UPSTATE COMMUNITY MEDICAL P C: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
UPSTATE COMMUNITY MEDICAL P C (EIN 20-3889761)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-15
IRS object ID
202421369349308047
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-15T14:46:39-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUSTCHARLES LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S WARREN STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203889761EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPSTATE COMMUNITY MEDICAL PCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUPSTBusinessNameControlTxt
Phone3156349272PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 BROAD ROAD 1507AddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMY TUCKERPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone3154925140PhoneNum
Signature2024-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAMYPersonFirstNm
Person LastTUCKERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS J GIUFREPreparerPersonNm
PTINP00841958PTIN
Phone3154463600PhoneNum
Preparation2024-05-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAMY TUCKERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 EAST ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$29,188,773GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UPSTATE.EDU/COMMUNITY/UCM/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. (UCM) IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO ADVANCE THE MISSION OF UPSTATE MEDICAL UNIVERSITY OF NEW YORK. UCM WAS FORMED FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITY SERVICED BY THE HOSPITAL AND ADVANCING THE CHARITABLE PURPOSE OF THE UNIVERSITY.ActivityOrMissionDesc
Voting Members Governing Body1VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee153TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$27,538,353PYProgramServiceRevenueAmt
CY Program Service Revenue$27,884,935CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$578,646PYOtherRevenueAmt
CY Other Revenue$1,303,838CYOtherRevenueAmt
PY Total Revenue$28,116,999PYTotalRevenueAmt
CY Total Revenue$29,188,773CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,788,927PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$15,466,752CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,721,547PYOtherExpensesAmt
CY Other Expenses$13,982,530CYOtherExpensesAmt
PY Total Expenses$28,510,474PYTotalExpensesAmt
CY Total Expenses$29,449,282CYTotalExpensesAmt
PY Revenues Less Expenses-$393,475PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$260,509CYRevenuesLessExpensesAmt
Total Assets BOY$6,847,097TotalAssetsBOYAmt
Total Assets EOY$7,397,282TotalAssetsEOYAmt
Total Liabilities BOY$10,447,658TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,258,352TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,600,561NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$3,861,070NetAssetsOrFundBalancesEOYAmt
MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO UNINSURED AND UNDERINSURED INDIVIDUALS IN THE COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,964,056ExpenseAmt
Revenue$7,951,069RevenueAmt
DescHOSPITALIST SERVICE - PROVIDED ACUTE MEDICAL CARE FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,791,191ExpenseAmt
Revenue$4,791,191RevenueAmt
DescANESTHESIA SERVICE - PROVIDED ANESTHESIA SERVICES FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,670,607ExpenseAmt
Revenue$3,452,344RevenueAmt
DescOB AMBULATORY - PROVIDED OBGYN HEALTHCARE SERVICS FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUSDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$11,288,849ExpenseAmt
Revenue$12,994,169RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$11,288,849TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$12,994,169TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$27,714,703TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee153EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members1GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JONATHAN W FEHLMANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3154721488PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 W FAYETTE STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13204ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
AMY TUCKER MD
OFFICER2.0040.00Yes (X)Yes (X)$0$514,621$0
ALFREDO LOPEZ MD
PHYSICIAN40.00$336,706$0$27,745Yes (X)
ANTHONY M STIRPE
PHYSICIAN ASSISTANT40.00$334,458$0$30,488Yes (X)
KENNETH K RHEE
PHYSICIAN40.00$369,271$0$38,261Yes (X)
FADI N MAKHLOUF MD
PHYSICIAN40.00$323,688$0$12,200Yes (X)
ADAM A THABET
PHYSICIAN ASSISTANT40.00$299,788$0$38,833Yes (X)
MATTHEW GLIDDEN
FORMER OFFICER0.0040.00$0$422,098$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,663,911TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$936,719TotReportableCompRltdOrgAmt
Total Other Compensation$147,527TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K54IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DEPARTMENT OF MEDICINE MEDICAL SERVICE
550 E GENESEE ST SUITE 201SYRACUSENY13202PROFESSIONAL MEDICAL SERVICES$5,062,344
CHAG ANESTHESIA GROUP
5000 BRITTONFIELD PARKWAYEAST SYRACUSENY13057PROFESSIONAL MEDICAL SERVICES$4,308,430
PRACTICE RESOURCES LLC
1001 W FAYETTE STSYRACUSENY13204ADMINISTRATIVE AND BILLING SERVICES$775,350
FAMILYCARE MEDICAL GROUP PC
1001 W FAYETTE STSYRACUSENY13204PROFESSIONAL MEDICAL SERVICES$407,156
UNIVERSITY OBGYN ASSOCIATES INC
736 IRVING AVE 3 WEST TOWERSYRACUSENY13210PROFESSIONAL MEDICAL SERVICES$308,687
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROFESSIONAL SERVICE AGREEMENT -621110$21,569,371$21,569,371
PROFESSIONAL SERVICES621110$6,315,564$6,315,564
FieldValueIRS element (for citing)
Total Program Service Revenue$27,884,935TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROFESSIONAL SERVICE REIMBURSEMEN900099$1,288,090$1,288,090
RECOVERY OF BAD DEBTS900099$15,568$15,568
LEASED EMPLOYEE INCOME900099$180$180
FieldValueIRS element (for citing)
Other Revenue Total$1,303,838OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,188,773TotalRevenueColumnAmt
Related Or Exempt Func Income$29,188,773RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,332,461TotalAmt
Program Services$13,053,427ProgramServicesAmt
Management And General$279,034ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$407,375TotalAmt
Program Services$390,683ProgramServicesAmt
Management And General$16,692ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$807,634TotalAmt
Program Services$807,634ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$919,282TotalAmt
Program Services$891,536ProgramServicesAmt
Management And General$27,746ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$169,200TotalAmt
Management And General$169,200ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$44,029TotalAmt
Management And General$44,029ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,154TotalAmt
Management And General$21,154ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$383TotalAmt
Management And General$383ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,975TotalAmt
Management And General$31,975ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$439,570TotalAmt
Program Services$418,330ProgramServicesAmt
Management And General$21,240ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$219,409TotalAmt
Program Services$203,977ProgramServicesAmt
Management And General$15,432ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$21TotalAmt
Program Services$21ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$45,871TotalAmt
Program Services$43,992ProgramServicesAmt
Management And General$1,879ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$760,822TotalAmt
Program Services$690,241ProgramServicesAmt
Management And General$70,581ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$11,636,448$10,624,111$1,012,337
BILLING FEES$566,400$566,400
MISCELLANEOUS$24,716$3,700$21,016
PERMITS, LICENSES, DUES$22,532$20,651$1,881

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$29,449,282TotalAmt
Program Services$27,714,703ProgramServicesAmt
Management And General$1,734,579ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$852,211BOYAmt
EOY$2,287,820EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$339,371BOYAmt
EOY$310,750EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$65,151BOYAmt
EOY$130,929EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$94,395LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$94,395LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,590,364BOYAmt
EOY$4,667,783EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,847,097BOYAmt
EOY$7,397,282EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,307,936BOYAmt
EOY$787,450EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,139,722BOYAmt
EOY$10,470,902EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,447,658BOYAmt
EOY$11,258,352EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$10BOYAmt
EOY$10EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$90BOYAmt
EOY$90EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$3,600,661BOYAmt
EOY-$3,861,170EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,600,561BOYAmt
EOY-$3,861,070EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,847,097BOYAmt
EOY$7,397,282EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$260,509ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$250,594CurrentTaxYearMinus3YearsAmt
Total$250,594TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,138,125CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$25,668,422CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,003,580CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,538,353CurrentTaxYearMinus1YearAmt
Current Tax Year$27,884,935CurrentTaxYearAmt
Total$129,233,415TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,138,125CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$25,919,016CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,003,580CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,538,353CurrentTaxYearMinus1YearAmt
Current Tax Year$27,884,935CurrentTaxYearAmt
Total$129,484,009TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$129,484,009PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$673CurrentTaxYearMinus4YearsAmt
Total$673TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$673CurrentTaxYearMinus4YearsAmt
Total$673TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$913,847CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$513,036CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$676,758CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$578,646CurrentTaxYearMinus1YearAmt
Current Tax Year$1,303,838CurrentTaxYearAmt
Total$3,986,125TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,052,645CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26,432,052CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,680,338CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,116,999CurrentTaxYearMinus1YearAmt
Current Tax Year$29,188,773CurrentTaxYearAmt
Total$133,470,807TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97010PublicSupportCY509Pct
Public Support PY5090.97750PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,395OtherCostOrOtherBasisAmt
Depreciation$94,395DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM UNIVERSITY HOSPITAL$3,267,024
OTHER RECEIVABLES$1,400,759
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,667,783TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED PARTIESDesc
Amt$10,470,902Amt
FieldValueIRS element (for citing)
Total Liability$10,470,902TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$29,232,371TotalRevEtcAuditedFinclStmtAmt
Other Revenue$43,598OtherRevenueAmt
Revenue Not Reported$43,598RevenueNotReportedAmt
Revenue Subtotal$29,188,773RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$29,188,773TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$29,492,880TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$43,598OtherExpensesIncludedAmt
Expenses Not Reported$43,598ExpensesNotReportedAmt
Expenses Subtotal$29,449,282ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$29,449,282TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:HEALTHCARE WORKER BONUS RECLASS 43,598.
PART XII, LINE 2D - OTHER ADJUSTMENTS:HEALTHCARE WORKER BONUS RECLASS 43,598.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
AMY TUCKER MD
OFFICER$0$514,621$0$0$0$0$0$0$0$0$0$514,621$0$0
MATTHEW GLIDDEN
FORMER OFFICER$0$422,098$0$0$0$0$0$0$0$0$0$422,098$0$0
KENNETH K RHEE
PHYSICIAN$366,225$0$0$0$3,046$0$12,200$0$26,061$0$407,532$0$0$0
ANTHONY M STIRPE
PHYSICIAN ASSISTANT$333,930$0$0$0$528$0$12,200$0$18,288$0$364,946$0$0$0
ALFREDO LOPEZ MD
PHYSICIAN$334,800$0$0$0$1,906$0$12,200$0$15,545$0$364,451$0$0$0
ADAM A THABET
PHYSICIAN ASSISTANT$299,449$0$0$0$339$0$11,978$0$26,855$0$338,621$0$0$0
FADI N MAKHLOUF MD
PHYSICIAN$323,191$0$0$0$497$0$12,200$0$0$0$335,888$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF FORM 990 WAS DISTRIBUTED FOR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPANY BYLAWS REFLECT THAT THE BOARD ENFORCES A POLICY THAT REQUIRES ALL DIRECTORS, OFFICERS, AND OTHER PERSONS IN A POSITION TO INFLUENCE CORPORATE DECISIONS TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AND THE PROCESS THAT SHALL BE FOLLOWED WHEN A DISCLOSURE IS MADE. ENHANCEMENTS TO THE POLICY CONTINUE TO BE MADE.
FORM 990, PART VI, SECTION B, LINE 15SALARY AND BONUS OR INCENTIVE COMPENSATION IS DETERMINED BASED ON A REVIEW OF RELEVANT MARKET DATA. PERIODIC REVIEWS ARE CONDUCTED AS APPROPRIATE FOR REASONABLENESS, VALUATION, PERFORMANCE, AND COMPLIANCE WITH CONTRACTUAL REQUIREMENTS.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SUNY UPSTATE UNIVERSITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 E ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13210ZIPCd
FieldValueIRS element (for citing)
EIN161469571EIN
Primary ActivitiesPATIENT CAREPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SUNY UPSTATE UNIVERSITY HOSPITAL
L$21,569,371PROFESSIONAL SERVICES AGREEMENT
SUNY UPSTATE UNIVERSITY HOSPITAL
M$1,012,337ADMIN SERVICES AGREEMENT

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