2026-06-25T08:31:22-05:00 2024-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2024-01-01 141731786 ADIRONDACK MEDICAL CENTER ADIR 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 WILLIAM CHAPIN CFO 5188914141 2026-06-24 1 1 DESIREE M BENNETT P01263666 3154463600 2026-06-24 2024 2025-03-06 01:10:19Z X WILLIAM CHAPIN PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 159220790 0 X WWW.ADIRONDACKHEALTH.ORG X 1991 NY THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. 14 11 1018 14 0 0 4878689 787616 139216182 149895648 155820 317110 723371 1034798 144974062 152035172 0 0 0 0 73614048 78381484 0 0 0 70038222 70300150 143652270 148681634 1321792 3353538 100860604 106092711 50469449 51995354 50391155 54097357 X THE MEDICAL CENTER PROVIDES ACUTE AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHICAL AREA. 0 1 31596966 36829232 ADIRONDACK MEDICAL CENTER IS A 95-BED ACUTE CARE FACILITY IN SARANAC LAKE. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES (SURGICAL, MATERNITY, PEDIATRIC AND GERIATRIC PSYCH). 96466574 112452214 REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES IN SARANAC LAKE, LAKE PLACID, TUPPER LAKE, ST. REGIS FALLS AND KEENE. 1273861 MISCELLANEOUS PROGRAM SERVICE REVENUE DERIVED FROM SUPPORT OF ADIRONDACK MEDICAL CENTER, INCLUDING: DIETARY REVENUE, REBATES AND REFUNDS, PURCHASE DISCOUNTS AND OTHER REVENUE. 1273861 128063540 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 292 0 1 1018 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X WILLIAM CHAPIN 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 AARON KRAMER PRESIDENT/CEO 40.00 X X 392193 0 15189 GLENN KEET TRUSTEE 4.00 X 0 0 0 CRAIG SHELDON SECRETARY/TREASURER 4.00 X X 0 0 0 ERNEST STRETTON PHD TRUSTEE 3.00 X 0 0 0 MICHAEL BETTMANN MD VICE CHAIR 3.00 X X 0 0 0 JANET BLISS TRUSTEE 3.00 X 0 0 0 ELIZABETH BUCK MD TRUSTEE 3.00 X 0 0 16800 VIRGINIA GINNY VALKENBURGH TRUSTEE 3.00 X 0 0 0 ROSS WHALEY RESIGNED MID-YEAR TRUSTEE 0.00 X 0 0 0 TIM REILLY CHAIR 3.00 X X 0 0 0 HARRIS SEMEGRAM TRUSTEE 3.00 X 0 0 0 WILLIAM SMITH MD TRUSTEE 3.00 X 0 0 0 KATHY WOUGHTER TRUSTEE 3.00 X 0 0 0 BARTLOMIEJ SZCZECH MD MEDICAL STAFF PRESIDENT 3.00 X 35000 0 0 JEANNIE CROSS TRUSTEE EMERITUS 0.00 X 0 0 0 ELI SCHWARTZBERG TRUSTEE 3.00 X 0 0 0 DAN KELLEHER TRUSTEE/FOUNDATION CHAIR 3.00 X 0 0 0 WILLIAM B CHAPIN CFO 40.00 X 191555 0 20401 DARCI BEIRAS MD PHYSICIAN 40.00 X 294136 0 65025 DAVID MADER CNO 40.00 X 230932 0 22777 DANIEL KILBOURNE-HILL COO 40.00 X 237866 0 34966 IRWIN LIEB MD CMO 40.00 X 261821 0 21048 JONATHAN VB RIDDELL PHYSICIAN 40.00 X 587883 0 39084 ANTHONY TRAMONTANO PHYSICIAN 40.00 X 661708 0 38508 CLAUDE ROLAND PHYSICIAN 36.00 X 596958 0 15555 JAMES W PATE PHYSICIAN 3.00 X 575465 0 64986 HENRI GABORIAU PHYSICIAN 40.00 X 462711 0 40062 4528228 0 394401 175 0 1 0 LAKE PLACID SPORTS MEDICINE PLLC 203 OLD MILITARY ROAD LAKE PLACID NY 12946 ORTHOPAEDIC SERVICES 4356857 PREMIER ANESTHESIA ON NEW YORKPC 2655 NORTHWINDS PARKWAY ALPHARETTA GA 30368 ANESTHESIA SERVICES 3050542 AHSA LLC 10126 E CHERRY BEND ROAD TRAVERSE CITY MI 49684 CONTRACTED LABOR 1616621 ADIRONDACK GASTROINTESTINAL AND COLORECT 2249 NY-86 2 SARANAC LAKE NY 12983 GASTROENTEROLOGY SERVICES 1472895 WEATHERBY LOCUMSINC V060987 PO BOX 972633 DALLAS TX 75397 CONTRACTED LABOR 986628 27 557731 19408 210477 787616 NET PATIENT SERVICE REVENUE 900099 148769022 148769022 DIETARY REVENUE 900099 578324 578324 340B CONTRACT PHARMACIES 900099 512424 512424 MERCY LIVING CENTER 900099 35878 35878 149895648 532543 532543 375139 0 375139 375139 375139 6902411 67774 6794004 391614 108407 -323840 -215433 -215433 ALL OTHER REVENUE 900099 560854 560854 REBATES & REFUNDS 900099 98805 98805 659659 152035172 150555307 0 692249 X 1923370 962599 960771 60967464 51717229 9250235 1765044 1505735 259309 9284576 7815992 1468584 4441030 3724180 716850 752907 55999 696908 92599 92599 172053 172053 20115 20115 24833847 20673299 4160548 161967 161967 1250537 777777 472760 1650377 1588814 61563 189880 148274 41606 870014 870014 4098123 4098123 1152717 1152717 MEDICAL SUPPLIES 25759575 25751801 7774 BAD DEBT 4294428 4294428 FOOD COSTS 604911 604911 MINOR EQUIPMENT 321216 140246 180970 4074884 2181402 1893482 148681634 128063540 20618094 0 -125114 486962 5123266 5715442 16050646 18683033 2943988 3265217 3423100 4080993 152866304 99191415 56569010 53674889 8093759 12438840 8781949 7747335 100860604 106092711 19317355 21963583 1164179 1173179 22231880 20751781 1172000 1172000 6584035 6934811 50469449 51995354 X 49334904 53013230 1056251 1084127 50391155 54097357 100860604 106092711 3353538 352664 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 172053 172053 0 PART II-B, LINE 1: THE AMOUNT REFLECTED ON PART II-B, LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATION OF NYS (HANYS), AMERICAN HOSPITAL ASSOCIATION (AHA), KELLER, BROWN AND WEINRAUB AND OSTROFF ASSOCIATES ATTRIBUTABLE TO LOBBYING ACTIVITIES. 1056251 33283 5407 1084127 993961 25000 37790 -500 1056251 989048 4913 993961 988665 383 989048 988287 378 988665 0.83680 0.16320 0 0 347004 347004 91688281 43767999 47920282 58729147 54228624 4500523 2101872 1194792 907080 53674889 OTHER RECEIVABLES 5837898 DUE FROM AFFILIATES 115716 RIGHT OF USE ASSET 1793721 7747335 DEBT-CURRENT 2131509 ASSET RETIREMENT AND OTHER LT 898835 CAPITAL LEASE PAYABLE 1929346 THIRD-PARTY LIABILITY 1975121 6934811 X PART V, LINE 4: ADIRONDACK HEALTH'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. PART X, LINE 2: ADIRONDACK HEALTH (PREVIOUSLY DEFINED AS THE COLLECTIVE ENTITY) QUALIFIES AS NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ADIRONDACK HEALTH AND THE FOUNDATION HAVE BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS. AS OF DECEMBER 31, 2024 AND 2023, ADIRONDACK HEALTH DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES OR ANY RELATED ACCRUED INTEREST OR PENALTIES. ADIRONDACK HEALTH DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES WILL CHANGE IN THE NEXT TWELVE MONTHS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL STATE TAXING AUTHORITIES ARE 2021 THROUGH 2024. 1 1 X 1 X 1 X 1 1 0 1 1 71829 1594 70235 0.00050 18714311 13383115 5331196 0.03690 18786140 13384709 5401431 0.03740 48997 48997 0.00030 388480 0 388480 0.00270 971987 923269 48718 0.00030 1409464 923269 486195 0.00330 20195604 14307978 5887626 0.04070 1 1597527 390372 33271221 40799814 -7528593 X 1 1 2 1 ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86-PO BOX 471 SARANAC LAKE NY 12983 X X 95 ACUTE BEDS; ADK SURGICAL GROUP, GERIATRIC PSYCH UNIT A 2 ADIRONDACK MEDICAL CENTER-LAKE PLACID 203 OLD MILITARY ROAD LAKE PLACID NY 12946 X ORTHOPEDICS & PHLEBOTOMY A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 0 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ADIRONDACK MEDICAL CENTER, - FACILITY 2: ADIRONDACK MEDICAL CENTER-LAKE PLACID GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM STAKEHOLDERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITIES WE SERVE. THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) REGION INCLUDES CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN, AND WASHINGTON COUNTIES. THERE ARE HEALTH PROFESSIONAL SHORTAGE AREAS WITHIN THE COUNTIES, RESULTING IN SIGNIFICANT DISPARITIES IN ACCESS TO CARE AND THE POPULATION. LOW-INCOME AND INCONSISTENT ACCESS TO SUPERMARKETS IS SIGNIFICANTLY HIGHER THAN THE ARHN REGION AND UPSTATE NEW YORK. THE WELL-BEING OF THE COMMUNITY IS REFLECTED THROUGH A WIDE ARRAY OF FACTORS, INCLUDING ACCESS TO MEDICAL SERVICES, INDIVIDUAL BEHAVIORS, SOCIO-DEMOGRAPHIC CHARACTERSTICS, AND THE ENVIRONMENT IN WHICH ONE LIVES. ARHN'S 2022 COMMUNITY STAKEHOLDER SURVEY WAS DRAFTED BY THE ORGANIZATION'S AD-HOC DATA SUBCOMMITTEE.THE SURVEY IS CREATED WITH SUPPORT FROM NYS DOH AND HEALTH RESOURCES AND SERVICES ADMINISTRATION. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 806 COMMUNITY STAKEHOLDERS. ULTIMATELY, 263 SURVEYS WERE COMPLETED DURING THE EIGHT-WEEK SURVEY PERIOD, A RESPONSE RATE OF 32.63 PERCENT. COMMUNITY STAKEHOLDERS WERE ASKED TO INDICATE ONE SECTOR THAT BEST DESCRIBED THEIR ORGANIZATION. OF THE 198 ORGANIZATIONS THAT RESPONDED, 153 REPORTED PROVIDING A VARIETY OF SERVICES INCLUDING EDUCATION, HEALTH CARE, SOCIAL SERVICES, PUBLIC HEALTH, AND HEALTH BASED COMMUNITY BASED ORGANIZATIONS, AMONG MANY OTHERS. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL.TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTS ORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.BUSINESS: 1CIVIC ASSOCIATION: 2COLLEGE/UNIVERSITY: 1DISABILITY SERVICES: 6EARLY CHILDHOOD: 6ECONOMIC DEVELOPMENT: 2EMPLOYMENT/JOB TRAINING: 0FAITH-BASED: 0FOOD/NUTRITION: 4FOUNDATION/PHILANTHROPY: 0HEALTH BASED CBO: 1HEALTHCARE PROVIDER: 49HEALTH INS. PLAN: 0HOUSING: 2LAW ENFORCEMENT: 7LOCAL GOVERNMENT: 22MEDIA: 1MENTAL, EMOTIONAL, BEHAVIORAL HEALTH PROVIDER: 13PUBLIC HEALTH: 26RECREATION: 3SCHOOL (K-12): 58SENIORS/ELDERS: 12SOCIAL SERVICES: 12TRANSPORTATION: 0TRIBAL GOVERNMENT: 0VETERANS: 1 GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS AT THE ESSEX COUNTY HEALTH DEPARTMENT, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK - ALICE HYDE MEDICAL CENTER, UVM HEALTH NETWORK - ELIZABETHTOWN COMMUNITY HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 11: ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH ALONE CANNOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR QUALITYAIR QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT AND INDOOR ENVIRONMENTSIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, AND PASSING TOBACCO FREE GROUNDS POLICIES. THESE EFFORTS IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION.FOCUS AREA: WATER QUALITYWATER QUALITY INDICATORS ARE GOOD, THOUGH DRINKING WATER VIOLATIONS WERE REPORTED IN BOTH ESSEX & FRANKLIN COUNTIES (2019).FOCUS AREA: FOOD AND CONSUMER PRODUCTSIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS.PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDRENFOCUS AREA: MATERNAL AND WOMEN'S HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS. ADIRONDACK HEALTH DELIVERES MORE THAN 180 BABIES ANNUALLY, OFFERS FREE COMMUNITY CHILDBIRTH CLASSES, LACTATION CONSULTS FOR ADIRONDACK HEALTH PATIENTS, AND PROMOTES NATURAL, VAGINAL BIRTHS, WHILE RESPECTING AND FACILITATING EVERY MOTHER'S WISHES, AS CLINICALLY SAFE AND APPROPRIATE.FOCUS AREA: PERINATAL AND INFANT HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS (INCLUDING THE BIRTH-TO-THREE ALLIANCE) AND COUNTY HEALTH DEPARTMENTS.FOCUS AREA: CHILD AND ADOLESCENT HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS.FOCUS AREA: CROSS CUTTING HEALTHY WOMEN, INFANTS, AND CHILDRENIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS.PREVENT COMMUNICABLE DISEASESFOCUS AREA: VACCINE PREVENTABLE DISEASESTHE RATE OF INFLUENZA VACCINATIONS IN FRANKLIN COUNTY (46) IS EQUAL TO THE STATE AS A WHOLE (46), THOUGH LOWER THAN TOP U.S. PERFORMERS (52). THE RATE OF INFLUENZA VACCINATIONS IN ESSEX COUNTY (52) IS HIGHER THAN THE STATE AS A WHOLE (46), AND EQUAL TO TOP U.S. PERFORMERS (52). FOCUS AREA: HUMAN IMMUNODEFICIENCY VIRUS (HIV)THE RATE OF HIV IS FAIRLY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV.FOCUS AREA: SEXUALLY TRANSMITTED INFECTIONS (STI)THE RATE OF SEXUALLY TRANSMITTED INFECTIONS IN FRANKLIN COUNTY (193.4) AND ESSEX COUNTY (129.9) ARE SIGNIFICANTLY LOWER THAN NEW YORK STATE AS A WHOLE (552.8)FOCUS AREA: HEPATITIS C VIRUS (HCV)HEPATITIS C VIRUS DID NOT RATE AS A HIGH CONCERN IN THE 2022 STAKEHOLDER SURVEY, WITH FOUR RESPONDEES (OUT OF 263 TOTAL) SCORING HCV AS A "TOP FIVE" HEALTH CONCERN.FOCUA AREA: ANTIBIOTIC RESISTANCE AND HEALTHCARE ASSOCIATED INFECTIONSANTIBIOTIC RESISTANCE AND HEALTHCARE ASSOCIATED INFECTIONS DID NOT APPEAR IN THE RESPONSE COUNTS FOR THE 2022 STAKEHOLDER SURVEY. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM STAKEHOLDERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITIES WE SERVE. THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) REGION INCLUDES CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN, AND WASHINGTON COUNTIES. THERE ARE HEALTH PROFESSIONAL SHORTAGE AREAS WITHIN THE COUNTIES, RESULTING IN SIGNIFICANT DISPARITIES IN ACCESS TO CARE AND THE POPULATION. LOW INCOME AND INCONSISTENT ACCESS TO SUPERMARKETS IS SIGNIFICANTLY HIGHER THAN THE ARHN REGION AND UPSTATE NEW YORK. THE WELL-BEING OF THE COMMUNITY IS REFLECTED THROUGH A WIDE ARRAY OF FACTORS, INCLUDING ACCESS TO MEDICAL SERVICES, INDIVIDUAL BEHAVIORS, SOCIO-DEMOGRAPHIC CHARACTERSTICS, AND THE ENVIRONMENT IN WHICH ONE LIVES. ARHN'S 2022 COMMUNITY STAKEHOLDER SURVEY WAS DRAFTED BY THE ORGANIZATION'S AD-HOC DATA SUBCOMMITTEE.THE SURVEY IS CREATED WITH SUPPORT FROM NYS DOH AND HEALTH RESOURCES AND SERVICES ADMINISTRATION. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 806 COMMUNITY STAKEHOLDERS. ULTIMATELY, 263 SURVEYS WERE COMPLETED DURING THE EIGHT-WEEK SURVEY PERIOD, A RESPONSE RATE OF 32.63 PERCENT. COMMUNITY STAKEHOLDERS WERE ASKED TO INDICATE ONE SECTOR THAT BEST DESCRIBED THEIR ORGANIZATION. OF THE 198 ORGANIZATIONS THAT RESPONDED, 153 REPORTED PROVIDING A VARIETY OF SERVICES INCLUDING EDUCATION, HEALTH CARE, SOCIAL SERVICES, PUBLIC HEALTH, AND HEALTH BASED COMMUNITY BASED ORGANIZATIONS, AMONG MANY OTHERS. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL SEVEN-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL.TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTS ORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.BUSINESS: 1CIVIC ASSOCIATION: 2COLLEGE/UNIVERSITY: 1DISABILITY SERVICES: 6EARLY CHILDHOOD: 6ECONOMIC DEVELOPMENT: 2EMPLOYMENT/JOB TRAINING: 0FAITH-BASED: 0FOOD/NUTRITION: 4FOUNDATION/PHILANTHROPY: 0HEALTH BASED CBO: 1HEALTHCARE PROVIDER: 49HEALTH INS. PLAN: 0HOUSING: 2LAW ENFORCEMENT: 7LOCAL GOVERNMENT: 22MEDIA: 1MENTAL, EMOTIONAL, BEHAVIORAL HEALTH PROVIDER: 13PUBLIC HEALTH: 26RECREATION: 3SCHOOL (K-12): 58SENIORS/ELDERS: 12SOCIAL SERVICES: 12TRANSPORTATION: 0TRIBAL GOVERNMENT: 0VETERANS: 1 GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS AT THE ESSEX COUNTY HEALTH DEPARTMENT, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK - ALICE HYDE MEDICAL CENTER, UVM HEALTH NETWORK - ELIZABETHTOWN COMMUNITY HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 11: ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH ALONE CANNOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR QUALITYAIR QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT AND INDOOR ENVIRONMENTSIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, AND PASSING TOBACCO FREE GROUNDS POLICIES. THESE EFFORTS IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION.FOCUS AREA: WATER QUALITYWATER QUALITY INDICATORS ARE GOOD, THOUGH DRINKING WATER VIOLATIONS WERE REPORTED IN BOTH COUNTIES (2019).FOCUS AREA: FOOD AND CONSUMER PRODUCTSIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS.PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDRENFOCUS AREA: MATERNAL AND WOMEN'S HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS. ADIRONDACK HEALTH DELIVERES MORE THAN 180 BABIES ANNUALLY, OFFERS FREE COMMUNITY CHILDBIRTH CLASSES, LACTATION CONSULTS FOR ADIRONDACK HEALTH PATIENTS, AND PROMOTES NATURAL, VAGINAL BIRTHS, WHILE RESPECTING AND FACILITATING EVERY MOTHER'S WISHES, AS CLINICALLY SAFE AND APPROPRIATE.FOCUS AREA: PERINATAL AND INFANT HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS (INCLUDING THE BIRTH-TO-THREE ALLIANCE) AND COUNTY HEALTH DEPARTMENTS.FOCUS AREA: CHILD AND ADOLESCENT HEALTHIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS.FOCUS AREA: CROSS CUTTING HEALTHY WOMEN, INFANTS, AND CHILDRENIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS AND COUNTY HEALTH DEPARTMENTS.PREVENT COMMUNICABLE DISEASESFOCUS AREA: VACCINE PREVENTABLE DISEASESTHE RATE OF INFLUENZA VACCINATIONS IN FRANKLIN COUNTY (46) IS EQUAL TO THE STATE AS A WHOLE (46), THOUGH LOWER THAN TOP U.S. PERFORMERS (52). THE RATE OF INFLUENZA VACCINATIONS IN ESSEX COUNTY (52) IS HIGHER THAN THE STATE AS A WHOLE (46), AND EQUAL TO TOP U.S. PERFORMERS (52). FOCUS AREA: HUMAN IMMUNODEFICIENCY VIRUS (HIV)THE RATE OF HIV IS FAIRLY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV.FOCUS AREA: SEXUALLY TRANSMITTED INFECTIONS (STI)THE RATE OF SEXUALLY TRANSMITTED INFECTIONS IN FRANKLIN COUNTY (193.4) AND ESSEX COUNTY (129.9) ARE SIGNIFICANTLY LOWER THAN NEW YORK STATE AS A WHOLE (552.8)FOCUS AREA: HEPATITIS C VIRUS (HCV)HEPATITIS C VIRUS DID NOT RATE AS A HIGH CONCERN IN THE 2022 STAKEHOLDER SURVEY, WITH FOUR RESPONDEES (OUT OF 263 TOTAL) SCORING HCV AS A "TOP FIVE" HEALTH CONCERN.FOCUA AREA: ANTIBIOTIC RESISTANCE AND HEALTHCARE ASSOCIATED INFECTIONSANTIBIOTIC RESISTANCE AND HEALTHCARE ASSOCIATED INFECTIONS DID NOT APPEAR IN THE RESPONSE COUNTS FOR THE 2022 STAKEHOLDER SURVEY. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS. PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.ADIRONDACKHEALTH.ORG/ABOUT/ABOUT-US PART V, LINE 7B, OTHER WEBSITE: HTTPS://AHIHEALTH.ORG/HTTPS://WWW.FRANKLINCOUNTYNY.GOV/DEPARTMENTS/HUMAN_SERVICES/PUBLIC_HEALTH/DOCUMENTS.PHP#OUTER-196HTTPS://ESSEXCOUNTYNY.GOV/HEALTH/COMMUNITY-HEALTH-ASSESSMENT/ PART V, LINE 10A, MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY'S WEBSITE: HTTPS://WWW.ADIRONDACKHEALTH.ORG/ABOUT/ABOUT-US PART V, LINE 16A, FAP WEBSITE HTTPS://WWW.ADIRONDACKHEALTH.ORG/BILLING/FINANCIAL-ASSISTANCE-SUMMARY PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.ADIRONDACKHEALTH.ORG/BILLING/FINANCIAL-ASSISTANCE-SUMMARY PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.ADIRONDACKHEALTH.ORG/BILLING/FINANCIAL-ASSISTANCE-SUMMARY PART V, SECTION B, LINE 20A: ECAS ARE NOT PERFORMED AT THE HOSPITAL. 7 1 - LAKE PLACID HEALTH CENTER 203 OLD MILITARY ROAD LAKE PLACID NY 12946 PRIMARY CARE; RADIOLOGY 2 - SARANAC LAKE HEALTH CENTER 285 COUNTY ROUTE 47 SARANAC LAKE NY 12983 PRIMARY CARE AND WOUND CARE CLINICS 3 - TUPPER LAKE HEALTH CENTER 7 STETSON ROAD TUPPER LAKE NY 12986 PRIMARY CARE, WOMEN'S HEALTH; LAB AND RADIOLOGY 4 - WOMEN'S HEALTH CENTER 309 OLD LAKE COLBY ROAD SARANAC LAKE NY 12983 WOMEN'S HEALTH CLINIC 5 - KEENE HEALTH CENTER 2841 NYS ROUTE 73 KEENE NY 12942 PRIMARY CARE CLINIC 6 - ST REGIS FALLS HEALTH CENTER 6 NORTH MAIN STREET ST REGIS FALLS NY 12980 PRIMARY CARE CLINIC 7 - COSMETIC CLINIC 309 COUNTY ROAD 47 SUITE 2 SARANAC LAKE NY 12983 COSMETIC AND RECONSTRUCTIVE SURGERY PART I, LINE 7: AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,294,428. PART II, COMMUNITY BUILDING ACTIVITIES: ADIRONDACK HEALTH STAFF ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE OF $1,597,527 IS CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. PART III, LINE 3: THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THESERVICE. PART III, LINE 4: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ADIRONDACK HEALTH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8: CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. PART III, LINE 9B: ACCORDING TO OUR CHARITY CARE POLICY, THE LARGEST NUMBER OF OUR FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION EFFORTS ARE NECESSARY. PART VI, LINE 2: ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS.AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY.THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE HOSPITAL BOARD OF TRUSTEES, MEDICAL STAFF, AMC STAFF, AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN.FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. PART VI, LINE 3: ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. PART VI, LINE 4: ADIRONDACK HEALTH, LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX-(6)-MILLION-ACRE PATCHWORK OF PUBLIC AND PRIVATE LANDS. THE ADIRONDACK PARK CREATES A UNIQUE SETTING WHERE SMALL POPULATION CENTERS ARE SURROUNDED BY SUBSTANTIAL AREAS OF STATE-OWNED WILDERNESS AREAS. IT IS BEST KNOWN FOR ITS MOUNTAINS, THE HIGHEST IN NEW YORK STATE, AND ITS LAKES. THERE ARE EXPANSIVE AREAS OF BACKCOUNTRY INTERSPERSED WITH VILLAGES, PRIVATE HOMES, AND FARMS. ADIRONDACK HEALTH'S SERVICE AREA IS MAINLY COMPRISED OF TOWNS IN SOUTHERN FRANKLIN AND NORTHERN ESSEX COUNTIES, BUT ALSO INCLUDES PORTIONS OF SOUTHWESTERN CLINTON, NORTHERN HAMILTON, AND SOUTHEASTERN ST. LAWRENCE COUNTIES. FRANKLIN COUNTY'S POPULATION IS 46,373. SIMILAR TO THE REST OF UPSTATE NEW YORK, FRANKLIN COUNTY'S POPULATION IS VERY LIMITED IN ITS DIVERSITY, OVER 86% ARE WHITE/NON-HISPANICS, FOLLOWED BY 3.1% BLACK/AFRICAN AMERICAN, NON-HISPANICS AND 2.8% HISPANIC/LATINOS. NEARLY 20% OF THE POPULATION IS 65 YEARS OF AGE AND OLDER. ESSEX COUNTY'S POPULATION IS 36,910, MAKING IT THE SECOND LEAST POPULATED COUNTY IN THE ARHN REGION. SIMILAR TO THE REST OF UPSTATE NEW YORK, ESSEX COUNTY'S POPULATION IS VERY LIMITED IN ITS DIVERSITY, OVER 95% ARE WHITE/NON-HISPANICS, FOLLOWED BY 3.0% HISPANIC/LATINOS AND 2.1% BLACK/AFRICAN AMERICAN, NON-HISPANICS. OVER 26% OF THE POPULATION IS 65 YEARS OF AGE AND OLDER. WHILE THERE ARE NO SIGNIFICANT HEALTH DISPARITIES BASED ON RACE AND ETHNICITY IN FRANKLIN OR ESSEX COUNTIES, THERE ARE SIGNIFICANT ACCESS TO CARE ISSUES. PART VI, LINE 5: AMC IS A SOLE COMMUNITY HOSPITAL AND ALTHOUGH NOT AFFILIATED WITH A LARGER MEDICAL NETWORK, IS PART OF THE ADIRONDACK ACCOUNTABLE CARE ORGANIZATION, WHICH IS COMPRISED OF 450 PRIMARY AND SPECIALTY CLINICIANS THROUGH NEW YORK AND VERMONT. AMC COLLABORATES CLOSELY WITH MANY COMMUNITY-BASED ORGANIZATIONS IN THE REGION, INCLUDING PUBLIC HEALTH AGENCIES IN BOTH FRANKLIN AND ESSEX COUNTIES AND BEHAVIORAL HEALTH AGENCIES TO FURTHER THE GOALS OF THE COMMUNITY SERVICE PLAN. EFFORTS INCLUDE: -COLLABORATION WITH THE NORTH COUNTRY HEALTHY HEART NETWORK TO PROVIDE CHRONIC DISEASE COACHING THAT FOCUSES ON COACHING PATIENTS WHO HAVE CHRONIC DISEASES OR ARE AT RISK FOR THEM LIKE COPD, HYPERTENSION, HEART DISEASE AND DIABETES. -ENGAGED IN QUALITY IMPROVEMENT INITIATIVES AIMED AT REDUCING HOSPITAL READMISSIONS. -UTILIZED CHRONIC DISEASE WELLNESS COACHES WHO WORK IN THE PRIMARY CARE SETTING TO CONNECT WITH AT-RISK, LOW-RISK INDIVIDUALS OF PRE-DIABETES, DIABETES AND OTHER CHRONIC ILLNESSSES TO MAKE LIFESTYLE CHANGES THAT IMPROVE HEALTH OUTCOMES. -OFFERED FREE ADVANCED CARE PLANNING TO ALL MEMBERS OF THE COMMUNITY TO DECREASE IN-HOSPITAL DEATHS, INCREASE THE USE OF HOPSICE CARE AND DECREASE UNNECESSARY MEDICAL TREATMENTS. -SPONSOR OF ADIRONDACK HEALTH PROGRAMS AND EMPLOYEE WELLNESS PROGRAMS TO ENCOURAGE PHYSICAL ACTIVITY AND HEALTHY LIFESTYLES. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X 0 1 0 0 0 0 0 0 0 ANTHONY TRAMONTANO PHYSICIAN 515155 0 146553 0 0 0 13850 0 24658 0 700216 0 0 0 JAMES W PATE PHYSICIAN 275934 0 299531 0 0 0 47479 0 17507 0 640451 0 0 0 JONATHAN VB RIDDELL PHYSICIAN 587883 0 0 0 0 0 14646 0 24438 0 626967 0 0 0 CLAUDE ROLAND PHYSICIAN 487758 0 109200 0 0 0 14367 0 1188 0 612513 0 0 0 HENRI GABORIAU PHYSICIAN 462711 0 0 0 0 0 14645 0 25417 0 502773 0 0 0 AARON KRAMER PRESIDENT/CEO 342752 0 49441 0 0 0 14923 0 266 0 407382 0 0 0 DARCI BEIRAS MD PHYSICIAN 265239 0 28897 0 0 0 40601 0 24424 0 359161 0 0 0 IRWIN LIEB MD CMO 228971 0 32850 0 0 0 9342 0 11706 0 282869 0 0 0 DANIEL KILBOURNE-HILL COO 207739 0 30127 0 0 0 10308 0 24658 0 272832 0 0 0 DAVID MADER CNO 202248 0 28684 0 0 0 9843 0 12934 0 253709 0 0 0 WILLIAM B CHAPIN CFO 191555 0 0 0 0 0 0 0 20401 0 211956 0 0 0 PART 1, LINE 4B THE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR PARTICIPATING PHYSICIANS WHO PROVIDE SERVICES THROUGH THE HOSPITAL'S "ON-CALL" PROGRAM. $16,800 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON BEHALF OF ELIZABETH BUCK, MD. $36,860 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON BEHALF OF DARCI BEIRAS, MD. $30,000 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON BEHALF OF JAMES W. PATE. A FRANKLIN COUNTY CIVIC DEVELOPMENT CORPORATION 800627350 2016-10-18 24455000 MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS- REFINANCE 0 0 0 B ESSEX COUNTY CAPITAL RESOURCE CORPORATION 274698218 2017-10-05 9500000 MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS 0 0 0 A 110000 24455000 479474 14335658 349674 2019 1 0 1 1 B 9500000 190000 9238750 71250 2018 0 0 1 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 LAKE PLACID SPORTS MEDICINE PLLC (LPSM) WILLIAM SMITH, MD AND BARTLOMIEJ SZCZECH, MD OWN GREATER THAN 35% OF LPSM 4356857 LPSM PROVIDES ORTHOPAEDIC SERVICES TO THE ORGANIZATION 0 FORM 990, PART III, LINE 3 IN OCTOBER 2022, ADIRONDACK HEALTH ENTERED INTO A NON-BINDING LETTER OF INTENT TO SELL MERCY LIVING CENTER. THE PLANNED DIVESTITURE OF MERCY LIVING CENTER INCLUDES THE OPERATING LICENSE AND CERTAIN PROPERTY AND EQUIPMENT. ON JULY 17, 2023, ADIRONDACK HEALTH EXECUTED PURCHASING AND CONSULTING AGREEMENTS RELATED TO THE SALE OF THE PROPERTY AND EQUIPMENT ASSOCIATED WITH MERCY LIVING CENTER. THE CERTIFICATE OF NEED WAS APPROVED AND OPERATING LICENSE WAS TRANSFERRED ON JANUARY 31, 2024. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES WILLIAM SMITH, MD AND BARTLOMIEG SZCZECH, MD HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. THESE ARE THEN REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL AND REGIONAL SALARY SURVEY DATA WHICH IS ANALYZED BY THE COMPENSATION COMMITTEE AND THEN APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G COLLECTION AGENCIES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 52,489. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,489. CONSULTING FEES: PROGRAM SERVICE EXPENSES 64,000. MANAGEMENT AND GENERAL EXPENSES 432,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 496,275. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,932,474. MANAGEMENT AND GENERAL EXPENSES 32,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,964,474. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 8,009,500. MANAGEMENT AND GENERAL EXPENSES 3,013,222. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,022,722. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 417,987. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 417,987. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 9,963,798. MANAGEMENT AND GENERAL EXPENSES 474,288. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,438,086. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 73,525. MANAGEMENT AND GENERAL EXPENSES 156,274. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,799. TRASH REMOVAL: PROGRAM SERVICE EXPENSES 212,015. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 212,015. FORM 990, ITEM B, AMENDED RETURN: THE FORM 990 FOR THE TAX YEAR ENDED DECEMBER 31, 2024, IS BEING AMENDED TO CORRECT THE ALLOCATION OF FUNCTIONAL EXPENSES RELATED TO EMPLOYEE BENEFITS AND PAYROLL TAXES. ON THE ORIGINALLY FILED RETURN, THE ALLOCATION OF EXPENSES REPORTED IN PART IX, LINE 8 (PENSION PLAN ACCRUALS AND CONTRIBUTIONS), LINE 9 (OTHER EMPLOYEE BENEFITS), AND LINE 10 (PAYROLL TAXES) BETWEEN PROGRAM SERVICES ACTIVITIES AND MANAGEMENT AND GENERAL ACTIVITIES WAS NOT CONSISTENT WITH THE ALLOCATION METHODOLOGY APPLIED TO PART IX, LINE 7 (OTHER SALARIES AND WAGES). THE AMENDED RETURN REFLECTS THE PROPER ALLOCATION OF THESE EXPENSES IN PART IX, LINES 8 THROUGH 10. AS A RESULT OF THESE REVISIONS, THE PROGRAM SERVICE EXPENSE AMOUNT LISTED IN PART III, LINE 4A WAS CORRECTED, AND THE TOTAL PROGRAM SERVICE EXPENSES REPORTED IN PART III, LINE 4E WAS ADJUSTED TO AGREE WITH THE TOTAL PROGRAM SERVICE EXPENSE IN PART IX, LINE 25, COLUMN B. NO CHANGES WERE MADE TO THE TOTAL EXPENSES, REVENUE, NET ASSETS OR THE ORGANIZATION'S EXEMPT PURPOSE AND ACTIVITIES. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ADIRONDACK MEDICAL CENTER FOUNDATION PO BOX 120 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 161528554 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)3 BOX 11 ADIRONDACK MEDICAL CENTER 0 ADIRONDACK HEALTH REGIONAL MEDICAL PC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 475676016 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)3 BOX 11 ADIRONDACK MEDICAL CENTER 0 TRUDEAU HEALTH SYSTEMS LLC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141788211 CONTRACTING - HEALTH SERVICES NY AMC AND TRUDEAU HEALTH SYSTEMS C 1980 0.50000 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 ADIRONDACK MEDICAL CENTER FOUNDATION C 577731 FAIR VALUE