2023-11-15T07:34:04-06:00 2022-12-31 135565207 KPMG LLP 515 BROADWAY 4TH FLOOR ALBANY NY 122072974 990 2022-01-01 232875157 BRADFORD REGIONAL MEDICAL SERVICES BRAD 7163756190 515 MAIN STREET OLEAN NY 14760 DR JILL OWENS PRESIDENT & CEO 7163756190 2023-11-14 1 DR JILL OWENS 999009999 0 STEPHANIE LONCZAK P01880207 5184274600 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z DR JILL OWENS 515 MAIN STREET OLEAN NY 14670 3728358 0 X N/A X 1997 PA MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA. 15 12 45 0 0 0 87320 0 3189636 3651352 0 0 13101 77006 3290057 3728358 0 0 0 0 3904389 4673465 0 0 0 778559 1088726 4682948 5762191 -1392891 -2033833 1969519 1851254 4894313 6809881 -2924794 -4958627 MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA. 0 0 4581224 3651352 MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA. 4581224 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 1 45 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X TANNYAH M CHAPMAN 7163757426 515 MAIN STREET OLEAN NY 14760 JEFF BELT BOARD CHAIRMAN 1.00 5.50 X X 0 0 0 SHABIR BHAYANI MD DIRECTOR 40.00 5.50 X 63975 0 0 MARC BOUTILLETTE DIRECTOR 1.00 5.50 X 0 0 0 DANIEL DEROSE DIRECTOR 1.00 5.50 X 0 0 0 LISELLE ESPOSITO DIRECTOR (AS OF 06/2022) 1.00 5.50 X 0 0 0 DAVID FERGUSON DIRECTOR 1.00 5.50 X 0 0 0 LISA FIORENTINO PHDRN BOARD SECRETARY 1.00 5.50 X X 0 0 0 MUHAMMED JAVED MD BOARD VICE CHAIRMAN 1.00 5.50 X X 0 147167 0 JULIE MARASCO DIRECTOR 1.00 5.50 X 0 0 0 ZAFAR MIRZA MD DIRECTOR AND PHYSICIAN 1.00 40.00 X 0 1926246 0 DOUGLAS PISANO PHD DIRECTOR 1.00 5.50 X 0 0 0 ANIL PRADHAN MD DIRECTOR 1.00 5.50 X 0 0 0 DAVID PRINCE DIRECTOR 1.00 5.50 X 0 0 0 PAUL RIDLEY BOARD TREASURER 1.00 5.50 X X 0 0 0 GILBERT WITTE MD DIRECTOR 1.00 5.50 X 0 0 0 MELISSA SCHOLL OSF DIRECTOR (THRU 04/2022) 1.00 5.50 X 0 0 0 JEANNINE SCHOENECKER SECRETARY (THRU 04/2022) 1.00 5.50 X 0 0 0 MARY LAROWE INTERIM PRES AND CEO (THRU 04/2022) 1.00 40.00 X X 0 0 0 LUIS GONZALEZ MD MEDICAL STAFF PRES (AS OF 01/2022) 40.00 5.50 X 763809 0 119594 RICHARD G BRAUN JR CHIEF OPERATING OFFICER (UNTIL 5/22) 1.00 40.00 X 0 287440 30975 JILL OWENS PRESIDENT & CEO 1.00 40.00 X 0 327987 3229 DAVID MONROE CHIEF ADMIN OFFICER (AS OF 6/22) 1.00 40.00 X 0 151435 40595 P HENRI LAMOTHE VP - MEDICAL AFFAIRS (AS OF 5/22) 1.00 40.00 X 0 154349 13280 WILLIAM F MILLS VP - MEDICAL AFFAIRS (UNTIL 1/22) 1.00 40.00 X 0 139233 26949 GAIL A BAGAZZOLI VP - QUALITY & CNO (UNTIL 8/22) 1.00 40.00 X 0 126764 39375 LAURIE DUNN CNO (AS OF 7/22) 1.00 40.00 X 0 70232 7078 MELISSA SULLIVAN VP - CLINICAL & SUPPORT (UNTIL 1/22) 1.00 40.00 X 0 14142 10666 PAUL B KIRSCH PHYSICIAN 40.00 0.00 X 250000 0 49318 DANIELLE P GREGOIRE PHYSICIAN ASSISTANT 40.00 0.00 X 134808 0 23190 STEPHANIE L MARTUCCIO NURSE PRACTITIONER 40.00 0.00 X 126992 0 7528 JEFFREY S ZEWE FORMER PRESIDENT & CEO 0.00 0.00 X 0 184025 20799 1339584 3529020 392576 4 1 1 0 CHANGE HEALTHCARE LLC PO BOX 742526 ATLANTA GA 30374 BILLING SERVICES 126644 1 PATIENT SERVICE REVENU 621990 3651352 3651352 3651352 4000 0 4000 4000 4000 OTHER 900099 73006 73006 73006 3728358 3651352 0 77006 827784 827784 3225843 2280486 945357 504242 363054 141188 115596 83229 32367 352822 327150 25672 188556 188556 8000 8000 9718 9718 59842 59842 216761 216761 SUPPLIES 225683 216644 9039 OTHER 27344 27344 5762191 4581224 1180967 0 313989 632502 427279 181269 150000 83333 106140 41564 1016819 339233 737111 677586 235000 235000 1969519 1851254 499194 591250 252149 147491 4142970 6071140 4894313 6809881 X -2924794 -4958627 -2924794 -4958627 1969519 1851254 -2033833 0 X X 0 1 X 1 0 X 850000 242412 607588 166819 96821 69998 677586 GOODWILL 235000 235000 DUE TO AFFILIATES 6071140 6071140 X PART X, LINE 2: FIN 48 FOOTNOTE FORM 990 KALEIDA AND SUBSTANTIALLY ALL OF ITS AFFILIATES HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED. X X X 1 0 0 0 0 0 0 0 0 ZAFAR MIRZA MD DIRECTOR AND PHYSICIAN 0 1926246 0 0 0 0 0 0 0 0 0 1926246 0 0 LUIS GONZALEZ MD MEDICAL STAFF PRES (AS OF 01/2022) 763809 0 0 0 0 0 20500 0 99094 0 883403 0 0 0 JILL OWENS PRESIDENT & CEO 0 324773 0 0 0 3214 0 0 0 3229 0 331216 0 0 RICHARD G BRAUN JR CHIEF OPERATING OFFICER (UNTIL 5/22) 0 108979 0 0 0 178461 0 11493 0 19482 0 318415 0 0 PAUL B KIRSCH PHYSICIAN 250000 0 0 0 0 0 13000 0 36318 0 299318 0 0 0 JEFFREY S ZEWE FORMER PRESIDENT & CEO 0 0 0 0 0 184025 0 9017 0 11782 0 204824 0 0 DAVID MONROE CHIEF ADMIN OFFICER (AS OF 6/22) 0 151435 0 0 0 0 0 5356 0 35239 0 192030 0 0 P HENRI LAMOTHE VP - MEDICAL AFFAIRS (AS OF 5/22) 0 154349 0 0 0 0 0 0 0 13280 0 167629 0 0 WILLIAM F MILLS VP - MEDICAL AFFAIRS (UNTIL 1/22) 0 56996 0 0 0 82237 0 13010 0 13939 0 166182 0 0 GAIL A BAGAZZOLI VP - QUALITY & CNO (UNTIL 8/22) 0 126764 0 0 0 0 0 14045 0 25330 0 166139 0 0 DANIELLE P GREGOIRE PHYSICIAN ASSISTANT 134808 0 0 0 0 0 2600 0 20590 0 157998 0 0 0 PART I, LINE 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (III). - RICHARD G. BRAUN, JR. - $178,461 - WILLIAM F. MILLS - $82,237 - JEFFREY ZEWE - $184,025 FORM 990, PART VI, SECTION A, LINE 6 ARTICLE III OF THE BRADFORD REGIONAL MEDICAL SERVICES (BRMS) BYLAWS DISCUSSES THE ORGANIZATION'S BOARD OF DIRECTORS. OLEAN GENERAL HOSPITAL BECAME THE MEMBER OF BRMS WHEN BRMC, ITS FORMER SOLE MEMBER, WAS MERGED INTO OGH ON JANUARY 12, 2018. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD SHALL CONSIST OF VOTING DIRECTORS APPOINTED BY OLEAN GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B ALL POWERS OF THE CORPORATION SHALL BE EXERCISED BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS, HEREINAFTER REFERRED TO AS THE "BOARD AND THE BUSINESS, PROPERTY AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED UNDER THE BOARD'S DIRECTION. PROVIDED, HOWEVER, THAT THE BOARD SHALL OBTAIN THE APPROVAL OF OLEAN GENERAL HOSPITAL (OGH) BEFORE ACTION ON ANY OF THE FOLLOWING MATTERS BECOMES FINAL AND EFFECTIVE: 1, AMENDMENT OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION OR THESE BYLAWS; 2. THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THIS CORPORATION; 3. MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; 4. DISSOLUTION OF THIS CORPORATION; 5. APPROVAL OF AN ANNUAL BUDGET FOR THIS CORPORATION; 6. ANY TRANSFER OF FUNDS BY GRANT, GIFT, OR LOAN FROM THIS CORPORATION; 7. ANY OTHER MATTER THAT BY LAW WOULD REQUIRE THE APPROVAL OF BRMC. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE FORM 990 IS REVIEWED FOR ACCURACY AND COMPLETENESS BY THE UAHS CHIEF FINANCIAL OFFICER AND OTHER SENIOR MANAGEMENT OF THE UPPER ALLEGHENY HEALTH SYSTEM. A DRAFT COPY OF THE FORM 990 IS THEN PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS PERIODICALLY REVIEWED, AND EACH MEMBER OF THE BOARD COMPLETES A DISCLOSURE FORM. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES COMPENSATION PACKAGES PROVIDED TO THE PRESIDENT AND OTHER ORGANIZATION VICE PRESIDENTS. COMPARABILITY DATA FROM THE HOSPITAL COUNCIL OF WESTERN PA MANAGEMENT COMPENSATION SURVEY IS USED DURING THE REVIEW. FORM 990, PART VI, SECTION C, LINE 19 BRADFORD REGIONAL MEDICAL SERVICES' FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST, FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), DOCUMENTS MAY BE VIEWED AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART XII, LINE 2C: THE AUDIT AND COMPLIANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. KALEIDA HEALTH 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161533232 HOSPITAL NY 501(C)(3) 3 N/A 0 MILLARD FILLMORE AMBULATORY SURG CENTER 726 EXCHANGE STREET SUITE 200 BUFFALO NY 12410 161307129 SUPPORT ORG NY 501(C)(3) 12A KH 0 VNA HOME CARE SERVICES 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161491203 HOME HLTHCARE NY 501(C)(3) 10 KH 0 VNA OF WESTERN NEW YORK 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 160743214 HOME HLTHCARE NY 501(C)(3) 10 KH 0 VISK INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738425 SUPPORT ORG NY 501(C)(3) 10 KH 0 THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161332044 FUNDRAISING NY 501(C)(3) 7 KH 0 KALEIDA HEALTH FOUNDATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161579143 FUNDRAISING NY 501(C)(3) 7 KH 0 UPPER ALLEGHENY HEALTH SYSTEM INC 515 MAIN STREET OLEAN NY 14760 271255425 SUPPORT ORG NY 501(C)(3) 12A KH 0 OLEAN GENERAL HOSPITAL 515 MAIN STREET OLEAN NY 14760 160743102 HOSPITAL NY 501(C)(3) 3 UAHS 0 HEALTH SYSTEM PHYSICIAN PC 130 SOUTH UNION ST OLEAN NY 14760 232875157 PHYS. GROUP NY 501(C)(3) 10 OGH 0 CHILDREN'S HEALTH HOME OF WNY INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 814086046 PED HOME HEALTH NY 501(C)(3) 10 KH 0 HARLEM ROAD LEASING LLC 3435 MAIN STREET BUFFALO NY 14214 205588135 EQUIPMENT LEASING NY KALEIDA HEALTH 0 0 AMTON IMAGING LLC 199 PARK CLUB LANE SUITE 300 WILLIAMSVILLE NY 14221 262925470 HEALTH CARE NY KALEIDA WNYI 0 0 SITE E LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 272124795 REAL ESTATE MGMT NY KPI 0 0 SOUTHTOWNS IMAGING LLC 5959 BIG TREE ROAD SUITE 105 ORCHARD PARK NY 14127 471123230 EQUIPMENT LEASING NY KALEIDA WNYI 0 0 COLLABORATIVE CARE VENTURES L 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 472365690 HEALTH CARE NY KALEIDA HEALTH 0 0 GREAT LAKES MED BILLING SVCS 199 PARK CLUB LANE WILLIAMSVILLE NY 14221 461668448 MEDICAL BILLING NY KALEIDA WNYI 0 0 ALTUS MANAGEMENT LLC 840 AERO DRIVE CHEEKTOWAGA NY 14225 900149184 GROUP PURCH ORG NY KALEIDA HEALTH 0 0 SOUTHTOWNS SURGERY CENTER LLC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 464742028 HEALTH CARE NY KALEIDA HEALTH 0 0 BRADFORD HEALTH ENTERPRISES 116-156 INTERSTATE PARKWAY BRADFORD PA 16701 251591420 INVESTMENTS PA OLEAN GENERAL HOSPITAL C 0 KALEIDA PROPERTIES INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 222738483 PROP MGMT SER NY N/A C 0 WESTLINK CORPORATION 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 161354421 MED & DIAG SV NY N/A C 0 KHBC INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 462164089 HEALTH CARE NY N/A C 0 GREAT LAKES INTEGRATED NETWORK INC 726 EXCHANGE STREET SUITE 200 BUFFALO NY 14210 823184375 HEALTH CARE NY N/A C 0 OLEAN MEDICAL PRACTICE PLLC 726 EXCHANGE STREET SUITE 515 BUFFALO NY 14210 881324896 HEALTH CARE NY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0