1155,318,000

~a~ z~§.ccg

Project# 142185 BFA Attachment A

Project f/142185 BFA Attachment A (cont.)

The New York and Presbyterian Hospital

Assets Current assets:

Statements of Financial Position

Cash, cash equivalents and short-term investments: Cash and cash equivalents Short-term investments

Total cash, cash equivalents and short-term investments

Patient accounts receivable, less allowance for uncollectibles (2013- $181 ,945; 2012- $219,727)

Other current assets Assets limited as to use- current portion Due from related organizations- net · Professional liabilities insurance recoveries receivable- current

portion Beneficial interest in net assets held by related

organizations- current portion Total current assets

Assets limited as to use- noncurrent Property, buildings and equipment- net ( Other noncurrent assets - net Professional liabilities insurance recoveries receivable-

noncurrent . , Beneficial interest in net assets held by related

organizations- noncurrent ,

Total assets

$

December 31 2013 2012

(As Adjusted) (In Thousands)

152,982 $ 181,856 8821499 770,773

1,035,481 952,629

559,638 466,157 71,252 83,121 28,390 25,578

4,658

60,812 53,729

682420 61,615 1,823,993 1,647,487

1,490,430 906,287 2,169,218 2,088,036

36,941 35,191

165,350 153,692

1,684,944 1,401,209

$ 7,370,876 $ 6,231,902

Project #142185 BFA Attachment A (cont.)

December 31 2013 2012


Liabilities and net assets Current liabilities:

Long-term debt - current portion $ 113,411 $ 94,487 Accounts payable and accrued expenses 334,479 320,266 Accrued salaries and related liabilities 175,823 211,206 Due to related organizations - net . 4,671 Pension and postretirement benefit

liabilities- current portion . 12,112 11,384 Professional liabilities and other - current portion 60,812 55,729 Other current liabilities 1202879 113,378

Total current liabilities 822~187 806,450

Long-term debt 1,063,385 666,778 Professional liabilities and other 331,170 311,121 Pension liability 38,633 213,724 Postretirement benefit liability ; 24,823 28,148 Deferred revenue 3,770 4,813 Other noncurrent liabi lities 2912595 271,613 Total liabilities 2,575,563 2,302,647


Net assets: Unrestricted 3,041,949 2,446,864 Temporarily restricted:

Lower Manhattan Hospital 12,857 Held by related organizations 125072968 1!234,020

Total temporarily restricted 1,507,968 1,246,877 Permanently restricted:

Lower Manhattan Hospital 6,710 Held by related organizations 245J96 228,804

Total permanently restricted 2452396 235,514 Total net assets 4!795,313 3,9292255 Total liabilities and net assets $ 7,370,876 $ 6,231,902

Project /1142185 BFA Attachment A (cont . )

The New York and Presbyterian Hospital

Operating revenues Net patient service revenue Provision for bad debts

Statements of Operations

Net patient service revenue, less provision for bad debts Other revenue : Total operating revenues

Operating expenses Salaries and wages Employee benefits Supplies and other expenses lnterest and amortization of deferred financing fees, including

loss on extinguishment of debt Depreciation and amortization Total operating expenses

Operating income

lnvestment return Excess of revenues over expenses before net medical resident

tax refund, prior year reimbursement settlement, and gain on previous year sale of real estate

Net medical resident tax refund Prior year reimbursement settlement Gain on previous year sale of real estate Excess of revenues over expenses

Other changes in unrestricted net assets: Transfer of fixed assets from Royal Charter Properties, Inc. Transfer of unrestricted net assets related to Lower

Manhattan Hospital from New York-Presbyterian Healthcare System, Inc. :

Distributions from New York-Presbyterian Fund, Inc. and other for the purchase of fixed assets

Change in pension and postretirement benefit liabilities to be recognized in future periods

Change in unrestricted net assets

Year Ended December 31 2013 2012


$4,050,632 (54,081)

3,996,551 267,959

4,264,510

1,945,813 551,330

1,270,885

39,022 255,297

4,062,347

202,163

153,945

356,108

214

356,322

3,191

77,785

157,787 $ 595,085

$ 3,720,255 (47,346)

3,672,909 240,962

3,913,871

1,785,613 494,447

1,143,925

56,598 239,880

3,720,463

193,408

99,424

292,832

4,180 27,714 24,000

348,726

197,846

47,616

(45,456) $ 548,732

Project #142228 Strong Memorial Hospital

BFA Attachment A (A Division of the University of Rochester) Balance Sheets December 31, 2013 and 2012

2013 2012 .

A...w Current a»eta

Cash and cash equivalents $ 371,072,209 $ 334.386,3-42 Investments 89,328,65-4 46,110,258 PAtient ~~~onts ~IY!'ble, Mt of "timat.<f vn~oll9ar111• 8mQIIOIS

of approXImately~ 1,418,511 and $39,075,908, respectively 99,474,728 78,989,294 Assets whose use is limited 11 ,910,204 2,159,758 Pledges receivable 6 ,300.634 4,110,000 Insurance claims receivable 11,960,279 11.635.363 Other receivables 24,357,<473 31,725,663 Deposits In captive insurance company 1,579,831 1,493,169 Inventory 25,486,158 23,934,812 Other current assets 2 ,6661122 3.886.528

Total current assets 644,356,490 538,431 ,207

Assets whose use Is limited 20,690,016 8,938,964 Deferred financing costs, net 2,260,532 1,719,768 Pledges re<:eiVable 8,796.280 7,715,644 1nsuranoe Claims receivable 33,635,806 36,049,967 Investments held for long-tenn p~ses 5,097,526 4,742,324 Equity investments '43,387,041 31,358,372 Property and equipment, net 463,535,602 407,762,230 Othor non~rrent ••••t• 7,793,01!i 10,707,119

Total assets $ 1,229,552,708 $ 1,053,446,195

LlabiiiU.. and Net Anet. Current liabilities

Current Installments of long-tenn debt $ 8,755,000 $ 7,715,000 Accounts payable and accrued expenses 40,401 ,798 65,920,223 Construction accounts payable 23,325,688 15,563,004 Accrued payroll and payrol taxes 21,215,741 23,998,209 Acaued vacotlon 18,&60,219 17,:!:17,008 Accrued postemployment benefits 15,159,726 23,909,240 A~ postretirement benefits 1,697,341 2,040,129 Accrued professional liability costs 11,960,279 11.635,363 Acaued third-party pavor settlements 6:\,171 ,!153 43,089,911 Due to other University of Rochester divisions 15.780,388 20,412,359

Total current liabilities 22D,328,133 231,840,446

Accrued postemptoyrnent benefits 23,89M38 22,553,835 A~ed poslnltirement b•nefit& 07,102,721 71,471,000 Accrued professional liability costs 52,869,531 59,120,598 A«erUed third-party payor settlements 51,017,110 51,15-4,947 Fair value of Interest rate swaps 10,295,410 15,629,549 Fair value of asset retirement obligation 3.015.260 182.558 Other long-term llabllitleS 825,323 Long-tenn debt. excluding current Installments 237.368,404 169.262.251

Total liabilities 666.797,836 621 .215.740

Commitments and contingencies •

Net assets Unrestricted 503,933,482 387,685,488 Temporarily restricted 53,723,864 39,602,643 PAnn~nen~yres~ 5,097,526 4 ,742.324

Total net assets 562,754,872 432.230.455

Total tiabllities and net assets $ 1,229,552,708 $ 1,053,446,195

Strong Memorial Hospital Project 1/142228 (A Division of the University of Rochester) Statements of Operations and Changes in Net Assets BFA Attachment A (cont.) For the Years Ended December 31, 2013 and 2012

2013 2012

Unrestricted revenues Patient service revenue $ 1,215,927,225 $ 1,107,3IT,391 Provision for bad debts p4;4471381l (10,880,686)

Net patient service revenue 1,201 ,479,844 1,096,496. 705

Other revenue 84,472,711 82,892,275 Net assets released from restrictions • operations 653,338 466,320

Total unrestricted revenues 1,286,605,893 1,179,855,300

Expenses Salaries 4IT,235,251 441 ,937,536 Benefits 156,008,702 147,306,859 Pharmaceutical and medical supplies 258,651 ,174 236,559,571 University and Medical Center cost allocations 52,296,941 , 45,967,415 Professional and contract services 20,920,914 20,646,019 Interest 7,658,873 7,006,592 Depreciation and amortization 58,335,681 54,990,367 University of Rochester Medical Faculty Group clinical support 23,386,799 25,967,051 Other expenses 108,830,587 103,345,110

Total expenses 1.163,324,922 1,083, 726,520 Income from operations 123,280,971 06,128,780

Other gains (losses), net Investment activity 13,750,280 7,865,156 Loss on earty extinguishment of debt (55,603) Other 1ti,:.!Hl,U~ (8,745,046)

Total other gains (losses), net 31,9681366 (935,493)

Excess of revenues over expenses 155,249,337 95,193,287

Otherc:hangG6 Net assets released from restrictions ·capital 695,510 217,874 Transfer of endowment to temporarily restricted net assets (108,620) (3,100,000) Transfers to the University of Rochester Medical Center Divisions p9.588,233l (40,335,289)

Increase In unrestr1cted net assets 116,247.994 51 ,975,872

Temporarily rest ricted net assets Contributions 11,856,634 3,498,269 Investment income 548,4?4 ~92,288

Net realized and unrealized gains on Investments 2,457,753 1,280,562 Change in valuation of deferred gift annuities 108,620 (826,157) Transfer of endowment from restricted net assets 3,100,000 Transfer of gifts from the School of Medicine and Dentistry 298.638 400,000 Net assets released from restrictions ~1 .348,848l (684,194)

Increase In temporarily restricted net assets 13,921 ,221 7.140.766

Permanently restricted net as .. l$ Contributions to endowment 355,202 21 ,971

Increase in permanently restricted net assets 355,202 21 ,971

Increase in net assets 130,524,417 59,138,609

Net aseets, beginning of yoor 432,230,400 3 / 3,091 ,tl4ts

Net ass~ts. end of year $ 562,754,872 $ 432,230,455

STRONG MEMORIAL HOSPITAL Project 1/142228

BALANCE SHEET BFA Attachment B FOR THE PERIODS ENDED NOVEMBER 30,2014 AND DECEMBER 31 ,2013

11/30/14 12131/13 Assets

Current assets: Cash and cash equivalents $ 361 ,979,168 $ 371 ,072,209 Short-term investments at mar1(et value 102,573,254 89,328,654 Patient accounts receivable. net of estimated

uncollectibles of $26,298,567 and $21 ,113,128 respectively 192,248,455 160,834,941

Advances from third-party payors {65,243,871} {61,360,213}

Net patient accounts receivable 127,004,584 99,474,728

Assets whose use is limited 11 ,910,204 1-'ledges recervable 4,254,047 6 ,300,834 Insurance claims receivable 11,147,549 11 ,960,279 Other receivables 28,104,199 24,357,473 Deposits in captive insurance company 1,579,831 hwo::mlvry :u,1U~,Ut:iU 25,486,156 Other current assets 9 970 077 2 886 121

Total current assets 672,141,938 644,356,490

Assets whose use is limited 6,134,564 20,690,016 Deferred financing costs, net 2,161 ,666 2 ,260,532 Pledges receivable 6,116,334 8,796,280 Insurance claims receivable 32,486,928 33,635,606 Investments held for long-term purposes 5,230,207 5,097,526 Equity investments 33,847,368 43,387,041 Property and equipment. net 516,660,564 463,S3S,602 Other noncurrent assets 5,883,034 7 793 615

Total assets $ 1,279,661 ,604 $ 1,229,552, 708

Liabilities and Net Assets

Current liabilities: Current installments of long-term debt $ 9,600,000 $ 8 ,755,000 Due to other University of Rochester divisions 15,983,231 15,780,388 Accounts payable and accrued expenses 47,245,991 40,401,798 Construction accounts payable 8,531 ,872 23,325,688 Accrued payroll and payroll taxes 17,772,903 21 ,215,741 Accrued vacation 20,137,236 18,860,219 Accrued postemployment benefits 16,238,477 15,159,726 Accrued postretirement benefits 1,944,475 1,697,341 Al.:<.:rut:!O IJIUft~sslonalllablllty costs 11,147,549 11,960,279 Accrued third-party payor settlements 47,970,011 63,171,953 Deferred revenue 1,556,028

Total current liabilities 198,127,n3 220,328,132

Accrued postemployment benefits 26,071 ,413 23,895,938 Accrued postretirement benefits 69,894,251 67,182,727 Acctued professional liability costs 51,323,715 52,869,531 Accrued third-party payor settlements 62,799,403 51 ,017,110 Fair value of interest rate swaps· 10,955,470 10,295,410 Fair value of asset retirement obligation 6,001 ,886 3,015,260 Other lono-terrn liabilities 825,32"1 826,324 Long-term debt, excluding current installments 227,568,149 237,368,404

Total liabilities 653,567,384 666,797,836

Net assets: Unrestricteq 563,274,989 503,933,482 Temporarily restricted 57,589,023 53,723,864 Permanently restricted 5,230,207 5 097 526

Total net assets 626,094,220 562,754,872

Total liabilities and net assets $ 11279,661,604 $ 1,229,552,?08

STRONG MEMORIAL HOSPITAl STATEMENT OF OPERATIONS

FOR THE ELEVEN MONTHS ENDING NOVEMBER 30, 2014 (in thousands)

NOVEMBER 2014 CYTO

Operating Revenue: Patient Service Revenue $ 1,226,495 Rc3Crvc for Third f"'erty Scttlement3 ~0,40::1)

Patient Service Revenue before Uncompensated Care 1,218,012

Charity Care (37,910) Provision for Bad Debts ~15,936)

Net Patient Service Revenue 1,164,166

Other operating revenue 120,787 Net assets released from restrictions-operations 789

Total Operating Rovonuo 1,285,742

Operating Expenses: Salaries 472,769 Outside Temporary Service Costs 2,482 Benefits 157,043 Allocations: .

University 21 ,660 Medical Center 29,117

Professional liability Insurance 3,404 Depreciation & Amortization 54,913 Interest 6,820 Medical Supplies 134,572 Pharmaceuticals 147,529 All Other 134,240

Total Operating Expenses 1 164,54!)

Income from Operations before Clinical Transfers 121,193

Clinical Transfers: Primary Care Network Support (4,262) Net Cash Collections on Article 28 PC sites - FY13 DOS (103) URMFG Faculty Support (19,309)

Total Clinical Transfers (23,674)

Income from Operations after Clinical Transfers 97,519

Non-Operating Revenue (Expense): Auxiliary Activities 681 Advancement Activities (2,445) Investment Income 1,828 Net realized gains 5,889 Net unrealized gains (loss) (207) Change in SFAS 1581iability (956) Unrealized gain (loss) on interest rate swaps (660) Gain (loss) on disposal of fixed assets, net of sales 48 Net assets released from restrictions-<:apital 930

Net Non-Operating Revenue (Expem;e) 6,108

Non-Clinical Transfers: Medical Center Strategic Research Plan (12,375) SMD/SON Advancement Initiative (8,691) Highlands at Brighton Operating Suppport (1 ,355) Visiting Nurse Service Support (1,400) Medical School Anonymous Endowment Transfer (6,299) Medical School, Capital and Other Support (10,613)

Total Non-Clinical Transfers ~40,733l

lncrA;~!'IA In Unr~,.trlcted Noe>t A~s:ets $ 61,8Q1

Project 1/142228 BFA Attachment B (cont.)

FLHSA Attachment

MEMO

TO: CON Project File RE: CON Project 142228- NICU Expansion DATE: January 12, 2015

Service Location:

601 Elmwood Ave Rochester, NY 14620

Description:

Strong Memorial Hospital (SMH) seeks to renovate existing space within the hospital to add eight (8) Neonatal Intensive Care beds for a total of 34 NICU Intensive Care beds.

Project Cost & Revenue:

Current Year Year 1 Incremental Year 3 Incremental ·-----Project Capital Cost $2,261 ,373 N/A N/A Operating Cost $24,661 ,397 $399,186 $11 ,124 0Qerating Revenue $38,181,812 $461 ,154 $461 ,154

Projected Changes to Community Capacity:

Community Capacity

Monroe County nas tnree facilities witn at least one type of NICU bed. The county contains a total or 77 NICU beds including 19 NICU Continuing Care, 30 NICU Intermediate Care, and 28 NICU Intensive Care beds. The majori ty of those beds are located at SMH which has designation as a Reg ional Perinatal Center. The available beds by facility are in Table 1. The addition of 8 NICU Intensive Care beds would bring the regional total to 85 and SMH total NICU beds to 68.

Table 1. NICU Capacity. Monroe County Number of Beds

-------- ... __ _ ...... --.......... __ , ......... .------ ... -----·---:--:-:-

NICU NICU NICU __ ..... ·- _ ---:-:--------- - Con!inuing_Jnterme_Qi§l~_ Intensive Rochester General Hos ital 5 7 2 ___ ,__ _., .... ___ ,_, __ ,.,, __ _

_§tr~r19 Memorial Hospital ____ .. _ .. _ 1.i__ _____ .:::.20=------ 26 The _l),!.!lty Ho~ital of Rochest~-~---....... __ 0__ _ 3 0 Monroe Count Total 19 30 28 ___ , __ ,

FLHSA Attachment

Community Need

Utilizing 2012 SPARCS data we reviewed the number of NICU services provided by the facilities in Monroe County (Defined by Revenue Codes 0172-0174). Due to an apparent coding aberration by one of the faci lities in Monroe County, community review of NICU by severity is not possible. Therefore for the purposes of regional analysis we combine NICU Continuing, NICU Intermediate and NICU Intensive care for both bed type and utilization (Defined henceforth as Level II-IV NICU).

In Monroe County in 2012 there were 2,236 Patients in the NICU accounting for a total of 31 ,989 patient days with an average length of stay (ALOS) of 14.3 days. This results in an average daily census (ADC) uf 87.6. A facility level breakdown is provided in Table 2.

Patients Patient ADC ALOS

-c-----···········---- Days_ The Un.!!Y Hosp_i~al of Rq~hester 1.?_1 _______ 6_8!....... 1.87 --··---~2% 3 .98 Strong MemorJ.§ll Hos ital 19~_7 __________ 2_6_36_~ ...... 72.23 .... __ 1_20% 24.94 Roch~~ter Ge_r:)E:l.ral Ho~pj_!.§ll___ :4~_3 -·············--2_6_3_4 ...... __ 7--..-=22;:;__ ___ 52% ...... ___ 9,_;_08 _

_!:!lg_bl~~-d HosQ_j!~P 575 2311 6.33 N/A 4.02 Monr_2~ Coun!Y__ Facilities 223-s--········· __ 31_9_89.······) 7 .64 ___ 11~_% ___ --·----~~!;(31

In order to determine whether current capacity is accurate at a regional level we utilized a Poisson distribution at 95% and 99.9% Confidence Intervals. Table 3 details tne results or tne regional analysis. In order to achieve 95% availability there is a need for approximately 105 beds, compared to the 77 currently available. This would result in capacity overflow for 1-2 days a month which is reasonable given the fact that SMH has demonstrated the ability to operate above capacity at a significantly higher rate. There is variability in need by facility. While SMH demonstrates a need for additional beds it appears that Rochester General Hospital has adequate capacity at the 95% level. Unity Hospital, which represents a small percentage of the overall capacity demonstrates minimal additional need.

Regarding occupancy, SMH is the only facility in the region to report occupancy rates over 100% in 2012. Because of the volume of patients that SMH sees for these services. this drives the reqional occupancy rate of 114%. NY State does not define an appropriate for occupancy rate for NICU services, but the occupancy rates of the other two facilities in the county with NICU beds are below the urban need thresholds for Medical/Surgical Pediatric and Obstetric Beds (85%, 70%, and 75% respectively).

------::::----'T....;;:a.::.b.::.le,..;;3;.;... . .:....:N"-7/C:..:U~C,gmmunity Need P~isson An<!_fr_,s_i=-s --=----· Communi Need for Additional Level II-IV NICU Services

SMH RGH Unit~ Monroe County ·-----·-· RegjQ_nal Le'{_E)_I_ji-IV ADC 72.23 7.22 1.87 87.60 Level II-IV PqL~_son (95°~. 88.80 12.45 4.53 105.85 ----Level II-IV Pois_?On (99.9%)

······~···--- ·

107.18 19.34 8.68 125.91 Current Capac_iy 60.00 14.00 3.00 77.00 ·----.. 95% Difference 28.80 -1.55 1.53 28.85 ------N•• --·--·-···--· 99% Difference 47.18 5.34 5.68 48.91 ---·····~·-----.. ·····- ......... ___ , ..

1 While Highland Hospital does not have any NICU beds on its license the facility may still bill for NICU level care if the diagnoses are appropriate. These patients are included in the community need analysis in the interest of identifying the entire patient population needing intensive care.

FLHSA Attachment

At a facility level, SMH also demonstrates a significant need for additional capacity to achieve 95% availability for the Intensive Care (Level IV) beds which are being requested. The Level IV analysis for SMH is in Table 4. It should be noted that the ALOS SMH Level IV patients is 25 days which is significantly higher than the both the statewide and county rates of 15.8 and 14.3 respectively in the same year. The NY State median ALOS for Level IV NICU patients in 2012 was 6 Days. SMH reports a median ALOS of 10 days for the same timeframe.

It does appear that SMH has a larger than expected number of patients with extended lengths of stay. Based on NY State rates SMH hospital should expect to have 2% of Level IV NICU patients stay longer than 100 days, accounting for 22 patients per year. However, SMH's actual number of patients with stays longer than 100 days in 2012 was 72, more than 300% of the expected number based on NY State utilization rates.

Patient Origin

Table 4. NICU Institutional Need, SMH, Poisson Analysis SMH Level IV NICU Need

Level IV Total ADC Level IV Poisson (95'%) Level IV Poisson (99.9%) Current Capacity 95% Difference 99% Difference

SMH 71.89 88.42

106.76 26

62.42 80.76

Overall Monroe county facilities provided NICU services to 577 neonates originating from outside Monroe County in 2012 constituting 26% of all NICU stays. However this rate varies greatly from facility to facility. SMH has the largest percent of patients from outside Monroe County and accounts for 70% of the total NICU patients in Monroe County hospitals residing outside Monroe County. This aligns with the facility's designation as a Regional Perinatal Center.

Table 5. Monroe County NICU Patient Origin

NICU Level II·IV Patient Population from Outside Monroe County

SMH Rr,H Unity Highland Hospital Monroe County

Need Conclusion

NICU Patients %of Facility NICU Patients %of Monroe NICU Patients 406 38% 70%

Fi~ 11% 10% 23 13% 4% 90 16% 16%

577 26% 100%

The demonstrated community and institutional need indicate that the addition of 8 NICU Intensive Care Beds at SMH is appropriate.

Projected Changes to Community Access:

The addition of eight beds has no impact on geographic access for the community, except that this may increase ability for SMH to see additional regional patients requiring highly specialized care from the region. SMH has a good history of providing care to underserved populations.

FLHSA Attachment

Comments:

While SMH's LOS is significantly longer than the NY State average, it appears that the facility may see a larger proportion of patients with more intensive needs that have longer stays than is typical even for a Level IV NICU.

Recommendation - Approval

Contingencies: None Conditions: None.

DRAFT Project /1142134 BFA Attachment A

Mohawk Valley Eye Surgery Center Balance Sheet

As of December 31, 2013

ASSETS Current Assets

Checking/Savings First Niagara Bank

Total Checking/Savings

Total Current Assets

Fixed Assets Accumulated Depreciation Furniture and Equipment

Canon Color Copier Nurse Call System

Total Furniture and Equipment

leasehold Improvements Medical Equipment

Total Fixed Assets

Other Assets Due from Officer

Total Other Assets

TOTAL ASSETS

LIABILITIES & EQUITY liabilities

Current liabilities Other Current liabilities

Due to K&P Acquisitions Due to Kwiat Eye & Laser Payroll Liabilities

Total Other Current Liabilities

Total Current Liabilities

Total liabilities

Equity Members Equity Net Income

Total Equity

TOTAL LIABILITIES & EQUITY

Dec 31, 13

-2.264.74

-2,264.74

-2,264.74

-11 ,277.00

1,517.40 6,935.12

8,452.52

6,730.56 68,105.68

72 ,011 .76

45,000.00

45,000.00

114,747.02

71,863.61 151 ,599.76

1,435.98

224,899.35

224 ,899.35

224,899.35

3,329.96 -113 ,482.29

-110,152.33

114,747.02

DRAFT

Mohawk Valley Eye Surgery Center Profit & Loss

January through December 2013

Ordinary Income/Expense Income

Fee fo r Service Income

Total Income

Expense Automobile Expense Bank Service Charges Depreciation Expense Dues and Subscriptions Equipment Lease Expense Filing Fees Insurance Expense

Health Insurance Insurance Expense- Other

Total Insuran ce Expense

Janitorial Expense Licenses & Certifications Linen Service Meals and Entertainment Medical Supplies Office Supplies Payroll Expenses Payroll Taxes Postage Professional Education Professional Fees

Accounting Consult ing Professional Fees- Ot her

Total Professional Fees

Repairs and Maintenance Security Staff Expenses Telephone Expense Utilities

Cable/Internet Gas/Eie1::tric

Total Ut ilit ies

Total Expense

Net Ordin ary Income

Net Income

Jan- Dec 13

293.572.79

293,572.79

2.899.01 790.30

11 ,277.00 226.06

0.00 9.00

1.319.76 4,799.14

6,118.90

5,395.26 4,476.00 2,326.00

795.24 249,409.08

8,965.63 71 ,970.24

7,709.22 25.50

485.00

6,000.00 600.00

____ 3,;_,412.10

10.012.10

7,642.07 211.68

3,978.19 32.90

1,925.76 10,374.94

12,300.70

____ 407,055.08

-113,482.29

-113,482.29

Pr oj ec t 11142134 BFA Attachment A (cont.)

DRAFT Project #142134 BFA Attachment B


As of October 27, 2014

ASSETS

Cu"ent Assets

Checking/Savings

First Niagara Bank


Other Current Assets

VGI-HL TH CA AD

Total Other Current Assets


Fixed Assets

Accumulated Depreciation

Furniture and Equipment

Canon Color Copier

Nurse Call System

Total Furniture and Equipment

Leasehold Improvements

Medical Equipment

Total Fixed Assets

Other Assets

Due from Officer

Total Other Assets

TOTAL ASSETS

LIABILITIES & EQUITY

Liabilities

Cu"ent Liabilities

Other Current Liabilities

401k Payable

Due to K&P Acquis itions

Due to Kwiat Eye & Laser

Total Other Current Liabilities


Total Liabilities

Equity

Members Draw

Oct 27, 14

19.050 21

19.050.21

5,000.00

5,000.00

24,050.21

-11 ,277.00

1,517.40

6 ,935 12

8,452.52

6,730.56

68,105.68

72.011 76

127,750.00

127.750.00

223,811.97

71 .03

61 ,863.61

141.624.76

203.559.40

203,559.40

203.559.40

-5.000.00

Members Equity

Net Income

Total Equity

TOTAL LIABILITIES & EQUITY

DRAfT Project #142134 BFA Attachment B (con t .)


As of October 27, 2014

Oct 27, 14

-235,730.15

260,982.72

20,252.57

223,811.97

DRAFT

Mohawk Valley Eye Surgery Center Profit & Loss

January 1 through October 27, 2014

Ordinary Income/Expense

Income

Bad Checks

Fee for Service Income

Refunds

Total Income

Expense

Automobile Expense

Bank Service Charges

Continuing Education

Corp Tax

Dues and Subscriptions

Filing Fees

HCRA Pool Surcharge

Insurance Expense

Health Insurance

Insurance Expense - Other

Total Insurance Expense

Interest Expense

Janitorial Expense

Leased Employees

Licenses & Certifications

L inen Service

Meals and Entertainment

Medical Supplies

Medical Waste Disposal

Office Supplies

Payroll Expenses

Payroll Taxes

Postage

Professional Fees

Accounting

Consulting

Legal Fees

Professional Fees -Other

Total Professional Fees

Real Estate Taxes

Rent Expense

Repairs and Maintenance

Travel Expense

Utilities

Jan 1 - Oct 27, 14

-50.00

916,334.37

-2,735.34

913.549.03

530.20

1,770.94

336.00

175.00

450 00

25.00

1.033.00

-2.200.00

7.595.87

5.395.87

8.44

8.992.10

4.500.52

24.00

5,259.35

3,364.97

371 ,632.73

3.079.46

13,497.49

107,328.00

9,510.06

50.28

13,500.00

2.500.00

4 ,380.38

7,068.40

27,448.78

7,084.80

47 ,499.33

8,683.00

10 .862 .12

Project 1/ 142134 BFA Attachmen t B (cont.)

DRAFT Proje c t //142134 BFA At t achment B (cont . ) Mohawk Valley Eye Surgery Center

Cable/Internet

Gas/Eie<:tric

Total Utilities

Total Expense

Net Ordinary Income

Net Income

Profit & Loss January 1 through October 27, 2014

Jan 1 · Oct 27, 14

2,134.01

11 ,890.86

14,024.87

652,566.31

260,982.72

260,982.72

CON#132305

BFA Attachment A

Jewish Home of Rochester- Financial Summary

2013 2012 2011 CURRENT ASSETS $18,591,146 $10,009,019 $9,409,553

LONG TERM ASSETS 28,998,383 35,163,855 38,514,464 TOTAL ASSETS $47,589,529 $45,172,874 $47,924,017 CURRENT LIABILITIES $5,917,457 $6,590,466 $8,831,055

LONG TERM LIABILITIES 16,563,837 17,133,698 19,611,499

TOTAL LIABILITIES $22,481,294 $23,724,164 $28,442,554

WORKING CAPITAL POSITION 12,673,689 3,418,553 578,498 NET ASSETS $25,108,235 $21,448,710 $19,481,463

REVENUES $41,916,949 $43,731,177 $42,403,715 EXPENSES 42,745,394 44,926,471 44,415,765

EXCESS OF REVENUES OVER EXPENSES ($828,445) ($1,195,294) ($2,012,050)

NUMBER Of BEDS 362 362 362

PERCENT OCCUPANCY 96.40% 94.41% 93.23%

MEDICAID 55.60% 60.07% 59.28%

MEDICARE 18.30% 14.96% 15.73%

PRIVATE PAY 26.10% 24.96% 25.09%

Project /1132305 BFA Attachment B

JEWISH SENIOR LIFE FOUNDATION, INC.

STATEMENTS OF FINANCIAL POSITION December 31,

ASSETS 2013 . 2012

Current assets: Cash anc cash equ valents $ 795,580 $ 239,334 Investments 49,783,245 46,104.490 Pledges receivable 1,435,409 316,162 Prepaid expense 11,561 7,527

Total current assets 52,025,795 46.667 ,513

Pledges rece'vable, net 468,887 630,171 Due from Jewish Senior L1fe Community Services, Inc. 120,850 150,000 Due from Jewish Home of Rochester Senior Housing, Inc. 409,800 409,800 Due from JeYiish Home of Rochester Enriched Housing, Inc. 1,860,662

Beneficial interest in perpetual trust 2,437~~ ---~?_9 . 138

Total assets $ 55,463,091 $ 51,897,284

LIABILITIES AND NET ASSETS

Current liabilities: Accounts payable $ 104,558 s 42,497

Annuities payable 32,645 32 645

Due to J~wish Home of Rochester, Inc. 356,828 7,386

Due to Jewish Home of Rochester Senior Housing, Inc. 8,529 10.313

Due to Jewish Sen'or Life 14,750

Oeferrec. revenue 86,269 :?.5,"189

Total current liabilities 603,579 118,630

Annuities payable 92,684 103,412

Contributions held on behalf of Jewish Home of Rochester, 11c. 5,478,344 4,790,279

Contributions held on behalf of Jewish Home of Rochester Enriched Housing, Inc. 41 ,303 35,069


Net assets: Unrestricted 48,688,915 46,283,561

Temporarily restricted 553,266 561,333

Permanently restri·:ted 5,0_~~-- 5,000

Total net assets 49,247,181 46,849.894

Total liabilities and net assets $ 55 ,46~.0~1 $ 51,897,284

JEWISH SENIOR LIFE FOUNDATION, NC.

STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS For the Year Ended December 31,2013

Revenues, gains, and other support: Contributions l -=gacies and bequests Otwlends and interest irtcorne N~t realized ;;md unrealized guins on tnvestrr.ents Net :.~ssels rcleasec.J from restrictions

rotal revenues

Expenses: Program services Suppnrtin\) service:;:

M<mag(;:rnent ar d general Fundraising

Total expenses

Excess of revenues over P-xpenses

()t:-,f,r ctlanges in net assets: f'o:givene~s of su~ported organization's lo~:~n

Unrestricted

$ 480,939 1 '175,265

572,598 6.013,658

___ 527 ~46_

8.769.tl06

3,2:.'2,138

477 .003 804,649

_ _ 4_.503.792_

4,266.0!6

(1.860,662)

Project //132305 BFA Attachment H (cont.)

Temporarily Restricted

$ 504,232

15,047 (5:.'7.346)

(!3,067)

(8,067)

·---·· --·---.. ····---

Permanently _ Bcs_!ricted

Total 2013 ---·---

s $ 985,171 1 '175,265

572.598 6,028,705

. - -·- -----· -·----- -----·-8,761 ,739

3,222,138

477,003 804,649

·- . ... 3,503,79Q

4,257 ,949

Increase in net assets 2,405,354 (8.067)

___ _11 ,860,66~.)_

2,397 ,287

Net ~~ssels . beginning of year 46.283.561 --~1 ,333 .. 5.000 --~~~49,6~

Net assets · end of·year

JEWISH SENIOR LIFE FOUNDATION, INC.

STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS For the Year Ended December 31,2012

Unrestricted

Revenues, gains, and other support: Contributions $ 413,120 Legacies and bequests 980,394 Dividends and interest income 727,955 Net realized and unrealized gains on investments 5,025,017 Net assets released from restrictions 781,302

Total revenues 7,927,788

Expenses: Progr;:~m services 3,844 ,339 Supporting services:

Management and general 377,940 Fundraising 582,950

Total expenses 4,805,229

(Deficiency) excess of revenues over expenses 3,122,559

Other changes in net assets: Forgiveness of supported organization's loan ~976,019l

Increase in net assets 2,146,540

Net assets - beginning of year 44,137,021

Net assets - end of year $ 46,283,561

Project //132305 BFA Attachment B (cont.)

Temporarily Permanently Total Restricted Restricted 2012

$ 932,884 $ $ 1,346,004 980,394 727,955

7,281 5,032,298 {781 ,302~

158,863 8,086,651

3,844,339

377,940 582,950

4,805,229

158,863 3,281,422

~976 ,019}

158,863 2,305,403

402,470 5,000 44,544,491

$ 561 ,333 $ 5,000 $ 46,849,894

;):j., "'1 1'1 !I> 0 ....... > Ill n n n nIl! () ~ :l" ...... 3 w fb "; ~ \..) n 0

"' 0

Jewish Home of Rochester Balance Sheet

For lha period For the penod For the Audited period

Uabilities and Equity ending 10/31/2014 ending 9/3012014 ending 1213112013

Liabilities

Current Llabllllles

Accounts payable and accrued expei\Ses $1.596,655 $1,897.109 $2,392.5()4 UneofCredH Accrued payrol, vacations and related

400.000 -400,000

withho1du1gs 2;410,686 2,609,142 1,894,7+4 Due to Aliihiltes 11,913 Pauent Funds 168,260 167,673 163,210 Deterred revenue 168,-460 235,719 614,293 Mortgage payable - Short 1erm 886,683 862,023 840,169

Tom/ cu11ent liabilities 15,630,944 $6,191,6d6 $5,916,833

Long ttrm liabilities

Accrued pension and post retirement benefliS 3,440,720 3,416,472 3,467,831 Due to third party payOtS 2,348,722 2,421,283 1,797 ;.247 Mortgage payable -long term $10,354,989 $10,431,040 $11,098,758

Tom/long torm Jlabllltlos $tll,144,432 $16,25$,196 $16,36.3,837

Total U1bJI/tlu $21,775,376 122,460,461 $22,280,6~~

NetAs$81$

Unrestricted

Operating prior years ($5.006,178) ($5,006, 178) ($8,044,771) :X~ Limited use 24,659,702 24,659,698 24,659,698 '"lj t1

OperaUng cunent year 1.243,449 1,208,981 3 ,038,666 )> 0 ...... Tcbl Unrestrlcted Net Assets $20,896,973 $20,862,5{)1 $1D,653,593 ;> 1:>

... ('l

... rt Restric1ed use 2,319,-436 2,358,532 2,193,999 PJ Pennanently restricted 3.346,702 3,379,041 3,330,394 (:: ~

::T -Toul Ner APtts $26,563,111 $24,600,014 l_l~,1I7,9BI El w

CD N ;:l w

Total Uablllties and Net Assets $48,338,486 .J1!k060,536 $47,458,656 rt 0 I.J1

(')

....... n 0 ;:l ...

.........

REVENUE

ROII!Ioe S.mce R..,.nue Pnnle MeOlc:aid Meecare Mlnagell C.ll! Tocat Routne S4wv:u Revenue

-AnCillary Ravenue Adtjt 0"1' Hea.'lll Cale R......,. Olhet lnccme No• Ol*allng Cnco.-:-.t ToW Revenue t>ehn NYS Cash Rtce!S:CS As$6utrAnl

NVS (:W, R~~k~nenllncoiN TCU1Rn5lllt

EXPENSES

Hutsiftg Mrmnbt:auoo RffCF NUI'Wog TCP Nursong Tolal

Adult O-r Hedh Cate

YTD ~1_3 _ _

SS.U1,00S 13,810,385 2,154,376 .c 1 ... 185

~

1.Za8,102 2.429,1~

305.VSS ~8,8!.0

~ 1.608,008

~

«;3,531 7.eo4,528 2, .. 5.1-48

10.71~.211

4oC6.21D

ACT\.oAl

SV.Je3,66C 13,521,314 2.~9.872 5.384,322

~ 1,$14,171 2.M7.018

Je5.8D1 51,1103

35.391.24D

1,M3.638

.21:!!!

711,188 7,7&0,-405 2,657.226

11,121.&28

~3.230

Jewi$h Heme of Rochester Statement of Revenue and Expe11$t

For the Period Ended 10131/2014 Pretim:nary & Unaudit~d

YfARTOOATE

-~- VARIANCE %

YAAIAHCE

S8.2.C2.873 14,3t$,o437 2.230,735 4,513,832

~

1,400,17~ 2,-421,871 2~.068

50.512

3-4591,76-4

1,&74,784

~

881,&22 7.n&.150 2.802.831

11.063.61e

417,o488

$12.:>.687 {866,128) 41tl.2J7 1170.300

~-'" 14,997

125,147 111,822

1,331

eofi • .ces

{131,1-45) 676.3-40

2~.375

(l7.7SO) M,547 81,212

-45.7-41

1.31% ..t.01% 18.7snlo 18.211% 1.711%

10(1'4 6.17%

48.611% 2.83%

2.33%

-7.83% 1.18%

-4.31% .023% 2.10K 0.~

1096%

ACTUAL

$12M10 U11,U815

323,eel &28,151

3.252,324

11'1Q,482 2n.Jn 41,034

5.551

3,788,878

154.588 3,045.264

78,&50 m,J38 21U,6115

1,135,678

&o.e~e

MONTlfTOIMTE 1

§UOG£1' V~

1042.5-40 1.461.031 227.~71

.ce6,5VI 3.105,852

155.124 2&0,2115 48,440

___ S,172

~.57-4.11&2

250.~72

3.825,1M

68,878 832.~27 nc.ote

1,178,424

•un

54~~ 19~083 (8 5&8)

78 ;

213~~-

(~lliJG) 12'il!:to

qoto ( S~OQ1)

687 44748

~.v.ca

" VARIAiiCI!

·12.12% 0.3-4%

'23711. 3-4.05% •. 72%

3S.OS% 7.33%

-13.43% 7.32%

S.DV'Jo

.J7.46% 3.14%

12.40~ -8.82% 2.07%

-3.48%

18.81%

!;d -.:: "'j I'(

)> 0 ...... :> ~ n n ('t rt ~ n ~ :Y>-3 w ~ N ;:J w n C

()

n 0 ;:J n

'-"

Jewish liome ol Roche5ter Statement of Revenue arx! ~pense

For the Period Ended 101311201~ Preliminary & Ur.audite:l

YEAR TO DATE

" I.IONTH TO OAT E

YTO 1- % 2013 ACTUAL IIUOGET - VA!l~otJ;CE VA!liAACE ACTUAL BUDGET V~~IIINCE

ANCILlARY

Cer.tr.al 54.q:ly 59,461 65,1107 64.&01 017 U!MI. 7,501 6,155S 2~3 1~% ubol3tory 63.2&1 5U21 65.000 (0.119) -12.58% ~.~2 uoo 538) •23.110% Hadlolog)l S3,783 37.1~1 M,1ts0 (I MOw) -30.11% 2,075 ~.4!8 ~1) -4a.n.., I/Dlvn:ce11 52,337 0,878 41.17~ (4.1t8) ~.71% 4,411 0 ,141 737) -21.2&"-ReaeatJon TheBpy 412.711 489,aet 565,171 (7S.J02) -13.32% 50,868 80,438 .673) -1$.84% PllanMcy 59U5i 743,199 5&8,937 1~262 24.ce% 92,475 5a.o~ r 57.~,. Podiatry 1,162 787 450 33"' 74.95% 84 45 4D 108.27,.. De nul 4~.180 53,997 ~.811 11.305 2U2'.4 . s.oae 4,813 47~ 10.4't% I'S)dl\atry 02.S30 ~2.S3tl a2,520 iO 0.01'.1. 8 ,253 3.252

2 .4~; 0.01% Plryaocel The01py 601,804 &:la,891 663,870 175.221 211.40'.4 89,359 68,136 211.63% Occu~1 Thcr;opv 890,002 a60,323 721.573 138,75<1 11.23% 87,012 74,723 • .21D IUS% Speech & Her no 9 7.131 131.36& 105,131 28.2» ~4.9ti% 12.851 11,103 i.84n 18.65% Ou~tienl Eoplns.on 171.582 l112,0GO 220,220 (l8.13e) -1278% 22 .~sn 22.684 '(H l ) .0.7S'IC. SoaaiWOIIc 183.473 1DU2!> 200,893 (6,!157) -H'l% 21 .~ 20.884 1 10() 0.~6,., IAedoclll Recio.,. 35.181 37.106 35,D78 f,JSO 3.14% 4,4110 3 .7e.5

4t.~~~ 10.43%

~len! 1.284.837 1.5<Xl,401 1.2115.875 21>4,7:16 15.80'.4 174.752 125,732 35.76% E~HuM sa.n1 58,818 58,752 (t34) .0.23% 4.715 0.088 ( .3H) -22.58% Ho .... ~ .. 246,0$1 273,345 28&.352 (13.007) -4.M% 35,1160 30,185 .n5 11.13% Opi!L'IIlmology 11,:110 12.31~ 10,000 2.~5 23.US'IC. 800 1,000 -j200l -20.00% AncRialyTOial 4.&111.152 5673360 5.1221255 551.105 1~.76% 630,Sii3 524.1102 10k.~1 20.12%

NONREVENUE SUPPORT

SIIII&~O.V ~.352 2~.11'$ 311.201 (72.2511) -23.22% 21.758 3~,1113 '$·856) -4S.08% fine Oln.ng 3.033.247 2.751.~ 2.GM.•28 (115,885) ..;J.36" 310.18() 288.423 ,767 7.18,. PlAnt Opouallotl< 681.111. 612,006 812,7;)0 1t.278 12.1W% oa.eaa 81.786

1'~ S8.&e%

IJt.litiea 450.473 601.511 412.515 1UOI J.D4% 57,016 48,251 18.31% }i()me Se<vaa 73.1116 75,587 6U.~D f,l88 8.13% 811 7,187 ,377) .... 72% Gl:>unlb 76.707 88,674 1 12.!142 (25.61l8) -22.111% 4.31U 4.G&9 (300) -8.40% Sec:vrUy 1110.758 113.875 200.773 (7.088) -3.!14" 21,28U 20,184 1 3115 1.8814 Ellllito-lal SeMca6 716.581 811.615 421.688 (10.071) -1..23% 85,1111 84.3011 I iSI 1.01% l.amdoy & U..n 107,485 124.958 114,748 10,200 I .UO% 13,747 n.nz

rm 111.n%

Tmupo11211ion 473,013 45-4,817 416,862 (32.1145) ~.58% 40,445 48.818 6.242) -1U3% Flrlance 053.580 852.7117 115U78 (e,o81) .0.83% 114,655 17,437 7.11S 17.S7% lnlonna~c" Tecllnology 3~.180 591,502 &20.m (20.276) ~.72% 53,<168 42,114 t ..... al -16.01% AClflllulcns 129.534 117.202 139,523 (22.320) -16.00% 11.4SO ~4 .125 2.~7~) -11.84% AC""*''ssra~n 814,460 353.548 795.658 ~r.eev 7.2814 n .1o1 78 ,008 1 .~00 2 .11'.4 PoalotalC...O 06.805 73,07\ 6>.137 3.834 5.8~ 7,054 7,110 I (:M) -1.48% r,-.:; Hoat>ioo '>:: ,.,

Pubic Relallons 2&2,870 314.27~ 313,055 1,218 0.31'.4 3&,10.0 22.648 ,.,_.!18 32113% )> 0 ......

Qu.rity~:ll 58.740 64.017 83,717 300 0.47% 5,583 5.567 I 17 0.30'11 )> Ct Communicalions 40,1;12 ... 2.1~2 44.851 (1,855) -4.38% 4,707 4.380 I ~37 10.03')(. rt ()

P~e 1U,-453 ~.27D 22.7~ 2..523 11.011% 3.385 4,443 ~ I ii!:.G) -23.81% rt n PriiiUno & OuoiQIIng 58Jl21 4D.t43 57.;41 (7,e911) -13.10% 1.334 5.818 : 5'11 11.811., ;!)

Hum•n Anoun:::et 721,781 ns.112 74:,568 JS.C43 03% 1)7,474 132.IQO 1 ·-~e.. 3.-45% () ~

S~Pian ::r --- :1 w Total Hon Rever« Suppcn 0.754.036 8.788.~ u~.7~ ill..illl .o.ee% 1,103.&72 t.050C47 1>3 52~ ___ 5.11%

~ N ::I ......, t"t 0

\J1 ~

....... ()

0 ::I rt

Jewish Home ot Roch&s!er Statement of Revet~ue and Expense

For lhe Period Ended 1013112014 Prelim'nary & Unaudited

YEAR TO OA TE MOHlli TO DA"Ti. ~ % I :Z013 ACTU"l 8UJG£T VARIANCE VAHii\NCE ACTUAl. BUOG!;T VAIUAP\¢E

UNASSIGNED EXPENSES •• --- --- I

De~reOiton 2,242,188 2.213.388 2.'71,7n 41.597 1.t~ 22&,075 217,433 ~ '.!42 Amoi'Jza!lon 7U45 75.1145 75,1145 0.00% 7,585 7,585 · l'lllpef1y l u ).),041 33,23& 3-1,6&3 (1,457} ~.20% 3,3:!A 3.488 ! (14e) Long Torm Dellllnloreal e57.on 814.360 eH,J~ 4 o.OO% sa,nfi 58,n1 1 4 UneoiCtecntJnttraal 18,718 11.851 7.292 4,560 62.5.4% 1,806 7211 1,075 ~:>surance 1811,1128 201,875 zw.e~ {7,7!0) ..J.71'llo 12,008 20,LIII8 ( •• 157) ~ B-'ill ~.523.032 4,715,843 4,883,301 (187,358) -3.43% 450,;()5 405,724 &:§ TOUIIUIIMilgnedE><pereee 7.751.408 ·~ 7.!86.500 ws 7.811U34 !130,435) -1.83% 701..480 eoun .. ,19

NON OPERATING EXPENSES

Dulllldan 60,457 6&,840 71.288 ... (2.34G) -3.28% 6,832 7,412 ___j~ To4111 Non Opera~"'l E><penscs 08,457 88.840 71.288 (2.348) -3.29% 8.832 7,412 __j.J.!!El

TOIII E>pen- belmo NYS c .. ~ RI'N!i!"' I AsleSIIIIelll 33,6SM83 35,)()(),322 l4,SGS,327 434,906 1.2E% J,6811,G32 3,807,216 Ja.7•7 NYS Catldtec*~ A$Seumen: El<pe"Ue 2.071,184 2,081,147 2.082.072 (025) -4.04% 290,203 288.1185 : 323 ~~~ ~ TCltiiExoonMs 35,624,847 37,081.468 36,8273Q8 434071 1.10% 3.878,2~ ~1'80,076

"-tlUiom.FounCIIIdonCcnl11~vt!On 1,017,381 838,.63 1,087,4111 (1.f7,856) ·13.61% 72,885 133,842 («fo,747) l'no< Yeet Adi-JIImonll 0.00% I ~IDJSL 1120,1en ____1129.187) (IZS.1e?l o.OO% !12.8t7) (:2,1117) I Calni{LOM) From()penotlcN 251.8'2 600.715 687,o(02 83.313 16.02% 26,888 46,700 (1z.712

I Doneticnt 703 6.645 0,845 0.00% Aldoity Dontl.lo:lt Jowisll FC<Ietallol! ConCI!bullofl 79.167 71,887 79,1&7 (7,SOO) -0.47'% 4,107 7,817 ,3.750) U~WayOO:>OCCIIoloolAIIIIIbllllon 1b.931 16,200 16,667 (~n) · 2..26% ?,G70 1,657 1,003 DI!Crfbullon 1c JHR ~~ Hoc&lng JSLfoandalion ConlribUiion- MCP 450.000 450,000 0.00% GU\I(loss)Mei'Con:rlbuiJ:n' 347.o(82 1235,316 883,236 542,C61 78.20% 32.824 50.2113 (~6,450)

-;rVARWoiCE

3.87% 0.00%

· 4.20% 0.011~

148.00% -4212'llo -0.04% ..s.~

..1.~7% -6,o(7%

2.Z"I%

0.11'1(,

2.11%

-ol5.45% O.DO'M. 0.110%

-46.84%

0.00%

-47.37% e0.11%

0.~

-4!.M%

o:l"'Q "':1 "1

> :.S. :> !II M n rt M Ill 0 ~ :::; ..... E1 w 11> N ::l w rt 0

\,n 0

,.... 0 0 !:) n

132305 BNHLC Attachment A – Quality Measures and Inspection Report

Source: NYS Department of Health website, Nursing Home Profile

Jewish Home of Rochester

The following table shows how this nursing home performs in key quality measure areas.

Percentage of residents who... Performance Ranking

Self-report moderate to severe pain (short stay) Reporting period: July 2013 to June 2014 25.7% This Facility 14.1% State average 18.8% National average

1 out of 5 stars

Have pressure sores that are new or worsened Reporting period: July 2013 to June 2014 1.5% This Facility 1.2% State average 1.0% National average

2 out of 5 stars

Were given, appropriately, the seasonal influenza vaccine (short stay) Reporting period: July 2013 to June 2014 94.8% This Facility 85.9% State average 84.4% National average

4 out of 5 stars

Were given, appropriately, the pneumococcal vaccine Reporting period: July 2013 to June 2014 90.7% This Facility 84.7% State average 83.0% National average

3 out of 5 stars

Newly received an antipsychotic medication Reporting period: July 2013 to June 2014 0.5% This Facility 2.4% State average 2.4% National average

5 out of 5 stars

Needed increased help with daily activities (long stay) Reporting period: October 2013 to June 2014 16.0% This Facility 14.4% State average 15.7% National average

2 out of 5 stars

Self-report moderate to severe pain (long stay) Reporting period: October 2013 to June 2014 10.6% This Facility 5.5% State average 7.7% National average

1 out of 5 stars

Have pressure sores (long stay) Reporting period: October 2013 to June 2014 5.4% This Facility 7.7% State average 6.0% National average

4 out of 5 stars

http://nursinghomes.nyhealth.gov/nursing_homes/about_quality/#ranking

http://nursinghomes.nyhealth.gov/nursing_homes/about_quality/#m12265










Lose too much weight (long stay) Reporting period: October 2013 to June 2014 4.5% This Facility 6.4% State average 7.2% National average

4 out of 5 stars

Lose control of their bowels or bladder (long stay, low risk) Reporting period: October 2013 to June 2014 59.6% This Facility 44.5% State average 44.3% National average

2 out of 5 stars

Had a catheter inserted and left in their bladder (long stay) Reporting period: October 2013 to June 2014 2.0% This Facility 2.6% State average 3.1% National average

3 out of 5 stars

Had a urinary tract infection (long stay) Reporting period: October 2013 to June 2014 4.5% This Facility 5.6% State average 5.8% National average

3 out of 5 stars

Have depressive symptoms (long stay) Reporting period: October 2013 to June 2014 5.7% This Facility 11.7% State average 6.2% National average

3 out of 5 stars

Were physically restrained (long stay) Reporting period: October 2013 to June 2014 0.0% This Facility 1.6% State average 1.2% National average

5 out of 5 stars

Experienced one or more falls with major injury (long stay) Reporting period: October 2013 to June 2014 6.5% This Facility 2.7% State average 3.2% National average

1 out of 5 stars

Were given, appropriately, the seasonal influenza vaccine (long stay) Reporting period: October 2013 to June 2014 100.0% This Facility 96.8% State average 94.0% National average

5 out of 5 stars

Were given, appropriately, the pneumococcal vaccine (long stay) Reporting period: October 2013 to June 2014 99.4% This Facility 96.9% State average 94.2% National average

3 out of 5 stars

Received an antipsychotic medication (long stay) Reporting period: October 2013 to June 2014 12.8% This Facility 18.0% State average 19.8% National average

4 out of 5 stars













Jewish Home of Rochester

Inspection Report Report Period: December 2010 to November 2014

PFI: 3374

Regional Office: WRO--Rochester Area Office

This report displays citations for Certification Surveys and Complaint Surveys during the reporting

period.

Summary

This table summarizes the citations in the details section of this report and compares them against the

statewide average.

Measure This

Facility

Statewide

Average

Standard Health Deficiencies 11 23

Life Safety Code Deficiencies 21 11

Total Deficiencies 32 34

Deficiencies Related to Actual Harm or Immediate Jeopardy 0 1

% of Deficiencies Related to Actual Harm or Immediate Jeopardy 0% 3%

http://www.nyhealth.gov/facilities/nursing/regional_offices.htm

HSP Attachment A- CON 132178 Big Apple Dialysis Management, LLC - "Dialysis Facility Compare"

CMS Certification Number (CCN)

City Location of Center

Patients who had an average hemoglobin value greater than 12.0 g/dL Note 1

NY Average: 1% National Average: 0% Lower percentages are better

Rate of Transfusions Noto 2

Lower numbers are better

Hemodialysis patients who had enough wastes removed from their blood during dialysis: Urea Reduct ion Ratio

HEALTH & HOSPITALS CORP

...,J

i! i£

f $ ~ ~

t!# ~~ oo

O...J Cl)j! 0i£ ~(/) ~0

:t"

...,J

~ i£

f ~

8 ~ ...,J

~/5 ~~ ::if} ~...,J 0~ ~i£ ~f

-~

~ . !J! Q c)

§..S ~ .._ .. 0./f! 0 ~ ~ Cl

- 0 § g

(j .s ...

i! c: rJ -~ ~

.i Q

l 't;

4Y

.!!! ., ~

tSo ~.s ~ ... ~./!! ~§ ;po ~

~

.,-./!! -9 0

~ 'f ti 0 ~s

Q:' "I! ~ ~

~

332354 332346 332394 332344 332646 332658 332620 332582

New YO<i<

3%

Btooklyn Bronx Now York

Number of Number of

Not I patients is patients is Reported too small too small

to report to report

Brookf)'ll

0%

Riverhead

4%

New Hyde Pari<

3%

Bronx

0%

... J!J

J -~

1.o g.s f I ~

332568

Astoria

2%

As

E-xpected As

Expected As I As

Expected Expected As

Expected As I As

Expected Expected As I As

Expected - Expected

greater than or equal to I 100% 96% 100% 92% 99% 99% 97% 100% 98% 65% Note 3

NY Average: 98% National Average: 99% Higher percentages are better

Adult hemodialysis patients who had enough wastes removed f rom their blood during dialysis: KW greater

than or equal to 1.2 Noto 4

NY Average: 90% National Average: 90% Higher percentages are better

26% Data

Missing 96% 85% 91% 95% 94% 96% 96%

DRS. BHAT & MATTOO

, .. s J!J ~ ~~

0 -~

~ .... !!}

~$Z Cl ...

0 .!J! .,Q

... ..!9 -~ ~~

0 .!J!

... J!J g

~.;. ~.!P

.!J! Q

u;~~ ~~:: .!!bq, C)~ (j

-~C) ~ .!'! ~

o::"t:: .... ~ ,., t:

.!!! ~ -~ c) tS.S 'b C) .!J!

f2 If ~(j .s

332652

Astoria

0%

f~ 0 • ~c) ~.s

332647

Elmhurst

2%

Q -~ (J f~ 0 •

l"u ~.s

! CZI

.g> ii

332648 I 332541

Bronx I Ridgewood

0% 0%

As I As I As Expected Expected Expected

As

Expected

100% 100% 98% 95%

94% 96% 84% 89%

... CZI~ §J.

0 -~ .!!!Q

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332514 332587 I 332610

New York Laure tton I Valley Stream

0% 1%

As I As Expected- Expected

97% 95%

86% 94%

1%

As

Expected

100%

96%

HSP Attachment A- CON 132178 Big Apple Dialysis Management, llC- "Dialysis Facility Compare"

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Adult peritoneal dialysis patients who had enough wastes removed from their ,blood: KW greater than or equal to 1.7 Note 5

NY Average: 74% :National Average: 81% Higher percentages are better

'Adult patients who received 1treatment through an

1arteripvenous fistula Note 6

NY Average: 65% I National Average: 63% I Higher percentages. ace-better._

Adult patients who had a catheter (tube) left in a vein longer than 90 days, for their regular hemodialysis treatments Note 7

NY Average: 13% National Average: 11% Lower percentages are better

Adult dialysis patients who had too much calcium in their blood: Average calcium greater than 10.2 mg/dl. Note 8

NY Average: 2% National Average: 2% Lower percentages are better.

Rate of hospital admisssion Note 9

Patient death rate Note 10

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Facility Facility Fadlity

Does Not Does Not Does Not

Provide Provide Provide

Peritoneal Peritoneal Peritoneal Dialysis Dialysis Dialysis

68%

1%

6%

As

Expected

Better Than

Expected

80%

7%

5%

As

Expected

As

Expected

72%

2%

8%

As

Expected

As

Expected

~.u/Js ~~

Data not

reported

28%

22%

1%

Worse

Than Exoected

As

Expected

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Fadlity Facility Number of Number of Does Not Does Not Patients is Patients is Provide Provide too small too small

Peritoneal Peritoneal to report to report Dialysis Dialysis

60%

17%

3%

Worse Than

Exoected

As

Expected

52%

14%

1%

As

Expected

As

Expected

74%

10%

1%

As

Expected

As

Expected

72%

10%

3%

A5

Expected

As

Expected

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Data Not

Reported

68%

9%

3%

A5

Expected

As

Expected

';2 ~2

ff ~ci .s

oao fti 0 • i'ci ~.s

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I (1J

.g> ii

Facility Facility Number of Fad lity Does Not

Does Not Patients is Does Not Provide

Provide too small Provide Peritoneal Peritoneal to report this Service Dialysis

Dialysis

65%

5%

2%

Worse Than

Exoected

As

Expected

67%

7%

2%

As

Expected

Better

Than

Expected

55%

33%

Number of Patients is

too small

to report

As

Expected

Worse

Than

Expected

68%

12%

1%

Worse Than

Exoected

Worse Than

Expected

Source: Dialysis Facility Compare (http:l/www.medicare.gov/dialysisfacilitycompare!search.html)

Prepared with data available on December4, 2014

Please see Notes page for explanation of quality indicators and data reporting periods.

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Facility Facility Facility

Does Not Does Not Does Not Provide Provide Provide

Peritoneal Peritoneal Peritoneal Dialysis Dialysis Dialysis

45%

24%

4%

Worse Than

Exoected

Worse

Than

Expected

66%

10%

5%

As

Expected

As

Expected

63%

18%

3%

As

Expected

Better

Than

Expected

Comparison of "Dialysis Facility Compare" Statistics for ESRDs

Explanation of Quality Indicators

Note 1: Anemia is a common complication in people with kidney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, however, often don't make enough EPO. As a result, the bone marrow makes fewer red blood cells. Other common causes of anemia include blood loss from hemodialysis and low levels of iron and folic acid. [Data Period 111113-121311131

Note 2: An important goal of anemia management in dialysis is to avoid unnecessary blood transfusions. Dialysis providers can help prevent unnecessary transfusions by providing several treatments for anemia. Some of the anemia treatments may have side effects for patients with some medical conditions, so decisions about anemia treatment must be tailored to individual patient's conditions. [Data Period 1/1/13-12/31/13]

Note 3: Urea Reouction Ratio (URR) - This shows the percentage of adult hemodialysis patients at each facility who had a URR of 65 or more. (Some experts recommend a URR of 65 percent or higher.) [Data Period 1/1/13-12131/13]

Note 4: For the KW, the top part of the fraction (Kt) represents the volume of fluid completely cleared of urea during a single treatment; the bottom part of the fraction (V) is the total volume of water a patient's body contains. The KW is more accurate than the URR in measuring how much urea is removed during dialysis. Patients with KW lower than 1.2 have a higher risk of health problems. [Data Period 1/1/13-12/31/1 3]

Note 5: Adults with kidney failure who get peritoneal dialysis need to be closely monitored to ensure that their blood is cleaned enough. This is measured by a blood test called KW. Test results of 1. 7 or higher show that the patient is getting the dialysis often enough and the right amount of dialysis solution. Peritoneal dialysis patients with KW lower than 1. 7 have a higher risk of health problems. [Data Period 1/1/1 3-12/31/1 3]

Note 6: This shows the percentage of adult patients receiving regular hemodialysis at a certain facility who used an arteriovenous fistula for their treatment. The arteriovenous fistula is considered the best long-term vascular access for hemodialysis because it allows good blood flow, lasts a long time, and has a lower complication rate than other types of

--------•aeeess7""Aittlel:l§R-seme-FJatients-may-net-ee-aele-te-Rave-an-AV-fist~:~la-er-may-net-want-ene,faeilities-tt-tat-Rave-t-li§tler-J:>er-renta§es-may-t;>e-seiA§-a-Getter-je9-ef-f:leiJ:>in§-J:>atient,s---

understand why they are important. [Data Period 1/1/13-12/31/13)

Note 7: This shows the percentage of adult hemodialysis patients being treated at a certain facility who had a catheter (tube) inserted into a vein for hemodialysis treatment that was left in place for more than 90 days. Patients who do not have time to get a permanent vascular access before starting hemodialysis treatments may need to use a venous catheter for temporary access. Catheters are not ideal for permanent access, because they can clog, become infected, and cause narrowing of the veins. But a catheter will work for several weeks or months while permanent access is developed. Although some patients may need them for longer periods, those numbers should be low. [Data Period 1/1/13-

Note 8: If calcium levels get too high or too low, it can affect how the nervous system and muscles work, including the heart. Dialysis providers, including dialysis facilities, can influence the amount of calcium in their patients' bodies in several ways, including changes to the calcium levels used in the dialysis solution and use of medications like vitamin D and calcium-containing phosphorus binders. Dialysis facilities with a high percentage of patients with high calcium blood levels may not be making the correct adjustments to keep patients' calcium levels normal. [Data Period 1/1/13-12/31/13]

Note 9: Even when they're getting dialysis treatments regularly, patients with kidney failure often get sick and have to go to the hospital because of infections or other problems that may be related to the dialysis treatment itself. Facilities whose patients have lower ratios of hospital admissions may be better at helping their patients avoid these serious problems. Patient hospitalizations at a facility can be worse than expected due to a variety of reasons. For example, a facility may specialize in treating patients who are very ill and who may not live long; it does not always mean they are not providing good care. [Data Period 111113-12131113]

Note 10: Generally, patients with kidney failure don't live as long as patients with normal kidneys. Many factors affect how long a dialysis patient lives. Some of these factors are under the control of the patient (like not skipping treatments), and some of these factors are under the control of the facility (like making sure patients get all the treatments the doctor prescribes). Patient deaths lets you know if the patients treated at a certain dialysis facility generally live longer, as long, or not as long as expected. Patient deaths at a facility can be worse than expected due to a variety of reasons. For example, a facility may specialize in treating patients who are very ill and who may not live long; it does not always mean they are not providing good care. [Data Period 111110-12131/13]

Source: Dialysis Facility Compare (http://www.medicare.gov/dialysisfacilitycompare/search.html)

The table below compares the Summary Statistic (which is the percent of scores at, or better than, the New York State average for the

acquiring or affiliated entity. The Summary Statistic is intended to be a rough indicator of performance. (Higher is better)

(1) (2) (3) (4) (5) (6) (7) (8) (9)

Total Denomina Summary

Statistics tor

Numerator Rate

Possible Statistics Reportable Not Statistics

Statistics at or1 worse

Operator Sites Statistics per (1)x(2)

Available (3)-(4)

Not than NYS (6)+(7) better

Site or Do Not Reported than NYS Apply

Average Average

1.00-((8)/(5))

HHC 4 10 40 5 35 3 9 12 66% Bhat & 12 10 120 12 108 1 36 37 66% Mattoo -------

" A:·t-\ C\.C h VYl "t" Vl + J3

COOK COUNTY HEALTH & HOSPITALS SYSTEM Toni Preckwinkle

President Cook C.ounty Board of Commissioners

John Jay Sbannon, MD Chief Executive Officer

Cook County Health & Hospitals System Board Members

M. Hill Hammock • Cllairman U>tnnli..~oner Jerry Butler • Vice Cbainnan

David Carvalho Cook County Heahh & Hospitals System Lewis M. Collens

October 17, 2014

Dr. Ram Raju, MD, F ACS. President and CEO,

John H. Stroger, Jr. Hospital 1969 West Ogden - Chicago, IL 60612.

New York Health and Hospitals Corporation 125 Worth Street, Room 514 New York, NY 10013

Ada Mary Gugenheim Wayne M. Lerner. DPH, FACHE

Rev. Calvin S. Morris, PhD Luis Munoz, MD. MPH

Jorge Ramirez Carmen Velasquez

Dorene P. Wiese, EdD

REPORT ON QUALITY OF CARE PROVIDED BY TWO {2) DIALYSIS ORGANIZATIONS, NYC HEALTH AND HOSPITALS CORPS {HHC) VERSUS BIG APPLE DIALYSIS MANAGEMENT LLC,

USING PUBLICLY AVAILABLE QUALITY INDICATORS.

Introduction/Background

Dr. Ram Raju, President and CEO, New York City Health and Hospitals Corporation requested for an independent expert review and comparison of the quality of care of two dialysis providers namely (a) New York Health and Hospitals G:orporation (HHC) and (b) Big Apple Dialysis management LLC in the New York City area.

The Key huestion is to determine whether the quality of care provided to dialysis patients by HHC compare~ to Big Apple dialysis management is (a) better, (b) the same or (c) worse, using publicly available Centers for Medicare and Medicaid Services (CMS) dialysis facility quality measures.

Brief Resume

Dr. Peter Hart is the Chairman of Nephrology' for Cook County Health and Hospitals System (CCHHS) and Associate Professor of Medicine at Rush University Medical College, Chicago. He is Board certified in Internal Medicine and Nephrology and has over 32 years of experience.

Dr. Kalyani Perumal is the Director of Dialysis Services for Cook County Health and Hospitals System (CCHHS) and Assistant Professor of Medicine at University of Illinois College of Medicine, Chicago. She is Board certified in Internal Medicine and Nephrology and has over 15 years of experience.

• A-.-y & C•m-•lty Haallh ......... • Ce~ak Hl.th So•vl-• ' Cook c ... oty Dopa•t-ot of -Uc Hoa ... • • John H. sJogor, Jr. Hospital • Oak Forest Health Center • Provident Hospital • Rulh M. Rothshln CORE Cenhr •

21 I

Source of Data: Medicare dialysis reports obtain~d from submissions by the dialysis .clinics and sourced from the Dialysis Facility Compare website: medicare.gov 1 dialysis facility compare.

Additional material on patient/payor- mix was upplied by both HHC and Big Apple dialysis management.

HHC Dialysis units

HHC has four (4) hospital based in-center dialysis nits namely Metropolitan, Harlem, Lincoln and Kings. The units are non-profit and owned by HHC and have a total of 59 dialysis stations. Home Hemodialysis training is not provided and periton~al dialysis is provided by Metropolitan Hospital Center only. A majority (72%) of the dialysi~ patients is minorities (Latino- 42%, African American- 30%) and over two- thirds of all the P.atients are Medicare and/or Medicaid patients and about 17% are uninsured. In Lincoln Hospital r ialysis Unit, 58% are uninsured.

Big Apple Dialysis units I Big Apple has twelve (12) privately owned and[' dependent in-center dialysis units and two of these are nursing home based units. Ten (10) are for profit and two (2) non-profit namely Ridgewood-Central Park and Newtown- Morisani dialysis centers.

They have a total of 295 dialysis stations, three (3~ units provide Home hemodialysis training and peritoneal dialysis is provided by Newtown, NeX Hyde Park and Broadway dialysis units. A majority (62%) of the dialysis patients is minori ies (African American- 42%, Latino- 20%) and 80% of all the patients are Medicare and/or Med'caid patients. Percentage of uninsured patients is not stated.

Results of Quality Indicators

TREATMENT OUTCOMES

Some quality indicators are expressed in percent, ge (%) and compared to State (NY) average and National average. Other indicators are expressrd qualitatively and dassified as: "better than expected", "as expected" or "worse than expected'. State (NY) and national averages are included for comparison. Of note, quality indicators are djusted for characteristics of patient mix in the facility such as race, age, gender and diabetes as c use of End Stage Renal Disease (ESRD).

{1) Anemia manai:ement

Hemoglobin: Percentage (%) of patient(s) who had an average hemoglobin value greater than12.0 g/d. Lower Percentages are better.

HHC vs Big Apple: HHC- 1 unit had Hb < 12g/dl 25%), 2 units did not have data for comparison (50%). 1 unit had Hb >12g/dl (25%). Big Apple- 4 units had Hb < 12g/dl (33%), 8 units had Hb >12g/dl (66%)

In this quality measure, 33% of Big Apple units a d 25% of units in HHC met the goal. 66% of units in Big Apple and 25% of units in HHC were aboveJgoal.

• Ambulatory & Community NeaiHt Network • Cermak Herlth Services • Cook County_Department of Public Health • • John H. Stroger, Jr. Hospital • Oak Forest Health Cenir • Provident Hospital • Ruth M. Rothstein CORI Center •

3

It is not possible to derive any conclusions forth's quality measure as 2 units in HHC did not have data for valid comparison of all the units in both tr e systems.

Rate of transfusions: HHC vs Big Apple

Both units had similar results; hence no difference was identified between these two systems

(2) Dialysis Adequacy Hemodialysis patients w o had enough wastes removed from their blood during dialysis:

Urea Reduction Ratio {URR) greater than or equal to 65%. Higher percentages are better. HHC vs Big Apple: 3 of the 4 units (75%) in HHC and 7 of the 12 units (58%) in Big Apple met the goal.

HHC units performed better than Big Apple syste['

KtjV in adults greater than or equal to 1.2. Higher percentages are better I

HHC vs Big Apple: 1 unit (25o/o)in HHC and 11~12 (91%) units in Big Apple system were at or above national average. 2 units in HHC system dtq not have data reported in this quality measure. Dialysis units in Big Apple system performed better in this measure of dialysis adequacy. Of note, both urea reduction ratio and Kt/V are rrleasures of dialysis adequacy. CMS has mandated use ofKt/v as a measure of dialysis adequacy sinJe 2013.

In this quality measure, assessing dialysis adequl cy both systems HHC and Big Apple performed similarly.

(3) Vascular Access

Ofo of adults receiving dialysis treatment with Ateriovenous fistula (A VF). percentages are better

Higher

HHC vs Big Apple: 3/4 (75%) of HHC units and 8 12 (67%) of Big Apple units were above national average. Both systems had similar rates of AV fist la.

% of adults receiving dialysis treatment wi~h catheter for more than 90 days. Lower percentages are better

HHC vs Big Apple: 3/4 units (75%) in HHC and /12 (50%) in Big Apple system met the national goal.

HHC units had better performance in this quality easure

{4) Mineral and Bone Disorder 1

% of adult dialysis patients with average calcium greater than 10.2mg/dL. Lower percentages are better I

1/4 (25%) in HHC group and 7 j12.(58°~o) in B.ig~pple group met national average.

Big Apple group performed better m thts quahty r easure

• Ambvlatory & Community Health Network • Cermak Health Services • Cook County Department of Public Health • • John H. Strogor, Jr. Hospital • Oak Forest Hecdth ConW,r • Provlclent Hospital • Ruth M. Rothstein CORE Center •

4

PATIENT OUTCOMES

Hospitalizations and deaths:

The Standardized Hospitalization ratio (SHR) and Standardized Mortality Ratio (SMR) and ranges of uncertainty indicate whether dialysis patients eing treated at a dialysis facility were admitted to the hospital or died more often ( worse than xpected), less often (better than expected) or about the same (as expected) compared to patient treated in similar facilities.

Notes: (a) Time at risk and deaths within 60days after patient transfer out are attributed to the original dialysis facility. (b) Time at risk and hospitalizations starting 3 days prior to kidney transplantation are excluded from SHR.

Standardized Hospitalization Ratio (SHR)

HHC vs Big Apple: Hospital admission- 75% of nits in both systems had "as expected rates". 1 unit in Big Apple had "worse than expected" SHR. j unit in HHC had no data.

Standardized Mortality Ratio (SMR) I HHC vs Big Apple: Patient death rate- SO% of un·ts in both systems had "as expected rates". 42% of units in Big Apple had" worse than expected" patient date rates. No data was available for 1 unit in HHC.

On face value, it seemed that the SHR and SMR fo Big Apple was worse than expected compared to HHC but both of these indicators- Hospital ad ission and patient death rates cannot be fully evaluated as patients are admitted for several rea ons and may have higher mortality due to their coexisting medical conditions. In the absence of patients' medical history, acuity of illness, reason for admission, readmissions or death, it is difficult to derive any valid conclusions from this data. Additionally, Big Apple has two (2) nursing homJ based dialysis units which may account for the worse than expected patient death date. It is weli known that nursing home residents, especially those on dialysis are typically very ill and are col' plex patients who require frequent admissions, readmissions with significant morbidity that res Its in higher SH R and SMR. These patients may negatively impact the patient care outcome varia les of an otherwise outstanding dialysis facility.

Summary and Conclusion

Dialysis Facility compare quality measures are a et of quality care measures developed over the last 10 years to assess quality performance at all Medicare certified facilities in the United States. Although they are adjusted for race, age, gender and presence of diabetes as the cause of ESRD, they do not (1) reflect provider-related varian9e in quality of care, (2) can't fully account for patient or case-mix differences between facilitie and (3) do not account for dialysis facility size (small versus large), location (urban versus sub-u ban) and neighborhoods. Indeed, the current

Ten (10) quality measures (treatment and patie t outcomes) are inadequate tools to gauge the optimal level of care provided by dialysis facil ties and there is no gold standard to estimate facility specific SHR and SMR. These measures compared to State and National norms are just averages and should not be misinterpreted as st~ndards that represent ideal care. In our opinion they are epidemiologic tools that may be useful for facility based quality improvement initiatives and unlikely to truly reflect the best care provided by outstanding dialysis facilities.

• Ambvlatory & Community Health Network • Cermak He llh Services • Cook County Department of Public Health • • John H- Sfl'oger, Jr. Hospital • Oak Fored Health Center • Provident Hospital • Ruth M. Rothst.ln CORI c .... t.r •

5

Summary: I 1) Anemia and Rate of transfusion- Taken together, there is insufficient data to compare both dialysis groups. I 2) Dialysis Adequacy- Both groups performed jell in this quality measure.

3) Vascular Access- HHC group had better performance compared to Big Apple group

4) Mineral and Bone disorder- Big Apple group r erformed better compared to HHC group

5) Standardized Hospitalization and Mortality ~atto: Both groups had comparable "as expected rates" for SHR and SMR ! Conclusion: The quality of care provided to dia ysis patients by Big Apple dialysis management compared to New York Health and Hospitals Co

1 poration is on the aggregate" the same" using

the Centers for Medicare and Medicaid Services ijCMS) dialysis facility quality measures. However, Big Apple has three (3) times the number of dia~sis facilities operated by HHS and more chronic dialysis treatment options for patients with E RD namely home hemodialysis and peritoneal dialysis.

Pe~ Chairman of Nephrology, CCHHS

~~ ptM.A.I\AJU Kalyani rumal, MD Director of Dialysis, CCHHS

• Ambulatory & Community Health Network • Cermak Heflth S.rvlc:es • Cook Cou.nty Department of Public H ... llh • • John H. Stroger, .lr. Hospital • Oak Forest Health Center • Provident Hospital • Ruth M. Rothstein CORI c-ter •

Yea1111 and 3 Budaets site saclfic and conaolld•ted Kings Lincoln Metropollt•n Hllltern

. Year1 Year3 Year 1 Year3 Year 1 Year3 Year 1 Year3

Total Revenues $5,102.345 $6,151,913 $3.214,988 $3,515,314 $2,694,082 $2.853,033 $4,079,413 $4,377.260

Total Expenses $4.235.617 U.Z~J.Z39 t? ~;;?n n?n 12.ZH§.Z~l $2.377.667 12.§J7,187 S2.888.382 ~~.1:!7,831

Net lncome/(Loss) $866,728 $1,398,674 $694,968 $728,573 $316,415 $215,846 $1 .191,031 $1 ,219,429

Utilization (treatments) 18,307 21,424 11,544 12,480 9,984 10,920 14,352 15,943

Cost per treatment $231 .37 $221 .87 $218.30 $223.30 $238.15 $241 .50 $201 .25 $198.07

Utilization by payor source for years 1 and 3 subsequent to the ch•nge In operator is summarized below:

Kings Lincoln Metropolitan Hart em Year 1 Year3 Year 1 Year3 Year 1 Year3 Year1 Year3

Medicaid Fee-For Service 10.51% 8.98% 1'0.81% 11.25% 10.94% 11.43% 10.65% 14.68%

Medicare Fee-For Service 78.98% 80.10% 78.38% 77.50% 78.12% 77.14% 78.69o/o 74.75%

Commercial Fee-For Service 10.51% 10.92% 10.81% 11 .25% 10.94% 11 .43% 10.65% 10.57%

Total 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% L._ lOO.OO% 100.00% --·--·

Project #132178

BFA Attachment B

Consolidated

Year 1 Year3

$15,090.828 $16,897,520

S1 ~.Q2j ,686 113,334,998

$3,069,142 $3,562,522

54,187 60.767

$221 .86 $219.44

Consolidated Year 1 Year3

10.69% 11.38%

78.62% 77.63%

10.69% 10.99%

100.00% 100.00%

Big Apple Dialysis Management, LLC

Consolidated and Site Specific Pro Forma Balance Sheet

ASSETS Consolidated Kings lincoln

Cash $2,222,499 $792,206 $464,457

Equip & Fixed Assets $1,137,380

TOTAL ASSETS $3,359,879 $792,206 $464,457

LIABILITIES AND MEMBERS EQUITY

Working Capital Loan $1 ,111,250 $396,103 $232,229

Permanent Financing $1,023,642

Total Liabilities $2,134,892 $396,103 $232,229

Members Equity $1,224,987 $396,103 $232,228

TOTAL LIABILITIES AND MEMBERS EQUITY $3,359,879 $792,206 $464,457

Metropolitan

$439,531

$439,531

$219,766

$219,766

$219,765

$439,531

Harlem

$526,305

$526,305

$263,153

$263,153

$263,152

$526,305

Project #132178

BFA Attachment C

Central Brooklyn Dialysis Center, llC


For the Period 1/1/2012-7/31/2014

Assets


Total Fixed & Other Assets

Total Assets



Total Long Term Liabilities

Total Liabilities

Equity

Total Equity

Total Liabilities and Equity

Revenues

Expenses

Total Other lncome/(Expense) Total Net Income

Balance Sheet

tnt Fin Stat

1/1/2014-7/31/2014

Cert Fin Stat

2013 2012

$3,396,700 $3.447,364 $4,131,305

$1,928,695 $1,931,578 $621 ,996

$5,325,395 $5,378,942 $4,753,301

$2,350,618 $2,279,705 $2,312.407

$300,734 $85,720 $101,904

$2,651,352 $2,365.425 $2.414,31 1

$2,674,044 $3,013,517 $2,338,990

$5,325,396 $5,378,942 $4,753,301

Income Statement

$5.478,163 $9,233,875 $8.491,605

$4.497,028 $7,231.489 $6,746,067

($39,951) $84,665 $27,377

$941,184 $1 ,938,132 $1,674,274

Project# 132178

BFA Attachment 0

. East End Dialysis Management, llC


For the Period 1/1/2012-7/31/2014

Assets



Total Assets




Total Liabilities

Equity

Total Equity


Revenues

Expenses

Total Other lncome/(Expense)

Total Net Income

Balance Sheet

lnt Fin Stat

1/1/201 4-7/31/2014

Cert Fin Stat

2013 2012

$1,501,088 $1 ,444,225 $1 ,270,986

$316,764 $350,035 $259,943

$1,817,852 $1,794,260 $1,530,929

$753,728 $683.451 $781,216

$75,000 $79.482 $83,964

$828.728 $762,933 $865,180

$989.124 $1,031,327 $665,749 $1 ,817,852 $1,794,260 $1,530,929

Income Statement

$2,530,214 $3,915,393 $3,647,640

$2,175,714 $3,370,428 $3.407,845

$3,296 $6.463 $2,873

$357,796 $545,578 $242,683

New Hyde Park Dialysis Center


For the Period 1/1/2012-7/31/2014

Balance Sheet lnt Fin Stat Cert Fin Stat

1/1/2014-7/31/2014 2013 2012

Assets

Total Current Assets $2.484,091 $2,800,281 $2,303,562

Total Fixed & Other Assets $368,964 $463,025 $524,205

Total Assets $2,853,055 $3,263,306 $2,827,767


Total Current Liabilities $1 ,207,169 $1,489,642 $1 ,402,168

Total Long T errn Liabilities $149,712 $192,607 $276,485

Total Liabilities $1 ,356,881 $1 ,682,249 $1,678,653

Equity

Total Equity $1,496,174 $1,581 ,057 $1,149,114

Total Liabilities and Equity $2,853,055 $3,263,306 $2,827,767

Income Statement

Revenues $4,485,303 $7,676,808 $6,743,606

Expenses $3,749,804 $6,346,896 $5,608,010

Total Other lncome/(Expense) ($"?.839) $2,003 $8,569 Total Net Income $727,660 $1,301,953 $1,129,762

Project # 132178

BFA Attachment 0 (Cont.)

Newtown Dialysis Center, Inc.


For the Period 1/1/2012-7/31/2014

Balance Sheet lnt Fin Stat Cert Fin Stat

1/1/2014-7/31/2014 2013 2012

Assets

Total Current Assets $6,233,807 $6;658,833 $7,641 ,168

Total Fixed & Other Assets $6,754,684 $1 ,291,554 $1,306,697

Total Assets $12,988,491 $7,950,387 1 $8,947,865

I Liabilities and Equity

Total Current Liabilities $5,129,065 $4,040,942 $5,947,359

Total Long T errn Liabilities $4,704,399 $1,725,224 $456,626

Total Liabilities $9,833,464 $5,766,166 $6,403,985

Equity

Total Equity $3,155,027 $2,184,221 $2,543,880


Income Statement

Revenues $11,414,696 $18,324,575 $15,661 ,669

Expenses $10,526,864 $17,497,627 $1 4,805,025

Total Other lncome/(Expense) ($37,021) ($19,418) $6,346

Total Net Income $850,811 $768,396 $747,761

Project #I 132178 BFA Attachment D (Cont.)

New York Renal Associates, Inc. Ridgewood Dialysis Center, Inc.


For the Period 1/1/2012-7/31/2014


For the Period 1/1/2012-7/31/2014

Assets



Total Assets




Total Liabilities

Equity

Total Equity


Balance Sheet

lnt Fin Stat

1/1/2014-7/31 /2014 Cert Fin Stat

2013 2012

$3,003,546 $3,195,700 $2,251 ,975 $1,409,766 $1,164,390 $1 ,481,313

$4,413,312 $4,360,090 $3,733,288

$1,747,253 $1,731 ,986 $1 ,623,970 $34,563 $0 $72,498

$1,781,816 $1,731 ,986 $1 ,696,468

$2,631,496 $2,628,104 $2,036,820 $4,413,312 $4,360,090 $3,733,288

Assets



Total Assets




Total liabilities

Equity

Total Equity


Income Statement

Revenues

Expenses

Total Other lncome/(Expenses)

Total Net I nco me

$4,878,173

$3,978,583 $3,802

$903,392

$8,390,106 $7,087,114 Revenues

$6,625,954 $6,508,664 Expenses

($1 ,044) $39,385 Total Other lncome/(Expenses)

$1,592,284 $514,081 Total Net Income

Balance Sheet

lnt Fin Stat

1/1/2014-7/31/2014

Cert Fin Stat

2013 2012

$9,151,478 $6,847.779 $8,065,318 $6,471,840 $4,143,255 $3,984,716

$15,623,318 $10,991,034 $12,050,034

$6,901,003 $1,630,362 $8,531,365

$5,186,126 $1,431,462

$6,617.588

$6,554,439 $1,785,521

$8,339.960

$7,091,953 $4,373,446 $3,710,074 $15,623,318 $10,991,034 $12,050,034

Income Statement

$14.788,918 $25,392,448 $20,109,479 $13,281,373 $23,002,849 $18,889,449

($13,804) $69,839 $43,948 $1,450,743 $2,283,372 $1,136,132

West Nassaa Dialysis Center, Inc.


For the Period 1/1/2012-7/31/2014

Balance Sheet tnt Fin Stat Cert Fin Stat

1/1/2014-7/31/2014 2013 2012

Assets

Total Current Assets $2,200,718 $2,802,595 $2,833,443

Total Fixed & Other Assets $373,162 $2,251,301 $2,239,131

Total Assets $2,573,880 $5,053,896 $5,072,574


Total Current Liabilities $1,150,437 $1 ,574,745 $1,543,236

Total Long Term Liabilities $155,512 $507,623 $740,1 10

Total Liabilities $1,305,949 $2,082,368 $2,283,346 .

Equity

Total Equity $1,267,931 $2,971,528 $2,789,228


Income Statement

Revenues $3,507,696 $6,282,730 $5,677,459 '

Expenses $2,937,480 $5,046,020 $4,393,178 I

Total Other lncome/(Expens ($21,228) ($40,564) ($45,767)i

Total Net Income $548,988 $1,038,407 $1,113,4871

Project# 132178

BFA Attachment D (Cont.)

Table of Organization

Pure Life Renal, Inc.

Holds 100% shares of

Pure Life Renal of

Buffalo, Inc.

Pure Life Renal of Buffalo, Inc.

Board Members:

Medical Director

Orestes Lugo Jeff Fernandez Stefano Sola

Administrator

BFA Attachment 1

Project #1421 15

PURE LIFE RENAL, INC Balance Sheet (Unaudited) As Of October 31, 2014

ASSETS

CURRENT ASSETS: Cash

Prepaids & Others


FIXED ASSETS, Net

DEPOSITS

TOTAL ASSETS

UABILITIES & SHAREHOLDERS' EQUITY

CURRENT LIABIUTIES:

Accounts Payable

Accrued Expenses

Accrued Preferred Dividends

Interest Payable


LONG-TERM LIABILITIES:

Deferred Rent

Total long-term liabilities

TOTAL LIABILITIES

SHAREHOLDERS' EQUITY: Preferred stock, $0.001 par value - 10,500,000 shares

issued and outstanding

Common stock, $0.001 par value- 5,229,412 shares

Issued and outstanding

W arrants

Additional paid-In capital

Retained Earnings (accumulated deficit)

TOTAL SHAREHOLDERS' EQUITY

TOTAL LIABILITIES & SHAREHOLDERS' EQUITY

$

$

$

BFA Attachment B Project #142115

7,140,920 28,255

7,169,175

71,348

2,420,905

9,661,428

3,346 108,581 512,581

624,508

24,000

24,000

648,508

10,500

5,229

11,713,109 (2, 715,918)

9,012,920

9,661,428

REVENUES: Hemo - Medlc:Me PO Acute HH On.Qolng RIIWI\u• Conlradual AdjuwnentJ Total Revenue

Mngement Feea lnc:ome

COST OF GOODS SOLD: Heme Supplies Hemo DtUgl PO Acute HH Total COGS

PAYROLL: Admirostr111ve Dltea lndlred Payron Tax" Feea, Senefita PTO Total Payroll

G&A Expen~e~

BadOebtl

Management FM Ellpeme

EBITDA

Oepreda!IOn & An10rtiU1IOn AlnDIUutlonolntanglbles

OPERAnNGINCOMEIEBrr

I!Ureat. Net

PURE UFE RENAL, INC Stlltement Of Operations (Unaudited)

For The Ten Months Ending October 31, 2014

YeAR TO OAT! YEAR TO DATE OCTOBeR

OCTOBER BUOGII!:T

$ $ 0 0 0 0 0 0

• $ 0 0

! !

5,000 0

0 0 0 0 0 0 0 0 0 0

! s

600,5-47 702,633 0 0 0 0

112,306 192 709

f 712,854 ! 895,342

471 ,355 427,080

0 0

0 0

! (1 '178,208) $ (1 ,322,422)

15.198 20,000 0 0

$ (1,114,406) $ (1.342.422)

!29,014! (15.QQ!!l

INCOME (LOSS) BEFORE MINORITY INTEREST ! (1,223,420) ! (1,357,422)

MinOrity lni«Nt

PRETAX INCOME (LOSS) $ (1,2.23,420) $ (1,3117,42.2)

lncameT- 0 0

NET INCOME (LOSS) ' 11.223.4201 ' !1.357,4221

BFA Attachment B(cont.) Project# 142115

YEARTO DAT! VARIANCE

$ 0 0 0

$ 0

$

6,000

0 0 0 0 0

$

102 086 0 0

80403 $ 1821488

(44,275)

0

0

$ 1.,,214

4,802 0

$ 148,016

(14,014!

! 134,002

$ 134,002

0

' 1341002

ASSETS

Cash

Inventories

Prepaids & Others


Property and Equipment-Net

Goodwill

Intangible Assets-Net

TOTAL ASSETS

LIABILITIES AND MEMBERS EQUITY

Accounts Payable

Accrued Expenses

Total Liabilities

Members Equity

Pure Life Renal of Buffalo, Inc.

Day 1 Pro Forma Balance Sheet

$1,200,000

$85,000 $40,000

$1,325,000

$140,000

$3,433,000 $8,302,000

$13,200,000

$0 $0

$13,200,000

TOTAL LIABILITIES AND MEMBERS EQUITY $13,200,000

BFA Attachment C Project# 142115

Pure Life Renal, Inc.

Capitalization Table

Shareholders

Stefano Ciampolini

Orestes Lugo

Jeff Fernandez

Kim Coyle

Fiduciaria Centro Nord SPA (Ciampolini Family Trust)

Stefano Sola

Jorge Pedraza

Stephen and Lori Sadaka

Reinaldo & Zoraida Fernandez

Eugene & Jumi Kim

Marvelus Investments LLC

IMZ Financial Services, Inc. 401 (k) Plan- FBO lrwim Zagoria

Stock 0Qtions and Warrants

Orestes lugo (Employee Stock Option)

Stefano Ciampolini (Employee Stock Option)

Stefano Sola (Employee Stock Option)

Arnold E. Freeman (Warrants)

Oded Ben Joseph (Warrants)

WM. Braun Jones, Ill ( Warrants)

Jonathan R. Wallace (Warrants)

Michael J. Cromwell, Ill (Warrants)

Future Warrants to Outcome Capital

Series A Preferred Stock

Noro-Moseley Partners VII, L.P.

Noro-Moseley Partners SBIC, L.P.

Montreux Equity Partners V Associatees Master Fund, LLC

Florida Growth Fund, LLC

Montreux Equity Partners V, LLC

Noro-MoseleyPartners VII, L.P.

Noro-Moseley Partners SBIC, L.P.

Florida Growth Fund, LLC

Tota l

Number of Shares

1,685,294 6.01% 1,444,941 5.15%

577,955 2.06%

361,222 1.29% 858,184 3.06% 281,664 1.00%

56,194 0 .20% 112,388 0.40%

56,142 0.20% 56,142 0.20%

223,873 0.80% 55,413 0.20%

5,769,412 20.56%

447,058 1.59% 111,764 0.40% 111,764 0.40%

98,353 0 .35%

98,353 0 .35% 36,883 0.13% 36,883 0.13%

36,883 0.13% 307,351 1.10%

1,285,292 4.58%

760,470 2.71% 2,239,530 7.98%

5,000,000 17.82% 2,500,000 8.91% 5,000,000 17.82%

760,470 2.71%

2,239,530 7.99%

2,500,000 8.91%

21,000,000 74.86%

28,054,704 100.00%

BFA Attachment D

Project #142115

Lutheran Medical Center and Affiliates Organizational Structure {Pre-Closing)·

LMC Health System, Inc. Key Sole Corporate Member of lMC --- Affiliated with tJUt not controlled

by Lvtheran Medical Cent~r J

Lutheran Medical Center Sole Member. lMC Health

System, Inc. Sunset Park Health Council . : Co-Operator with lMC of r - ___.

........ ___ Lutheran Family Health

: Center Network . . . . . I I I I I J I . . . . .

LMC Shore Ro:td S&.m:ct ~y Luther.an Shore Hill OHP H:trbor Hill Luther.an LMC Community R:adioloty Community AuEu:t:Jna Ho~ine {Health Plu~) Hou::in( CHHA,Ine. Physician Found:~tion As::oc.., P.C. Service~ CECR

Sole Sole No Members No Members Service::, P.C.

Self- Tax-Exempt Sole Sole Member: Member: LMC Directors Tax-E:~empt

perpetuating P.C., Member: Member: LMC LMC must be LMC P.C., So3rd controlled by LMC LMC iipproves

officers, controlled by NY Mitchell- PHSP Directors LMC

LMC Service for Nursing lama; HUD directors or LMC

Supporting Sole Seniors; Day Home and SectionS Section 202 employees Sole Senior Organization Sh3reholder C..re Extended Senior Housing Certified Sh3reholder > ~

is LMC's Chair Care home health is LMC'sCMO of Radiology Housing agency

Community C:lrc: Or::~na:~tion Sun::ct Go:~rdc:ns Hou::ine Corp.

Members and Directors = Foundation or No Members - LMC Directors, Officers or Employees 1-- Directors approved by Shore Hill & St. Nicholas

L1censed Home C3re Serv•ces Agency Section 202 Senior Housing

Shore: Ro:~d Community Service:: Shore Hill How:in! As:;oei:ate:: GP, Inc. For-Profit LMC Corporation For-Profit ...__

Sole Sh;~r~holder: Foundation '--- 79"./o Shore Hill Housing Senior Housing M;~n;~gement 21% LMC Community Foundation

~ ---- ~- --

\ NYU Langone '--MEDICAL CENiER

t10l'"d 1-zj 11 > 0

L..>.

> ~ ,., n ,., rt Ill n ~ i~ ~ N ::S N rt ......

00 >

YU and Affiliates: Organizational Structure {Post-Closing)

New York University

r NYU Langone Health system

("NYUHS"} '

Sole Corporate Member of NYUHC and LMC

NYU Langone Passive Active Medical Center

~

Key ---sole

I

School of Medicine (includes Faculty Group Practice)

I ···· --· Affilioted with but not controlled

by entity shoiVn above

D Unincorporated division of New York University

\. NYU Langone '-.-MEDICAL CENiEF:

I Parent I I

NYU Hospitals Center

(includes Tisch Hospital NYU HJO, Rusk Institute)

cccsso

Parent

lutheran Medical Center ( "LMC")

.-----. l . Non-Controlled Other Subsidiaries

Affiliates {including LMC Health System, Inc.)

t:xl"d '%j 11 )> 0

L..>. )> (I) rt 0 rt rt ~ n :;:. 0'1-' El .p. (I) N ::S N rt .....

00 > ....... n 0 ::s rt . .._,

Project //142218 BFA Attachment B

NYU Hospitals Center Consolidated Balance Sheets December 31, 2013 and 2012

(in thousands) 2013 2012

Assets Current assets

Cash and cash equivalents $ 87,566 $ 340,705 Marl<etable securities 3,438 3,470 Assets limited as to use 55,510 28,185 Assets limited as to use- Board designated 400,005 Patient accounts receivable, less allowances for uncollectibles (2013 - $77,1 96 and 2012 - $49,844) 270,577 189,614

Contributions receivable 95,067 28,851 Insurance receivables - billed 29,235 26,812 Due from related organizations 541 2,463 Inventories 30,722 19,226 Disaster recoveries receivable -federal grants 38,386 Commercial Insurance recoveries receivable 2,618 18,118 Other current assets 69,263 52,160

Total current assets 682,923 1,109,609

Marl<etable securities, less current portion 23,285 22,209 Assets limited as to use, less current portion 297,697 341 ,902 Assets limited as to use- Board designated 496,137 Contributions ~eceivable , less current portion 97,786 146,1 50 Other assets 29,270 10,789 Deferred financing costs 11 ,097 11,583 Property, plant and equipment, net 1,571,448 1,169,136

Total assets s 3,209,643 $ 2,811 ,378

Liabilities and Net Assets Current liabilities

Current portion of long-term debt $ 27,734 $ 85,680 Accounts payable and accrued expenses 132,182 168.272 Accounts payable and accrued expenses • disaster-related 34,258 36,053 Accrued salaries and related liabilities 56,668 49,998 Accrued interest payable 12,282 16,460 Current portion of accrued postretirement liabilities 1.798 1,737 Deferred revenue 1,377 35,529 Due to related organizations, net 18,413 2,000 Other current liabilities 70,758 74,038

Total current liabilities 355,470 469,767

long-term debt, less current portion 1,180,886 867,399 Outstanding losses and loss adjustment expenses 218,528 197,628 Accrued pension liabilities 62,257 138,179 Accrued postretirement liabilities, less current portion 58,362 67,080 Other liabilities 165,386 142,831


Net assets Unrestricted 822,730 576,058 Temporarily restricted 332.986 339,425 Permanently restricted 13 038 13,011

Total net assets 1,168 754 928,494

Total liabilities and net assets $ 3,209643 s 2,811 ,378

Project // 142218 BFA Attachment B (cont.)

NYU Hospitals Center Consolidated Statements of Operations Years Ended December 31, 2013 and 2012


Operating revenue Net patient service revenue, less provision

for bad debts (2013. $18,479, 2012- $23,547) $ 1 ,821 ,487 $ 1,726,882 Grants and sponsored programs 668 818 Premiums earned 35,053 39,082 Contributions 3,592 3,956 Endowment distribution and return on short-term investments 5,799 13,782 Commercial insurance recoveries-unallocated 3,850 54,118 Federal grant-disaster recovery 96,02 1 39,344 Other revenue 99,024 81,701 Net assets released from restrictions for operating purposes 15,867 20,836


Operating expenses Salaries and wages 698,641 678,392 Employee benefits 250,446 219,841 Supplies and other 827,781 756,156 Depreciation and amortization 87,051 78,088 Interest 35,572 24,674 Disaster-related expenses 81 ,530 40,495

Total operating expenses 1,981,021 1,797,646

Gain from operations 100,340 182,873

Other items Impairment of property, plant and equipment, net 3,327 (31,931) Loss on disposals of property, plant and equipment (4,745) (1 ,865) Investment return less endowment distribution, net (3,866) 342 Mission based payment to NYUSoM {30 ,000~ {35 ,735~

Excess of revenue over expenses 65,056 113,684

Other changes in unrestricted net assets Changes in pension and postretirement obligations 108,389 (44,064) Contributions for capital asset acquisitions 104 647 Net assets released from restrictions for capital purposes 73,123 810 Transfer of equity to NYUSoM {10,063~

Net increase in unrestricted net assets $ 246,672 $ 61,014

NYU Hospitals Center Consolidated Balance Sheets August 31, 2014 and 2013

(in thousands)

Assets Current assets

Cash and cash equivalents Marl<.etable securities Assets limited as to use Assets limited as to use • board designated Patient accounts receivable, less allowances for uncollectibles (2014- $79,552 and 2013- $73,614)

Contributions receivable Insurance receivables - billed Due from related organizations, net Inventories Disaster recovery receivable Commercial insurance recoveries receivable Other current assets


Mar'lletable securities, less current portion Assets limited as to use, less current portion Assets limited as to use - board designated, less current portion Contributions receivable, tess current portion Other assets Disaster recovery receivable. less current portion Deferred financing costs Property, plant and equipment, net

Total assets

Liabilities and Net Assets Current liabilities

Current portion of long-term debt Accounts payable and accrued expenses Accounts payable end accrued expenses -disaster-related Accrued salaries and related liabilities Accrued interest payable Current portion of accrued postretirement ~abilities Deferred revenue - disaster recovery Deferred revenue · other Due to relat~d organizations, net Other current liabilities


Long-term debt, less current portion Outstanding losses and loss adjustment expenses Accrued pension liabilities Accrued postretirement liabilities, less current portion Other ~abilities

Total liabilities

Net assets Unrestricted Temporarily restricted Permanently restricted

Total net assets

Total liabilities and net assets

Project /1142218 BFA Attachment C

2014

$ 323,459 $ 3,731

40,796 55,512

303,479 67,904 42,405

32,193 23,402

61,134

954,015

24,087 378,737 456 ,501 106,171

18,609 106,336

10,519 1,958,347

$ 4,013,322 $

$ 36,363 $ 176,425

42,166 46,840

9,754 1,916

64,886 23,709

2,269 44,841

449,169

1,401,199 233,239

96,594 72,646

199,640

2,452,487

1,031,365 516,425

13.045

1,560.835

$ 4 ,013,322 s

2013

162,861 3,562

48,350 20,000

258,400 103,907 37,251

3,161 28,796 10,441

2.618 39,889

719.236

22.177 306.399 468.918

70.745 18.565

11,976 1,473.762

3,091 778

77.165 155.779 20,612 35,695

7,925 1,740

17,617

64,518

381 ,051

1,1 21 ,794 215,972 85,909 57,279

176,451

2,038,456

758,080 282,2()4

13,038

1,053,322

3,091 ,778

Project //142218 BFA Attachment C (cont.)

NYU Hospitals Center Consolidated Statements of Operations Years Ended August 31, 2014 and 2013


Operating revenue Net patient service revenue, less provisio'n

for bad debts (2014- $11,611 , 2013- $19,583) $ 2,039,503 $ 1,662,617 Premiums earned 39,356 33,497 Contributions 6 ,190 3,367 Endowment distribution and return on short-term investments 21 ,194 3,060 Commercial insurance recoveries 9,232 54,118 Disaster recovery reimbursement 97,098 107,420 Other revenue 110,836 80,971 Net assets released from restrictions for operating purposes 23,044 2,467


Operating expenses Salaries and wages 736,018 675,690 Employee benefits 257,451 241,900 Supplies and other 971 ,323 752,683 Depreciation and amortization 98,565 83,598 Interest 46,166 31,527 Disaster-related expenses 221139 115 074

Total operating expenses 2,131,662 11900,472

Gain from operations 214 ,791 47,808

Other Items Impairment of property, plant and equipment, net 2,540 (28,957) Gain (loss) on disposals of property, plant and equipment 231 (4.745) Disaster recovery reimbursement for capital 73,374 Grant for capital assets 140 104 Investment return in excess of (less than) endowment distribution. net 8,023 (7,550) Mission based payment to NYUSoM (30,000) (35,735)

Excess (deficiency) of revenue over expenses 269,099 (29,075)

Other changes in unrestricted net assets Changes in pension and postretirement obligations (22 ,854) 96,438 Net assets released from restrictions for capital purposes 15,040 72,658 Net assets released from restrictions for hazard mitigation 12,000

Net increase in unrestricted net assets $ , 273,285 $ 140,021

lUTHERAN HEAL THCARE

COMBINED BALANCE SHEETS AS OF DECEMBER 31, 2013 AND 201 2 (I n thousands)

ASSETS

CURRENT ASSETS Cash and cash equivalents Investments Assets limned as to use Patient accounts recetvable -less allowance for uncollecttble accounts ofSI7, 722 and Sl8,288 in 2013 and 2012, respectively

Premiums receivable Other recetvables Due from third-party payors Other current aSSels


ASSETS LIMITED AS TO USE- Less current portton

INVESTMENTS

PROPERTY AND EQUIPMENT - Net

OTHER ASSETS

TOTAL


CURRENT LIABILITIES: Accounts payable and accrued ex~nses Accrued salaries and related liabilities Accrued medical costs Current portion of obligations under capital leases Current portion oflong-term debt Current portion of professional liabili ties Other current liabilities Current port ton of due to third-pany payors


LONG-TERM LIABILITIES: Due to third-pany payors Professionalliabilittes- less current ponton Obligations under capt tal leases- less current pont on Long-term debt - less current porto on Accrued penston liability Other long-term habthties

Total long-term liabilittes

Total liabilities

COMMITMENTS AND CONTINGENCIES

NET ASSETS. Unrestricted (including contingent reserve ofS33,025 in 2012-Temporarily restricted Permanent!)• restncted

Total net assets

TOTAL

Projec t //142218 BFA Attachment D

2013

s 36,058 48,1 29

1,449

82,837 3,449

11,500 15,038 25 298

223,758

69,606

103,770

182,188

80 743

s 660065

s 51,360 29,293

4,898 3,012 6,525 2,600

14,924 14 463

127,075

30,439 88,076

5,485 108,313 51,480 19,920

303,7 13

430,788

224,261 4,505

511

229 277

s 660,065

2012

s 28,930 63,028

1,457

80,081 3,950

15,686 17,706 40,882

251,720

88,055

72,579

178,179

79 504

s 670,037

$ 51,1 27 27,967

5,852 2.946 6.4 14 2,600

21,962 17 319

136.187

33,262 86,538

4,502 110,833 91,536 20 717

347 388

483 515

182,093 3,872

497

186 462

s 670,037

Project /1142218 BFA Attachment D (cont.)

LUTHERAN HEAL THCARE

COMBINED STATEMENTS OF OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012 (In thousands)

2013 2012

REVENUE: Net patient service revenue (after contractual allowances and

discounts) $ 593,791 $ 528,565 Provision for bad debts (25,9 18) (18,955)

Net patient service revenue- net of provision for bad debts 567,873 509,610

Premium revenue 7,308 433,376 Grant income 50,859 47,992 Investment income 5,492 5,466 Net assets released from restrictions 5,321 1,652 Other revenue 28,827 27,468

Total revenue 665,680 1,025,564

EXPENSES: Salaries and wages 330, 165 333,214 Employee benefits 113,643 106,334 Supplies and expenses 211 ,584 228,301 Medical costs (5,820) 358,064 Depreciation. and amort ization 21 ,252 20,601 Interest 1,613 4,976

Total expenses 672,437 1,051,490

OPERA TTNG LOSS (6,757) (25,926)

NONOPERA TTNG (LOSSES) GAINS {899) 73,976

(DEFICIENCY) EXCESS OF REVENUE OVER EXPENSES (7,656) 48,050

-OTHER CHANGES TN UNRESTRlCTED NET ASSETS: Defined benefit plan adjustments 42,330 (23,525) Changes in unrealized gains and losses on investments 3,034 3,744 Contributions 272 1,606 Net assets released for capital acquisitions 4 188 1,352

INCREASE TN UNRESTRICTED NET ASSETS $ 42,168 $ 31,227

LUTHERAN HEAL THCARE

COMBINED BALANCE SHEETS AS OF SEPTEMBER 30, 2014 AND DECEMBER 31, 2013 (In thousands)

ASSETS

CURRENT ASSETS;

Cash and cash equivalents

Investments Assets limited as to use

Patient care receivables, net Premiums receivable- net Other Receivables Due from third-party payors

Other current assets Total current assets

DUE FROM THIRD-PARTY PAYORS--Less currerlt portion

ASSETS LIMITED AS TO USE--Less currenl portion

INVESTMENTS

PROPERTY AND EOUIPMENT--Nel

OTHER LONG-TERM ASSETS

TOTAL

LIABIUTIES AND NET ASSETS

CURRENT LIABILITIES: Borrowings under line of credit Accounts payable and accrued expenses Accrued salaries and related liabilities

Accrued medical costs Current portion of long-term debt Current portion of professional liabililies

Other currentliabilitres Current portion of due to third-party payors


DUE TO THIRD-PARTY PAYORS - Less currenl portion

PROFESSIONAL LIABILITIES··Less currer11 portion

LONG-TERM DEBT-Less current portion

ACCRUED PENSION LIABILITY

OTHER LONG-TERM LIABILITIES

Tolalliel> lilies

NET ASSETS:

Unrestricted Temporarily restrrcted Perma nently re stricted

Tolol nel assets

TOTAL

Project #142218 BFA Attachment E

9130/2014 1213112013

s 18,159 s 36,058 24,635 48,129

1,449 1.449 83,795 82,837

3.449 11 ,825 11,500 9,441 15,038

15,210 25.298

164,514 223.758

60,373 69,606

132,952 103,770

176,234 182,188

83,828 80.743

s 617,901 $ G60,065

s 10,000 43,388 51 ,360 22,527 29,293

1.723 4,898 9,256 9,537 2,600 2,600

599 14,924 13,831 14.463

103 924 127,075

29,550 30,439

92.782 8!3,076

112,237 113,798

49,123 51,480

20 7:}3 19,920

408,349 430 788

206,124 224,261

2,917 4,505 511 51 1

~.552 229.277

s 617 901 ~0,065

LUTHERAN HEALTHCARE COMBINED STATEMENTS OF OPERATIONS FOR THE NINE MONTHS ENDED" SEPTEMBER 30,2014 (In thousands)

REVENUES: Pnlicnl scrvic~ n:v.:11uc Prm·isio11 lor 0;~1\ D<!br Net patient ser1ice revenue Premium revenue Grants and contributions Investment income Net assets released from restrictions Other revenue

Total revenues

EXPENSES: Salaries and wages Employee benefits Supplies and expenses Medical costs Deprec•alton and amortrzallon Interest

Total expenses

OPERATING NEl" INCOME (LOSS)

Other Non·Operating Revenue

EXCESS OF REVENUES OVER (UNDER) EXPENSES

DEFINED BENEFIT PLAN ADJUSTMENTS

CHANGE IN UNREALIZED GAINS AND (LOSSES) ON INVESTMENTS

CONTRIBUTIONS AND GRANTS

TRN..JSFERS TOIFR RESTRICTED AND UN RESTRICTED ASSETS

TRANSFERS OF NET ASSETS TO/FROM RELATED ENTITIES

NET ASSETS RELEASED FOR CAPITAL ACQUISITIONS

INCREASE (DECREASEj IN UNRESTRICTED NET ASSETS

Project 11142218 BFA Attachment E (cont.)

2014 YTD

$ 472,701 16 437

456,264 3,015

?.?.,328 3,734 4,535

23 203

513,079

262,209 82,390

167,906

16,213 3.484

532,202

(19, 123)

(19.123)

674

285

26

$ (18, 138)

Project 11141253 BFA Attachment B

DIGESTIVE DISEASE DIAGNOSTIC AND TREATMENT CENTER, LLC (A Umited Liability Company)

BALANCE SHEETS

December 31, 2013 and 2012

CURRENT ASSETS Cash Accounts Receivable

TOTAL CURRENT ASSETS

ASSETS

LEASEHOLD IMPROVEMENTS AND EQUIPMENT- NET (Note 3)

ORGANIZATION COSTS- Net (Note 4)

TOTAL ASSETS

CURRENT LIABILITIES Accounts Payable' Accrued Expenses Accrued Payroll Member Loan (Note 5)

LIABILITIES AND MEMBERS' EOUIJY

Loan Payable - Current Portion (Note 6)

TOTAL CURRENT LIABILITIES

WNG-TERM LIABILITIES Loan Payable - Less Current Portion (Note 6)

TOTAL LONG-TERM LIABILITIES

TOTAL LIABILITIES

COMMITMENTS AND CONTINGENCIES (Note 7)

MEMBERS' EQUITY

TOTAL LIABILITIES AND MEMBERS' EQUITY

2013 2012

$ 474,320 s 340,817 632,126 1,592,681

1.106.446 1.933.498

274,148 366,005

2.451 7.116

~ ll~J !:!~~ ~2 ~g~ ~12

$ 74,175 $ 85,342 22,883 15,249 34,764 40,332

9,357 9;357 124.914 120,862

266.093 271.142

98.957 223.065

98.957 223.065

J6:!,0:!Q 494,2Q7

1,017,995 1.812.412

$ I 383 045 $ 2]06 619

Project 11141253 BFA Attachment B (cont.)

DIGESTIVE DISEASE DIAGNOSTIC AND TREATMENT CENTER, LLC (A Limited Liability Company)

STATEMENTS OF INCOME AND MEMBERS' EQUITY

For the Years Ended December 31,2013 and 2012

2013

REVENUES Medical Income $4,382,555 Other Income 2,501

TOTAL REVENUES 4.385.056

OPERATING EXPENSES Salaries (Schedule I) 466,829

Employee Benefits (Schedule II) 85,520 Medical Expenses (Schedule Ill) 866,156 Property Costs (Schedule IV) 622,202 Administrative and General (Schedule V) 879.366

TOTAL OPERATING EXPENSES 2.920.073

NET INCOME 1,464,983

MEMBERS' EQUITY -BEGINNING OF YEAR 1,812,412

MEMBERS' CONTRIBUTIONS 171,000

MEMBERS' WITHDRAWALS (2.430.400}

MEMBERS' EQUITY - END OF YEAR $ 1 017,995

2012

$4,474,151 7,800

4.481.951

407,904 73,925

391,421 593,498 661.422 '

2, 128.170

2,353,781

1,530,631

(2,072.000)

l Ul'~"

Digestive Disease Diagnostic and Treatment Center, LLC


Internal Financial Statements for the period 1/1/2014-10/31/2014

Balance Sheet

Assets


Total Accounts Receivable & Other Current Assets

Total Fixed Assets

Total Other Assets

Total Assets


Total Accounts Payable

Total Other Current liabilities


Total Long Term liabilities

Total Liabilities

Equity

Total Equity


Revenues

Expenses

Total Other lncome/(Expense)

Total Net Income

Income Statement

$243,289

$629,627 $410,742

$78,158 $1.361.816

$53,949 $84,539

$138,488

$2,253,027

$2,391,515

($1,029,699)

$1.361.816

$5,579,019 $3,009,383 ($150,511)

$2,419.125

Project # 141253 BFA Attachment C

Odyssey Fou ndati on of New York, Inc.

Balance Sheets

June 30, 2014 and 2013

ASSETS

Current Assets:

Cash

cash held for t he benefit of related party

Prepaid expenses

Total curre nt assets

Equipment, net

Total aaets


Current Liabilities:

Accrued Expenses

Accounts payable and accrued expenses

Due to related party

Total c urrent liabilities

Net Assets :

Unrestric ted

Temporarily restricted for grants to related party

Temporarily rest ric ted for e-..ents

Total net assets

Tota l liab ilities and net assets

Project /1 142 152 At tachment A

$

.,

""$

$

.,

" $

2014

906,139

156,116

1,062,255

467

1,062,722

9 ,366

1,838

11,204

846,902

156,116

48,500

1,051,518

1,062,722

$

2013

888,1 06

156,116

5 ,559

1,047,781

" $ 1,047,781

$

.,

" $

13,716

76,637

90,353

789,862

156,116

11 ,450

957,428

1,047,781

Project /1142152 Attachment A ( cont . )

Odyssey Foundation of New York, Inc.

S tatements of Activities

Years Ended .June 30, 2014 and 2013

, 2014

.. 2013

Unrestricted Re\€nue:

Contributions $ 53,007 $ 46,664

Net re\€nua from special e\€nts:

Spec ial e-.ents re\€nue and support 194, 210 120,918

Net assets released from restrictions for special e\€nts 11 ,450 70,330

Less: costs of direct benefit to donors (36,876) (27,157)

Net revenue from special events 168,784 164,091

Interest income 1,005 781

Other re\€nue 1 ,562 3 ,827

Net assets released from restrictions - grants to related party 6,916 24,093

Total u nl"estricted ~"avenue ,.

231,274 239,456

Expenses:

Program ser.Aces 117,377 150,831

Management and general 29,350 42,199

Fund-raising acti..;ties 27,507 15,330

Total expenses 174,234 208,360

Increase in unrestricted n et assets ,

57,040 31,096

Temporarily Restricted Net Assets:

Contributions - grants for related party 6,916 11,000

Contributions for special e-.ents 48,500 1 1,450

Net assets released from restrictions (18,366) (94,423)

lnc:-ease i n temporarily restri cted net assets 37,050 (71 ,973)

Increase in net assets ,.

94,090 (40,an)

Net Assets :

Beginnir g 957,428 998,305

Ending ... $ 1 ,051,518 $ 957 ,428

CON1tl42152 BFA /' .. - ,.. ~o- . ..,Qnt d

ASSETS:

Cash

Total Assets

LIABILITIES:

Working Capital Loan

TOTAL LIABILITIES

NET ASSETS

Pro Forma Balance Sheet

$265,660 $265 ,660

$132,830

$132,830

$132,830

DRNC OPERATING. UC Doing Business As

DELHI REHABIUTATION & NURSING CENTER

ORGANIZATIONAL CHART

DRNC OPERATING, LLC Memb8rs: Ephraim Zagelbaum 48.00% Alexander Barth 23.00% Yehudah J . Walden 23.00% Pincus lagelbaum 2.00% Yechiel Zagelbaum 2.00% Yoel Zageibaum 2.00%

Doing Business As

DELHI REHABIUTATIQN & NURSING CENTER

RHCF Administrator Director of Nursing Direct Care Staff

Support Staff Clerical Staff

Lease

Members:

ORNC REALTY. LLC

(RHCF Real Estate)

Ephraim Zagelbaum, Member Alexander Barth, Member Yehudah J. Walden, Member Pincus Zagelbaum Yechiel Zagelbaum Yoel Zagelbaum

48.00% 23.00% 23.00% 2.00% 2.00% 2.00%

OJ

~ ):. ::; Ql 0 ::7'

3 CD :::J ..... )>

0 <0 Ql :::J N. ~ o· :::J ~ (") ::7' Ql ;4.

I

~ ...... ~ N ...... <D (J1

0 ~ ::7'

BFA-Attachment C Pro Forma- #142195 Delhi '

DRNC OPERATING1 LLC d[b[a DELHI REHABILITAT10N & NURSING CENTER 176-BED RESIDENTIAL HEALTH CARE FACILITY

PRO FORMA BALANCE SHEET

ASSETS

Working Capital $2,424,505

TOTAL ASSETS $2,424,505

UABILITIES AND EQUITY

LIABILITIES

Working Capital Loan $1 ,212,252 TOTAL LIABILITIES $1 ,212,252

MEMBER EQUITY $1,212.253

TOTAL LIABILITIES AND MEMBER EQUITY $2,424,505

ORNC REALTY, LLC

PRO FORMA BALANCE SHEET

ASSETS

Project Cost $28,066,346 ,Acquisition of Property $2,780,000 TOTAl ASSETS $30,846,346

LIABJLITIES AND EQUITY

LIABILITIES Project Loan $23,134.760

TOTAL LIABILITIES $23,134,760

MEMBER EQUITY $7,711,587

TOTAL LIABILITIES AND MEMBER EQUITY $30,846,346

BFA Attachment D Financial Summary- #142195 Delhi

CON 142196 DRNC Operating, LLC cllb/a Delhi Rehab & Nursing Cent.r

Al~ine Rehabilitation & Nursing Center 2013 2012 2011 Current Assets $992,011 $947,235 $819,452 Fixed Assets $1 ,637,592 $1,807,684 $1 ,171 ,675 Other Assets $341 ,695 $521 ,654 $0 Total Assets $2 ,971 ,298 $3,276,573 $1 ,991 ,1 27 Current Liabilities $1 ,330,282 $1 ,449,175 $1 ,207,301 Long Term Liabilities $1 ,066,317 $1 ,465,786 $568,139 Total Liabilities $2,396,599 $2,914,961 $1 ,775,440 Net Assets $574,699 $361 ,612 $215,687 Working Capital Position ($338,271) ($501 ,940) ($387,849) Operating Revenues $7,066,847 $5,899,989 $6,057,574 Operating Expenses $6,923,887 $5,760,415 $6,082 ,101 Operating Net Income $142,960 $139,574 ($24,527)

Highland Rehabilitation & Nursing Center 2013 Current Assets $1 ,642,375 Fixed Assets $458,997 Other Assets $136,090 Total Assets $2,237,462 Current Liabilities $2,260,759 Long Term Liabilities $47,721 Total Liabilities $2,308,480 Net Assets ($71 ,018) Working Capital Position ($618,384) Operating Revenues $8,137,283 Operating Expenses $8,227,261 Operating Net Income ($89,978)

Norwich Rehabilitation & Nursing Center 2013 2012 2011 Current Assets $1,300,807 $1,278,742 $571,465 Fixed Assets $560,355 $584,725 $342,787 Other Assets $87,072 $85,344 $0 Total Assets $1,948,234 $1,948,811 $914,252 Current Liabilities $1 ,665,260 $1 ,967,074 $1 ,093,998 Long Term Liabilities $336,106 $85,344 $70,431 Total Liabilities $2,001,366 $2,052,418 $1 ,164,429 Net Assets ($53,132) ($103,607) ($250,177) Working Capital Position ($364,453) ($688,332) ($522,533) Operating Revenues $6,858,036 $5,895,365 $5,681 ,516 Operating Expenses $6,864,703 $5,749,421 $5,917,693 Operating Net Income ($6,667) $145,944 ($236,177)

Tarrvtown Hall Care Center 2013 2012 2011 Current Assets $2,873,733 $3,526,220 $1 ,915,300 Fixed Assets $1 ,980,509 $1 ,901,358 $2,010,035 Other Assets $1 ,548,891 $1 ,501,872 $1,498,627 Total Assets $6,403,133 $6,929,450 $5,423,962 Current Liabilities $3,575,620 $4,460,145 $3,967,179 Long Term Liabilities $1,991 ,523 $1 ,318,821 $1,967,936 Total Liabilities $5,567,143 $5,778,966 $5,935,115 Net Assets $835,990 $1 ,150,484 ($511 '153) Working Capital Position ($701 ,887) ($933,925) ($2,051 ,879) Operating Revenues $13,226,817 $12,797,986 $12,138,139 Operating Expenses $13,450,978 $11,123,161 $13,799,078 Operating Net Income ($224,161) $1 ,674,825 ($1 ,660,939)

BFA-Attachment E Financial Summary/Combined - #142195 Delhi

CON 142195 DRNC Operating, LLC d/bla Delhi Rehab & Nursing Center

Combined Flnanclals for Paclllty Operating LLC & R-lty LLC as Indicated:

Al(!ine Rehabilitation & Nursing Center YTD 10/31/2014 2013 2012 2011

YEY Group, LLC Current Assets $1 ,252,229 $1 ,062,423 $995,997 $819,452 Fixed Assets $4,774,684 $4,603,467 $4,847,809 $1 ,171 ,675 Other Assets $191 ,096 $389,795 $600,600 Total Assets $6.218,009 $6,055,685 $6,444,406 $1 ,991 ,127 Current Liabilities $1 ,206,995 $1 ,472,369 $1 ,585,400 $1 ,207,301 Long Term Liabilities $4,011 ,698 $4,022,242 $4,544,443 $568,139 Total Liabilities $5,218,693 $5,494,611 $6,129,843 $1 ,775,440 Net Assets $999,316 $561 ,074 $314,563 $215,687 Working Capital Position $45,234 ($409,946) ($589,403) ($387,849) Operating Revenues $5,739,961 $7,066,847 $5,899,989 $6,057,574 Operating Expenses $4,722,715 $5,790,512 $5,554,658 $6,082,101 Operating Net Income $1 ,017,246 $1 ,276,335 $345,331 ($24,527)

Highland Rehabilitation & Nursing Center YTD 10/31/2014 2013

HRNC Realty, LLC Current Assets $1 ,944,570 $1 ,743,375 Fixed Assets $5,871,649 $6,078,372 Other Assets $594,798 $273,842 Total Assets $8,411 ,017 $8,095,589 Current Liabilities $1 ,909,996 $2,478,053 Long Term Liabilities $5,327,389 $4,681 ,055 Total Liabilities $7,237,385 $7,159,108 Net Assets $1 ,173,632 $936,481 Working Capital Position $34,574 ($734,678) Operating Revenues $8,038,770 $8,137,283 Operating Expenses $7,154,754 $7,169,762 Operating Net Income $884,016 $967,521

Norwich Rehabilitation & Nursing Center YTD 10131/2014 2013 2012 2011

Norwich R~alty Associates, LLC Current Assets $1 ,229,138 $1 ,028,776 $1 ,006,886 $571 ,465 Fixed Assets $2,602,963 $2,709,956 $2,785,249 $342,787 Other Assets $203,039 $175,938 $209,756 Total Assets $4,035,140 $3,914,670 $4,001,891 $914,252 Current Liabilities $945,750 $1 ,786,635 $2,088,908 $1 ,093,998 Long Term Liabilities $2,790.463 $2,195,273 $2,059,511 $70,431 Total Liabilities $3,736,213 $3,981 ,908 $4,148,419 $1,164,429 Net Assets $298,927 ($67,238) ($146,528) ($250,177) Working Capital Position $283,388 ($757,859) ($1 ,082,022) ($522,533) Operating Revenues $6,240,636 $6,858,036 $5,895,365 $5,681 ,516 Operating Expenses $4,874 472 $5,660,888 $5,469,613 $5,917,693 Operating Net Income $1 ,366,164 $1 ,197,148 $425,752 ($236,177)

Tarrvtown Hall Care Center YTD 10/31/20::14 2013 2012 201 1

Phamex GroUI! Realty, LLC Current Assets $3,136,302 $3,419,617 $3,621 ,754 $2,148,101 Fixed Assets $2,517,576 $1 ,980,509 $1,901 ,358 $2,010,035 Other Assets $1 ,494,678 $1,548,891 $1,501 ,872 $1,498,627 Total Assets $7,148,556 $6,949,017 $7,024,984 $5,656,763 Current Liabilities $2,393,690 $3,862,792 $4,548,317 $3,958,946 Long Term Liabilities $3,183,211 $1 ,991 ,523 $1 ,318,821 $1 ,967,936 Total Liabilities $5,576,901 $5,854,315 $5,867,138 $5,926,882 Net Assets $1,571 ,655 $1 ,094,702 $1 ,157,846 ($270,119) Working Capital Position $742,612 ($443,175) ($926,563) ($1 ,810,845) Operating Revenues $11,1 45,368 $13,226,817 $12,797.986 $12,138,139 Operating Expenses $9 714,492 $11 ,601 ,628 $11 ,061 ,833 $10,344,093 Operating Net Income $1 ,430,876 $1,625,189 $1 ,736,153 $1 ,794,046



Tarrytown Hall Care Center




4 out of 5 stars


4 out of 5 stars


5 out of 5 stars


5 out of 5 stars


3 out of 5 stars


4 out of 5 stars


3 out of 5 stars


5 out of 5 stars













2 out of 5 stars


4 out of 5 stars


5 out of 5 stars


1 out of 5 stars


1 out of 5 stars


5 out of 5 stars


2 out of 5 stars


4 out of 5 stars


4 out of 5 stars


2 out of 5 stars













Tarrytown Hall Care Center


PFI: 1115

Regional Office: MARO--New Rochelle Area Office


period.

Summary


statewide average.

Measure This

Facility

Statewide

Average









Alpine Rehabilitation and Nursing Center




2 out of 5 stars


5 out of 5 stars


3 out of 5 stars


3 out of 5 stars


1 out of 5 stars


1 out of 5 stars


1 out of 5 stars


4 out of 5 stars













4 out of 5 stars


4 out of 5 stars


1 out of 5 stars


1 out of 5 stars


2 out of 5 stars


3 out of 5 stars


3 out of 5 stars


5 out of 5 stars


5 out of 5 stars


1 out of 5 stars













Alpine Rehabilitation and Nursing Center


PFI: 0364

Regional Office: Central New York Regional Office


period.

Summary


statewide average.

Measure This

Facility

Statewide

Average









Norwich Rehabilitation & Nursing Center




2 out of 5 stars


3 out of 5 stars


2 out of 5 stars


2 out of 5 stars


4 out of 5 stars


3 out of 5 stars


5 out of 5 stars


5 out of 5 stars













1 out of 5 stars


2 out of 5 stars


2 out of 5 stars


5 out of 5 stars


1 out of 5 stars


3 out of 5 stars


5 out of 5 stars


1 out of 5 stars


2 out of 5 stars


4 out of 5 stars













Norwich Rehabilitation & Nursing Center


PFI: 4522

Regional Office: Central New York Regional Office


period.

Summary


statewide average.

Measure This

Facility

Statewide

Average









Highland Rehabilitation and Nursing Center




1 out of 5 stars


2 out of 5 stars


2 out of 5 stars


2 out of 5 stars


1 out of 5 stars


3 out of 5 stars


1 out of 5 stars


1 out of 5 stars













1 out of 5 stars


3 out of 5 stars


2 out of 5 stars


1 out of 5 stars


1 out of 5 stars


5 out of 5 stars


3 out of 5 stars


2 out of 5 stars


1 out of 5 stars


3 out of 5 stars













Highland Rehabilitation and Nursing Center


PFI: 0691

Regional Office: MARO--New Rochelle Area Office


period.

Summary


statewide average.

Measure This

Facility

Statewide

Average







_,.,

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment A- Page 1 of 1 Before and After Gentiva Organizational Charts

--·-· - --··-

Gentiva Health Services, Inc. (DE) 36-4335801

I Gentiva Health Services Holding Corp.

(DE) 11-3454104

I

------

QC-Mcdi New York, Inc. (CHHAs) Quality Care-USA, Inc. (LHCSAs) (NY) 11-2750425 (NY) 11-2256479

KINDRED HEALTHCARE, INC. KINDRED HEALTHCARE OPERATING, INC.

ORGANIZATIONAL SCHEMATIC AFTER STOCK TRANSFER

KINDRED HEALTHCARE, INC. (DE)

KINDRED HEALTHCARE OPERATING, INC. (DE)


Gentiva Health Services Holding Corp. (DE) 11-3454104

QC-Mcdi New York, Inc. (CHHAs) Quality Care-USA, Inc. (LHCSAs) (NY) 11-2750425 (NY) 11-2256479

=provider Entity

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment 8- Page 1 of 8 Kindred Providers/Facilities

Kindred Healthcare: long-Term Care Hospitals

State Facility Name State Facility Name

AZ. Kindred Hospital Arizona- Northwest Phoenix IL Kindred Hospital- Chicago (Northlake Campus)

AZ. Kindred Hospital - Arizona - Phoenix IL Kindred Hospital- Chicago (North Campus)

AZ Kindred Hospital- Tucson IL Kindred Hospital - Sycamore CA Kindred Hospital Baldwin Park IL Kindred - Chicago - Central Hospital

CA Kindred Hospital Riverside IL Kindred Hospital Peoria

CA Kindred Hospital South Bay IL Kindred - Chicago - Lakeshore CA Kindred Hospital South Bay- Tri-City Campus IN Kindred Hospital -Indianapolis

CA Kindred Hospital Rancho IN Kindred Hospital- Indianapolis South CA Kindred Hospital- Brea IN Kindred Hospital Northwest Indiana CA Kindred Hospital - Ontario IN Kindred Hospital Northern Indiana

CA Kindred Hospital- San Francisco Bay Area KY Kindred Hospital - Louisville

CA Kindred Hospital- La Mirada KY Kindred Hospital- Louisville at Jewish Hospital

CA Kindred Hospital - San Gabriel Valley LA Kindred Hospital - New Orleans CA Kindred Hospital - Santa Ana MA Kindred Hospital - Boston CA Kindred Hospital - Westminster MA Kindred Hospital - Boston North Shore

CA Kindred Hospital - San Diego MA Kindred Hospital Northeast - Natick CA Kindred Hospital - Los Angeles MA Kindred Hospital Northeast- Stoughton co Kindred Hospital - Denver Ml Kindred Hospital Detroit co Kindred Hospital Aurora MO Kindred Hospital - Kansas City FL Kindred Hospital Ocala MO Kindred Hospital - St. Louis FL Kindred Hospital The Palm Beaches MO Kindred Hospital - St. Louis - St. Anthony's

FL Kindred Hospital -South Florida- Coral Gables MO Kindred Hospital Northland

FL Kindred Hospital - Bay Area St. Petersburg MO Kindred Hospital~ St. Louis at Mercy

FL Kindred Hospital- Bay Area~ Tampa NJ Kindred Hospital New Jersey - Morris County

FL Kindred Hospital - South Florida Ft. Lauderdale NJ Kindred Hospital New Jersey - Rahway

FL Kindred Hospital - North Florida NJ Kindred Hospital New Jersey - Wayne

FL Kindred Hospital- Central Tampa NM Kindred Hospital - Albuquerque

FL Kindred Hospital Melbourne NV Kindred Hospital- Las Vegas (Sahara Campus)

FL Kindred Hospital- South Florida- Hollywood NV Kindred Hospital Las Vegas- Flamingo Campus

GA Kindred Hospital- Atlanta NV Kindred Hospital- Las Vegas at St. Rose Dominican Hospitals - Rose de Uma Campus

GA Kindred Hospital Rome NC Kindred Hospital- Greensboro

CON Project #142193~E and LHCSA Application #2556~L Programmatic Attachment B ~Page 2 of 8 Kindred Providers/Facilities

Kindred Healthcare: LongwTerm Care Hospitals


OH Kindred Hospital ~ Dayton TX Kindred Hospital (Houston NW) OH Kindred Hospital - Cleveland TX Kindred Hospital (Bay Area) OH Kindred Hospital -Cleveland- Gateway TX Kindred Hospital- Mansfield OH Kindred Hospital Central Ohio TX Kindred Hospital - Fort Worth OH Kindred Hospital Lima TX Kindred Hospital Houston Medical Center OK Kindred Hospital - Oklahoma City - South TX Kindred Hospital - White Rock OK Kindred Hospital - Oklahoma City TX Kindred Hospital Town & Country PA Kindred Hospital Philadelphia - Havertown TX Kindred Hospital Sugar Land PA Kindred Hospital- Philadelphia TX Kindred Hospital Dallas Central PA Kindred Hospital ~ Pittsburgh TX Kindred Hospital El Paso PA Kindred Hospital at Heritage Valley TX Kindred Hospital Spring PA Kindred Hospital South Philadelphia TX Kindred Hospital Tomball TN Kindred Hospital - Chattanooga TX Kindred Hospital The Heights TN Kindred Hospital- Nashville TX Kindred Hospital Baytown TX Kindred Hospital ~ Dallas TX Kindred Hospital Clear Lake TX Kindred Hospital - San Antonio WA Kindred Hospital Seattle - Northgate TX Kindred Hospital- Tarrant County (Arlington Campus) WA Kindred Hospital Seattle- First Hill

TX Kindred Hospital- Tarrant County (Fort Worth Southwest Campus)

Kindred Healthcare: Rehabilitation Hospitals Hospital Based Subacute Units


MO St. Luke's Rehabilitation Hospital CA Kindred Hospital - Brea TX Kindred Rehabilitation Hospital Northeast Houston KY Kindred Hospital ~ Louisville TX Kindred Rehabilitation Hospital Arlington NC Kindred Hospital - Greensboro TX Kindred Rehabilitation Hospital Clear Lake NV Kindred Hospital Las Vegas - Flamingo Campus TX Central Texas Rehabilitation Hospital OH Kindred Hospital- Cleveland

TX Kindred Hospital - Dallas

WA Kindred Seattle- Northgate

WA Kindred Seattle - First Hill

•

CON Project #142193-E and LHCSA Application #2556-l Programmatic Attachment B - Page 3 of 8 Kindred Providers/Facilities

Kindred Healthcare: Nursing Centers


AZ Kindred Nursing and Rehabilitation-Hacienda 10 Kindred Transitional Care and Rehabilitation-Lewiston

CA Kindred Transitional Care and Rehabilitation-Village Square 10 Kindred Nursing and Rehabilitation- Nampa

CA Kindred Transitional Care and Rehabilitation-Tunnel! Center 10 Kindred Nursing and Rehabilitation- Weiser

CA Kindred Nursing and Rehabilitation-Nineteenth Avenue 10 Kindred Nursing and Rehabilitation - Aspen Park CA Kindred Transitional Care and Rehabilitation-Canyonwood 10 Kindred Nursing and Rehabilitation- Mountain Valley CA Kindred Nursing and Healthcare - Livermore IN Kindred Transitional Care and Rehabilitation-Bridgewater CA Kindred Transitional Care and Rehabilitation-Lawton IN Kindred Transitional Care and Rehabilitation-South Pointe

CA Kindred Transitional Care and Rehabilitation - Valley IN Kindred Transitional Care and Rehabilitation-Eagle Creek Gardens

CA Kindred Nursing and Transitional Care- Santa Cruz IN Kindred Transitional Care and Rehabilitation-Allison Pointe

CA Kindred Transitional Care and Rehabilitation - Walnut Creek IN Kindred Transitional Care and Rehabilitation-Dyer

CA Kindred Nursing and Heatthcare-Bayberry IN Kindred Transitional Care and Rehabilitation-Greenwood CA Kindred Nursing and Transitional Care-South Marin IN Kindred Transitional Care and Rehabilitation-Greenfield CA Kindred Nursing and Rehabilitation -Medical Hill IN Kindred Transitional Care and Rehabilitation-Sellersburg CA Kindred Nursing and Transitional Care - Pacific Coast IN Kindred Transitional Care and Rehabilitation-Indian Creek CA Kindred Transitional Care and Rehabilitation-Smith Ranch IN Kindred Nursing and Rehabilitation-Valley View CA Kindred Nursing and Rehabilitation- Ygnacio Valley IN Kindred Transitional Care and Rehabilitation~Dyer CA Kindred Transitional Care and Rehabilitation-Siena IN Kindred Transitional Care and Rehabilitation-Greenwood CA Kindred Nursing and Rehabilitation-Golden Gate IN Kindred Transitional Care and Rehabilitation-Greenfield CA Kindred Nursing and Healthcare- Victorian IN Kindred Transitional Care and Rehabilitation-Sellersburg CA Kindred Transitional Care and Rehabilitation-Foothill IN Kindred Transitional Care and Rehabilitation-Indian Creek

co Kindred Nursing and Rehabilitation - Aurora IN Kindred Nursing and Rehabilitation-Valley View CT Kindred Nursing and Rehabilitation-Crossings West IN Kindred Transitional Care and Rehabilitation-Kokomo

CT Kindred Transitional Care and Rehabilitation-Windsor IN Kindred Transitional Care and Rehabilitation-Wildwood CT Kindred Nursing and Rehabll'ltation-Crossings East IN Kindred Transitional Care and Rehabilitaflon-Southwood

CT Kindred Transitional Care and Rehabilitation-Parkway IN Kindred Transitional Care and Rehabilitation-Columbus Pavilion

GA Kindred Transitional Care and Rehabilitation~Lafayette IN Kindred Transitional Care and Rehabilitation-Wedgewood 10 Kindred Nursing and Rehabilitation -Caldwell IN Kindred Transitional Care and Rehabilitation-Harrison ID Kindred Nursing and Rehabilitation- Canyon West IN Kindred Transitional Care and Rehabilitation-Rolling Hills

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment B -Page 4 of 8 Kindred Providers/Facilities

Kindred Healthcare: Nursing Centers


KY Heritage Manor Healthcare Center OH Kindred Transitional Care and Rehabilitation-The Greens

KY Kindred Nursing and Rehabilitation-Maple OH Kindred Nursing and Rehabilitation-Community

KY Kindred Nursing and RehabHitation-Bashford OH Kindred Transitional Care and Rehabilitation-Stratford

MA Kindred Transitional Care and Rehabilitation-Harrington OH Kindred Transitional Care and Rehabilitation-LakeMed

MA Kindred Nursing and Rehabilitation-Hallmark TN Kindred Nursing and Rehabilitation - Loudon

MA Kmdred Nursing and Rehabilitation-Timberlyn Heights TN Kindred Transitional Care and Rehabilitation-Maryville

MA Kindred Transitional Care and Rehabilitation-Westborough TN Kindred Nursing and Rehabilitation - Fairpark

MA Kindred Transitional Care and Rehabilitation-Eagle Pond TN Kindred Nursing and Rehabilitation -Smith County

MA Kindred Nursing and Rehabilitation-Great Barrington TN Kindred Nursing and Rehabilitation- Northhaven

MA Kindred Transitional Care and Rehabilitation-Country Estates TX Kindred Transitional Care and Rehabilitation-Ridgmar

MA Kindred Transitional Care and Rehabilitation-Highgate TX Kindred Transitional Care and Rehabilitation-Mansfield Plaza

MA Kindred Transitional Care and Rehabilitation-Avery TX Kindred Transitional Care and Rehabilitation-Grapevine

MA Kindred Nursing and Rehabilitation-Tower Hill UT Kindred Nursing and Rehabilitation- Wasatch Care

MA Kindred Nursing and Rehabilitation-Harborlights UT Kindred Nursing and Rehabilitation- St. George

MA Kindred Nursing and Rehabilitation~Braintree VT Kindred Transitional Care and Rehabilitation~Birchwood Terrace

MA Kindred Transitional Care and Rehabilitation-Forestview VT Starr Farm Nursing Center

MA Kindred Transitional Care and Rehabilitation~Highlander VA Kindred Transitional Care and Rehabilitation~Nansemond Pointe

MA Kindred Nursing and Rehabilitation-Laurel Lake VA Kindred Nursing and Rehabilitation-River Pointe

MA Ledgewood Rehabilitation and Skilled Nursing Center VA Kindred Transitional Care and Rehabilitation-Bay Pointe

MA Seacoast Nursing and Rehabilitation Center WA Kindred Nursing and Rehabilitation-Arden

MA Clark House Nursing Center at Fox Hill Village WA Kindred Transitional Care and Rehabilitation~Lakewood

MT Kindred Transitional Care and Rehabilitation-Park Place WA Kindred Transitional Care and Rehabilitation-Vancouver

MT Kindred Nursing and Rehabilitation- Parkview WY Kindred Transitional Care and Rehabilitation- Cheyenne

NH Kindred Transitional Care and Rehabilitation-Greenbriar WY Kindred Nursing and Rehabilitation • Rawlins

NC Kindred Transitional Care and Rehabilitation-Rose Manor WY Kindred Nursing and Rehabilitation- Wind River

NC Kindred Nursing and Rehabilitation-Henderson

NC Kindred Transitional Care and Rehabilitation~Eiizabeth City

OH Kindred Transitional Care and Rehabilitation-Newark

CON Project #142193-E and LHCSA Application #2556-l Programmatic Attachment B - Page 5 of 8 Kindred Providers/Facilities

I Assisted Living Facilities: Independently licensed j Hospice ···- -· -- .... -·

I Kindred at Home-Hospice-Glendale

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment B - Page 6 of 8 Kindred Providers/Facilities

State Facility Name

AZ Granite Mountain Home Care

AZ Kindred at Home-Home Health-Glendale

CA Professional Healthcare at Home

CA Kindred at Home (San Diego)

CA Kindred at Home (Garden Grove)

CA Professional Healthcare at Home

CA Kindred at Home-Torrance

CA Community Home Health

co Kindred at Home-Home Health-Denver

co PeopleFirst Homecare (Ft. Collins}

Fl Senior Home Care (Boynton Beach)

FL Senior Home Care (Miami Lakes)

FL Senior Home Care (Port Saint Lucie}

FL Senior Home Care {Sunrise)

FL Senior Home Care, Inc. (Clearwater)

FL Senior Home Care, Inc. (Fort Myers)

FL Senior Home Care, Inc. (Ocala)

FL Senior Home Care, Inc. (Jacksonville}

FL Senior Home Care, Inc. (Maitland)

FL Bodymax Physical Therapy

Fl Senior Home Care, Inc. (Pensacola)

FL Senior Home Care, Inc. (Spring Hill)

FL Senior Home Care, Inc. (Tampa)

il Kindred at Home- Chicago Home Health

IN Kindred at Home-Home Health-Indianapolis

LA Synergy Home Care-Acadiana Region, Inc.

LA Synergy Home Care-Capitol Region, Inc.

LA Synergy Home Care-Central Region, Inc.

LA Synergy Home Care-Northeastern Region, Inc.

LA Synergy Home Care-Northshore Region, Inc.

LA Synergy Home Care-Northwestern Region, Inc.

Home Care Agencies

State Facility Name

LA Synergy Home Care-Southeastern Region, Inc.

MA Kindred at Home-Marlborough

NV Kindred at Home-Home Health-Las Vegas

OH Kindred at Home-Home Health-Akron

OH Kindred at Home-Home Health-Columbus

OH Kindred at Home-Home Health-Findlay

OH Western Reserve Senior Care

TX lntegraCare of Abilene, LLC

TX lntegraCare of Albany, LLC

TX lntegraCare of West Texas Home Health, LLC

TX lntegraCare of Athens Home Health, LLC

TX lntegraCare of South Central Texas

TX lntegraCare Home Health Services ' TX lntegraCare Home Health of Big Spring

TX lntegraCare of Olney

TX lntegraCare ofT exas, LLC i TX lntegraCare of Cleburne

TX lntegraCare Home Health of Colorado City

TX lntegraCare of El Paso I TX lntegraCare of Granbury, LLC I

TX Kindred at Home-Home Health-South Houston

TX Kindred at Home-Home Health-West Houston

TX lntegraCare of Littlefield, LLC

TX lntegraCare of North West Texas

TX lntegraCare Home Health and Hospice

TX lntegraCare of North East Texas

TX lntegraCare Home Health-Permian Basin • TX lntegracare of the Panhandle

TX lntegraCare of North Texas

TX lntegraCare of South West Texas

TX lntegraCare of Seymour

CON Project #142193~E and LHCSA Application #2556~L Programmatic Attachment B ~Page 7 of 8 Kindred Providers/Facilities

State Facility Name

TI< lntegraCare of North Central Texas

TI< lntegraCare of Waco-Home Health

TI< lntegraCare of Wichita Falls, LLC

Home Care Agencies

State Facility Name

UT Kindred at Home ~ Home Health ~ Murray

UT Southern Utah Home Care VA All Heart Home Health and Hospice

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment 8 -Page 8 of 8 Kindred Providers/Facilities

Rehab Care Agencies

State Facility Name State

AL RehabCare Agency AL MN

AR Arkansas Agency MO CA RehabCare Agency S CA (Laguana Hills) MO CA RehabCare Agency N CA (Pleasant Hill) MO co Atria Inn at Lakewood MO co Balfour Retirement MO co RehabCare, LLC - Colorado NC co Springbrooke NC

FL RehabCare Agency FL NV

FL RehabCare/Barrington Terrace NV

IL RehabCare Agency IL NV

IL Cedarhurst at Shiloh OH IN Atria Eastlake Terrace OK IN Atria Tangelwood Trace PA IN First Steps KINDRED (special Medicaid program in IN) sc IN Kindred Rehab Service, Inc., d/b/a Bedford Outpatient TN

Therapy Specialists

IN RehabCare Agency IN TX KS RehabCare Agency KS TX

LA The Therapy Group, Inc. VA

MD Mercy Ridge Retirement Community (formerly Villa VA Assumpta/Maria Hlth) Ml Atria Shorehaven WI Ml RehabCare Agency Ml

Facility Name

RehabCare Agency MN I TCK Coon Rapids (#5514) **PEDS

Autumn View Gardens Ellisville

Crab Apple Village Senior Estates

Little Sisters of the Poor

Mother of Good Counsel

RehabCare Agency MO

Brooks Howell Home

RehabCare Agency NC Emeritus at Spring Valley (Kindred Nevada LLC dba Torrey Pines Care Cente-r) Emeritus at Sun Mountain (Kindred Nevada LLC dba Torrey Pines Care Center) Emeritus of Las Vegas (Kindred Nevada LLC dba Torrey Pines Care Center) RehabCare Agency OH

RehabCare Agency OK

RehabCare Agency at Davidsville Care Center

RehabCare Agency SC

RehabCare Agency TN

Isle at Watermere

RehabCare Agency TX Peopfefirst Virginia, LLC, d/b/a Peoplefirst Rehabilitation Services {Envoy of Staunton)* Peoplefirst Virginia, LLC, d/b/a Peoplefirst Rehabilitation Services (Envoy of Winchester)*

RehabCare Agency WI

CON Project #142193-E and LHCSA Application #2556-L

Programmatic Attachment c ~ Page 1 of 1 Ms. Yale Affiliations

National Surgical Healthcare, Inc. -Locations

State Name

Arizona Arizona Spine and Joint Hospital

Arizona Canyon Ambulatory Surgery Center

California Aspen Surgery Center

California Brentwood Surgery Center

California Sequoia Surgical Pavilion

California Skyway Surgery Center

California Sutter Surgical Hospital- North Valley

Connecticut Fairfield Surgery Center

Idaho Northwest Specialty Hospital

Illinois NSH Corporate Offices

Louisiana Lafayette Surgical Specialty Hospital

North Carolina North Carolina Specialty Hosp.1tal

North Carolina Triangle Orthopaedics Surgery Center

Michigan Lakes Surgery Center

Michigan Michigan Surgical Hospital

Texas El Paso Specialty Hospital

Texas South Texas Spine & Surgical Hospital

Texas South Texas Surgical Hospital

Texas The Physicians Centre Hospital

Utah Cache Valley Specialty Hospital

Wisconsin OakLeaf Surgical Hospital

Wyoming Mountain Vtew Regional Hospitals

CON Project #142193-E and LHCSA Arrlication #2556-L

Programmatic Attachment 0 -Page 1 of 2 Mr. Diaz Affiliations

(DaVita Healthcare Partners, Inc. New York State Affiliates

[Operator· liberty RC Inc . • .

Type Name

Diagnostic and Treatment Cleve Hill Dialysis Center

Center 0"1agnostic and Treatment

Bedford Park Dialysis Center Center Extension Clinic

Diagnostic and Treatment Celia Dill Dialysis Center Center Extension Clinic

Diagnostic and Treatment Dyker Heights Dialysis Center

Center Extension Clinic Diagnostic and Treatment

Eastchester Road Dialysis Center Center Extension Clinic Diagnostic and Treatment

Hudson Vally Dialysis Center Center Extension Clinic Diagnosf1c and Treatment

Lowville Dialysis Center Center Extension Clinic Diagnostic and Treatment

Niagara Falls Kidney Care Center Center Extension Clinic Diagnostic and Treatment

Port Chester Dialysis & Renal Center Center Extension Clinic Diagnostic and Treatment

Renal Care of Buffalo Center Extension Clinic Diagnostic and Treatment

South Brooklyn Nephrology Center Center Extension Clinic Diagnostic and Treatment

Southtowns Dialysis Center Center Extension Clinic Diagnostic and Treatment

White Plains Dialysis Center Center Extension Clinic Diagnostic and Treatment

Yonkers East Dialysis Center Center Extension Clinic

City

Buffalo

Bronx

Carmel

Brooklyn

Bronx

Tarrytown

Lowville

Niagara Falls

Port Chester

West Seneca

Brooklyn

Hamburg

White Plains

Yonkers

CON Project #142193-E and LHCSA Arrlication #2556-L

Programmatic Attachment D - Page 2 of 2 Mr. Diaz Affiliations

!oaVita Healthcare Partners, Inc. New York State Affiliates

joperator: Knickerbocker Dialysis, Inc.

Name

Bronx Dialysis Center

Boston Post Road Dialysis Center

Catskill Dialysis Center

Central New York Dialysis Center

Garden City Dialysis Center

Jamestown Dialysis Center

Long Island Renal Care

Lynbrook Dialysis Center

Northtowns Dialysis Center

Orange Dialysis Center

Orachard Park Dialysis Center

Peeksill Cortland Dialysis Center

Port Washington Dialysis Center

Queens Dialysis Center

Queens Village Dialysis Center

Richmond Kidney Center

Riverdale Dialysis Center

Sheepshead Bay Renal Care Center

Soundview Dialysis Center

South Bronx Dialysis Center

Staten Island Dialysis Center

Suburban Dialysis Center

Waters Place Dialysis Center

Yonkers Dialysis Center

City

Bronx

Bronx

Monticello

Syracuse

Garden City

Jamestown

Amityville

Lynbrook

Tonawanda

Middletown

Orchard Park

Cortlandt Manor

Port Washington

Jamaica

Queens Village

Staten Island

Bronx

Brooklyn

Bronx

Bronx

Staten Island

Williamsville

Bronx

Yonkers

CON Pro,ect #142193-E and LHCSA AUFiication #2556-L

F'rogrammauc Attachment E - Page 1 of 1 Mr. Short Affiliations

Seton Family Facilities. Texas

Seton Edgar B Davis Hospital

Seton Highland lakes Home Health· Texas Department of Aging and Disability Services

Seton Highland lakes Hospice- Texas Department of Aging and Disability Services

Seton Highland lakes Hospital

Seton Lampasas Healthcare Center

Seton Lockhart Family Health Center

Seton Marble Falls Healthcare Center

Seton Medical Center Hays

Seton Medical Center Williamson

Seton Northwest Hospial

Seton Riverbend Home Health- Texas Department of Aging and Disability Services

Seton Shoal Creek Hospital

Seton Smithville Regional Hospital

Seton Southwest Hospital

SHL Care-A-Van

SHL Professional Support Services

Towers Nursing Home- Texas Department of Aging and Disability Services

Dell Children's Medical Center

Emergency Medical Center

SEBD Care-A-Van

SEBD Professional Support Services

Seton Bertram Healthcare Center

Seton Burnet Healthcare Center

Seton Community Health Centers

University Medical Center at Brackenridge

CON Project#142193-E and lHCSA Application #2556-l Programmatic Attachment F - Page 1 of 3 Kindred Legal Actions

Schedule 2A Responses

ITEM 6.11(a)

Veneer, Inc. filed voluntary petitions for protection under the Bankruptcy Code on September 13, 1999, primarily as a result of decreased Medicare and Medicaid reimbursement rates introduced by the Balanced Budget Act of 1997, which led to the company being unable to meet its then existing financial obligations, including rent payable to its principal landlord, Ventas, Inc. ("Ventas"), ond debt serviee obligations under existing indebtedness. On March 1, 2001, the Bankruptcy Court approved the Veneer, Inc. Plan of ReorganiZation. From September 13, 1999 until the company emerged frmn bankruptcy on April20, 2001, the company operated as a debtor-in-possession subject to the jurisdiction of the Bankruptcy Court.

Pursuant to the Plan of Reorganization, the company bsued creditors (in exchange for their claims) secured notes, common stock and two series of warrants, entered into a new credit agreement as well as new master lease agreements with Ventas, and can¢elled all existing senior debt and equity. The company also appointed a new board of directors including representatives ofprint>ipal security holders, adopted fresh~start accounting pursuant to applicable accounting rules end changed its name to Kindred Healthcare, Inc.

ITEM 6.11(c)

1. OJG Investigation inlo SNF RUGs Coding. In October Md November of2009 the Department of Health and Human Services Office of the Inspector General C'OIG') served various administrative subpoenas for doclnllents on nine Kindred skilled nursing facilities located in seven different states, the corporate office and Kindred R®ab Services, Inc. The subpoenas sought numerous documents related to the billing of rv~hab therapy services to Medicare Part A and Part B from January !, 2004 to the present. The O!G confirmed to us thet this is an active industry-wide investigation involving skilled nursing providers in addition to Kindred, and. that there is no wbistleblower or ~·qui tam" lawsuit pending against Kindred. The federal government has not made any demand for money on the Company.

2. Boston DOJ Investigation into RehabCare. In September 2012 the Compsny received a subpoena from the United States Attorney's Office in Boston, Massachusetts f'USAO") which sought extensive information about RehabCarets business customers and employees and various records concerning RehabCarets provision of rehab therapy services to 1ong term care facilities including skilled nursing facilities in Massachusetts from January 1, 2007 to December 31) 2011. The Company has continued to receive document requests including subpoenas seeking various records of RehabCare concerning its rehab therapy services and billings to skilled nursing facilities nationwideJ and we have produced these records to the USAO. The Company's attorneys met with USAO and other Government employees in Boston on July 22, 2014, end August 26, 2014, to discuss the G<lvernmenl's federal False Claims Act (''FCA") ailegations against RehabCare and our defense response. Th" USAO has not made any demand for money upon the C...ompany.

CON Project #142193ME and LHCSA Application #2556ML Programmatic Attachment F - Page 2 of 3 Kindred Legal Actions

3. Whistleblower Lawsuit regarding a RehabCare Missr,uri Tran$action in 2005-2006 Settled. Investigation began with a subpoena dated Augnst 29, 2008, from the St Patd Field Office~ U.S. Department of Health and Human Services, Office of Inspector General (the "Subpoena"), being served upon RehabCare Group, Inc. A whisUeblower lawsuit pending tlunder seal" in federal. court in Minnesota apparently initiated the investigation. [Kindred Healthcare, Inc. purchased RehabCare Group Inc. and its subsidiaries on June l. 2011.] The Government intervened in the lawsuit styled J)nited States ex- rei. Health Dimensivns Rehabilitation. Inc. v. RehabCare Qrnuo Inc., et al., Case No. 4:12-CV-00848AGF, by filing a new complaint and demand for jury trial in the U.S. District Court for the District 1lf Mnmesota against tho defendants including RehabCarc Group on December 5, 2011. !'he Government alleged vlolations of the federal Anti~ Kickback Statute, the federal False Claims Act and other common Jaw causes of action. This action was transferred to the U.S. District Court for the Eastern District of Missouri in St. Louis in May 2012. A final Settlement Agreell'l.ent was executed by all parties effective January 17, 20 I 4. RchabCare Group paid $25 million to the United States and $150,000 to the whistleblowcr's attorneys as fees and the unrelated eo-defendants paid an additional $5 million to the United States to settle the lawsuit Tire court dismissed the lawsuit with prejudice on Jonuary 31, 2014.

4. Bettencourt!Harrison (formerly Walsh) v. Kindred Healthcare, Inc., et al. On November 30,2010, in state court in San Francisco County, Califomi~ a discharged resident of our Golden Gate nursing facility filed a purported class action lawsuit against the Company's nursing centers in California for alleged failures to meet the statutory :~.2 hour nursing home per patient day ("NHPPD") minimum during the alleged class period, w;1ich runs from November 23,2006 through April 15,2013. In June 2013 the parties agreed to" settlement in principle in which the Company agreed to fund up to $8.25 million to pay eligible class members who file timely elaims pursuant to a fonmula. Defendants also agreed to pay up to $200,000 for settlement administration cost.;. using a third~party administrator; to pay a total of $35,000 as service payments to the seven named plaintiffs representing the class; to pay the costs of a thirdparty monitor to monitor the Company's compliance with a two-year forwnrd injlUlCtion up to $100,000; and to pay the plaintiffs class counsets• attorneys fees and expenses in the amount of $2.6 million as approved by the court. The court has approved the :rettlement. This matter is insured by the Company's whoUy-0\vned subsidiary, Cornerstone Insurance Company.

5. Bethany Lutheran Home, Inc. v. RehabCare Group East, et al. On September 10, 2012, the plaintiff uursing home ("Bethany'), which formerly contracted fur rehab therapy services with RehabCare, ftled an indemnification action against RehubCare in the U.S. District Court for the Southern District of Iowa. The complaint seeks to recover $675,000 paid by Bethany to the U.S. Government in settlement of alleged False Claims Act violations ba.~ on RehabCare's having provided excessive therapy services to Bethany's residents for the 2005 through 2008 time period. The claims include breach of contract, negligence and fraudulent misrepresentation; and plaintiff seeks money damages and iojw1etive relief. Plaintiff further seeks future indenmifieation for false claims allegedly submitted to Medicare from 2009 to 2011. The court has denied RebabCare's motion to dismiss the complaint f:Jr failure to state a claim. Discovery is ongoing.

CON Project #142193-E and LHCSA Application #2556-L Programmatic Attachment F- Page 3 of 3 Kindred Legal Actions

6. United StaJcs of America, et at., v. Amgen, Omnicare. PharMerica and Kindred Healthcare. On February 4, 2014, the Company was served with a Summons and Complaint in the above-styled action which has been pending under seal as Case #31JCV1464JFA in the U.S. District Court for the District of South Carolina since June 2011. The lawsuit is brought by a whistleblower under the federal False Claims Act alleging violations of the federal aud state Anti-Kickback Statules. The defendants allegedly received illegal rebates and other kickbacks from Amgen for switching patients who were prescribed certain drugs from other nlanufacturers to Amgen' s produets instead. The complaint seeks damagea, statutory fines and penalties, the whistleblower's attorneys' fees and an injunction prohibiting such conduct in the future. Apparently tl1e United Sla!es and twenty-five state Attorneys General and the District of Columbia and the City of Chicago have infonned the court that they arc intervening in the lawsuit as against Omnicarc. Il also appears from the recently unsealed court docket sheet that the United States is entering into a settlement with Omnicare and is declining to intervene inlo the action against PharMetica aud Kindred Heallbcare. These actions by the Government leave the whistleblower to pursue his claims against PharMerica and Kindred Healthcare on his own. The Company has made a claim for indemnification against PharMerica as provided for in the Master Transaction Agreement related to Kindred's spinoff of its former subsidiary, Kindred Pharmacy Services, Inc., to PharMerica on July !, 2007, which PharMerica has accepted.

ITEM 6.11(d)

Effective April 20, 200 I, Kindred Heahhcare, Inc. entered into a Corporate Integrity Agreement with the Office of Inspector General of the U.S. Department of Health and Human Services (the "OIG"} to promote compliance with the requirements of \1edicarc, Medicaid and aU other federal healthcare programs. Ueder the Corporate Integrity Agreement, the company implemented a comprehensive internal quality improvement program rutd a system of internal financial controls in its hospitals, nursing centers, pharmacies, rehabilitation operations. and reglonal and corporate offices. The Corporate Integrity Agreement expired in April 2006.

The Corporate Integrity Agreement required the Company to, among other things:

• engage the Long Tenn Care Institute to monitor and evaluate the company's quality improvement program and report its findings to the OIG;

6 adopt and implement written standards on federal healthcare pngnun requirements with respect to financial and quality of care issues;

• conduct training each year for all employees to promote compliance with federal healthcare requirements;

• put in place a comprehensive internal quality improvement pror~ram; • enhance its system of internal financial controls to promote corapliance with federal

healthcare program requirements on billing and related financiftl issues, including a variety of internal audit and compliance reviews;

• notify the OIG of allegations that the company committed a crime, engaged in fraudulent activity, or discovered a potential violation of the federal flaud and abuse laws or other criminal or civil laws related to any federal healthcare program~ and

• submit an implementation report to the O!G in August 2001 and an annual report each year thereafter.

Project 1/142 193 BFA Att achment A

lOQC-MEDI NEW YORK, INC. QUALITY CARE - USA, INC.

ORGANIZATIONAL SCHEMATIC BEFORE STOCK TRANSFER


I Gentiva Health Services Holding Corp.

(DE) 11-3454104

I

QC-Medi New York, Inc. (CHHAs) . Quality Care-USA, Inc. (LHCSAs) (NY) 11-2750425 (NY) 11-2256479

KINDRED HEALTHCARE, INC. KINDRED HEALTHCARE OPERATING, INC.

ORGANIZATIONAL SCHEMA TIC AFTER STOCK TRANSFER

KINDRED HEAL THCARE, INC. (DE)

I KINDRED HEALTHCARE OPERATING, INC.

(DE)

I Gentiva Health Services, Inc.

(DE) 36-433580 l ' I

Gentiva Health Services Holding Corp. (DE) 11-3454104

I

QC-Mcdi New York, Inc. (CHHAs) Quality Care-USA) £nc. (LHCSAs) (NY) 11-2750425 (NY) ll-2256479

=Provider Entity

KINDRED REALTHCARE, INC.

CONSOUDATED BALANCE SREET

(ln thousands, except per shore amounts)

ASSETS

Current asseu:

Cash and c>sh equivalents

Cosh-restricted

Insurance subsidiary invesonents

Accounts receivable less allowance for loss ofS41.025- 2013 and $23,959- 2012

Inventories

Deferred t.ax assets

Income taxes

Other

Property and equ1pment. a1 cost:

Land

Buildings

Equipment

Construction in progress

Accumulated depreciation

Goodwill

Intangible assets less accumulated amonization of$52,211 -2013 and $34,854 - 2012

Assets held for sale

Insurance subsidiary mvestments

Deferred lllx assets

Other

Total assets

Current liabilities:

Aceounts payable

Salaries, wages and other compensation

Due to third party payors

l'rofessionnl liability risks

Other l\CCI'Ued liabilities

Long-tcnn debt due within one: year

Long-term debt

Professional liability risks

Deferred tax liobilities

Deferred credits and other liabilities

Commitments and contingencies (Note 13)

Equity:

Stockholders' equity:

LIABILITIES AND EQUITY

Preferred stock, S0.2S par value; authorized I ,000 shares: none issu.ed and outstanding

Common Stock. $0.25 par volue; authorized 175,000 shares; issued 54, 165 shores - 201 3 and 53,280 shares - 2012

Capital in excess of par value

Accumuloted other comprehensive loss

Retained earnings (deficit)

Noncontrolling interem

Total equity

Total liabilities and equity

Projec t ltl4 2193 BFA Attachment B

s

$

Dec-ember 31. lOll

35,972

3,713

96.295

916.529

25,780

37.920

36.846

43,673

1,196,728

82.444

984.134

815,670

24.118

1.906.366

(979,791 )

926,575

992,102

423_,303

20.978

149,094

17,043

220.046

3.945,81>9

181,772

361.192

33.747

60.993

146,495

8,222

792,421

1.579.391

246,230

206,611

13,541

1,146,193

(252

(76,825 )

1.082.657

38,559

1,121,216

3,945,869 s

O«tmhcr 31, lOll

50,0

5,1

86,1

1.038.1

n.< 12,(

13,!

35,!

1,273,i

93,1

1,209.S

900,1

23l

2,226.S

(1.083,i

1.143,1

1.041,2

439,i

4.1

116,4

219.4

4,23H

210,6

389.0

35.4

54.0

137,2

8.9

835.3

1.64~.7

236.6

9,7

214,6

13.3

1,145,9

(1.8

98,7

1.256.1

36,6

1,292,8

4,237,9

Pr oject 11 142193 BFA Attachment B (cont . )

KINDRED HEALTH CARE, INC.

CONSOLI DATED STATE"E:\T OF OPERATIONS fln thnncanAc ,..~,.nl ,..r chtlrtt arnnun tc\

Vurt-nd~ Decc:mberJt,

2013 2012 2011

Revenues s 4,900,510 s 4,928,509 4,212,!

Salaries, wages and benefilS 2.988.487 3,012,32 1 2,576,1

Supplies 3l8,999 343,102 314.1

Rent 318,077 310.178 281.:

Oiher operating expenses 985,883 914.272 852.!

Other income (1,440 ) (1 2.660 ) (13.1

lmpairmem chart;es 77,193 108.953 73,!

Depreci.uion and amoniwion 157.329 162.685 128.!

Interest e.<pense 108.049 107.875 BO.S

Investment income (4,051 ) (997 ) (S

4,958,526 4,945.729 4,293.f

Loss from con11numg operauons before mcome wes (58.016 ) (17,220 (81.<

Provision (benefit) for income taxes (13,204 ) 29.707 (14,(

Loss from continuins operations (44,812 ) (46,927 (67."

Discontinued operations. net of income ta.es:

Income (loss) from operations (36. 136 ) 12,348 13.~

Loss on divestiture of operations (83,887 ) (4.745 )

Income (loss) from dascontinued operauons ( 120.023 ) 7.(103 13.!

Net loss ( 164.m > (39.324 {53,i

(Earnings) loss attributable to noncontrolling interests (3.657 ) (1,043

Loss attnbut:lble to Kindred s (168.492 ) s (40.367 ) (53,4

Amounts aunbutable to Kindred stockholders:

Loss from continuing operations {48,469 ) s (47.970 ) s (66,S

Income (loss) from disconunucd openuons (120.023 ) 7.603 l 3.5

Net loss s (168.492 ) (40.367 ) s (53,4

Loss per common share:

Basic:

Loss from continumg operations s (0.93 ) (0.93 ) s (I.

Discontinued operations:

Income {loss) from operations (0.69 ) 0.24 0.

Loss on divc$lil\lrc of operation~ ( 1.61 ) (0.09 )

Income (loss) from discontinued operotions (2.30 ) 0. 15 0.

Net loss s (3.23 ) s (0.78 (I.

Diluted:

Loss from continuing operations s (0.93 ) s (0.93 ) s (I.

Discontinued operations·

Income (loss) from operat1ons (0.69 ) 0.24 0

Loss on divestiture of opcntions (1.61 ) (0.09

lncoone {Joss) from discontinued operations (2.30 ) 0.15 0.

Net loss s (3.23 ) s (0.78 s (1.

Shares used in computing loss per common share:

Baste 52,249 51.659 46.2

Diluted 52,249 51.659 46,2

Cash dividends declared nnd paid per common share 0.24 s

Project /1142193 BFA Attachment C

GE:'iTlVA HEALTH SERVICES. INC. AND S UBSIDIARfES CONSOLIDATED BALANCE SfffiETS

(1 n thousands. except share and per share umounts)

ASS~:TS

Current as~ets·

Cash and l·ash equivalent~

A.l·coun!s r~.·ceivnblc. less alluwam:c fi.)r doubtful nc.:onnl'; o i" $10.680 and SR.777 3t

Dec~mbcr 3 I . 2013 nnd 0..-cembcr 3 l. 20 I~ . rc~pectivcly

Dl.'fl.'rrcd tax ass~t,, net

Prepaid cxpcn~c:s and other current :lsset~


Note~ receivable from Car._'('cntTix

Fixc:d HS$Cts. net

lnt:mgibk :Jsscts. net

Goodwill

Oth.:r a,<,et~

Total assets

LIABILITIES ;\~D EQUITY

Current liabi lit ie~:

CurNnt p1.1rtion of long·tcnn deht

Accounts payabk

Payroll and rclmcd taxc->

Deferred rrvenm;

r-.-1-:di..:ar.:· hab1hllc~

Obligation .... under insumn~:c program~

A~:crued nur~ing home cos~

01 ha a.:cru~d extxn><.'S

T<>tal curr..:nt liabilities

long·t.:nn debt

[).;-f.:rrc'd tax J bbilitic~ . nc-1

Other liabilities

CommitmenL\ and .;onting.:ncics <Note 171

Equiry:

Gcntiva shareholders' equity:

Common stock. $1). 1 0 par Y3luc: 31lthorized I 00.000.000 shares: issued n . 7 I 3.302 3nd 32.009.:!86 shares at Dec,•mbcr J I, :!0 I 3 und December J I. 20 I~. respectively

Additional paid-in capi1a l

Trc3~UIY stock. nr cost. 1.337.382 and 1.260.37•> shar;;s a\ Dc.'ccmbcr 31. 2013 and Dl'<:cmbcr J I. 201 :!. respectively

Accumulated dctlcit

Totn l Genriva sharo::holdl'r>' equit y

Noncontrolling interests

Tot3l equity

Tot3lli:tbllitic~ 3nd equ ity

$

$

$

$

Occcmbl' r 31. 20lJ

HC>.957

289,905

28, 153

64,746

469.76 1

2~.4 7 1

49.375

256.282

390,03 1

68,64 7

1,262,6i 7

45.325

15.659

64 ,857

43,864

2.\894

X:!,6.)4

22,2!9

77.01R

37 5.4 70

1,124,432

9,H25

53,084

.1. 771

46~.262

(18,773)

(750.32\1)

(303.069)

2X75

1 :;oo. l94)

i ,2o2,617

s

s

$

s

D<'c<'mbcr 31. 2012

:!07.()52

251.01>0

12.263

45,6n

516,027

l f) A71

41,414

193.61 3

65(1.364

75.045

i,5 10.<l34

25.000

13.445

45.357

37A44

27,1 '22

56,536

I ~A2f;

61J567

2H9.S9•J

9 10.1 82

42.165

33.988

3.201

399.148

( 17.852)

I 151}35)

~33, 1 6~

1.531:!

234.7(1()

1.510.9:14

Pro j ec t /1142193 BFA At tachment C (cont. )

GE:'\TlVA HEALTH SERVICES. INC. Al\'0 Sl; BSIDlARIES CONSOLIDATED STATD:fENTS OF CO~IPREITE~SIVl!: INCOME (LOSS)

(ln thousands, except· per share amounts)

For the Ycur F:nded

Orct•mlwr 3 1, 20 IJ Occcmbcr 31. 2012

Net rcv~nues $ 1.726.6-l.l :) l.7 12,Sfl4

Cost of $..:rvit·..:~ sold 9~2.18() 9(1S.7~ 1

Gross prflfit 784.464 804.06)

Selling, !;('llCr:ll lthl udminisrrativc c'lpcnses (70 I. 716) (6:'5.766)

Gnodwtll. .nt~tlgib t..:s and oth,-r long-livt.>d Js~.:l impainncnt (610,436) (19.132)

( iam on <ale ,,r ass~t~ and busith!~•o::s . net 1<,014

Divtdend inc<)ll1C

I merest iot'Otnc 2.704 2,1'ittl

1nrcre:,, e~pen~<: and t>ther 1113.()1!8) 192,60:\}

(Lf!ss) inc:ottK' frt>m 'onlinuing t>per:Hi,lns b~ft•r.: in.:omc lax<'s :tnd equity in net (lo;~) ('llnting~ <>fCut(,{.'entnx 1(>;8.072) 47.2)2

Income tu~ b<:11tfh (-:xpcnsc) 39,565 t 17.~51)

Equtty in n~t (lr•ss) e<tming~ ofC<~reCemnx (2.30 I)

I U•ss) income frorn contmuing op~ration~ (59~.507) 27,(>):10

Dlscominut'<l op.::rarion~. net tlf tax

Nel (lo>s) incom.: (5<i~.507) 27,tiSil

U:s~: Net inc,Jtne attrihurnblc lt'J n<Jncnntrollin!,\ !nrere~ts (487) t8S41

N('t (los~) incumt· ,\ltribtH:thlc to Gc:nlivn •h"rch,11dcrs $ (598.994) s ::!6.796

Total <'C•mprthen~ivc: (ltlS.') income $ 1598.507) s 27,680

Basic eurnings per t·cmmun shu n•:

(Loss) in..:ome fn:m1 c..1nrinuing t)perotions attribulllble to Gcmiva sharehol<kr~ $' (IS.75) s 0.88

Discominucd C>pcrarion.<.. net of t;n

Ncr (los~) income att:ribuU1bk Lo G~nlh".J sharchold~rs $ llk.75) $ O.f\S

\v\:ighreJ average shore,; (lUistunding .~1.9~4 .10509

Diluted earn in::~ p~r commno shar~:

(LossJ income t'rum .:onrinuing opc·Ju lions artributabk 10 Gcntiv:t :.hilreholdi.'J'l' :r. IIR.75) s O.R7

Di~cont i nut'll operations. net of tax

Net liOSS) incom.: anribulllble to n .-nliva ,;hardl\>lder.; ) ll$.75) $ 1).87

\V~ight~c..l a~eragc :;hi.J rt!.!-' \)utsleil1ding 31.954 30,riX7

;\nwunr~ artrihutahl<' ru Ccnllv:1 sharl'lwld<'I'S:

(l O$>) inco111c !'nun C(.'lltinlling orcra t ton~ s r~9R.99.J) s ~6.796

Di~cr:olinuct! 0p.:rutions " '' ' of !:IX

Net II!'$$ I in,!'mc .j, (59[(,994) s 26,796

Deccmher 31.2011

s. 1,79t:.77!>

<14 8,455

$50323

(7.~0.407)

(64.~.305)

l.fJ61

8.590

2,6~(\

(91 .:!96)

(60~.,.~8)

75.763

6~U!ll

t45~U99.,

lUIS

(4~9.1<~4)

(1141 )

$ (450.525)

s t45<U6~)

s (15.13)

0.211

s ( 14.!\5)

30.336

s (15. 13)

().21<

s (1 4.!'<5)

30,r16

$ l45S.~Ol

lU15

s (-1511.525)

Project l/142193 BFA Attachment C (cont .)

ASSETS Current assets:

Financial Statements

Cash and cash equivalents

PART I- FINANCIAL INFORMATION

Gentiva Health Services, Inc. and Subsidiaries Consolidated Balance Sheets

(In thousands, except share and per share amounts) (Unaudited)

Accounts receivable, less allowance for doubtful accounts of $11 ,990 and $10,680 at June 30, 2014 and December 3 I, 2013 . respectively

Deferred tax assets, net

Prepaid expenses and other current assets


Notes receivable from CareCentrix

Fixed assets, net

Intangible assets, net

Goodwill

Other assets

Total assets

LIABILITIES AND SHAREHOLDERS' DEFICIT Current liabilities:

Current portion of long-term debt

Accounts payable

Payroll and related taxes

Deferred revenue

Medicare liabilities

Obligations under insurance programs

Accrued nursing home costs

Accrued interest expense

Other accrued expenses


Long-term debt

Deferred tax liabilities , net

Other liabiiHies

Equity:

Gentiva shareholders' deficit:

Common stock, $0.10 par value; authori zed 100,000,000 shares; issued 38,216,282 and 37,713,302 shares at June 30, 2014 and December 31,2013 , respectively

Additional paid-in capital

Treasury stock, 1,370,544 and 1,337,882 shares at June 30,2014 and December 31, 2013, respective I y

Accumulated deficit

Total Gent iva shareholders' deficit

Noncontrolling interests

Total deficit

Total liabilities and shareholders' deficit

$

$

$

$

June 30, 2014 December 31,2013

106,155 $ 86,957

280,731 289,905

24,287 28 ,153

54,773 64,746

465946 469,761

28,471 28,47 I

44948 49.375

253,178 256,282

390,081 390,081

67,927 68,647

1,250,55 I $ 1,262,617

49,200 $ 45,325

14,585 15,659

55,239 64,857

48 ,936 43,864

17,360 23,894

76,605 82,634

20,554 22,219

17,010 I 7,239

54,295 59,779

353,784 375,470

1,1 11,972 1,124,432

15,701 9,825

54,822 53 ,084

3,822 3,771

465,643 462,262

(19,165) (1 8 ,773)

(740 ,004) (750 ,329)

(289,704) (303,069)

3,976 2,875

(285 ,728) (300,194)

1,250,55 I $ 1,262,617

Project /1142193 BFA Attachment C (cont.)

Gentiva Health Services, Inc. and Subsidiaries Consolidated Statements of Comprehensive Income (Loss)

(In thousands, except per share amounts) (Unaudited)

For the Three Months Ended For the Six Months Ended

June 30,2014 June 30, 2013 June 30, 2014 June 30,2013

Net revenues $ 498,040 $ 4 14,424 $ 985,545 $ 830 ,0 15

Cost of services sold 267,350 218,947 540,418 440,520

Gross profit 230,690 195,477 445,127 389,495 Selling, general and administrative expenses (I 89,103) (161,937) (378,123) (321,814)

Goodwill and other long-lived asset impairment (224,320)

Interest income 633 642 1,266 I ,427

Interest expense and other (25,322) (22,790) (50,453) (45,868)

Income (loss) before income taxe~ 16,898 11,392 17,817 (201 ,080)

Income tax (expense) benefit (6,899) (4,829) (7,320) 587

Net income (loss) 9,999 6,563 10,497 (200,493)

Net loss (income) attributable to noncontrolling interests 12 (216) (172) (337)

Net income (loss) attributable to Gentiva shareholders $ 10,01 I $ 6,347 $ 10,325 $ (200,830)

Total comprehensive income (loss) $ 9,999 $ 6,563 $ 10,497 $ (200,493)

Earnings per share

Net income (loss) attributable to Gentiva shareholders:

Basic $ 0.28 $ 0.21 $ 0.28 $ (6.5 I)

Diluted $ 0.27 $ 0 .20 $ 0.28 $ (6 .51 )

Weighted average shares outstanding:

Basic 36,298 30,941 36,243 30,863

Diluted 36,927 3 I ,239 36,790 30,863

Documents

PHHPC Committee Day - January 29, 2015 Attachments